I'm not very scientifically oriented, Dave so maybe I missed something in your technical explanation. Why is low carbing "non-optional for a tight controlling T2."
Yes, insulin is a powerful anabolic hormone. Without insulin it is practically impossible to build stores of fat, glycogen, or even muscle, really. Insulin is still important for getting glucose into cells though, but that's not its only role.
So, even the notion of "Insulin Resistance" is role specific. There seems to be some resistance to the ability of cells to use insulin to allow glucose to gain entry, but there doesn't seem to be much resistance to the adipose building role of insulin for people with diabetes who are obese.
"Insulin Resistance" is not a monolithic disorder, in that tissues are not proportionally resistant to the all the various signaling that insulin does. Think of it this way: Insulin is a knob you can turn from 0-10. At 0, no glucose gets in, no glucose gets converted to fat.
At setting 1, 1 "unit" of glucose is admitted, 1 "unit" of glucose gets converted to fat. Let's say, for the sake of argument, a setting of 1 is the normal setting for a person with a healthy glucose metabolism.
Now a person with the combination of factors for IR starts to get it. It now takes a setting of 2 on the insulin dial to get 1 "unit" of insulin into the cell. However, fat cells are not more "resistant" to the insulin as a signal to convert glucose to fat, so turning the dial up to 2 now causes 2 "units" of fat to be converted from glucose.
So, the worse IR gets, requiring larger and larger amounts to process the same amounts of glucose, fat tissue gets biased more and more toward taking available glucose and converting it to fat, because it is only glucose uptake that is affected by IR.
So, for a T2 using insulin to achieve tight control, ALL carbs you eat tend more to go to fat than normally.
The physiological explanation for this has to do with how insulin functions in these different roles. There is no resistance to insulin itself passing into cells, so the high concentrations get in to the fat cells no problem, and rev up the glocose->fat conversion. However, IR messes with the glucose channels and their receptors on the cell membrane, making them less sensitive to circulating insulin landing on these receptors like a "key" to open the channel and let glucose molecules pass into the cell. IR interferes with that.
So, this is why IR makes it so much easier to get fat when you're a T2. You can eat the same things, do the same exercise, etc. as someone else, and yet gain weight while they lose.
Of course, T2s are basically no different than T1s when out of control. They lose weight too!
Thanks Dave. Again, I am glad I "chose" type 1 over type 2 - not that I'd choose any. If I had to choose one type over another, I would have chosen gestational, since I never had any interest in having children. I wonder, would by body have known I pulled a fast one?
You have the basic idea dead on Dave, insulin has different effects depending upon the role and tissue.
For production of fat in adipose tissue, however, insulin's predominant role has nothing to do with it's ability to enter a cell. In fact, since insulin is a peptide hormone, it interacts with receptors on the cell membrane surface and never actually enters the cell at all. Insulin stimulates enzymes necessary for fat production in adipose tissue, activates circulating enzymes that help provide building blocks that will enter adipose tissue for fat production, and suppresses metabolic pathways that lead to the breakdown of fat.
Interestingly, glucose is necessary for adipose tissue to build fat as well, but the fact that insulin's role in allowing glucose in to fat cells might be compromised in the first place because of IR shows how small a role that might actually be in fat production.
Oops, I read your comment above as "not an option" instead of "not optional" - makes more sense now; whew!
Me? If non-diabetic at 52, I'd choose juvenile diabetes (nyuck nyuck :-))
Thanks for the clarification!
Yes, and this improved understanding of this complex system is causing some real serious rethinking along "chicken-and-egg" paradigm... What comes first: The obesity, or the T2?
As with so many incredible things about the human body, the insulin production capability of the pancreas is many times that necessary for normal healthy glucose metabolism. As such, all T2's (with some fringe-case exceptions) first enter of phase of hyperinsulinemia, often for years, before any symptoms of diabetes (including impaired BG control) appear.
During this time, it's quite possible that that's when obesity sets in. I know that in my case I was very active, fit, energetic, and a bit of a daredevil adventurer (used to Hanglide, scuba instructor, used to technical dive, I mountain bike, etc.)
I started noticing I was gaining weight kind of mysteriously around 35, even though I was still as active as ever. Upped activity. Still gained weight, just more slowly. A few years later I had packed on 20 lbs, had lost a lot of energy, and was diagnosed.
I'll bet I had IR starting at least a decade before I was diagnosed.
I'm new here, but I need to put in my two cents. Having just been diagnosed T1 after being told I was T2(only for a week) I find that label to be detrimental to the Diabetes community. After my first diagnosis I went through a major guilt trip thinking that if I hadn't drank Monster like it was going out of style, this never would have happened to me. Like the majority of Americans, I knew next to nothing about diabetes or how people got it except what I had seen in the media. Now imagine someone else with no knowledge of the disease going through the same thing. My belief is it will just add to the misinformation and guilt already associated with it. Instead I think they should just leave it at known risks; not theoretical. Sorry if this was stated before, I didn't read the rest of the thread. :)
I fully agree with you, Sensorium!! :)
Sugary (or more likely HFCS) sodas are crap, but wont these warnings steer people to artificial sweeteners which are probably more dangerous, and probably more likely to mess with our metabolism and immune system?
Why would they be more likely to?
I do not like this proposed legislation. There are known facts about sugary drinks and that it causes any type of diabetes is not one of them.
If they wish to put a warning on the sugary drinks then great but stick to the facts
-Sugary drinks do not cause diabetes
-They can contribute to tooth decay.
-They can cause weight gain and contribute to obesity for some people
-Obesity can hasten the progress of T2 but it does not cause it.
-Obesity does not cause T1 but it makes it harder to control.
It will be a shame if they reinforce the guilt of having diabetes.
Personally, I don't think we've looked deeply enough at their safety.
http://www.nytimes.com/2006/02/12/business/yourmoney/12sweet.html?pagewanted=all&_r=0
I'm also concerned since artificial sweeteners are no longer being labeled on products in any meaningful way. They are slipping them in to just about everything now.
This is such a great discussion.Excellent posts!! You have all given formidable reasons for the wording to be changed on the soft drink labels. Many doctors who treat type 1 and Type 2 diabetes do not possess anywhere close to the wealth of information, compassion, and ability to articulate the facts about diabetes as the actively posting members of Tudiabetes. I agree with the majority of the posters: This label will add to the stigma and "Its' ALL YOUR FAULT" branding of Type 2 PWD; which is grossly unfair,inaccurate,demeaning, and insulting. Go Tu D crew!!
God bless,
Brunetta
Diabetes is not caused by sugary soda. I agree to label and try to keep away from kids b/c it causes weight gain. Vaccines and all the pesticides they put in our food is the reason for the high increase in diabetes, except....NO ONE WILL GO AFTER DRUG CO'S!!!!!!!
Drinking soda does not contribute to Type 1 but it does contribute to obesity and those who are diagnosed with Type 2 due to lifestyle choices. I understand Type 2 is largely genetic but there is that subset (one-third, I think?) who are morbidly obese for years, causing pre-diabetes and progressing to Type 2. That's still a lot of people who can be helped if they lay off the soft drinks. And why should our children drink this crap?