Insulin Resistance: The Precursor to Type 2-Diabetes
Now that we have completed our discussion on Fat Cells and Triglycerides, we will be learning about insulin resistance.
As a Health Educator, I would often speak to the parents of children about insulin resistance and how it can lead to type 2-diabetes. Many of those parents would look at me with disbelief, and ridicule, when I would tell them that their child was on that one-way road to developing type 2-diabetes if they did not make a very quick exit of their current lifestyle and got on the road to wellness. Many parents would tell me that diseases like type 2-diabetes and coronary artery disease where diseases that happened to “old people.” This is an exchange I had with a family that has been seared into my brain because they were mocking me at first, and then they got really serious:
I met with Caribbean parents to 15 year old and 12 year old boys. Their primary healthcare provider asked me to speak to the parents because their children’s fasting triglyceride levels were consistently high: the 15 year old’s latest fasting triglyceride levels were over 1500 and the 12 year old’s latest fasting triglycerides was even higher, 1750. (BTW, the levels should be lower than 150 when fasting). When I saw those numbers, my hands started to shake. Those numbers were extremely high and I knew what that meant: their diet had been very poor for years and they were on a one way road to developing type 2-diabetes. When they came into my office, before I discussed the blood test results, I asked them to describe their dietary habits. Sadly, all of their meals were very heavy on sugars and saturated fats: refined carbohydrates, high fat meats and processed meats, sugary snacks and sugary drinks but basically no vegetables, fruits, whole grains or high fiber foods.
I asked them if they suffer from constipation, and they all said yes. The dad looks at me with a puzzled look and asks me: “y que tiene que ver eso con la sangre?” (“and what does that [constipation] have to do with the blood?”). I said one word: “Mucho” (“a lot”). He laughs. Their kids follow. The wife smirks. I shook my head.
I took a long breath, and I told them, “sus hijos estan en la carretera de una via a la diabetes” (“your children are on the one way road to diabetes”). They all started laughing. They thought I was exaggerating. I wasn’t.
“Por que se rien?” (“why do you laugh?”)
“Eso no es posible, ellos son niños y los niños to sufren de la diabetes.” (“That is not possible, they are children and children don’t suffer from diabetes”).
“Hay niños que sufren de la diabetes tipo 1, que es una enfermedad autoimmunologica, pero hay muchos niños que sufren de la diabetes tipo 2, que no es autoimmunologico, y, aunque puede ser genetica, generalmente es mas ambiental. (“There are children who suffer from type 1-diabetes, which is an autoimmune disease, but there are children who do suffer from type 2-diabetes, which is not autoimmune, and, although it can be genetic, it’s generally environmental).
They looked at me confused.
“En serio?” (“Seriously?”)
“Si. Si no me creen, preguntele a su medico. Por eso es que ustedes estan aqui hoy conmigo. Su medico tiene miedo de que sus hijos terminen desarollando diabetes tipo 2, una enfermedad que generalmente es el producto de maltrato a cuerpo. Aunque puede ser genetico tambien” (“Yes. If you don’t believe me, ask your doctor. That is why all of you are here with me today. Your doctor is afraid that you children will end up developing type 2-diabetes, a disease that is generally the result of poor treatment of the body. Although it can be genetic too”).
“O sea, que la diabetes puede ser genetica?” (“in other words, diabetes [type 2] can be genetic”)?
“Si, si uno de ustedes sufre de la diabetes tipo 2, es posible que sus hijos tambien sufran de la enfermedad.” (“Yes, if one of you suffer from type 2-diabetes, then it’s possible for your children to suffer from the disease).
The mother then replies, “yo sufro de la diabetes desde hace muchos años.” Mi pobre niños, esa es la herencia que les dejo: enfermedad y no dinero.” (“I have suffered from diabetes for many years. My poor children, that is the inheritance that I’m leaving them: disease and not money”).
The father chimes in, “Entonces, que se puede hacer si es genetico? Ellos van a sufrir de la enfermedad porque no se puede hacer nada.” (“So, what can be done if it’s genetic? They are going to suffer from the disease because there is nothing that can be done”).
I then explained to them, “Solo porque puede ser genetico, no quiere decir que es ‘la sentencia a muerte'. O’ sea, no quiere decir que no se puede hacer nada. Se puede prevenir porque si cambiamos la dieta, controlamos el estres, y hacemos ejercicios, se puede prevenir por muchos años. Es mas, si hacemos los cambios permanente a nuestro estilo de vida, podemos prevenir completamente el desarollo de la diabetes.” (“Just because it can be genetic, it doesn’t mean that it’s ‘ a death sentence.’ In other words, it doesn’t mean that there is nothing that can be done. It can be prevented because if we make changes to our diet, control our stress and exercise, we can prevent it for many years. As a matter of fact, if we make permanent changes to our lifestyle, we can permanently prevent [type 2] diabetes from developing”).
They were really shocked at learning that children can indeed develop type 2-diabetes. But, here’s the thing: the body doesn’t really care about age when it is not being properly taken care of. I am proud to say that they really listened to their primary care physician and to me, they made many changes to their diet, and they reduced their stress by going out as a family for walks almost daily and they enrolled their children in soccer. Within 1 year, the children’s triglyceride levels were brought down to within normal range (less than 150) and they all lost weight. The mom was even proud to share with me that she even reduced her hemoglobin A1C levels from 11 down to 8, which is a great drop.
In this next section, we will learn all about insulin resistance, a whole body problem that includes many things, like fatty acids which we discussed briefly in the Fat Cells and Triglycerides sections, as well the GLUT proteins, the beta cells of the pancreas and so forth. I strongly suggest you begin reading my entire Substack because it will help you understand this next section. Stay tuned…