Insulin and its role in ensuring the vital activity of the body. The functional role of insulin in the body The effect of insulin

The word "insulin" is familiar to many. It is injected to diabetics so that their body can absorb sugar. But it's not just insulin. How is it produced and why can't a person live even a day without it?

Production of insulin in the body

The pancreas is responsible for the production of insulin - for this it has special beta cells. In the human body, this hormone regulates the metabolism of carbohydrates, and therefore its secretion is vital. How does this happen? The process of insulin production is multi-stage:

1. First, the pancreas produces preproinsulin (a precursor to insulin).
2. At the same time, a signal peptide (L-peptide) is produced, the task of which is to help preproinsulin get into the beta cell and turn into proinsulin.
3. Further, proinsulin remains in a special structure of the beta cell - the Golgi complex, where it matures for a long time. At this stage, proinsulin is cleaved into C-peptide and insulin.
4. The produced insulin reacts with zinc ions and remains in this form inside the beta cells. In order for it to enter the blood, glucose in it must have a high concentration. Glucagon is responsible for the suppression of insulin secretion - it is produced by the alpha cells of the pancreas.

The most important task of insulin is to regulate the metabolism of carbohydrates by acting on insulin-dependent tissues of the body. How does this happen? Insulin binds to the cell membrane receptor (membrane), and this triggers the work of the necessary enzymes. The result is the activation of protein kinase C, which is involved in the metabolism inside the cell.

Insulin is needed in the body to maintain a constant level of sugar in the blood. This is achieved due to the fact that the hormone:

• Helps improve glucose uptake by tissues.
• Reduces the activity of glucose production in the liver.
• Starts the work of enzymes responsible for the breakdown of blood sugar.
• Accelerates the transition of excess glucose into glycogen.

The level of insulin in the blood also affects other body processes:

• Assimilation by cells of amino acids, potassium, phosphorus and magnesium ions.
• The conversion of glucose in the liver and fat cells into triglycerides.
• Production of fatty acids.
• Correct reproduction of DNA.
• Suppression of protein breakdown.
• Decrease in the amount of fatty acids entering the blood.

Insulin and blood glucose

How is blood glucose regulated by insulin? In a non-diabetic person, blood sugar stays about the same even when they haven't eaten for a long time, as the pancreas produces insulin in the background. After eating, carbohydrate foods are broken down in the mouth into glucose molecules, and they enter the bloodstream. The glucose level rises and the pancreas releases the accumulated insulin into the bloodstream, normalizing the amount of blood sugar - this is the first phase of the insulin response.

Then the gland again produces a hormone to replace the one spent, and slowly directs new portions to the breakdown of sugars absorbed in the intestine - the second phase of the response. The remaining unused excess glucose is partially converted into glycogen and deposited in the liver and muscles, and partially becomes fat.

When some time passes after eating, the amount of glucose in the blood decreases and glucagon is released. Due to this, the glycogen accumulated in the liver and muscles is broken down into glucose, and the blood sugar level becomes normal. Left without a store of glycogen, the liver and muscles receive a new portion of it at the next meal.

Norm

The level of insulin in the blood shows how the body processes glucose. The norm of insulin in a healthy person is from 3 to 28 mcU / ml. But if high sugar is combined with high insulin, this may mean that tissue cells are resistant (insensitive) to the hormone that the gland produces in normal quantities. A high blood glucose level and a low insulin level indicate that the body lacks the hormone produced, and the blood sugar does not have time to break down.

Enhanced Level

Sometimes people mistakenly believe that increased insulin production is a favorable sign: in their opinion, in this case, you are insured against hyperglycemia. But in fact, the immoderate release of the hormone is not beneficial. Why does it happen?

Sometimes this is due to a tumor or hyperplasia of the pancreas, diseases of the liver, kidneys and adrenal glands. But most often, increased insulin production occurs in type 2 diabetes, when the hormone is produced in a normal amount, and tissue cells “do not see” it - insulin resistance occurs. The body continues to release the hormone and even increases its amount, trying in vain to deliver carbohydrates into the cells. Therefore, in type 2 diabetes, the level of insulin in the blood is constantly higher than normal.

Scientists believe that the reason why the cell ceases to perceive insulin is genetics: nature provides that insulin resistance helps the body survive hunger, making it possible to stock up on fat in prosperous times. For modern society In developed countries, hunger has not been relevant for a long time, but the body, out of habit, gives a signal to eat more. Fat accumulations are deposited on the sides, and obesity becomes a trigger for metabolic disorders in the body.

