Exciting new research to prevent and treat diabetes
Dr. Gabe Mirkin's Fitness and Health E-Zine

Two exciting new research papers show how Type II diabetes can be prevented and
treated. They show two mechanisms by which a drug used to treat diabetes,
metformin, lowers blood sugar levels. First I will give you a brief explanation of
this research and then I will show how you can use this information to change your
lifestyle to help prevent diabetes, or help to treat it if you already have this
horrible disease.

Researchers at McMaster University have just shown how the drug metformin
(Glucophage) removes fat from the liver (Nature Medicine, November 2013). Most cases
of diabetes are caused by fat in the liver preventing the liver from doing its job of
removing sugar from the bloodstream. A healthy liver prevents high blood sugar levels
by removing sugar from the bloodstream into its liver cells every time blood sugar
levels rise too high. If fat accumulates in the liver cells, it can prevent liver
cells from responding to insulin and removing sugar from the bloodstream. Metformin
lowers high blood sugar levels by removing fat from liver cells. This makes liver
cells once again responsive to insulin, so the liver cells can do their job of
removing sugar from the bloodstream.

Six months ago, researchers at the University of Pennsylvania showed that metformin
lowers production of the hormone glucagon (Nature, published online Jan. 6, 2013).
Glucagon causes liver cells to release sugar into the bloodstream, so metformin helps
to lower blood sugar levels by blocking glucagon. When blood sugar levels are already
high, metformin helps to prevent the liver from releasing sugar from its cells to
raise blood sugar levels even higher.

How High Blood Sugar Levels Can Damage Every Cell in Your Body
Cell damage in diabetes is caused by a high blood sugar level causing sugar to stick
to the outer surface membranes of cells and destroying cells. If you can prevent
blood sugar levels from rising too high, you can prevent sugar from sticking to cells
and thus prevent all the horrible side effects of diabetes. For example, sugar stuck
on:
* brain cells causes dementia,
* arteries causes heart attacks or strokes,
* penile nerves causes impotence
* nerves anywhere causes burning pain, tingling, numbness or other signs of nerve
damage.

How Your Liver Regulates Blood Sugar Levels
Your liver determines blood sugar level. When blood sugar levels drop, your liver
releases sugar from its cells into the bloodstream to raise blood sugar levels. When
blood sugar levels rise, your liver removes sugar from the bloodstream by taking
sugar into its cells.

Your liver is regulated by insulin that is released from your pancreas.
* When blood sugar levels rise too high, your pancreas releases insulin into the
bloodstream. Insulin specifically lowers blood sugar levels by driving sugar from the
bloodstream into all cells in your body. Most of the sugar goes into your liver
cells.
* When blood sugar levels drop, your pancreas releases glucagon into your
bloodstream. Glucagon raises blood sugar levels by driving stored sugar (glycogen)
from liver cells into the bloodstream.

How Fat in Your Liver Causes Diabetes
Before insulin can drive sugar from the bloodstream into your liver cells, insulin
must first attach to special hooks on cells called insulin receptors. Fat inside
cells prevents insulin from attaching to insulin receptor hooks and therefore
prevents insulin from lowering high blood sugar levels by driving sugar from the
blood into cells.

High blood sugar levels are caused by fat in the liver blocking insulin so the liver
cannot remove excess sugar from the bloodstream. Removing fat from the liver allows
insulin to do its job of driving sugar from the blood into the liver.

How Can You Tell If You Have Excess Fat in Your Liver?
Your doctor can order a safe and inexpensive sonogram of your liver to see if it is
full of fat. Sound waves take a picture of your liver and the radiologist can see the
fat inside liver cells.

A simpler way is just to look at yourself in a mirror. Almost all people who store
fat primarily in their bellies have a fatty liver and have difficulty responding to
insulin. If you have a big belly and small buttocks, you are most likely already
diabetic or are on your way to becoming diabetic. When your protruding belly
disappears, you are probably cured of your diabetes.

Once you remove fat from your liver cells, your liver usually regains its ability to
respond to insulin to remove sugar from the bloodstream. This prevents blood sugar
levels from rising too high and you no longer have active diabetes.

Lifestyle Changes to Prevent or Treat Diabetes
* Exercise every day
* Avoid being overweight
* Avoid red meat, fried foods and sugar added foods
* Avoid all sugared drinks except during vigorous exercise
* Eat lots of fruits and vegetables
* Get blood levels of hydroxy Vitamin D above 75 nmol/L