Update on Type II Diabetes in America | The Reasoned Society

http://thoughtdigest.wordpress.com/2013/01/21/update-on-type-ii-diabetes-in-america/[6/6/2014 5:21:49 PM]

Update on Diabetes in America
Epidemiology and New Research Findings
Taking Aim at Violence against Children
Part I Gun Violence [The Importance of a
Broader Contextual Viewpoint]
Update on Type II Diabetes in America
January 21, 2013 by rmkc
Part II
Update on Type II Diabetes in America
[Epidemiology and New Research Findings]
Introduction
In Part II a short review of new research on diabetes is provided. In the last
decade thousands of studies on diabetes have been carried out in a variety of
settings including hospitals, medical schools, pharmaceutical research laboratories,
and universities involving both private and or public funding. As a person with
Type II Diabetes the last 22 years Ive chosen to review just a few exciting
research projects involving Type II Diabetes.
One of the long-standing areas of research over the last several decades has been
obesity among Type II Diabetics. Obesity appears to be growing exponentially on
a global scale and has correspondingly contributed to the increase in diabetes
worldwide. While treatment plans for diabetes normally involve diet, exercise,
hypoglycemic medicine and various forms of insulin, there is also a lot of pending
weight loss drugs in the wings from the pharmaceutical industry. In recent
decades close daily monitoring of blood sugar has also helped diabetics immensely
along with the usual standard treatment plans. The future for overweight diabetics
is getting better all the time as new strategies are developed. However, many
diabetics are not overweight and this has led to other areas of research.
Nevertheless, research on why obesity is related to diabetes so intimately is still
the focus of major research efforts to find a cure for diabetes.
What everyone has realized for some time is that there is a very close relationship
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Update on Type II Diabetes in America | The Reasoned Society
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between Type II diabetes, obesity and insulin resistance. This latter relationship
between insulin resistance and obesity has been found to be connected in recent
years through a new factor that has emerged in the medical research on Type II
Diabetes. That factor is Inflammation. But first here is a review of what is known
about insulin resistance.
Insulin Resistance
All humans need energy to live. Consequently, every cell in the body needs
energy, including cells in our large muscle groups. How do our cells get this
energy? Normally, the foods we eat provide that energy. The food is then
converted to blood glucose (blood sugar) and leads to circulation in our blood
stream. The pancreas produces a hormone called insulin, and sends it into your
bloodstream to travel to the various cells of the body. Insulin then attaches to a
receptor on the cells surface and causes the cell membrane to permit blood
glucose to enter. That is the normal process.
However, in Type II diabetes this system doesnt work very well. The insulin gets
to each cell; however, when it arrives, it has trouble unlocking the door to each
cell and then the cell fails to permit the glucose to enter. Since glucose cannot get
into the cells, it then builds up in the bloodstream. This condition is called
I nsulin Resistance.
The mystery of Type II diabetes has always been to find out why insulin resistance
occurs. We now have a pretty good idea of the cause. So, what is the cause of
Type II diabetes? Insulins ability to work is blocked in the human cell (like gum
jamming up a lock as the metaphor suggests) by actual FAT. The cells receptors
are blocked or jammed by fat.
Normally small amounts of fat are stored for energy in an emergency in each cell.
However, in a diet (like the Western diet high in fat and cholesterol) excessive fat
builds up in each cell creating the jamming process that prevents glucose from
entering. If fat, called intramyocellular lipid, accumulates inside the cell it
interferes with insulins intracellular signaling process.
Tiny organelles, called mitochondria, are supposed to burn fat. But their failure to
keep up with the accumulating fat may be the origin of Type II diabetes. It turns
out fatty foods actually do more than add excessive fat to each cellthey also
interfere by turning off the genes that would help them create
mitochondria and thus burn fat. The genes become disabled and do not allow
the cells to produce the needed mitochondria. Your ability to eliminate fat inside
your cells seems to slow down when you eat fatty foods.
Continue this faulty intracellular activity long enough, and guess whatyou end up
being diagnosed with Type II diabetes. This scenario of explanation is a good one,
but new research is suggesting that other variables are involved in connecting
obesity to insulin resistance. All of this leads (in this diabetics humble opinion) to
answering the question why does the excess fat in a cell lead to the disabling of
genes? What is the etiology of disabled genes in diabetics.
