Glucagon stimulates the conversion of glycogen in the liver to glucose to be released into the blood. So, why is glucagon not being suppressed in people living with type 2 diabetes after they eat a high glucose meal?
This effect is further compounded by the lack of the postprandial insulin spike in type 2 diabetics. Here we return to the common theme that has been running through the work of many the above research groups: pancreatic fat levels. Professor Unger provides a mechanism for this effect:.
This provides a possible explanation for the mechanism for why the postprandial insulin release is suppressed in type 2 diabetics due to beta cell death , and why glucagon release is not suppressed alpha cell insulin resistance. Does weight gain or hyperinsulinemia come first? In this case, this would mean looking at people that have absolutely no fat cells, and the most obese population on the planet. What are these exceptions to the mainstream notion of more body fat means a higher risk of diabetes?
You might expect that sumo wrestlers would have a high prevalence of type 2 diabetes, and people with Berardinelli-Seip lipodystrophy would have a low prevalence. However, in reality, the opposite is true. How is this possible? Sumo wrestlers eat high-carb meals, resulting in high insulin levels, which convert excess sugars to fat to be stored. This means there is no insulin resistance to overcome while sumo wrestlers are training. Contrastingly, individuals with Berardinelli-Seip lipodystrophy have no fat cells.
So even if insulin levels dramatically increase, excess energy has nowhere to go after a high carb meal.
This is why insulin resistance develops in this demographic. This model provides an explanation for the diverse range of people who have type 2 diabetes or are at risk of developing type 2 diabetes. If there is somewhere for excess energy to go easily, insulin levels will not go up, and nor will blood sugar levels.
Aside from anything else in this guide, it does provide a compelling rationale for regularly engaging in high-intensity exercise or lifting weights; both deplete your muscle glycogen levels much more effectively than moderate-intensity exercise, like jogging.
Dr Kendrick believes insulin resistance, or hyperinsulinemia, strongly drives weight gain due to issues of energy storage. Up to this point, this guide has highlighted that type 2 diabetes, and prediabetes, are conditions that are much more complex than the commonly held view of you gain weight, and then you get type 2 diabetes.
Other factors also appear to be involved in the development of type 2 diabetes, including genetic factors e. Since we cannot change our genes, a lower carbohydrate diet, rather than low-fat, could be a good first line of treatment, rather than drugs. Genetics must have quite a bit to do with it as well. I am joining Second Nature to lose a lot of weight, but my husband who eats the slightly more than me — we both are home all day — is thin as a rake. My weight has piled on during our married life partly because I simply eat as much as he does.
What about hunger? Why are some people more hungry than others? This must play a part in becoming overweight and at risk of diabetes as well. I used to be slim until I had a child. My mother was the same. After I had my son the hunger I experienced in my pregnancy never seemed to leave me.
Dear Diana Prince, if you are hungry during pregnancy that is normal. To alleviate symptoms, just simply suckle on a few sips of your own breast milk or till satiated. Nice discussion, but you totally left the role of dietary fats, especially certain saturated fats in the insulin resistance pathophysiology. Instead, you focused only on researchers that highlight the role of carbohydrate. There is another side of the coin and it plays a very significant role as well.
Excellent article. So good to read the different in depth views and research about this important issue. I am a type 1 diabetic whose body produces no insulin and relies on me getting my insulin doses correct in relation to the amount of carbohydrate I consume in order to lower my blood glucose levels manually. The body is amazing when it does it all for you and the message I get from this is that people should strive to help their bodies by not overeating and making sure they do enough exercise — both types!
I appreciate the reminder about how the body processes glucose and deals with it. It is so worth making the effort to lose excess weight, eat healthily and exercise enough. Our bodies are incredible machines and we should all strive to maintain them and make them work for us on the best way they can. Thanks so much for proving us with the guidance and tools, evidence based research and information.
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This content does not have an Arabic version. See more conditions. Insulin and weight gain: Keep the pounds off. Products and services. Insulin and weight gain: Keep the pounds off Insulin and weight gain often go hand in hand, but weight control is possible. By Mayo Clinic Staff. Thank you for Subscribing Our Housecall e-newsletter will keep you up-to-date on the latest health information. Please try again. Something went wrong on our side, please try again.
Show references Cichosz SL, et al. Prediction of excessive weight gain in insulin treated patients with type 2 diabetes. Journal of Diabetes. Brown A, et al. Insulin-associated weight gain in obese type 2 diabetes mellitus patients — What can be done? Diabetes, Obesity and Metabolism. In press. Accessed June 17, Bray GA. Obesity: Etiology and natural history. Accessed June 20, Diabetes Public Health Resource: Eat right.
Centers for Disease Control and Prevention. Other injectable medications. American Diabetes Association. What are my options? See also Medication-free hypertension control A1C test After a flood, are food and medicines safe to use? Strategies include limiting dose by increasing insulin sensitivity through diet and exercise or by using adjunctive anorectic or insulin-sparing pharmacotherapies such as pramlintide or metformin.
Insulin replacement regimens that attempt to mimic physiological norms should also enable insulin to be dosed with maximum efficiency. The novel acylated analogue, insulin detemir, appears to lack the usual propensity for causing weight gain. Elucidation of the pharmacological mechanisms underlying this property might help clarify the mechanisms linking insulin with weight regulation.
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