Reduced level

Low insulin can indicate type 1 diabetes, when a lack of the hormone leads to incomplete utilization of glucose. Symptoms of the disease are:

• Frequent urination.
• Strong constant thirst.
• Hyperglycemia - glucose is in the blood, but due to a lack of insulin it is not able to cross the cell membrane.

An endocrinologist should deal with the reasons for a decrease or increase in insulin production - you need to contact him with blood tests.

The main reasons for the decrease in insulin production are:

• Improper nutrition, when a person prefers fatty, carbohydrate, high-calorie foods. Therefore, the insulin that the pancreas produces is not enough to break down the incoming carbohydrates. The production of the hormone increases, and the beta cells responsible for this are depleted.
• Chronic overeating.
• Stress and lack of sleep depress insulin production.
• Deterioration of immunity as a result of chronic diseases and as a result of past infections.
• Physical inactivity - due to a sedentary lifestyle, blood glucose increases, and the amount of insulin produced by the body decreases.

The hormone insulin is produced by the pancreas in response to food intake. It helps the body use energy from food by directing nutrients to the cells. When the digestive tract breaks down carbohydrates into glucose, insulin directs the glucose to storage sites - muscle glycogen, liver glycogen, and adipose tissue.

Agree, it would be great if our muscles were fed with carbohydrates, but insulin does not care where to send them. Skinny people can benefit from stimulating it after workouts to build muscle, but overweight people should keep it steady most of the time.

Insulin should not be afraid, because in addition to its anabolic functions (building muscle and fat cells), it prevents the breakdown of muscle protein, stimulates glycogen synthesis, and ensures the delivery of amino acids to the muscles. Its main function is to maintain a safe blood sugar level.

Problems begin when insulin sensitivity decreases. For example, a person regularly eats sweets and gets fat. He gets fat not because of insulin, but because of excess calories, but in his body insulin is constantly at a high level - it constantly comes into play with blood sugar, trying to lower it to a safe level. Obesity in itself creates a load on the body and changes the lipid composition of the blood, but the increased secretion of insulin affects the pancreas in such a way that its cells lose sensitivity to it. This is how type 2 diabetes develops. Of course, this does not happen in a week or two, but if you abuse sweets, you are at risk.

Increased secretion of insulin blocks the breakdown of internal fat stores. As long as there is a lot of it, you will not lose weight. It also reduces the use of fat as an energy source by diverting the body to carbohydrates. How does this relate to nutrition? Let's consider.

The body produces insulin in response to food intake. There are three concepts that help control its level - this is the glycemic index (GI), glycemic load (GL) and insulin index (II).

The glycemic index measures how your blood sugar rises after you eat a carbohydrate meal. The higher the index, the faster the sugar rises and the more insulin the body produces. Low GI foods tend to be more (whole grains, greens, and non-starchy vegetables), while high GI foods tend to be low in fiber (processed cereals, potatoes, sweets). So, white rice has a GI of 90, while brown rice has a GI of 45. During heat treatment, dietary fiber is destroyed, which increases the GI of the product. For example, the GI of raw carrots is 35, and that of boiled carrots is 85.

Glycemic load allows you to find out how a particular serving of carbohydrate food will affect the body. Scientists from Harvard found that the larger the serving of carbohydrates, the higher the insulin surge. Therefore, portions should be controlled.

To calculate the load, the formula is used:

(Product GI / 100) x carb content per serving.

Low GN - up to 11, medium - from 11 to 19, high - from 20.

For example, a standard 50 g serving of oatmeal contains 32.7 carbohydrates. The GI of oatmeal is 40.

(40/100) x 32.7 = 13.08 - average GN.

Similarly, we calculate a serving of ice cream ice cream 65 g. The glycemic index of ice cream is 60, a serving is 65 g, carbohydrates in a serving are 13.5.

(60/100) x 13.5 = 8.1 - low GN.

And if for the calculation we take a double portion of 130 g, we get 17.5 - close to high GN.

The insulin index shows how this hormone rises in response to. Eggs, Cheese, Beef, Fish and Beans have the highest AI. But you remember that this hormone is involved in both the transport of carbohydrates and the transport of amino acids. Therefore, this parameter should be kept in mind for people with diabetes. For others, it is less important.

Products with low glycemic index will allow not only to reduce the secretion of insulin, but also provide due to the content of fiber. Such products should form the basis of the diet of losing weight.

Cleansing of dietary fiber and heat treatment increase the GI of food when fiber in the diet and the presence of fat slow down the absorption of foods. The slower the absorption, the lower the rise in blood sugar and the lower the production of insulin. Try to eat, do not avoid vegetables and.

