Thinking Out Aloud about Diabetes
I just want to sound out if my understanding of diabetes is correct, so please correct me if my understanding is incorrect, so that I can learn. Understanding what’s going on, cures you. Because the correct understanding empowers and motivates you to make the necessary lifestyle changes. Diabetes, after all, is a lifestyle disease.
Pancreas
There are cells called the islets of Langerhans in the pancreas that produces insulin. These cells constitute only 1% of the cells in the pancreas. The other 99% of the cells produce various digestive enzymes for you to digest various foods.
Pancreatic Cancer
Patients with pancreatic cancer have a very grim prognosis. The survival rate at 5 years is 9% and at 10 years is 1%. There has been very little progress in the treatment of patients since World War II, or at least in the past 40 years. The main treatment modality is radiotherapy.
Patients have a low survival rate because without digestive enzymes, they are unable to metabolise the food they eat, starving all their cells, tissues, organs and muscles of nutrition. Its a very systemic shutdown of the whole human body.
Type 1 Diabetes
This is usually diagnosed in childhood or in the teens. Most patients have some genetic make-up that causes their pancreas to be unable to produce insulin at all, or only in very small amounts.
Type 1.5 Diabetes
I’ve heard this term used, but am unsure what it means.
Type 2 Diabetes
This used to be called adult onset diabetes. In these patients, their blood glucose levels are high and there can be many different causes. That is why some experts say that there are actually between 47-50 different types of diabetes, depending on what particular aetiology is responsible for the high blood glucose.
In patients who cannot produce insulin at all, they have to take insulin artificially, usually by injection; the route of administration may be subcutaneous, intramuscular, intravenous. If they can produce insulin, but only in insufficient amounts, two treatment modalities are usually employed:
a) insulin injections
b) medications (such as gliclazide and metformin). They work in various ways. Some meds may cause the pancreas to increase production of insulin, others work by forcing the cells to uptake glucose from the blood. Yet others work by removing the excess glucose in the blood by excreting it in the urine, hence the Malay name for diabetes, “kencing manis” - sweet urine. In the old days, people with diabetes would notice that ants would go hurong their urine.
Type 3 Diabetes
I’ve heard this term used to mean “diabetes of the brain,” but again, I am unsure exactly what it means.
Insulin
Insulin is a hormone produced by the islets of Langerhans in the pancreas. It has a half-life of only 4 to 7 minutes. Its production is triggered by eating carbohydrates. So, counter-intuitively, if your pancreas is still able to produce insulin, you need to eat some (a little) carbohydrate to trigger the production of insulin. The exact amount differs from person to person and also on your state or condition.
In layman’s terms, the best analogy is to think of insulin as a key. Insulin binds with the receptor site (think of it as a keyhole) on the surface of your cells. When your cells require energy, it signals insulin to come to the keyhole to unlock the door that allows glucose to enter your cells.
Carbohydrates
This is an umbrella term for both starches and sugars. Laymen usually use it to refer specifically to starches, though, not to sugars. However, medically trained people use the term carbohydrate to collectively refer to both starches and sugars. This can sometimes lead to misunderstandings.
Saccharides, polysaccharides, oligosaccharides
These terms are used in biochemistry to refer to various types of sugar. The simplest form of sugar is called glucose. All starches, all other types of complex sugars are broken down to glucose in the digestive process. Glucose is what is required by your muscles to make them contract. Basically, we metabolise glucose to create energy. I don’t quite understand the exact process but it involves a chemical called ATP - adenosine triphosphate (ATP) is a complex organic chemical that provides energy to drive many processes in living cells, e.g. muscle contraction, nerve impulse propagation, chemical synthesis. Fructose is fruit sugar, sucrose is cane sugar. Usually, chemicals ending with “-ose” is some kind of sugar, i.e. galactose, lactose (milk sugar), maltose, and etc.
Starches
Also known as complex carbohydrates. These are long chains of molecules, structurally bound with cellulose (aka dietary fibre) that slowly get digested to eventually become glucose. The whole idea is to eat complex carbohydrates rather than glucose or simple sugars such as sucrose or fructose so that our bodies are “drip fed” with small amounts of glucose over time as our digestive process breaks down these complex carbohydrates. As opposed to getting a “sugar rush” or spike in blood glucose by consuming a lot of simple sugars in one go.
