Triglycerides and Fat Cells

I'm sure you're wondering why am I jumping from Diabetes to Triglycerides and Fat Cells. Let's follow this trail...

Photo by Mehrshad Rajabi on Unsplash

One of the most significant risks associated with numerous diseases is the lack of defined symptoms. Oftentimes, symptoms overlap, and in some cases, no symptoms are present at all. As a result, individuals may disregard healthcare provider notifications, such as reports indicating high triglyceride levels, because they do not experience any noticeable symptoms. This was the case with many of the patients at the clinic; they had no symptoms until it was too late.

I met with a female Mexican patient who spoke very little English for her follow-up appointment at the clinic to discuss her type 2-diabetes and her latest blood-work. I felt bad because not only her A1C levels were at 11 (extremely high), but because I had to now discuss her triglyceride levels as well. She was already suffering from type 2-diabetes before she came to the United States. She didn’t know anything about it other than what people had told her, which was she had to stop eating sugar. So she did; she stopped adding sugar to her coffee and lemonade and opted for sugar substitutes. She stopped drinking soda and juices and reduced her intake of sugary snacks like cookies and cakes. Yet, she didn’t know about carbohydrates, so she was still consuming more sugar than what she needed. She also didn’t engage in any physical activity, so her A1C levels just kept getting higher and she was getting more and more frustrated.

During our first meeting, when I discussed her A1C levels and diabetes, I explained where sugars come from, and we then reviewed her daily diet. She was shocked to discover that foods like white rice, tortillas, corn, and potatoes were all sugars. She admitted that she was going to have a really hard time adjusting her diet and was getting exasperated, so exasperated in fact that she exclaimed during our discussion on type 2-diabetes : “la diabetes es la enfermendad del diablo (diabetes is the devil’s disease)! You can imagine how bad I felt about having to talk to her about her lipid panel and triglycerides.

When she came to her appointment with me, she had a worried look.

“Dame la mala noticias (Give me the bad news),” she tells me right away.

“Sus niveles de trigliceridos no estan bien, estan sobre 300 (Your triglyceride levels are not good, they are over 300).”

She asked having difficulty pronouncing the word, “Y qué son los trigli-trigliceridos (And what are trigly-triglycerides)?”

I answered, “Grasa en la sangre (Fat in the blood).”

She exclaimed in exasperation, “Pero yo no como grasa (But I don’t eat fat)!”

I explained, “trigliceridos no solamente vienen de grasa, ellos tambien vienen de la azucar (triglycerides don’t just come from fat, but they also come from sugar).”

She was utterly confused. “La azucar no tiene grasa (Sugars don’t have fat),” she said.

I continued to educate her about triglycerides. She was stunned, and furious.

“Asi qué no puedo comer nada (so I can’t eat anything)?!” She asked and exclaimed at the same time. (Many of my patients repeated this phrase, over and over again).

I calmly explained that, “usted puede comer sus comidas favoritas, pero hay que hacer modificaciones si usted quiere disfrutar una buena calidad de vida (you can eat the foods that you enjoy, but you have to make modifications if you want to enjoy a good quality of life).”

Her shoulders slumped, and she looked defeated. “Y porque mis viejos vivieron hasta los 90’s y no sufrieron de estas cosas (and why did my old folks [grandparents] lived until their 90s without suffering from any of these things)?”

I told her, “No se, pero supongo que ellos no tenian tantas opciones de comidas y ellos hacian mas ejercicios que nosotros hoy en dia (I don’t know, but I suspect that they didn’t have so many food options and they engaged in more exercise than we do today).”

She left at the end of our appointment with her head down, looking very depressed. It left me feeling devastated for her because I understood her frustration all too well. My mother was also very frustrated and depressed with her type 2-diabetes, and it took her a very long time to finally “get the hang of it” and adapt her diet to her medical conditions.

This patient never came back for her follow-up visit. I wish I knew what happened to her, but unfortunately, I never saw her again. I tried reaching out to her by calling the telephone number we had, but it was disconnected. I hope she never gave up. But I wish I knew what happened to her.

When your healthcare provider runs blood tests and they check your “Lipid Panel”, you may have noticed the word Triglycerides and maybe you asked yourself: “what are triglycerides?” Many of my patients, just like this woman, were completely unaware of what triglycerides are, so let’s find out.

Triglycerides are fats in the blood. They are a combination of a sugar molecule called glycerol and three (3) fatty acids. Just like a car needs oil in the engine in order for the engine to work properly, the body needs fat in order for it to run smoothly. The body stores and uses triglycerides because they are needed for vitamins A, D, E, and K (which are the fat-soluble vitamins), to be used by the body. Triglycerides are also needed because it provides insulation, keeping organs warm and it provides cushioning for the organs. When the body needs energy, triglycerides can be broken apart to provide the body with the energy it needs—sugar and fatty acids. Triglycerides are also needed because they are the “pre-cursors” to LDL’s (low-density lipoproteins, which we will learn about in future substacks). Although the body needs triglycerides, too much can be a problem.

Triglycerides are responsible for the “muffin top,” “beer belly,” or “spare tire.” This is the type of fat causes weight gain because it is the most abundant type of fat in the body. Saturated fats, trans fats, and unsaturated fats are in reality triglycerides in the blood. (I will continue to refer to these types of triglycerides as “fats” since that’s how they are mostly known). Saturated fats, trans fats, and unsaturated fats all have sugar. What distinguishes them from each other is how the fatty acids are arranged. Therefore, it is extremely important to choose fats wisely because the type of fat chosen and the amount consumed can either help or harm the body.

As you can see, triglycerides have a sugar molecule. Excess triglycerides go hand-in-hand in the development of insulin resistance and ultimately type 2-diabetes (as well as high cholesterol, which will be discussed in a future substack). It was important to discuss diabetes first because we needed to learn about cells, tissues, the role of sugar and how the body manages sugar (insulin and glucagon). With this topic, we will be getting into more details about what goes on in the body when an individual is on its way to developing type 2-diabetes. Stay tuned…