Portion control is important. The larger the serving, the greater the load on the pancreas and the more insulin the body releases. In this case it might help. By eating fractionally, you will avoid high glycemic load and hormonal surges.

Excess food of any kind leads to obesity, and obesity often causes diabetes. You should create and control the quality and quantity of carbohydrates in it. People with poor insulin sensitivity should eat fewer carbs but more protein and fat as part of their calorie intake.

You can determine your sensitivity subjectively. If after a large portion of carbohydrates you feel alert and energetic, then your body produces insulin normally. If you feel tired and hungry after an hour, then your secretion is increased - you should.

A calorie deficit, fractional meals, low GI food choices, portion control, and carbohydrate control will help keep insulin levels stable and lose weight faster. However, in case of any suspicion of diabetes, it is necessary to urgently seek the advice of a doctor.

Receptors for insulin are found mainly in the liver, muscles and adipose tissue. They consist of 2 α-subunits located outside the cell and being a recognition part, and 2 β-subunits that pierce the cell membrane through and have tyrosine kinase activity. Insulin binds to α-subunits, increases the activity of tyrosine kinase of β-subunits, which leads to phosphorylation of proteins inside the cell: proteins that transport glucose, proteins that transport potassium and phosphate ions into the cell, hexokinase, glycogen synthetase, and others, which leads to a change in metabolic processes. The insulin-receptor complex then enters the cell, where it breaks down. The receptor is again integrated into the membrane, and insulin promotes the uptake of amino acids by cells, activates the functions of the ribosomal protein, and then is digested by lysosomes.

Physiological effects of insulin.

Hypoglycemic action: increases glucose transport through cell membranes, activates glucose phosphorylation, increases glycogen synthesis, inhibits glycogenolysis and gluconeogenesis.

Effect on fat metabolism: activates the formation and deposition of triglycerides, inhibits the conversion of fatty acids into keto acids, reduces lipolysis by inhibiting intracellular lipase.

Effect on protein metabolism: increases the synthesis of proteins from amino acids, inhibits the conversion of amino acids into keto acids.

The use of insulin:

For the treatment of diabetes.

Children develop diabetes Type 1, caused by destruction of pancreatic β-cells and absolute insulin deficiency (autoimmune, idiopathic).

Dosing of insulin: depending on the level of glucose in the blood, glucosuria, acetonuria. 1 unit of insulin utilizes 2.5-5 g of sugar. More precisely: 1 unit of insulin reduces glycemia by 2.2 mmol/l (normal fasting glucose = 3.3-5.5 mmol/l) or 0.3-0.8 units/kg of body weight per day.

First take the maximum figure, then the dose is selected individually. During the selection of the dose of insulin, the level of glucose in the blood is measured up to 7-9 times a day. Children are much more sensitive to insulin than adults.

Insulin regimens.

- traditional: short-acting insulin is injected subcutaneously or intramuscularly 4-5 times a day 30 minutes before meals.

- basal bolus (intensified): short-acting insulin 30 minutes before meals + injections of medium- and long-acting insulins, they provide basal insulin levels, but do not eliminate postprandial hyperglycemia, which is eliminated by short-acting insulins (best - humalog).

Insulins are also used

- to increase appetite with a lack of body weight,

- as part of polarizing therapy,

- with type 2 diabetes mellitus,

- with schizophrenia (coma therapy).

Side effects:

hypoglycemia(more difficult than hyperglycemia):

Tachycardia, sweating, tremor, nausea, hunger, central nervous system dysfunction (confusion, strange behavior), encephalopathy, convulsions, coma.

Help: easily digestible breakfast, sweetness. With a coma in / in a 40% glucose solution.

Lipodystrophy at the injection sites of insulin - the disappearance or increase in the deposition of subcutaneous fat. It develops as a result of the introduction of poorly purified insulins, in violation of the technique of administering the drug (cold, superficial administration (must be deep subcutaneously)) injection into the same place. Insulin is absorbed most quickly and completely from the subcutaneous tissue of the anterior abdominal wall, more slowly from the shoulder area, anterior thigh surface, and very slowly from the subscapular region and buttocks. No more than 16 IU of insulin is administered in one place, 1 time in 60 days.

allergic reactions(itch, rash, anaphylactic shock). This is the result of poor purification of insulin, for preservatives, for animal insulin. It is necessary to transfer the patient to a less immunogenic drug (human insulin), prescribe antihistamines, GC.

Edema of the brain, lungs, internal organs.

