NutritionFacts.

org SEARCH SEARCH EN REGISTER SIGN IN

VIDEO LIBRARY BOOKS RESOURCES SUBSCRIBE DONATE ABOUT

Support

 Subscribe to Videos Diabetes as a Disease of Fat Toxicity

Michael Greger M.D. FACLM · April 8th, 2015 · Volume 24
 Discuss

4.67 (93.43%) 67
votes
REPUBLISH

The “twin vicious cycles” explain how the buildup of fat in the cells of our muscles, liver, and
pancreas causes type 2 diabetes, which explains why dietary recommendations for diabetics
encourage a reduction in fat intake.

VIEW TRANSCRIPT SOURCES CITED ACKNOWLEDGEMENTS TOPICS

Both prediabetes and type 2 diabetes are caused by insulin resistance. Insulin resistance is now accepted to be closely associated with the
accumulation of fat within our muscle cells. This fat toxicity inside of our muscles is a major factor in the cause of insulin resistance and Type 2
diabetes, as it interferes with the action of insulin. I’ve explored how fat makes our muscles insulin resistant, how that fat can come from the fat we
eat or the fat we wear, and how not all fats are not the same. It’s the type of fat found predominantly in animal fats, relative to plant fats, that
appears to be especially deleterious with respect to fat-induced insulin insensitivity. But this insulin resistance in our muscles starts years before
diabetes is diagnosed.

This is a graph of fasting blood sugars in the 13 years prior to the onset of diabetes. Insulin resistance starts over a decade before diabetes is
actually diagnosed, as blood sugar levels slowly start creeping up. And then all of a sudden, the pancreas conks out, and blood sugars skyrocket.
What could underlie this relatively rapid failure of insulin secretion?

At rst, the pancreas pumps out more and more insulin, trying to overcome fat-induced insulin resistance in the muscles, and high insulin levels can
lead to the accumulation of fat in the liver, called fatty liver disease. Before diagnosis of type 2 diabetes, there is a long silent scream from the liver.
As fat builds up in the liver, it becomes resistant to insulin too.

Normally, the liver is constantly producing blood sugar to keep our brain alive between meals. As soon as we eat breakfast, though, the insulin
released to deal with the meal normally turns o liver glucose production, which makes sense since we don’t need it anymore. But lled with fat, the
liver becomes insulin resistant like our muscles do. It doesn’t respond to the breakfast signal, and so keeps pumping out blood sugar all day long
on top of whatever we eat. So the pancreas pumps out even more insulin to deal with the high sugars, and our liver gets fatter and fatter. That’s one
of the twin vicious cycles of diabetes. Fatty muscles, in the context of too many calories, leads to a fatty liver, which leads to an even fattier liver.
This is all still before we have diabetes, but then the next vicious cycle starts.

Fatty liver can be deadly. So the liver starts trying to o oad the fat by dumping it back into the bloodstream in the form of something called VLDL,
and that starts building up in the cells of the pancreas that produce the insulin in the rst place. So now we know how diabetes develops. Fatty
muscles lead to a fatty liver, which leads to a fatty pancreas. It is now clear that type 2 diabetes is a condition of excess fat inside our organs.

The only thing that was keeping us from diabetes, from unchecked skyrocketing blood sugar, is that the pancreas was working overtime pumping
out extra insulin to overcome insulin resistance. But as the so-called islet or beta cells in the pancreas are killed o by the fat buildup, insulin
production starts to fail, and we’re left with the worst of both worlds–insulin resistance combined with a failing pancreas. Unable to then overcome
the resistance, blood sugar levels go up and up and we have type 2 diabetes.

This has implications for cancer as well. Obesity leads to insulin resistance, and our blood sugars start to go up, so our pancreas starts pumping out
more insulin to try to force more sugar into our muscles, and eventually the fat spills over into the pancreas as well, killing o the insulin-producing
cells, and we’ve got diabetes–in which case we may have to start injecting insulin at high levels to overcome the insulin resistance, and these high
insulin levels promote cancer. That’s one of the reasons we think obese women get more breast cancer. It all traces back to fat getting into our
muscle cells, causing insulin resistance. Fat from our stomach, or fat going into our stomach.

Now it should make sense why the American Diabetes Association recommends reduced intake of dietary fat as a strategy for reducing the risk for
developing diabetes.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an
approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

DOCTOR'S NOTE
This is part two of an extended series on Type 2 diabetes that will continue for months. I’d put them all back-to-back, but then it would be
diabetes all day every day for weeks. If you really want to understand this process, I suggest watching the three “prequel” videos:

What Causes Insulin Resistance?

The Spillover E ect Links Obesity to Diabetes
Lipotoxicity: How Saturated Fat Raises Blood Sugar

The reason I’m going into all this detail is that I’m hoping to empower both those su ering from the disease and those treating su erers so
as to better understand dietary interventions to prevent and treat the epidemic. Maybe one day I’ll record hour-long disease-speci c
lectures that put it all together for those who’d want to watch it all straight through.

Meanwhile, here some videos on prevention:

Lifestyle Medicine Is the Standard of Care for Prediabetes

How to Prevent Prediabetes in Children
Preventing Prediabetes By Eating More
How to Prevent Prediabetes from Turning into Diabetes
Eggs and Diabetes
Fish and Diabetes

And here’s some on treatment:

Plant-Based Diets and Diabetes

Diabetics Should Take Their Pulses
Amla versus Diabetes
Flaxseed vs. Diabetes

If you haven’t yet, you can subscribe to my videos for free by clicking here.

PREVIOUS VIDEO NEXT VIDEO

Peppermint Aromatherapy for Nausea How to Prevent a Stroke

English Spanish

Nutrition Videos Get the App Get Social Help

Browse Topics Daily Dozen iOS Facebook About NutritionFacts.org
Introductory Videos Daily Dozen Android Twitter Help Center
Latest Videos Daily Dozen Challenge Pinterest FAQ
How Not to Die Instagram Copyright Guidelines
Foods for Dreaded Diseases Support Us YouTube Privacy Policy
Foods for Disabling Diseases Donate Vimeo Terms of Service
Foods for Common Diseases Our Supporters NutritionFacts.org 中文
Foods for Killer Diseases Donor Rewards & Recognition Get in Touch
Evidence-Based Weight Loss Subscribe Contact Us
Get Involved E-Mail Subscriptions Press
Blog and Volunteer Opportunities Volunteer Newsletter Speaking Inquiries
Resources Internship Opportunities Video RSS Feed Virtual Speaking Inquiries
NutritionFacts.org Blog Employment Opportunities Blog RSS Feed Interview Inquiries
Webinars Open Source Initiative
Speaking Dates Submit a Testimonial
Evidence-Based Eating Guide Host a Screening
Nutrition FAQs
Optimum Nutrition
Recommendations
COVID-19 Resources

Get the Books

How Not to Die
The How Not to Die Cookbook
How Not to Diet
How to Survive a Pandemic
How Not to Diet Cookbook

We  our volunteers! Apply Now!

Charity ID: 05-0559626