New Research Findings Emerge
In November 2007 Science Daily reported that researchers at the University of
California, San Diego (UCSD) School of Medicine have discovered that
Inflammation provoked by immune cells called macrophages leads to insulin
resistance and Type II diabetes. Their discovery may pave the way to novel drug
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Update on Type II Diabetes in America | The Reasoned Society
http://thoughtdigest.wordpress.com/2013/01/21/update-on-type-ii-diabetes-in-america/[6/6/2014 5:21:49 PM]
development to fight the epidemic of Type II diabetes associated with obesity, the
most prevalent metabolic disease worldwide. But, as you will shortly see,
inflammation is intimately related or involved in a number of medical conditions
and diseases.
A Quick Definition of Inflammation and Its Relationship to Disease
A quick definition of inflammation is needed. Inflammation is the first response by
the immune system to infection or irritation. It often involves redness, heat, pain,
swelling, and dysfunction of the organ involved. Chronic inflammation is an
ongoing, low level of inflammation, invisible to the human eye and is associated
with many diseases (this was an eye opener to me) including: Heart Disease,
Cancer, Stroke, Diabetes, Metabolic Syndrome, Alzheimers Disease, many forms
of arthritis such as Rheumatoid and Lupus, Inflammatory Bowel Disease such as
Ulcerative Colitis and Crohns Disease, age-related Macular Degeneration, Sepsis
which is infection in the blood stream, Multiple Sclerosis, hundreds of diseases
ending in itis including Meningitis, Acne, and everyones favoriteAllergies. The
mechanisms of Inflammation are complex, but just understand that it is controlled
by fatty acids called prostaglandins. Just like cholesterol there are good
prostaglandins and bad prostaglandins.
Discovery of Inflammation and Diabetes
In recent years, it has been theorized that chronic, low-grade tissue inflammation
related to obesity contributes to insulin resistance, the major cause of Type II
diabetes. In research done in mouse models, the UCSD scientists proved that, by
disabling the macrophage inflammatory pathway, insulin resistance and the
resultant Type II diabetes can be prevented.
The findings of the research team, led by principle investigators Michael Karin,
Ph.D., Professor of Pharmacology in UCSDs Laboratory of Gene Regulation and
Signal Transduction, and Jerrold Olefsky, Distinguished Professor of Medicine and
Associate Dean for Scientific Affairs, were published as the feature article in an
issue of Cell Metabolism.
According to Olefsky, Our research shows that insulin resistance can be
disassociated from the increase in body fat associated with obesity. Macrophages,
found in white blood cells in the bone marrow, are key players in the immune
response. When these immune cells get into tissues, such as adipose (fat) or liver
tissue, they release cytokines, which are chemical messenger molecules used by
immune and nerve cells to communicate. These cytokines cause the neighboring
liver, muscle or fat cells to become insulin resistant, which in turn can lead to Type
II diabetes.
The UCSD research team showed that the macrophage is the cause of this cascade
of events by knocking out a key component of the inflammatory pathway in the
macrophage, JNK1, in a mouse model. This was done through a procedure called
adoptive bone marrow transfer, which resulted in the knockout of JNK1 in cells
derived from the bone marrow, including macrophages.
With this procedure, bone marrow was transplanted from a global JNK1 knockout
mouse (lacking JNK1 in all cell types) into a normal mouse that had been
irradiated to kill off its endogenous bone marrow. This resulted in a chimeric
mouse in which all tissues were normal except the bone marrow, which is where
macrophages originate. As a control, the scientists used normal, wild-type mice as
well as mice lacking JNK1 in all cell types. These control mice were also subjected
The Age of Science
Update on Type II Diabetes in America | The Reasoned Society
http://thoughtdigest.wordpress.com/2013/01/21/update-on-type-ii-diabetes-in-america/[6/6/2014 5:21:49 PM]
to irradiation and bone marrow transfer.
