Type 2 diabetes is one of the fastest growing epidemics world-wide. In a recent article published in the Lancet, the number of people with diabetes has risen from 460 million in 2019 to 529 million in 2021. t’s estimated that by 2050 over 1.3 billion people worldwide will have this disease. Of those 529 million diagnosed in 2021, roughly 96% of those were type 2 diabetes, which makes that specific form of diabetes a very prevalent and concerning health epidemic (Collaborators, 2023).Type 2 diabetes is also one of the highest cost burdens for society. According to the American Diabetes Association, the economic cost of diabetes was 327 billion dollars in 2017, and that number is quickly rising as the number of cases continues to grow.
The body’s main fuel source for cells is glucose and as such it is an essential substance that we ingest every day from the foods that we eat. However, the body has a very narrow window of homeostasis for blood glucose levels (4-6 mM), and when we eat a meal or fast, the body has to respond to keep blood glucose levels within that window (Pia V Röder, 2016). There are two main hormones responsible for keeping blood glucose within these levels: glucagon and insulin. Glucagon is released by alpha cells of the pancreas, and it raises blood glucose during periods of fasting such as when we are sleeping or when we need more glucose quickly s
uch as when the fight or flight response is triggered. Insulin is released from beta cells of the pancreas in response to rising blood glucose levels. It binds to cells allowing them to take glucose out of the blood and into the cell where it can be utilized for energy or stored for later use and subsequently lowers blood glucose levels.
As opposed to type 1 diabetes, which is an autoimmune disorder where the body attacks the cells that produce the hormone insulin, type 2 diabetes is largely a disease of lifestyle where the body’s cells become insulin resistant. When a person ingests too much glucose from food and drinks the pancreas responds by releasing large amounts of insulin to maintain blood glucose levels. This in turn can drop blood glucose too low which leaves the person in a state of hypoglycemia, low blood sugar, and in search of high sugar foods to bring blood glucose back up. This blood sugar/insulin roller coaster overtime leaves the cells of the body essentially deaf to the signal of insulin. They have enough glucose inside to maintain function, because they cannot take in anymore, they become resistant to insulin’s signal to take up blood glu
cose which results in higher-than-normal blood glucose levels. A chronically high blood glucose level is the main diagnostic criteria for diabetes.
Polycystic ovarian syndrome (PCOS) is the most common hormone disorder in women affecting between 4%-20% of reproductive aged women worldwide (Ritu Deswal, 2020). PCOS is a complex disorder that is characterized, in part, by insulin resistance and beta cell dysfunction, two of the main factors that lead to the development of type 2 diabetes (Sarantis Livadas, 2022). While PCOS doesn’t always lead to type 2 diabetes, the prevalence of the disease developing in women with PCOS is statistically higher than in women without PCOS. However, BMI was also a major factor in the development of diabetes, regardless of PCOS diagnosis (Rasa Pelanis, 2017). PCOS patients also typically have reactive hypoglycemia, which is what the blood sugar roller coaster is that I talked about earlier, and that metabolic state often leads to pancreatic beta cell stress, insulin resistance and type 2 diabetes. The direct cause of PCO
S is unknown, and it is more likely that it is caused by a number of factors, but it is very clear that insulin resistance and hyperinsulinemia play a significant role in the disorder.
While PCOS and diabetes are not the same, the causes are similar as are the dietary and lifestyle protocols. Also, if you consider that PCOS often leads to type 2 diabetes, it isn’t too surprising to find some of the same root disfunctions and similar solutions. Stress, high glycemic diets, sedentary lifestyles, inadequate sleep, and environmental toxins all contribute to insulin resistance, hyperglycemia, hyperinsulinemia and ultimately can lead to these diseases.
Stress increases the hormone cortisol which raises blood sugar as part of its job to prepare the body for fight/flight. If this response is chronic it will lead to reactive hypoglycemia; blood sugar highs mitigated with large amounts of insulin followed by blood sugar lows which triggers the release of cortisol to start the cycle over again. A sedentary lifestyle contributes to insulin resista
nce because exercise, especially weight bearing or resistance type exercise, helps the cells become more resistant to the signal of insulin. Even simple exercise like walking during lunch will help increase the cell’s reaction to insulin and can help improve insulin signaling. Sleep, or the lack of sleep I should say, also effects insulin’s signals. With just minimal sleep loss, insulin resistance is increased, and appetite signaling is off so hunger can be increased during the day. Various environmental toxins also have an effect on insulin signaling and can contribute to insulin resistance, hyperinsulinemia, and hypoglycemia. These include things like BPA, parabens, and dioxins. Avoidance of these substances is the best way to minimize their impact on blood glucose regulation in the body.
Finally, high glycemic diets, which are prevalent in modern society, play a role in blood glucose management and the development of blood sugar disorders. When someone eats a meal that is high in simple carbohydrates (sugar, white bread, white pasta, candy, cake, cookies, soda etc.)
the body must deal with that huge amount of glucose coming in at one time. In response to it, the pancreas releases a large amount of insulin, and a state of hyperinsulinemia ensues followed by a state of hyperglycemia which leaves the person craving high carbohydrate foods again. This pattern of eating over time puts too much stress on the body cells and on the insulin response mechanisms, and it essentially wears out leading to
resistance and disease.
The good news about insulin resistance, whether it’s in PCOS or type 2 diabetes, is that it is often manageable with diet and lifestyle modifications. Specifically, magnesium is a key nutrient in supporting blood glucose regulation as it is involved in helping improve insulin sensitivity. It has been shown that people with type 2 diabetes show improved blood glucose levels when they supplement with magnesium (Lianbin Xu, 2023). Zinc is another important mineral for people with blood glucose dysfunction as it also plays a crucial role in the function of insuli
n. It binds to insulin receptors and helps to activate insulin pathways in cells, improving the function of insulin and lowering overall blood glucose levels (Khanrin Phungamla Vashum, 2013).
There are many other dietary and lifestyle modifications that can help with blood sugar disorders
such as PCOS and diabetes. As one of the fastest growing public health issues in our time, these dietary and lifestyle modifications should not be overlooked for the value they can bring to individuals and the entire health care system. If we can stem the tide of resource and improve quality of life with changes in diet and lifestyle, even if the diseases or disorders can’t be cured, that will go along way to improving the outlook of this epidemic and our societies health in the years to come.
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