Weight gain ( obesity).

β-cell atrophy, insulin resistance(develops when the need for insulin is more than 2 units / kg of body weight, with the introduction of more than 60 units per day).

diabetic coma.

Ketoacidotic

Hyperosmolar

lactic acidosis

Electrolyte shifts, metabolic disorders, loss of consciousness, inhibition of reflexes, anuria, hemodynamic disorders.

Differentiation is difficult: i.v. 40% glucose solution.

Treatment:

In / in drip short-acting insulin (10-20 IU) + glucose as needed.

Additionally, subcutaneously or intramuscularly 5-10 units of insulin while monitoring glucose levels.

Infusion therapy - isotonic solutions of sodium chloride, potassium chloride.

When blood pH is less than 7.0, intravenous sodium bicarbonate solution.

Cocarboxylase to reduce the level of ketone bodies.

Non-insulin-dependent diabetes mellitus type 2

Oral hypoglycemic agents are prescribed, which are not used in pediatrics.

Oral hypoglycemic agents

Elevated blood sugar is the main symptom of diabetes and a major problem for diabetics. Elevated blood glucose is almost the only cause of diabetes complications. In order to effectively control your disease, it is desirable to have a good understanding of where glucose enters the bloodstream and how it is used.

Read the article carefully - and you will find out how blood sugar regulation occurs normally and what changes with impaired carbohydrate metabolism, i.e. with diabetes.

Dietary sources of glucose are carbohydrates and proteins. The fats we eat have absolutely no effect on blood sugar levels. Why do people like the taste of sugar and sugary foods so much? Because it stimulates the production of neurotransmitters in the brain (especially serotonin), which reduce anxiety, induce a feeling of well-being, and even euphoria. Because of this, some people become addicted to carbohydrates, as powerful as addiction to tobacco, alcohol or drugs. People dependent on carbohydrates have a reduced level of serotonin or reduced sensitivity of receptors to it.

How insulin works

Insulin is a means to deliver glucose - fuel - from the blood into the cells. Insulin activates the action of “glucose transporters” in cells. These are special proteins that move from the inside to the outer semi-permeable membrane of cells, capture glucose molecules, and then move them to internal “power plants” for burning.

In the cells of the liver and muscles, glucose enters under the action of insulin, as well as in all other tissues of the body, except for the brain. But there it is not burned immediately, but is deposited in reserve in the form glycogen. It is a substance similar to starch. If there is no insulin, then the glucose transporters work very poorly, and the cells absorb it insufficiently to maintain their vital functions. This applies to all tissues, except for the brain, which consumes glucose without the participation of insulin.

Another effect of insulin in the body is that under its influence, fat cells take glucose from the blood and turn it into saturated fats, which they accumulate. Insulin is the main hormone that stimulates obesity and prevents weight loss. The conversion of glucose to fat is one of the mechanisms by which insulin lowers blood sugar levels.

If the blood sugar level drops below normal and the reserves of carbohydrates (glycogen) have already been exhausted, then the process of converting proteins into glucose starts in the cells of the liver, kidneys and intestines. This process is called "gluconeogenesis" and is very slow and inefficient. At the same time, the human body is not able to convert glucose back into proteins. We also don't know how to convert fat into glucose.

In healthy people, and even in most people with type 2 diabetes, the pancreas in the “fasting” state all the time produces small portions of insulin. Thus, at least a little insulin is constantly present in the body. This is called "basal", i.e., "basic" concentration of insulin in the blood. It signals to the liver, kidneys, and intestines that it is not now necessary to convert proteins into glucose in order to raise blood sugar levels. The basal concentration of insulin in the blood "inhibits" gluconeogenesis, i.e. prevents it.

Blood sugar levels - official and real

In healthy people without diabetes, blood glucose concentrations are neatly maintained within a very narrow range of 3.9 to 5.3 mmol/L. If you take a blood test at a random time, regardless of meals, from a healthy person, then his blood sugar will be about 4.7 mmol / l. We need to strive for this figure in diabetes, that is, blood sugar after eating is not higher than 5.3 mmol / l.

Traditional blood sugar levels are too high. They lead to the development of complications of diabetes within 10-20 years. Even in healthy people, after a meal saturated with fast-absorbing carbohydrates, blood sugar can jump up to 8-9 mmol / l. But if there is no diabetes, then after eating it will drop to normal within a few minutes, and nothing will be needed to do this. In diabetes, “joking” with the body by feeding it refined carbohydrates is strongly discouraged.

