Within the hepatocyte, fatty acids can only be derived from de novo lipogenesis, uptake of nonesterified fatty acid and LDL, or lipolysis of intracellular triacylglycerol. The fatty acid pool may be oxidized for energy or may be combined with glycerol to form mono-, di-, and then triacylglycerols. It is possible that a lower ability to oxidize fat within the hepatocyte could be one of several susceptibility factors for the accumulation of liver fat (45). Excess diacylglycerol has a profound effect on activating protein kinase C epsilon type (PKCε), which inhibits the signaling pathway from the insulin receptor to insulin receptor substrate 1 (IRS-1), the first postreceptor step in intracellular insulin action (46). Thus, under circumstances of chronic energy excess, a raised level of intracellular diacylglycerol specifically prevents normal insulin action, and hepatic glucose production fails to be controlled (Fig. 4). High-fat feeding of rodents brings about raised levels of diacylglycerol, PKCε activation, and insulin resistance. However, if fatty acids are preferentially oxidized rather than esterified to diacylglycerol, then PKCε activation is prevented, and hepatic insulin sensitivity is maintained. The molecular specificity of this mechanism has been confirmed by use of antisense oligonucleotide to PKCε, which prevents hepatic insulin resistance despite raised diacylglycerol levels during high-fat feeding (47). In obese humans, intrahepatic diacylglycerol concentration has been shown to correlate with hepatic insulin sensitivity (48,49). Additionally, the presence of excess fatty acids promotes ceramide synthesis by esterification with sphingosine. Ceramides cause sequestration of Akt2 and activation of gluconeogenic enzymes (Fig. 4), although no relationship with in vivo insulin resistance could be demonstrated in humans (49). However, the described intracellular regulatory roles of diacylglycerol and ceramide are consistent with the in vivo observations of hepatic steatosis and control of hepatic glucose production (20,21).
Control and outcomes of both types 1 and 2 diabetes may be improved by patients using home glucose meters to regularly measure their glucose levels. Glucose monitoring is both expensive (largely due to the cost of the consumable test strips) and requires significant commitment on the part of the patient. The effort and expense may be worthwhile for patients when they use the values to sensibly adjust food, exercise, and oral medications or insulin. These adjustments are generally made by the patients themselves following training by a clinician.
The most detrimental thing sugar does is cause inflammation, and inflammation is the root of almost everything that misfires in your body. There is a direct link between inflammation and diabetes, and a lower carb diet reduces C-reactive protein, a marker of inflammation. In addition to sugar, it’s a good idea to keep an eye on your toxic load and keep your omega-3 to omega-6 ratio low to keep inflammation down.
Since the body functions as a whole, it is logical that when one hormone or part of the endocrine system is suffering, the other would be affected as well. This is the reason behind the recent research linking high stress levels to diabetes and other health problems. Most people think of stress only in the mental context (as in, “I’ve got a million things to do, I’m running late and I don’t have time to get anything done… I’m so stressed”) but stress can be physical, psychological, emotional, or mental and can be triggered by many factors including:
Type 2 diabetes is a chronic disease (meaning there isn’t a “cure”) and tends to be progressive. The longer that someone has been living with Type 2 diabetes the less insulin their beta cells may be producing. This doesn’t mean that lifestyle modification is irrelevant–but does mean that individuals should work on accepting their Type 2 diabetes diagnosis so they can focus on managing their diabetes in the best way possible.
It’s like packing your clothes into a suitcase. At first, the clothes go without any trouble. After a certain point, though, it is just impossible to jam in those last 2 T-shirts. You can’t close the suitcase. The luggage is now ‘resistant’ to the clothes. It’s waaayyy harder to put those last 2 T-shirts than the first 2. It’s the same overflow phenomenon. The cell is filled to bursting with glucose, so trying to force more in is difficult and requires much higher doses of insulin.
Lunch. Salads are always a good option for lunch – load it up with meat or tofu, cheese, avocado, veggies and a full-fat dressing like olive oil or ranch. In a rush? Grab a lettuce-wrapped burger or bread-less sandwich from any fast food outlet. Like to cook? Try steak and brussels sprouts smothered in butter, salmon and asparagus with hollandaise sauce or a Thai curry made with tofu, coconut milk and green beans.
Type I diabetes usually occurs in people who are below the age 20 and that is why it is also called as juvenile diabetes. In this type, the body becomes partially or completely unable to produce insulin. Type I diabetes is an autoimmune disease. In this, your immune system attacks the pancreas from where the insulin is produced, thereby making the pancreas inefficient or unable to produce insulin. Type I diabetes cannot be prevented, it can only be controlled with healthy lifestyle changes.
For our very insulin resistant patients with type 2 diabetes, after starting out at 30 grams, a few months later most of our patients find that they can increase their daily carb intake to 40 or 50 grams. Fifty grams of total carbohydrate typically allows 4-5 servings of non-starchy vegetables, 2 oz of nuts, and 3 oz of berry fruit (which includes avocado – but obviously you’d need to share it with someone unless it’s a tiny one!)”
He emphasizes lifestyle changes and weight loss as a first step. "We give them a 3-month trial of diet and lifestyle [modification] before starting medications," he says. "A lot of times, for many patients newly diagnosed, we will see the sugars melt back into the normal range" after the weight loss and other changes. He has seen it happen after a weight loss of 7% to 10% of their starting weight.
In the twentieth century, insulin was available only in an injectable form that required carrying syringes, needles, vials of insulin, and alcohol swabs. Clearly, patients found it difficult to take multiple shots each day; as a result, good blood sugar control was often difficult. Many pharmaceutical companies now offer discreet and convenient methods for delivering insulin.