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‘Diabesity,’ Insulin resistance and Leptin

Many health experts are using a new term to describe the combination of diabetes and obesity called ‘Diabesity’. It is now believed that Diabesity may be the largest epidemic the world has ever faced. Some estimates predict the total number of individuals with “obesity induced diabetes” will reach 366 million worldwide by 2030, with an average of 8-10 years reduction in their life expectancy.

Sadly, the entire spectrum of diabesity with all its complications including diabetes, high blood pressure, high cholesterol, and heart disease are often symptoms related to poor diet and life style choices. These poor diet and lifestyle choices lead to a condition called insulin resistance. Insulin resistance (or type 2 diabetes) is actually a condition of too much insulin, not too little. Too much insulin is what fans the flames of diabesity and systemic inflammation.

Aging individuals are often told to simply monitor their blood sugar levels without an understanding of the connection between obesity, diabetes and inflammation. Fat cells generate inflammatory molecules known as cytokines. Excess body fat can release these harmful signaling molecules triggering a cascade of inflammatory reactions in the brain and blood vascular tissues. Diabetics undergo an acceleration of inflammatory changes to blood vessel walls that produce dysfunction and ultimately atherosclerosis. Brain cells in diabetics are also very vulnerable to oxidative stress related to inflammation due to their lipid rich membranes.

A diet consisting of an overabundance of processed carbohydrates like bread, pasta, rice, and potatoes, as well as sugary drinks, can slow your body’s response to insulin. This results in your body requiring more and more insulin to do the same job of regulating your blood sugar level. A high level of insulin in your blood is a sign you are becoming insulin resistant. As insulin levels rise you can expect excess weight gain around your waist line, more inflammation, higher blood pressure, elevated cholesterol and triglycerides, increased risk of cancer, and of course higher blood sugar levels.

Treating diabesity and insulin resistance requires a multifaceted approach, and you must be ready and willing change some of your habits. Elimination of processed carbohydrates is crucial. Switching to whole foods including lean protein such as fish or chicken, green leafy vegetables, nuts, beans, whole grains, and free range organic eggs. In addition to changing the way you eat, exercise is the single best prescription for diabesity. This means 30-60 minutes at least 3 days a week. If you have trouble motivating yourself to exercise, seek out a certified trainer at a local health club or fitness center. It is worth the investment to regain your health.

There are several encouraging new studies relative to consumption of curcumin and stabilization of blood sugar levels. These studies demonstrate curcumin’s ability to increase the number of insulin receptors on the cell membranes and improve insulin binding capacity. This results in increased sugar uptake from the blood and decreased formation of new glucose. Other sugar balancing and insulin sensitizing nutrients include: alpha lipoic acid; cinnamon; chromium picolinate; green tea extract; gymnema leaf extract; and vanadium. Ask your health care provider or nutritionist about which nutrients might be the best choice for you.

Leptin is a protein hormone produced primarily by our bodies fat cells. Checking leptin levels has become an important blood marker for systemic inflammation, obesity and insulin resistance. In healthy people, baseline leptin levels are between 1-5 ng/dl in men and 7-13 ng/dl in women. An increased blood level of leptin is a marker of a condition known as leptin resistance. Leptin resistance is independently associated with insulin resistance and cardiovascular disease. Evidence suggests that central leptin resistance causes obesity and that obesity -induced leptin resistance can cause injury to numerous other tissues including the heart, liver and blood vessels.

If you feel you are at risk for insulin resistance, type 2 diabetes, systemic inflammation, cardiovascular disease or you are significantly overweight it is important to receive the proper blood tests to evaluate you for these conditions. Ask your doctor or health care provider about testing your total and fasting insulin levels, leptin level, glycohemoglobin and C-reactive protein.

Remember, proactive health care is the key to vitality and wellness.

Dr. John Dixon can be reached at the Natural Medicine Group 760.776.0022

References: 1) journal of the american college of cardiology, Martin et. al.2008. 2) curcumin is a potent anti-inflammatory recent anticancer drug discover. Lichtenberg et.al. 3) curcumin’s multiple effects on obesity and metabolism, annual rev. nutrition , Aggarwat et. al.

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