The mice were all fed a high-fat diet. In regular, wild-type mice, this diet would
normally result in obesity, leading to inflammation, insulin resistance and mild
Type 2 diabetes. The chimeric mice, lacking JNK1 in bone marrow-derived
cells, did become obese; however, they showed a striking absence of
insulin resistance a pre-condition that can lead to development of Type
2 diabetes.
If we can block or disarm this macrophage inflammatory pathway in humans, we
could interrupt the cascade that leads to insulin resistance and diabetes, said
Olefsky. A small molecule compound to block JNK1 could prove a potent insulin-
sensitizing, anti-diabetic agent.
The research also proved that obesity without inflammation does not result in
insulin resistance. Olefsky explained that when an animal or a human being
becomes obese, they develop steatosis, or increased fat in the liver. The steatosis
leads to liver inflammation and hepatic insulin resistance.
The chimeric mice did develop fatty livers, but not inflammation. Their livers
remained normal in terms of insulin sensitivity, said Olefsky, adding that this
shows that insulin resistance can also be disassociated from fatty liver. We arent
suggesting that obesity is healthy, but indications are promising that, by blocking
the macrophage pathway, scientists may find a way to prevent the Type II
diabetes now linked to obesity and fatty livers, Olefsky said.
In a related study, it was found that inflammation-causing cells in fat tissue may
explain the link between obesity and diabetes. The findings came from Walter and
Eliza Hall Institute researchers in Melbourne, Australia. The discovery, by Professor
Len Harrison and Dr John Wentworth from the institutes Autoimmunity and
Transplantation division, opens the way for new anti-inflammatory treatments that
prevent insulin resistance (where the body is unable to respond to and use the
insulin it produces) and other complications associated with obesity.
We have shown that insulin resistance in human obesity is closely related to the
presence of inflammatory cells in fat tissue, in particular a population of
macrophage cells, Professor Harrison said.
Once again this research team had similar findings to those of UCSD scientists.
That is, macrophages, white blood cells derived from the bone marrow, are
immune cells that normally respond to infections. In obese people, macrophages
move into the fat tissue where they cause inflammation and release cytokines,
which are chemical messenger molecules used by immune cells to communicate.
Certain cytokines cause cells to become resistant to the effects of the hormone
insulin, leading to diabetes and heart disease.
My hypothesis (as a diabetic, not as a medical doctor) is that these cytokines cause
the genes that produce mitochondria in our cells (especially adipose cells) to
become disabled. It is only a hypothesis of mine but it would be theoretically very
informative if some future research were to experimentally prove this.
Other Studies of Importance
It probably should be no surprise that inflammation in the body has an effect on
other medical problems, including Metabolic Syndrome. Metabolic syndrome is a
condition whereby a combination of medical disorders that, when occuring
together, increase the risk of developing cardiovascular disease and diabetes.
Update on Type II Diabetes in America | The Reasoned Society
http://thoughtdigest.wordpress.com/2013/01/21/update-on-type-ii-diabetes-in-america/[6/6/2014 5:21:49 PM]
Some studies have shown the prevalence in the USA to be an estimated 25% of
the population, and prevalence increases with age.
Individuals who are obese are at increased risk of developing a combination of
medical disorders associated with type II diabetes and heart disease known as the
metabolic syndrome. Recent studies have suggested that adipose (fat) tissue
obesity induces an inflammatory state that is crucial to the development of the
metabolic syndrome. UCLA researchers demonstrated that an over-the-counter
dietary supplement may help inhibit development of insulin resistance and glucose
intolerance, conditions that are involved in the development of Type II diabetes
and metabolic syndrome, which affect millions worldwide.
In this early preclinical study, a naturally produced amino acid-like molecule called
GABA was given orally to mice that were obese, insulin resistant and in the early
stages of Type II diabetes. Researchers found that GABA suppressed the
inflammatory immune responses that are involved in the development of this
condition.
According to study authors, GABA helped prevent disease progression and
improved glucose tolerance and insulin sensitivity, even after onset of Type II
diabetes in mice. Researchers also identified the regulatory immune cells that
likely direct GABA activity in inhibiting inflammation.