In medical and non-fiction books on diabetes, "normal" blood sugar levels are considered to be 3.3 - 6.6 mmol/L and even up to 7.8 mmol/L. In healthy people without diabetes, blood sugar never jumps to 7.8 mmol / l, unless if you eat a lot of carbohydrates, and in such situations it drops very quickly. Official medical standards for blood sugar are used so that the "average" doctor does not get too stressed out when diagnosing and treating diabetes.

If a patient's blood sugar after eating jumps to 7.8 mmol / l, then this is not yet officially considered diabetes. Such a patient is likely to be sent home without any treatment, with instructions to try to lose weight on a low-calorie diet and eat healthy food, i.e. eat more fruits. However, complications of diabetes develop even in people whose post-meal sugar does not exceed 6.6 mmol/l. Of course, it doesn't happen that fast. But within 10-20 years, it is realistic to acquire kidney failure or vision problems. Read more also "".

How is blood sugar regulated in a healthy person

Let's look at how insulin regulates blood sugar in a healthy person without diabetes. Suppose this person eats a disciplined breakfast, and for breakfast he has mashed potatoes with a cutlet - a mixture of carbohydrates with proteins. Throughout the night, his basal insulin concentration in his blood inhibited gluconeogenesis (read above for what this means) and maintained a stable blood sugar concentration.

As soon as food with a high content of carbohydrates enters the mouth, salivary enzymes immediately begin to decompose “complex” carbohydrates into simple glucose molecules, and this glucose is absorbed through the mucous membrane into the blood instantly. From carbohydrates, the blood sugar level rises instantly, although the person has not had time to swallow anything yet! This is a signal to the pancreas that it is time to urgently release a large number of insulin granules into the bloodstream. This powerful dose of insulin has been pre-produced and stored to be used when you need to cover up your post-meal sugar surge, in addition to your basal blood levels.

The sudden release of stored insulin into the bloodstream is called the “first phase of the insulin response”. It quickly lowers the initial spike in blood sugar caused by eating carbohydrates to normal and can prevent it from rising again. The stock of stored insulin in the pancreas is depleted. If necessary, she produces additional insulin, but this takes time. The insulin that slowly enters the blood in the next stage is called the “second phase of the insulin response”. This insulin helps to absorb glucose, which appeared later, after a few hours, during the digestion of protein foods.

As the meal is digested, glucose continues to enter the bloodstream, and the pancreas produces additional insulin to "neutralize" it. Some of the glucose is converted to glycogen, a starchy substance that is stored in muscle and liver cells. After some time, all the “capacities” for storing glycogen are filled. If there is still excess glucose in the bloodstream, then under the action of insulin it is converted into saturated fats, which are deposited in adipose tissue cells.

Later, our hero's blood sugar levels may start to drop. In this case, the alpha cells of the pancreas will begin to produce another hormone - glucagon. It acts as an insulin antagonist and signals to muscle and liver cells to convert glycogen back into glucose. With the help of this glucose, it is possible to maintain blood sugar stably in the norm. During the next meal, glycogen stores will be replenished again.

The described mechanism of glucose uptake with the help of insulin works great in healthy people, helping to keep blood sugar stable at normal levels - from 3.9 to 5.3 mmol / l. Cells get enough glucose to perform their functions and everything functions as intended. Let's look at why and how this circuit is disrupted in type 1 and type 2 diabetes.

What happens in type 1 diabetes

Let's imagine that in the place of our hero is a person with type 1 diabetes. Suppose he received an injection of “extended” insulin at night before going to bed and because of this he woke up with normal blood sugar. But if you do not take action, then after a while his blood sugar will begin to rise, even if he does not eat anything. This is due to the fact that the liver all the time gradually takes insulin from the blood and breaks it down. At the same time, for some reason, in the morning, the liver “utilizes” insulin especially intensively.

Extended insulin, which was pricked in the evening, is released smoothly and stably. But the speed of its release is not enough to cover the increased “appetite” of the liver in the morning. Because of this blood sugar can rise in the morning even if a person with type 1 diabetes is not eating anything. This is called the “dawn phenomenon”. The pancreas of a healthy person easily produces enough insulin so that this phenomenon does not affect blood sugar. But with type 1 diabetes, attention must be paid to “neutralize” it. Read how to do it.

Human saliva contains powerful enzymes that quickly break down complex carbohydrates into glucose, and it is instantly absorbed into the bloodstream. In a diabetic, the activity of these enzymes is the same as in a healthy person. Therefore, dietary carbohydrates cause sudden jump blood sugar. In type 1 diabetes, pancreatic beta cells make little or no insulin. Therefore, there is no insulin to organize the first phase of the insulin response.