Glucose Transfer Factor and Chromium
Glucose Transfer Factor (GTF) is a complex chemical that functions in assisting glucose through the doorway into the cells. At its core is the trace element chromium. Chromium is usually regarded as a heavy metal, and indeed, large amounts of it can cause toxicity. We require trace amounts of it for our GFT. MLM distributors are very gung ho in recommending chromium whenever they hear of anyone just been diagnosed with diabetes (their eyes light up as they see “hot prospect” so that they can kena you properly).
Guardian, Caring and Alpro have all stopped selling chromium tablets. Why? You only need trace amounts and if you eat enough whole fruits and leady vegetables daily, you will have sufficient chromium.
No need to spend RM100 buying chromium picolinate because its supposedly much better than other forms of chromium. You only need 200 micrograms (mcg) daily, not even milligrams (mg). Just spend a few dollars eating sayur lah.
Actually, you can get almost all your nutritional needs from the plant kingdom; the only stuff you need that you can only get from the animal kingdom are what are called essential amino acids. These are essential building blocks to produce protein that the human body cannot synthesise and is not available from the plant kingdom.
That is the conventional wisdom anyway and vegans and vegetarians dispute this. They point to the elephant, the largest animal in the jungle, so big and muscular, so much protein. Yet, I have never met an elephant that has eaten a single steak in its life. Have you?
Something to think about, yeah...
Lipoprotein
This is an umbrella term to cover lipids, oils, fats, fatty acids, triglycerides and the like.
Insulin Resistance
This term refers to the inability our cells to utilise insulin to unlock the door through which glucose can enter the cells. The main cause is lipoprotein overload. This simply means that we have too much lipoproteins. This excess lipoproteins block the keyhole (insulin receptor site) on the surface of our cells. Which means insulin cannot go into the keyhole to unlock the door which allows glucose to enter the cells.
Insulin resistance usually refers to patients who can produce sufficient amounts of insulin but the cells cannot use it to unlock the glucose door. For these patients, taking meds in the long term is problematic as the meds force insulin production to go into hyperdrive, leading to complications down the road. Logically, it would seem better to clean out the blockages in the keyhole in the first place, i.e. get rid of the excess lipoproteins.
“How?” you may well ask
Go on the 70-15-15 INSULIN RESISTANCE REVERSAL DIET. This diet is not suitable for all diabetic patients. Firstly, your body needs to be producing sufficient amounts of insulin in the first place. Usually, these patients with insulin resistance can produce sufficient insulin; its just that excess lipoproteins block it from doing its work. However, patients on insulin have also benefited in that they can reduce their insulin dose, as their insulin keyholes get unblocked. If your body can produce sufficient insulin in the first place, you only need go on this diet for 90 days; this would be sufficient time to get rid of the excess lipoproteins that has been blocking the insulin receptor sites.
But you need to do this under medical supervision, preferably in consultation with a dietician as well. You need to monitor five biomarkers, PILAF:
P - (Blood) Pressure (every other day)
I - Ideal Body Weight (how far are you from it?)
L - Lipoprotein Profile (every three months)
A - (Hb)A1c (every three months)
F - Fasting Blood Glucose (weekly is sufficient)
More about this diet at:
www.masteringdiabetes.org
Another credible and authoritative source of information about diabetes by the world’s leading experts and researchers that I highly recommend is:
www.coursera.org/learn/diabetes-essential-facts
Reminder
Please do not make a friend request unless we’ve met and I know you in real life as I routinely block people whom I have no idea who they are. I prefer to answer questions publicly either here or any of the pages I administer so that others may benefit, too, from the discussion. I am not a physician and am not in the business of giving medical advice so please do not message me. I am a fellow patient, just like you, on this same journey together. I can only speak from my own personal experience (read anecdotal evidence with a sample of one) and from what I’ve read and learnt. We really need to invest the time to educate ourselves about our health because we, as patients, need to be accountable and responsible for our own health - we cannot simply abdicate this responsibility to our healthcare providers.
