GENES LOAD THE GUN, BUT LIFESTYLE PULLS THE TRIGGER

Do you remember those times (let's agree that from a sentimental point of view ... beautiful) when we went on vacation and the only way to communicate with our parents was the only phone in the shed, to which you had to walk a long way.  Those of you who were lucky enough to have, or have your grandparents in the village will remember one store far away from home, a bus stop to which you had to run a long distance, and trips to the market, where you could buy unprocessed products straight from the farmer's hands.

I am sad to say that as a society we have lost the incentive to do physical activity.  

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Paradoxically, technological development, widespread access to transportation, and all the conveniences that are supposed to make our lives easier, have led to a situation where many people do not need to take more than 1000 steps a day to get to work, perform the tasks assigned by their employers, return home, and do some shopping on the way. I'm writing this not to deny or undermine the progress of civilization, but to put into a broader context a world in which chronic fatigue and the expressly increasing number of metabolic diseases must make you think.

Human nature cannot be fooled. We are amazing creatures who on the one hand take over the world, and on the other succumb to the temptations of an easy, fast, low-energy life.

Quick meals, processed foods, foods deprived of all nutritional value come to our aid.

The television, which fortunately is losing its influence on people's attitudes, for years "made us believe" that all those beautifully packaged, frozen, quick-to-prepare things are healthy, that the drinks that all athletes drink and the Santa Claus on the tarp of a truck lit up with lampposts are the quintessence of proper hydration, the essence of happiness and family atmosphere 😉 .  

That being said, there is a plague of insulin resistance, type 2 diabetes, obesity, and lack of motivation for any physical activity.  Below I will give you the most important information about insulin resistance and pre-diabetic state. You will see if these two situations differ in general, how it can be avoided and if it can be cured. Enjoy reading:)

What is insulin?

Insulin is a hormone produced by the pancreas. Since everything in nature is for something...insulin helps glucose from the blood to enter the cells in your muscles, fat and liver, where it is used to make energy. The source of glucose is the meals you eat. The more meals, the higher the Glycemic Index of the foods, the more glucose and the harder the pancreas works. (Coming soon, an article about the Glycemic Index 🙂 When after a meal, blood glucose levels rise, the pancreas releases insulin. Insulin then lowers blood glucose levels to maintain normal blood glucose levels.

What is the liver's role in glucose metabolism?

The liver is particularly important for maintaining normal blood glucose levels. It is where excess glucose is stored, in the form of glycogen, among other things. It removes excess glucose from the blood, stores it, and then returns it to the blood when the glucose level starts to drop too low, e.g. during a hunger strike.

This is called the liver's buffering function. In a person with impaired liver function, blood glucose levels after a carbohydrate-rich meal can rise two to three times higher than in a person with normal liver function.

See how important it is to take care of your liver and it's not just about alcohol....!!because it's obvious.

What is insulin resistance?

Insulin resistance occurs when your muscle, fat and liver cells do not respond well to insulin and cannot easily take up glucose from the blood. As a result, your pancreas makes more insulin to help glucose get into the cells. As long as your pancreas can make enough of this hormone to overcome your cells' poor response to insulin, your blood glucose levels will remain normal.

What is a pre-diabetic condition?

Pre-diabetes occurs when fasting blood glucose levels are higher than normal, but not high enough to be diagnosed with diabetes. The fasting blood glucose level at which pre-diabetes is diagnosed is (100-125 mg/dl).

Pre-diabetes can also be diagnosed with an OGTT (an oral glucose load test called a sugar curve) when the glucose level after 2 hours is 140-199 mg/dl. Pre-diabetes usually occurs in people who already have some degree of insulin resistance, or whose pancreas is not producing enough insulin. Without enough insulin, extra glucose remains in the blood instead of entering cells. Over time, this can lead to the development of type 2 diabetes.

Who can develop insulin resistance or pre-diabetes?

People who are genetically predisposed and live an unsuitable lifestyle are more likely to develop insulin resistance, or pre-diabetes. In future articles you will see what I mean by "inadequate lifestyle"!!!) A perfectly fitting statement regarding insulin resistance and pre-diabetes is the phrase repeated like a mantra by my Australian physician colleagues:

"...genes load the gun, but lifestyle pulls the trigger ...".

GENES LOAD THE GUN, BUT LIFESTYLE PULLS THE TRIGGER  

Risk factors for developing OI, are :

- overweight or obese
- 45 years or older
- Parent, brother or sister with diabetes
- lack of physical activity
- High blood pressure and abnormal cholesterol levels
- History of gestational diabetes
- a history of heart disease or stroke
- polycystic ovary syndrome, also called PCOS
- people with metabolic syndrome - a combination of high blood pressure, abnormal cholesterol and obesity - are more likely to develop type 2 diabetes.
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In addition to the above risk factors for developing insulin resistance, there are others, as follows:

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- use of certain medications such as, glucocorticoids, some antipsychotics, and some HIV medications
- hormonal disorders such as Cushing's syndrome and acromegaly
- sleep problems, especially sleep apnea

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Although we have no influence on genetic factors for the time being, we can change these elements related to lifestyle; food, physical activity and weight. These lifestyle changes can lower the risk of developing insulin resistance, or pre-diabetes. In those individuals diagnosed with OI, it is possible for the OI to regress under the influence of lifestyle changes and modification of eating habits.

What are the symptoms of insulin resistance and pre-diabetes?

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Constant fatigue, lethargy, decreased exercise tolerance, headache, lowered mood, and attacks of ravenous hunger are just a few of the symptoms that can accompany insulin resistance.  

Not a day goes by in an internal medicine office without at least a few patients reporting these symptoms and worrying about their health.  

The symptoms above are not just reserved for insulin resistance and pre-diabetes, but one direction the diagnosis should go in this case is IO and SP.

I believe, based on MANY years of experience and observation, that diagnosis for OI should be made in the following individuals:  

- people who are trying to lose weight, but despite intense attempts and hectoliters of sweat poured out, they do not achieve the expected results
- men with abdominal obesity: usually with already diagnosed hypertension
- people who have started sweating more intensely
- anyone with liver steatosis visible on ultrasound
- women with menstrual disorders  
- anyone who has noticed for some time a decrease in energy, increased sleepiness, decreased concentration, decreased exercise tolerance
- women with hypothyroidism  
- women who have been diagnosed with PCOS