Researchers note that in the future, GABA taken as a supplement or related
medications may provide new therapeutic agents for the treatment of obesity-
related Type II diabetes and metabolic syndrome. However, like any substance
science does not know what side effects there may be with GABA. Dont run out to
your health store just yet. Wait for the proper medical research to be conducted
on GABA efficacy and safety. Nobody wants to wait forever for something that
may work but FDA approval and the proper research protocols must be followed
first. Does this mean we cant utilize the new research to our advantage right
now? No not at all. One area we do have control over is the food we eat and the
lifestyle we choose for ourselves. Its time we all come into the 21
st
C entury folks.
Your doctor isnt responsible for your healthYOU ARE.
Connections
I am a 69 year old diabetic who has had diabetes since August 1991 (I was 48
years old at time of diagnosis). I ask myself, how can this new information help
me? Ive been a Vegan for two years that helped launch me down the road to
successfully losing weight (16 lb weight loss in 2011, but virtually very little weight
loss in 2012).
In 2012 Sciatica visited the nerves in my lower back and down my left leg,
hamstring, thigh, and buttocks. The pain impacted my ability, particularly after my
USA Track & Field Meets were over in July, to exercise 4-5 days a week the rest of
the year. This in turn helped explain why my weight loss stood still in 2012.
With physical therapy I have been getting better and intend on returning to a good
schedule of exercise in 2013. In terms of food consumption, as a tool to fight
inflammation, I have decided to integrate my Vegan diet with the Anti-
Inflammation Diet. For those interested in understanding the Vegan diet please
read some of my earlier Blogs.
People should be asking themselves this question: If inflammation (low-grade or
otherwise) plays a role in many other diseases besides Diabetes what dietary
Update on Type II Diabetes in America | The Reasoned Society
http://thoughtdigest.wordpress.com/2013/01/21/update-on-type-ii-diabetes-in-america/[6/6/2014 5:21:49 PM]
changes can I make to increase the success in lessening inflammation in the body?
Im glad you asked. Here is what Im going to do about it. As always, see your
primary care physician before undertaking any program.
Because of what is involved in using the anti-inflammatory diet and the vast
amount of information available I simply, with the rest of this Blog, want to
accomplish two things: (1) make the reader aware of two books I found valuable
with reducing inflammation, and (2) give the reader a preview of the kinds of food
one can eat right away to reduce inflammation in the body. These books are: (1)
The I diots Guide to The Anti- I nflammation Diet by Christopher P. Cannon,
M.D., and Elizabeth Vierck., and ( 2) The Anti- I nflammation Diet and
Recipe Book by J essica K. Black, N.D.
Top 10 Anti-Inflammatory and Inflammatory Foods
The above books listed go into great detail on the Anti-Inflammation Diet. In the
meantime, here are some quick suggestions.
Foods to Consume:
Wild Alaskan Salmon
Kelp
Extra Virgin Olive Oil
Cruciferous Vegetables
Blueberries
Turmeric
Ginger
Garlic
Green Tea
Sweet Potatoes
Foods to Avoid:
Sugar
Common Cooking Oils
Trans Fats
Dairy
Feedlot-Raised Meat
Red and Processed Meats
Alcohol
Refined Grains
Artificial Food Additives
Final Advice:
Add lots of fruits and vegetables to your diet, nuts and legumes, whole
grains, take a daily multiple vitamin-mineral; and, when in the grocery
storeREAD THE LABELS.
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Posted in Uncategorized | Tagged cancer, diabetes, epidemiology, Health, heart disease,
inflammation, insulin, insulin resistance, mitochondria, obesity, research on diabetes, Type
II Diabetes | 2 Comments
2 Responses
Jesse Drexel
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Debb McHugh
This article was very informative, and a
good confirmation to my beliefs for years about inflammation. I have
Type 1 diabetes for 45 yrs and only wish I could have had a choice to
change my lifestyle or become diabetic. This also is what my site is
about, a personal platform to educate people that they have choices and all
this information at their fingertips if they just use it.
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in America---
Epidemiology and
New Research
Findings
[Part I]---
Understanding the
Disease and Its
Root Causes
Part II---Reversing
Diabetes with the
Vegan Diet
In "amputation" In "Animal protein"
In "cancer"
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