Gabe Mirkin, M.D.
This week, a study showed that people who have normal
weight at the time of their diagnosis of diabetes are twice as
likely to die over the next 10 to 30 years as those who are
overweight at the time of diagnosis (Journal of the American
Medical Association. August 8, 2012). THIS DOES NOT MEAN THAT
OBESITY PROTECTS DIABETICS FROM DEATH. It means that if you are
thin when you develop diabetes, you have a type of diabetes that
is more likely to kill you.
THE MOST COMMON CAUSE OF DIABETES: Type II diabetes is most
commonly caused by inability of your cells to respond to insulin.
When blood sugar levels rise too high, your pancreas releases
large amounts of insulin. Insulin then attaches on insulin
receptors, special hooks on the outer membranes of cells. Then it
drives sugar into cells. ANYTHING THAT PREVENTS INSULIN FROM
ATTACHING TO ITS RECEPTORS CAN CAUSE DIABETES. If insulin cannot
attach to its receptors, it cannot drive sugar into cells. This
causes blood sugar levels to rise too high, and sugar attaches to
the outer membranes of cells. Sugar attached to cell membranes is
eventually converted to sorbitol which destroys the cells. This
cell destruction is what causes all of the known side effects of
diabetes. FULL FAT CELLS BLOCK INSULIN RECEPTORS. Fat inside
cells prevents insulin from attaching to its receptors, so having
extra fat in your body causes diabetes.
STORING FAT PRIMARILY IN YOUR BELLY IS A SIGN OF DIABETES.
Insulin causes fat to be stored in the belly, so almost all people
with big bellies and small buttocks have high insulin levels
because their cells cannot respond to insulin, and the pancreas
responds by producing excessive amounts of insulin. Most people
who store a lot of fat in their bellies and have small buttocks
already have diabetes or are pre-diabetic.
LACK OF MUSCLES CAN CAUSE DIABETES: Muscles help to prevent
blood sugar levels from rising too high and damaging the cells in
your body. Resting muscles are inactive and draw no sugar from
the bloodstream. On the other hand, contracting muscles actively
remove sugar from the bloodstream and don’t even need insulin to
WHY ARE PEOPLE WHO ARE FAT WHEN THEY ARE DIAGNOSED EASY TO
CURE? Virtually all people who are fat when they develop diabetes
can cure their diabetes by losing weight. When they empty their
muscle, liver and fat cells of fat, these cells can once again
respond to insulin. Blood sugar levels drop and the person is no
WHY ARE PEOPLE WHO ARE NOT FAT WHEN THEY ARE DIAGNOSED WITH
DIABETES MORE DIFFICULT TO CURE? More than 90 percent of
diabetics are overweight. Thin people who develop diabetes do not
have full fat cells. They are diabetic because:
* Their pancreas does not make enough insulin. We have drugs to
make the pancreas put out more insulin, but we do not have drugs
to permanently make the pancreas produce normal amounts of
* Their muscles are so small that they do not remove sugar from
the bloodstream adequately. Lifting weights would help, but
growing large muscles is beyond the motivation of most people with
small muscles. It takes a lot of consistent painful resistance
exercise to grow larger muscles.
* They may have other hormone abnormalities that are far more
difficult to treat.
WHAT SHOULD YOU DO IF YOU ARE DIAGNOSED WITH DIABETES,
STORE FAT PRIMARILY IN YOUR BELLY, HAVE VERY SMALL BUTTOCKS,
HAVE A FASTING BLOOD SUGAR LEVEL ABOVE 100, OR HAVE AN HBA1C
* Immediately try to lose fat by eating less and exercising more
* Start a supervised exercise program and try to exercise every
* Start a supervised weight lifting program to grow larger muscles
* Avoid all sugared drinks except when you exercise
* Avoid all sugar-added foods
* Avoid red meat (saturated fat from animals blocks insulin
* Eat large amounts of vegetables and fruits
* Get your blood levels of hydroxy-vitamin D above 75 nmol/L
Gabe Mirkin, M.D.