If there was no injection of “short” insulin before meals, then blood sugar will rise very high. Glucose will not be converted into either glycogen or fat. Eventually, at best, excess glucose will be filtered out by the kidneys and excreted in the urine. While this happens, elevated blood sugar levels will cause tremendous damage to all organs and blood vessels. At the same time, the cells continue to “starve” without receiving nutrition. Therefore, without insulin injections, a type 1 diabetic patient dies within a few days or weeks.

Treatment of type 1 diabetes with insulin

What is a low-carbohydrate diet for diabetes? Why limit yourself to food choices? Why not just inject enough insulin to absorb all the carbs you eat? Because insulin injections don't properly "cover up" the rise in blood sugar that carbohydrate-rich foods cause.

Let's look at what problems usually occur in patients with type 1 diabetes and how to properly control the disease in order to avoid complications. It's vital important information! Today, it will be the “discovery of America” for domestic endocrinologists and, moreover, for diabetics. Without false modesty, you are very lucky to have landed on our website.

Insulin given through a syringe, or even through an insulin pump, works differently than insulin, which is normally produced by the pancreas. Human insulin in the first phase of the insulin response immediately enters the bloodstream and immediately begins to lower sugar levels. In diabetes, insulin injections are usually given into the subcutaneous fat. Some patients, who love risk and excitement, master intramuscular injections insulin (no need to do this!). In any case, no one injects themselves with insulin intravenously.

As a result, even the fastest insulin begins to act only after 20 minutes. And its full effect is manifested within 1-2 hours. Until then, blood sugar levels remain significantly elevated. You can easily verify this by measuring your blood sugar with a glucometer every 15 minutes after eating. This situation causes damage to the nerves, blood vessels, eyes, kidneys, etc. Complications of diabetes develop at full speed, despite the best intentions of the doctor and the patient.

Why the standard treatment of type 1 diabetes with insulin is not effective is described in detail at the link ““. If you follow a traditional “balanced” diet with type 1 diabetes, then the sad ending - death or disability - is inevitable, and it comes much faster than we would like. We emphasize once again that even if you switch to, it still will not help. Because she also injects insulin into the subcutaneous tissue.

What to do? The answer is to switch to diabetes control. On this diet, the body partially converts food proteins into glucose, and thus, blood sugar still rises. But this happens very slowly, and an injection of insulin allows you to gently “cover” the increase. As a result, it is possible to ensure that after a meal in a diabetic patient, blood sugar will not at any time exceed 5.3 mmol / l, that is, it will be absolutely like in healthy people.

Low-carbohydrate diet for type 1 diabetes

The fewer carbohydrates a diabetic eats, the less insulin he needs. On a low-carbohydrate diet, insulin doses immediately drop several times. And this is despite the fact that when calculating the dose of insulin before meals, we take into account how much it will be needed to cover the proteins eaten. Although at traditional therapy diabetes proteins do not count at all.

The less insulin a diabetic needs to inject, the lower the likelihood of the following problems:

• hypoglycemia - critically low blood sugar;
• fluid retention in the body and swelling;
• development of insulin resistance.

Let's imagine that our hero, a type 1 diabetic, switched to eating low-carbohydrate foods from. As a result, his blood sugar will not jump to “cosmic” heights at all, as it used to be when he ate a “balanced” diet rich in carbohydrates. Gluconeogenesis is the conversion of proteins into glucose. This process raises blood sugar, but slowly and insignificantly, and it is easy to "cover" it with a small dose of insulin shot before meals.

How does the body of a person with type 2 diabetes work?

Our next hero is a type 2 diabetic, weighing 112 kg at a rate of 78 kg. Most of his excess fat is on his stomach and around his waist. His pancreas is still producing insulin. But since obesity has caused a strong one, this insulin is not enough to keep blood sugar normal.

If the patient manages to lose weight, then insulin resistance will disappear and blood sugar will normalize so that the diagnosis of diabetes can be removed. On the other hand, if our hero does not urgently change his lifestyle, then the beta cells of his pancreas will “burn out” completely, and he will develop irreversible type 1 diabetes. True, few people live to see this - usually patients with type 2 diabetes are killed earlier by a heart attack, kidney failure or gangrene on their legs.

Insulin resistance is caused in part genetic reasons, but mostly it occurs due to the wrong lifestyle. Sedentary work and excessive consumption of carbohydrates lead to the accumulation of adipose tissue. And the more body fat in relation to muscle mass, the higher insulin resistance. The pancreas has been working with an increased load for many years. Because of this, she is exhausted, and the insulin she produces is no longer enough to maintain normal blood sugar. In particular, the pancreas of a type 2 diabetic does not store any stores of insulin. Because of this, the first phase of the insulin response is disrupted.

