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Hyperinsulinemia Leads to Dysglycemia

Hyperinsulinemia Leads to Dysglycemia

What’s a real predictor of diabetes?

What is the real definition of diabetes? It is a little harder to define than some may think…

Doctors usually measure and diagnose it through high blood sugars. The American Diabetes Association focuses only on glucose in their diagnostic section.[1] Because they talk only of blood sugar, we must assume they are ignoring insulin’s role. There is a problem with their standard diagnosis methods.

Once there is high blood sugar, the metabolic problems have already started to manifest. There really is no way to make it better other than avoiding sugars and going on a ketogenic diet.

But what if we altered our definition of diabetes just a bit so we can diagnose it when there is time to change paths? Is there something we can measure as a precursor to “diabetes”? Imagine that! Being able to identify the onset of diabetes before it happens.

 

What if we could predict diabetes?


We are not talking a couple years’ prediction here. We are talking about identifying it over 20 years before it happens! Yes, we can see that a patient is becoming diabetic before the “official diagnosis” of high blood sugar. That’s a pretty big deal! Do you know how many people go to the doctor only to be surprised they have diabetes? A lot. Imagine if doctors were able to look at them 20 years ago and predict (with enough time for changes) that they will get “full blown diabetes” if they are not careful.

That requires us to have a deeper understanding of what diabetes is. It is not a disease of high blood sugar. It is a disease of high insulin that eventually results in the high blood sugars we diagnose.

Summary

For this week’s piece of research, I wanted to learn a bit more about the role of hyperinsulinemia in diabetes. I have done a few blog posts in the past (check it out here), but it was good to catch up on the topic. It made me wonder…

What if we really could change the definition of diabetes to include its ever-present twin, hyperinsulinemia? This article set out to show the relation between high insulin and high blood sugar. They found that people with hyperinsulinemia were way more likely to develop diabetes later on. They consider basal hyperinsulinemia an “independent risk factor” for messed up blood sugars.[2Feel free to see for yourself and learn to read the primary scientific literature on this stuff. [Click here for the file.]

Dankner R, Chetrit A, Shanik MH, Raz I, Roth J. (2012). Basal state hyperinsulinemia in healthy normoglycemic adults heralds dysglycemia after more than two decades of follow up. Diabetes & Metabolism Research and Reviews 28(7): 618-624.


Some of the most important facts I found in the article were:

  • This was a viable study because they looked at sample from total population
    • Variety of nationalities, genders, and ages.
  • Impaired glucose or insulin activity are involved in a group of diseases.
  • Basal insulin in the highest quintile was the strongest predictor of dysglycemia.

Diabetes as group of diseases

I thought this was especially interesting in the article. Although it comes a little in the article, it reveals something about diabetes to kick start this conversation. They hint at the idea that impaired glucose tolerance and insulin signaling are related to other diseases.

Through our own research here, we came to the same conclusion long ago. Diabetes is not just “diabetes.” That is not the disease state in and of itself. Diabetes is a highway that leads to other diseases. It is the tree trunk of metabolic disease, and the branches are the tangible and harmful diseases: heart disease, neuropathy, fatty liver, etc.

 

Diabetes is the umbrella under which diseases like heart disease exist


In the article this is how they put it. “Fasting glucose and basal insulin are markers of different pathways to an overlapping group of disease processes.”[2] They also mentioned earlier that other research found the predictive correlation between high blood sugars and heart disease. Do you know why that may be the case?

Because heart disease is a metabolic disease that occurs from impaired energy pathways. It has its roots in “diabetes.” But even then, there are deeper roots beyond that. That is what our next topic is about. Dysglycemia has its beginnings long before doctors can see it.

Predict diabetes with hyperinsulinemia

Dysglycemia is the fancy term for having abnormal blood sugars. In this context, it is relating to hyperglycemia specifically. That is when your blood sugars are above normal, and you are finally labeled as “diabetic.” However, by the time doctors actually find your high blood sugar, the problems have started. There is no way to “prevent” anything at that point. That’s when the advanced glycation end-products start messing up metabolic pathways.[3]

But what if we could find a predictor of those messed up blood sugars? We could then prevent the onset of dysglycemia and avoid the complications of diabetes altogether. This article claims (and I agree) that diabetes starts with hyperinsulinemia.

The study found that having high basal insulin levels is an independent risk factor for developing dysglycemia. It predicts it by more than 20 years! That is huge. We can diagnose diabetes 20 years before out doctors even see it? That allows time for change in lifestyle and diet to fix the problem.

How do you become hyperinsulinemic?

The simple answer is by eating too many refined carbs. When you overindulge in carbs (like our dietary guidelines advise us), you constantly trigger insulin responses. When you do that over a long period of time, you eventually become hyperinsulinemic. You need more insulin to get the job done because your body gains a tolerance for insulin.

Just like drinking too much causes you to need more and more to get drunk, too many carbs leads to your body needing more and more insulin to take care of it.

 

Hyperinsulinemia leads to eventually leads to high blood sugar


How does too much insulin cause too high of blood sugar?

The exact pathway for why hyperinsulinemia causes dysglycemia is fairly logical. At first, your body is able to respond to the carbs in your diet. Then it stops working as well, so there needs to be more insulin to take care of it.

Your body can “handle” pumping out more insulin over a long period of time. But eventually your body will cease to respond to insulin so much that there are constantly high blood sugars. That’s why it can take 20 years to develop hyperglycemia. Your body responds through more insulin for a long time, but then that stops working, so the glucose in your blood stays there.

Testing for your insulin responses is by far the best way to predict diabetes. If you have constantly high insulin levels, you know that eventually your body will stop responding to that and end up leaving glucose in the blood. Dr. Joseph Kraft would agree. If you have never read his book Diabetes Epidemic & You, you must! He goes through his decades of data to conclude the same thing.

Diabetes is a disease of insulin, not blood sugar. The blood sugar only comes out as a result. And by the time doctors see this, it is too lat. Having said that, you can work with your condition to make sure the high blood sugars don’t affect you. Through ketogenic therapy, not only do you avoid the blood sugar problems, you can also start repairing your metabolic organs. But even then, you will always have a insulin tolerance that interferes with your ability to eat carbs.

Summary

  • This was a viable study because they looked at sample from total population
    • Variety of nationalities, genders, and ages.
  • Impaired glucose or insulin activity are involved in a group of diseases.
  • Basal insulin in the highest quintile was the strongest predictor of dysglycemia.

References:

[1] “Diagnosing Diabetes and Learning About Prediabetes”. American Diabetes Association. 2018. [Online]. Available: http://www.diabetes.org/diabetes-basics/diagnosis/?loc=db-slabnav. Accessed: 8 July, 2018.

[2] Dankner R, Chetrit A, Shanik MH, Raz I, Roth J. (2012). Basal state hyperinsulinemia in healthy normoglycemic adults heralds dysglycemia after more than two decades of follow up. Diabetes & Metabolism Research and Reviews 28(7): 618-624.

[3] Goldin A, Beckman JA, Schmidt AM, Creager MA. (2006). Advanced Glycation End Products: Sparking the Development of Diabetic Vascular InjuryCirculation 114(6): 597-605.

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