Understanding type 2 diabetes: Study highlights role of diet, lifestyle, and metabolism
Diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. Insulin is a hormone that regulates blood glucose. Hyperglycaemia, also called raised blood glucose or raised blood sugar, is a common effect of uncontrolled diabetes and, over time, leads to serious damage to many of the body’s systems, especially the nerves and blood vessels.
In 2022, 14% of adults aged 18 years and older were living with diabetes, an increase from 7% in 1990. More than half (59%) of adults aged 30 years and over living with diabetes were not taking medication for their diabetes in 2022. Diabetes treatment coverage was lowest in low- and middle-income countries, as per the World Health Organization.
iThrive, a Pune-based health and wellness platform, recently analyzed findings from various studies and detailed a thesis on Root-Cause Strategy for Reversing Type 2 Diabetes that disputes the conventional notion that T2DM, ie, Type 2 Diabetes Mellitus, is a permanent condition. In fact, the study claims that the condition holds a chance for going into remission should the causes be addressed properly.
Citing some of the major findings from a functional medicine thesis entitled The Science of Reversal: A Functional Medicine Thesis on Root Cause Strategy for Reversing Type 2 Diabetes, the study claims that T2DM is not a permanent condition. In fact, it is a reversible metabolic condition provided the biological causes for the condition are properly addressed. The study presents an amalgamation of clinical trials, metabolic science, and population-based nutritional data to demonstrate the role of nutritional and metabolic interventions in improving insulin sensitivity and glucose metabolism.
One of the interesting findings of the study is the result of the Direct trial, which shows that 46% with type 2 diabetes went into remission after a weight loss program. This is also supported by the Twin Cycle Hypothesis, which posits that the fundamental problem with type 2 diabetes is the excessive fat content of the liver and pancreas. This fat content, which causes insulin resistance, can be reduced by restricting calorie consumption, causing the metabolic system to return to normal very quickly.
Commenting on the findings, Functional Nutritionist Mugdha Pradhan, Founder and CEO of iThrive, said, “For decades, Type 2 diabetes has been considered a lifelong condition that can be managed but not reversed. However, the emerging science of human metabolism now shows that when the underlying causes of Type 2 diabetes, such as liver fat, pancreas fat, micronutrient deficiencies, inflammation, and lifestyle, are corrected, the body has the ability to return to a balanced metabolic state. The analysis shows not only is remission possible, but the scientific evidence is now backing this up.”
The Science of Reversal also brings to the forefront the role of environmental and physiological factors that increase the risk of developing T2DM. A study on 471,686 people demonstrated the significant association between exposure to nighttime blue light and the risk of developing Type 2 diabetes, suggesting a connection that could be influenced by factors such as sleep duration, physical activity, and outdoor activity time. Another important factor that the study indicates is the role of micronutrient deficiencies in the development and progression of T2DM, wherein one in three people with T2DM had magnesium deficiency, an important mineral in the proper functioning of the body.
These findings are of particular interest in India, where the pattern of nutrition may contribute to increased risk of metabolic problems. In fact, a survey of 18,090 adults in India revealed that 56.4% of daily calories came from carbohydrates. White rice supplies almost a fifth of daily calorie needs, making it 19.3% of daily energy. Carbohydrates provide half of daily requirements in Himachal Pradesh (51%), rising to two-thirds of daily requirements in Mizoram (65.7%). However, iron, zinc, vitamin D, magnesium, and calcium are found to be deficient, which is termed hidden hunger.
Recent research by experts such as Dr. Cate Shanahan, Ben Greenfield, and Chris Masterjohn has shed light on the potential role of industrial seed oils in the development of diabetes. Industrial seed oils are predominantly composed of omega-6 fats, which can be detrimental when consumed in excess. Excessive consumption of industrial seed oils, which are high in omega-6 fats, poses a significant risk to metabolic health. These fats damage cell membranes, the “cellophane wrapper,” compromising their integrity. This structural alteration hinders cellular communication, a process vital for proper cellular function. This breakdown in communication is a critical initial step leading to insulin resistance, a central characteristic of type 2 diabetes. Furthermore, the excessive consumption of omega-6 fatty acids from seed oils has been linked to impaired insulin signaling. As a result, glucose accumulates in the bloodstream, leading to elevated blood sugar levels and, over time, the onset of type 2 diabetes.
Seed oils are a critical factor linking to diabetes due to their role in promoting inflammation and oxidative stress. The omega-6 fatty acids in these oils are precursors to pro-inflammatory molecules, which intensify the chronic, low-grade inflammation commonly observed in type 2 diabetes. Furthermore, the oxidative stress induced by these fats damages cellular components, disrupting normal metabolic function. This synergy of inflammation and oxidative stress negatively impacts both insulin sensitivity and glucose metabolism. Mitochondria, the energy powerhouses of cells, are also adversely affected by the high intake of omega-6 fatty acids. Healthy mitochondrial function is crucial for efficient energy production and metabolism. However, under the influence of omega-6 fats, mitochondrial efficiency declines, leading to reduced energy availability and metabolic dysfunction. This disruption contributes to insulin resistance and hampers the body’s ability to maintain normal glucose levels.
The thesis understands that type 2 diabetes is an ubiquitous metabolic disorder, which manifests as insulin resistance in the liver, muscles, fat, and pancreas. Type 2 diabetes is more than high blood sugar.
(This article is based on information available in the public domain and on input provided by experts consulted.)