Interestingly, overweight type 2 diabetics usually produce no less insulin, but vice versa - 2-3 times more than their slender peers. In such a situation, endocrinologists often prescribe pills - sulfonylurea derivatives - which stimulate the pancreas to produce even more insulin. This leads to "burnout" of the pancreas, due to which type 2 diabetes turns into insulin-dependent type 1 diabetes.

Blood sugar after eating in type 2 diabetes

Let's consider how the breakfast of mashed potatoes with a cutlet, that is, a mixture of carbohydrates and proteins, will affect the blood sugar of our hero. Usually, in the early stages of type 2 diabetes, blood sugar levels in the morning on an empty stomach are normal. I wonder how it will change after eating? Consider that our hero boasts an excellent appetite. He eats 2-3 times more food than slender people of the same height.

How carbohydrates are digested, absorbed in the mouth and instantly raise blood sugar - we have already discussed before. In a type 2 diabetic, carbohydrates are absorbed in the same way in the mouth and cause a sharp jump in blood sugar. In response, the pancreas releases insulin into the blood, trying to immediately extinguish this jump. But since there are no ready stocks, an extremely small amount of insulin is released. It is called .

Our hero's pancreas is trying its best to produce enough insulin to lower blood sugar. Sooner or later, she will succeed, if type 2 diabetes has not gone too far and the second phase of insulin secretion has not been affected. But within a few hours, blood sugar will remain elevated, and during this time complications of diabetes develop.

Because of insulin resistance, the typical type 2 diabetic needs 2-3 times more insulin to absorb the same amount of carbohydrates than their lean counterpart. This phenomenon has two consequences. First, insulin is the main hormone that stimulates the accumulation of fat in adipose tissue. Under the influence of an excess amount of insulin, the patient becomes even fatter, and his insulin resistance increases. This is a vicious circle. Secondly, the pancreas works with an increased load, which is why its beta cells “burn out” more and more. Thus, type 2 diabetes becomes type 1 diabetes.

Insulin resistance causes cells to be unable to use the glucose that a diabetic receives from food. Because of this, he continues to feel hungry, even when he eats an already significant amount of food. Usually, a type 2 diabetic eats too much, until the stomach feels full, and this further exacerbates his problems. How to treat insulin resistance, read. This is a real way to improve health in type 2 diabetes.

Diagnosis and complications of type 2 diabetes

To confirm or refute the diagnosis of diabetes, illiterate doctors often prescribe a blood test for fasting sugar. Recall that in type 2 diabetes, fasting blood sugar levels remain normal for a long time, even if the disease progresses and complications of diabetes develop in full swing. Therefore, a blood test for sugar on an empty stomach is categorically not suitable! Take or, preferably in an independent private laboratory.

Suppose a person's blood sugar after eating jumps to 7.8 mmol / l. Many doctors in such a situation do not write a diagnosis of type 2 diabetes, so as not to register the patient and not engage in treatment. They justify their decision by saying that the diabetic still produces enough insulin, and sooner or later his blood sugar drops to normal after eating. However, you must immediately switch to healthy lifestyle life even when your post-meal blood sugar is 6.6 mmol/l, and even more so if it's higher. We strive to provide an effective and most importantly realistic type 1 and type 2 diabetes treatment plan that can be followed by people who have a significant workload.

The main problem with type 2 diabetes is that the body gradually breaks down over decades, and this usually doesn't cause painful symptoms until it's too late. On the other hand, a person with type 2 diabetes has many advantages over someone with type 1 diabetes. His blood sugar will never rise as high as a type 1 diabetic if he misses an insulin shot. If the second phase of the insulin response is not too affected, then blood sugar can, without the active participation of the patient, drop to normal on its own a few hours after eating. A patient with type 1 diabetes should not expect such a “freebie”.

How to effectively treat type 2 diabetes

In type 2 diabetes, intensive therapeutic measures will lead to the fact that the load on the pancreas will decrease, the process of “burning out” of its beta cells will slow down.