Copyright 2003-2011 Azlan Adnan Legal Notice Copyright 2003-2011 Azlan Adnan. This blog post is sponsored by The Green Party of Malaysia
3 comments:
Rethinking Insulin | My Thoughts for the Day | Nov 5 2018
I’ve been thinking about diabetes, insulin resistance and glucose. I’m beginning to think that too much emphasis has been placed on insulin and not enough on equally or even more important physiological processes.
I’ll tell you why.
Insulin’s job is to unlock and open the doorway that allows glucose to enter our cells. Cells don’t demand glucose until it needs energy to contract muscles. Insulin is the key that needs be put into the keyhole (insulin receptor site). Insulin resistance is defined as fat being stored in tissues that are not designed to store fat. The fats (aka lipoproteins) clog up the keyhole and blocks the insulin from entering. Glucose remains in the blood at elevated levels.
So we need to think about exercise. To create the demand for glucose and to burn it up. Minimum 30 minutes of sweating a day is a rule of thumb. Better 30 minutes daily than 3 and a half hours once a week. Others say three 10-minute bouts of sweat-inducing exercise is even better than one 30-minute bout. Unless you’re bed-ridden, this shouldn’t pose too much difficulty for most people to achieve.
The other organ that has been neglected is the liver. Its role is as a store of energy, like a battery. When there is excess glucose in the blood and there is no demand for it by the cells, the liver converts glucose to glycogen for storage. Macam charging battery. When we exercise, the muscles take the glucose out of the blood and burn it. If there is insufficient glucose in the blood, the cells send a message to the pancreas to secrete a hormone called glucagon. Glucagon then tells to liver to release its store of energy. The liver does this by converting the glycogen back to glucose and releasing it into the blood for the cells to utilise.
So, liver function is important, too. Especially, in the case for diabetics, the battery charging part where the liver removes and converts excess glucose in the blood to glycogen. If this physiological function is impaired, we end up with high blood glucose levels.
How do we know when liver function is impaired?
When liver enzyme levels are elevated. When its elevated, it means the liver is having difficulty trying to do its job so it boosts enzyme levels to bulldoze its way through.
How do we normalise liver function?
I have done this with coffee enemas. The coffee flushes out excess fats in the liver, which clogs up the liver and causes impaired function.
Oils, fats, lipoprotein, fatty acids are more or less the same thing. When in excess, they cause impaired function of the arteries, liver and insulin resistance.
If you are reasonably active, the reason for your elevated blood glucose may not be insulin resistance. Because if your muscles don’t get glucose to burn, you’d be lethargic and inactive.
In my humble opinion, the reason for elevated blood glucose levels in reasonably active people (people who are not bed-ridden), is the inability or impaired ability of THE LIVER to convert glucose to glycogen and to store it for later use by the body.
This may go against conventional wisdom and ruffle a few feathers, I know, but I’ve always thought through problems from first principles and am wary of wishy washy reasoning.
If you think I’m dead wrong, then please elucidate and enlighten me.
Thank you.
https://www.joypremix.com/products/insourin
Was suggested as a solution.
But, I think this modality is missing the point. The problem doesn’t lie so much with the cells’ inability to utilise glucose. If this were the case, I’d be immobile, lethargic and bed-ridden even. According to Google Maps app, I walked 18 km last month (Oct 2018).
The problem, lies, rather, in the inability of my liver to convert the excess glucose in my blood to glycogen and store it for later use.
I think two things may be the problem with my liver:
1) lipoprotein overload from my previous keto diet. In the same way lipoprotein inhibits glucose uptake by the cells, lipoproteins inhibit glucose uptake by the liver.
2) There are other toxins that impair the liver’s ability to convert glucose to glycogen.
Both can be addressed by coffee enema and www.akubekam.com
Bitter melon and bitter-gourd is the same thing, right?
Anyway, after seeing that my blood glucose was 12.9 at 2045 hrs, I went and did some gardening - harvested 3 bamboo poles from a bamboo grove. I’ll be using them as a trellis for my passionfruit vines.
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