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MANAGING DIABETES WITH DIET AND EXERCISE The Price of Greatness Why excess body fat contributes to type 2 diabetes Gary Scheiner, MS, CDE By now, we’ve all seen the list at least a hundred times: RISK FACTORS FOR TYPE 2 DIABETES. It includes things like having a family history of diabetes (a factor we can’t do anything about); and belonging to certain ethnic groups (another factor we can’t do anything about); advancing age (makes sense… body starts to wear down); lack of physical activity (also makes sense… not burning as much sugar as we need to); and having had diabetes during pregnancy. It also includes one more item: BEING OVERWEIGHT. First, let’s get the meaning straight. We’re not talking about being big and muscular. We’re talking about having too much body fat. What is it about excess body fat that puts us at an increased risk for type 2 diabetes? It all comes down to something called “insulin resistance”. Behind the Resistance Insulin is a hormone made by the beta cells of an organ called the pancreas. Its job is to take glucose (sugar) out of the bloodstream and pack it into the body’s cells where it is either stored or burned for energy. In order to do its job, insulin connects to a receptor on the surface of the cell, like a key entering a door lock. Once insulin connects to the receptor, the cell allows the big sugar molecules to enter the cell, like turning the lock and opening the door. Without insulin, sugar cannot get into the cells, and the blood sugar level stays too high. For insulin to do its job, the cells must work properly. Insulin “resistance” means that there are problems with the receptors on the cell or actions inside the cell, like the lock being broken or the door being jammed. Insulin’s strength is lower when the body’s cells are insulin resistant. Not enough glucose is shuttled into the cells, and too much glucose remains in the bloodstream. Around 60 to 75 million Americans are insulin resistant. Why, then, do only some people with insulin resistance develop type 2 diabetes? Because in many cases, the beta cells of the pancreas make enough extra insulin to keep blood sugar levels in a normal range. However, if the pancreas cannot produce enough extra insulin, diabetes develops. In other words, you must have both insulin resistance and reduced beta cell function for type 2 diabetes to appear. 1
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This note was uploaded on 10/23/2010 for the course HED Hed44 taught by Professor Owens during the Fall '09 term at Pasadena City College.

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