All about insulin

So now that the initial diabetic freakout has passed I've begun doing a little more in-depth research about diet, nutrition, hormones, neurotransmitters – the whole "body" thing. Today I want to take note of a few things I've learned that I want to remember. I always thought I knew a lot about all this stuff ... and I still think I did ... but I didn't know there was so much more to know. It's exciting to have a new topic to look into – something that really matters, for a change! None of this "I wonder how spores really work," or "What happens again when you mix bleach and ammonia?" The random years of trivia I have stuffed into my brain ...

1. Eating too much of anything can raise blood sugar – not just eating too much carbohydrate. Eating too much sand could do it, or paper – anything with bulk. This is because when your small intestine gets really full, the cells that line it begin to stretch, and in doing so they release chemicals that signal the pancreas to dump insulin into your blood (to help handle the large amount of "food" you ate). And then, because your pancreas knows that insulin lowers blood sugar, and that lowering it too much is potentially life-threatening, it also releases other hormones that signal the liver and to a lesser extent the muscles to dump glucose into the blood. In a normal person this is a good thing, because it keeps everything balanced. In a diabetic person, it's not so good – because as a diabetic, you're by nature broken down in the glucose-lowering part of this pancreatic equation, so all you get is the glucose-increasing part. I already knew the liver could release glucose (it's called gluconeogenesis, if you really want to know) but I didn't know that bit about the stretching of those intestinal cells. It makes me think back sadly on all those times I worked 12-hour days without taking any breaks to eat (or ate nothing but a few handfuls of m&ms from the bowl on the old light table), then came home late, exhausted and depressed, and tried to catch up on a whole day's worth of food just before bed ... Sometimes I still can't believe I ever allowed me to do that to myself.

2. Eating carbohydrate along with fat causes you to gain more weight faster than eating fat without carbs. In fact, I'm learning that this whole "don't eat fat!" hysteria of the past 30 or so years is most likely responsible for much of the so-called "obesity epidemic," because when people think they can't eat fat, they bulk up on carbs, and THAT is what causes people to gain weight (it also wreaks havoc on your blood lipids, but that's another topic). Again, it's all about insulin: this is the hormone that allows excess calories to be stored as fat, and it's only released when you eat carbohydrate – not fat. Not dealing at the moment with protein (the third component of food), the thing I want to remember here is that eating carbs with fat causes more insulin to be present in my blood at the same time as all those calories, which means eating those two things together will probably make me fatter than just eating fat alone. Something else that seems relevant here is that I am not in fact insulin deficient – I'm insulin resistant, which means I actually have more insulin in my blood that I probably should – which is why I've been so predisposed to gain weight all these years. What hung me up there was the fact that it never occurred to me that just because my body can't efficiently use insulin for glucose transport, doesn't mean it can't still use it for fat-building. It can, and does.

3. Understanding this "thrifty gene" concept – not really news to me, but interesting – is making me feel not so guilty about having gotten so fat. The current conventional wisdom has it that fat people are basically just lazy, gluttonous, disgusting, and entirely responsible for their own repulsive and reprehensible bodies and lives. And yeah, I could've exercised more over the years, and eaten different things, and less of them. But I'm finding some interesting studies that indicate that the ability to gain that much weight in the first place is a sign that there's something more going on. It's not just a behavior – it's a genetic variation that allows some animals to survive up to six times longer without food than other animals. Here's a quote:

"... Although it may be simplifying somewhat, the mechanism essentially works like this: Those who naturally craved carbohydrate and consumed it whenever it was available, even if they weren't hungry, would have made more insulin and thereby stored more fat. Add to this the additional mechanism of the high insulin levels caused by inherited insulin resistance, and serum insulin levels would have become great enough to induce fat storage sufficient to enable them to live through famines."

Somehow just reading that passage again made me want to cry ... It really wasn't my fault that I was hungry all the time. All those years of feeling guilty about my hunger ... unnecessary. And my response to that guilt – to repudiate it, renounce it, reject it – because I did and still do believe that guilt is one of the most toxic emotions to indulge in (once its initial usefulness in identifying and correcting areas of disharmony has been explored) – my response was to say, "Screw you, Guilt – I am hungry, and I am going to eat until I'm not hungry anymore!" I was only trying to take care of myself. But all that overeating – also unnecessary. I just didn't know. I didn't know that there was any other way to deal with intense hunger than to eat. Because I always knew the hunger was real – not "emotional eating" or "stuffing my feelings" or any of the other terms supposedly well-meaning people use to try to make you feel like being HUNGRY is your own shameful fault because you're too weak, or emotionally out of touch with yourself, or unwilling to face your personal demons, or whatever – basically, too much of a loser to simply exercise a little self-control for once in your life, for crying out loud.

Whew! Lots of emotion still attached to that one, I see.

Anyway, I always knew it wasn't that. I really was hungry. Plus, facing down demons is something I know I am good at doing. And willing to do as often and for as long as necessary.

4. This one is actually not so much related to insulin, but I'll mention it anyway: I'm enjoying losing weight. It amazes me that it can be so easy to do, now that I understand more about how my own personal body works with various kinds of food and exercise. Lifting weights, for example. I've just added that to my bike-riding routine as a way of building more muscle, because muscle uses more glucose than other kinds of tissue, which decreases blood glucose, which decreases insulin resistance, which decreases the amount of insulin in your blood, which decreases your tendency to store calories as fat. I'm still losing weight pretty slowly – about a pound a week on average – actually, more than that, because I just counted and it's been only 19 weeks (wow!) since my diagnosis, so if I do the math (one moment ...) that actually works out to around 1.75 lbs a week. Not so bad. Nevermind for now that I'm only about halfway to where I need to be with all this ... I am halfway there, and that feels pretty good.