Lose a Gram of Fat, Reverse Diabetes

December 14, 2015

Lose a Gram of Fat, Lose Diabetes 

 Reference: Newcastle University, Diabetes Care 

 Published: Dec 14, 2015 

 Lose a gram of fat, lose diabetes. What a claim! But it is absolutely clear that losing weight does reverse adult-onset diabetes. In that light, how does this claim make sense?   It turns out that the fat you have to lose is from your pancreas gland. It appears from this study that fat in the pancreas gland plays a role in the disease. This is how this study argues. 18 people with diabetes, and 9 without who were scheduled for bariatric surgery all had measurements of fat levels in the pancreas and sensitivity to insulin, before and after surgery.   They all then had bariatric surgery and subsequently lost about 13% of body fat. 

Here is the critical finding: only the diabetics who then had their diabetes reversed lost fat from their pancreas gland. Those folks who weren’t diabetic didn’t have any fat loss from their pancreas glands.   Now, with a pancreas gland that is only 50 milliliters in volume, they had to develop a new procedure for calculating fat content based on the MRI scan.   Their finding was that only diabetics lost that fat, about 0.6 mls total. Did you get that, they only had to lose .6 milliliters of fat from their pancreas glands? Can you imagine that? Does it make sense? Could this be error? Are 18 patients enough for this to be credible? 

Can 0.6 mls really be measured that accurately in someone who weighs over 200 pounds and needs bariatric surgery? I’m skeptical because the numbers are so small, but it can make sense for the following reason.   Type II diabetes is high blood sugar (glucose) only because the fat cell is insulin resistant.   It is insulin resistant because it has become too large.   There is plenty of insulin around, but the fat cell won’t respond normally.   Your pancreas can only secrete so much insulin in a lifetime, and when you pump out high levels for years, you eventually exhaust your ability to make anymore. An arithmetic analogy would be to claim that your pancreas can only make a million units of insulin in a lifetime. If you consume more than 45 units a day, you will run out of insulin by age 60.   

That’s what we see. Folks who are overweight have insulin resistance. Their blood sugar is only slightly elevated, but their insulin is higher than ideal (my belief ideal is under 7 – most health systems claim normal range is 2-23 or so with an average around 12). In their 50s these folks have their pancreas glands starting to run out, so their insulin level starts to fall. Medication can squeeze you for a few years, but then you are using up insulin even faster. By age 60, you are completely out and need to be put on someone else’s insulin (a pig for example). A large fat cell has the same number of insulin receptors (about 170,000) as a small cell. But they are further apart and further from the nucleus of the fat cell.   Fat cells get bigger, not more numerous, as you put on weight. That makes insulin signaling on the surface of the cell less efficient. 

The only way to fix that is to reduce the size of the fat cell. The only way to do that is to lose weight. So, it makes sense. This falls in line with other studies and confirms that the proper method of reversing diabetes is weight loss, not pills. And it raises questions about what we should be testing and what our normal limits should be.   In my mind, a normal insulin level should be a goal for all of us, (<7) and a normal blood sugar should be considered as less than 87, not less than 100. At a blood sugar of 99, you are still putting out insulin, and if your fat cells are too big, too much insulin. 

 WWW. What will work for me?   I can’t do MRIs on folks' pancreas glands. This is obviously just a research study, but it falls in line and explains what’s happening when you lose weight. Your pancreas puts on weight, just like your fat cell. And your intracellular signaling gets out of whack with that.   You then must eat food that doesn’t require insulin: fat and green vegetables.   Hmmm. Bacon and spinach. Sounds like those Southern Gullah chefs had it figured out.   

 Pop Quiz  

  1. To reverse adult-onset diabetes I can get bariatric surgery? T or F                   Answer:  True. Crazy but true. Heavy-duty surgery that relapses after a couple of years is nuts when you can accomplish the same with eating differently.
  1. Weight loss from my pancreas gland on the order of 0.6 ml or 1 gram of fat is enough to reverse diabetes. T or F                          Answer:  Yup
  1. Adult-onset diabetes means you have likely been having relatively high insulin levels for years, and your pancreas gland is pooping out. T or F                   Answer:  True
  1. If you dramatically reduce your demand for insulin by losing weight and eating foods that need no demand for insulin (fat and greens), you can stretch out the life function of your pancreas dramatically. T or F                     Answer:  That’s the point
  1. You should have your insulin level checked as often as your blood glucose. T or F          Answer:    Well, maybe not as often, but often enough to help you get to normal.