Last week we reviewed the subject of carbohydrates and diabetes.  Many professionals and lay people believe carbs are the villain in the scourge of diabetes, and promote a low-carb, high fat diet.  However as we discovered, there are two basic types of carbs – unrefined and refined carbs – which are very different substances.  Refined carbohydrates rapidly elevate blood sugar and increase demands for insulin, compared to unrefined carbs which gradually release energy producing glucose in a controlled release capsule of natural fibre.  This results in increased insulin sensitivity and less insulin resistance – and thus counteracts the underlying defect of type 2 diabetes which is insulin resistance.

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So what is the main mechanism involved in insulin resistance?

The attached link connects us to a detailed review that was written 10 years ago already of the scientific understanding of the role of dietary fats in the development of insulin resistance and diabetes type 2.  It is quite long, but for anyone who has any questions about the authenticity of this concept and the validity of the arguments, you would do well to peruse that article.  I will try to summarise the important findings in simple terms.

1. Dietary fat affects glucose metabolism on a number of different levels – the cell membrane function (which acts as a gateway to the entrance of sugar into the cell); enzyme activity (which affects processing of sugars); signaling of insulin (which affects the communication to the pancreas that insulin is needed) and finally gene expression (the ability of the body to read the operator manual).
2. Overall the replacement of saturated fats (as found in animal sources such as meat, dairy but also palm/coconut oils) and trans-fats (such as hydrogenated fats in hard margarines and overheated oils) with unsaturated (polyunsaturated and monounsaturated fats as found in plant oils) reduces the insulin resistance and increases insulin sensitivity, and thus the incidence of diabetes type 2.
3. There is a dose related effect of these harmful fats (trans fats and saturated fats) on the incidence of diabetes and insulin resistance.
4. What is noteworthy about this paper though is that all the studies basically just replaced unhealthier fats with healthier fats, but did not reduce the fat content of the diet. Most of the diets had around 40% fat content.  But even at that high fat content benefits accrued from replacing saturated and trans fats with polyunsaturated and monounsaturated fats.

Our typical western diet is loaded with saturated and trans fats – when you think about foods like fried chicken, roasted meat, burgers, ice-cream, pastries, cakes, pizzas, chips and French fries.

Is it any wonder that the incidence of diabetes is skyrocketing!

Here is a very down-to-earth article that gives practical advice on how to increase insulin resistance by cutting all types of fat intake down to between 10-15%.  It also explains in simple lay terms how and why this happens.

Dr Cyrus Khambata explains how excess fat in the diet affects numerous steps in the development of insulin resistance and eventual diabetes.

1. Excess fat slows down stomach emptying time and thus availability of carbohydrates to the system.
2. Excess fat intake causes the fat globules in fat cells to expand to the point where many cells rupture causing inflammation in surrounding tissues.
3. Once fat cells are full, they are unable to mop up excess fat in the system, and that fat starts to accumulate in muscle and liver cells where it inhibits the ability of the insulin receptors to function.
4. In effect the muscle and liver cells tell the insulin receptors that they have enough energy and block the receptors from allowing glucose into the cells with more energy until they have used up the energy stored in those fat globules
5. This results in increasingly elevated levels of both insulin and glucose in the blood stream – typical of diabetes.
6. Fat excess also affects the insulin-producing cells in the pancreas and many die off, further reducing the body’s ability to handle glucose.

Dr Cyrus and his professional partner Robby run a very successful coaching programme for diabetics and have helped many thousands of diabetics to reverse their insulin resistance and often reverse type 2 diabetes and its complications, but also dramatically improve control of type 1 diabetes, with a low-fat, high unrefined-carbohydrate diet, together with exercise.

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Exercise is very important in improving insulin resistance, especially when accompanied by a low-fat diet.  If you keep recharging the fat in your muscle and liver cells by a high fat diet, the exercise is not going to be nearly as efficient at burning up that fat.

Another powerful mechanism to reduce intracellular fat and improve insulin resistance is intermittent fasting – which we will cover in another article.  But the benefits of intermittent fasting are dramatically reduced if you continue eating a high fat diet.

Here is a detailed explanation of the safe foods, low in fats that will enhance insulin sensitivity, and give amazing long term health.

I challenge you, if you are battling with your diabetes or insulin resistance, to seriously consider a low-fat, whole-food, plant-based diet, together with increasing your exercise and avoiding eating late at night.

To a new dawn in your diabetes control,

Dave Glass

Dr David Glass graduated from UCT in 1975. He spent the next 12 years working at a mission hospital in Lesotho, where much of his work involved health education and interventions to improve health, aside from the normal busy clinical work of an under-resourced mission hospital.

He returned to UCT in 1990 to specialise in obstetrics/gynaecology and then moved to the South Coast where he had the privilege of, amongst other things, ushering 7000 babies into the world. He no longer delivers babies but is still very clinically active in gynaecology.

An old passion, preventive health care, has now replaced the obstetrics side of his work. He is eager to share insights he has gathered over the years on how to prevent and reverse so many of the modern scourges of lifestyle – obesity, diabetes, ischaemic heart disease, high blood pressure, arthritis, common cancers, etc.

He is a family man, with a supportive wife, and two grown children, and four beautiful grandchildren. His hobbies include walking, cycling, vegetable gardening, bird-watching, travelling and writing. He is active in community health outreach and deeply involved in church activities. He enjoys teaching and sharing information.

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