What do we have to do:

• Read. It also describes how to treat it.
• Make sure you have an accurate glucometer (), and measure your blood sugar several times a day.
• Pay special attention to measuring blood sugar after meals, but also on an empty stomach.
• Go to .
• Get busy. Physical activity vital.
• If diet and exercise are not enough and sugar is still elevated, take it as well.
• If all together - diet, physical education and Siofor - do not help enough, then add insulin injections. Read the article "". First, extended insulin is prescribed at night and / or in the morning, and if necessary, also short insulin before meals.
• If insulin injections are needed, draw up an insulin therapy regimen together with an endocrinologist. At the same time, do not give up on a low-carbohydrate diet, no matter what the doctor says.
• In most cases, insulin has to be injected only for those patients with type 2 diabetes who are too lazy to exercise.

As a result of losing weight and exercising with pleasure, insulin resistance will decrease. If treatment is started on time, it will be possible to lower blood sugar to normal without insulin injections. If insulin injections are still required, then the doses will be small. The end result is a healthy happy life without the complications of diabetes, until old age, to the envy of “healthy” peers.

Insulin is an important hormone for our health and longevity, as well as for weight control and its structure (increase in muscle mass and decrease in body fat mass). However, there are many myths about insulin that deceive the reader without proper scientific background. Therefore, I will try to tell you in detail and with nuances.

Insulin stimulates and inhibits at the same time.

1. Insulin helps muscle growth. Insulin stimulates protein synthesis by activating its production by ribosomes. In addition, insulin helps transport amino acids into muscle fibers. Insulin actively transports certain amino acids into muscle cells. We're talking about BCAAs. Branched-chain amino acids are "personally" delivered by insulin to muscle cells. And this is very good if you intend to build up muscle mass.

2. Insulin prevents protein catabolism. Insulin prevents muscle breakdown. While it may not sound very exciting, the anti-catabolic nature of insulin is every bit as important as its anabolic properties.

Any financially savvy person will tell you that it's not just how much money you make that matters. It also matters how much money you spend. The same is true for muscles. Every day our body synthesizes a certain amount of proteins, and at the same time destroys the old ones. Whether you manage to gain muscle mass over time or not depends on “physiological arithmetic”. To increase muscle, you must synthesize more protein than you break down in the process of catabolism.

3. Insulin activates glycogen synthesis. Insulin increases the activity of enzymes (eg, glycogen synthase) that stimulate glycogen production. This is very important as it helps to supply glucose to the muscle cells, thus improving their performance and recovery.

4. Boosting insulin helps you feel full and suppresses hunger. Insulin is one of many hormones that play a role in making you feel full. For example, protein, by stimulating insulin, contributed to a decrease in appetite. Numerous studies have shown that insulin actually suppresses appetite.

The dark side of insulin (metabolism)

1. Insulin blocks hormone receptor lipase. Insulin blocks an enzyme called hormonal receptor lipase, which is responsible for the breakdown of adipose tissue. This is obviously bad, because if the body can't break down stored fat (triglycerides) and turn it into a form that can be burned (free fatty acids), you won't lose weight.

2. Insulin reduces fat utilization. insulin ( high level insulin) reduces the use of fat for energy. Instead, it promotes the burning of carbohydrates. Simply put, insulin "stores fat." Although this has a negative effect on our body image, this action makes sense if we remember that the main function of insulin is to get rid of excess glucose in the blood.

3. Insulin increases the synthesis of fatty acids.

And FFA (free fatty acids) is a key cause of insulin resistance! Insulin increases fatty acid synthesis in the liver, which is the first step in the fat storage process. But it also depends on the availability of excess carbohydrates - if their volume exceeds a certain level, they are either immediately burned or stored as glycogen. Without a doubt, excess insulin is the first reason advanced level in the body of triglycerides, fats that were previously considered relatively safe.

Pimples, dandruff and seborrhea. They did not expect? The higher the insulin - the more intense lipogenesis, the more intense lipogenesis - the higher the level of triglycerides in the blood, the higher the level of triglycerides in the blood - the more "fat" is secreted through the sebaceous glands located throughout the body, especially on the scalp and face. We are talking about hyperfunction and hypertrophy of the sebaceous glands under the action of insulin. In people with naturally very smooth skin who have never had acne or pimples, this side effect insulin may be completely absent. In persons with more or less oily skin, with the ability to form acne, insulin can cause severe acne, with hypertrophy of the sebaceous glands and expansion of the skin pores. Acne in women is often one of the signs of hyperandrogenism, which may be accompanied by hyperinsulinemia and dyslipidemia.

4. Insulin activates lipoprotein lipase.

Insulin activates an enzyme called lipoprotein lipase. If you are familiar with medical terminology, this may at first be perceived as a positive characteristic of insulin. After all, lipase is an enzyme that breaks down fat, so why not increase its volume?

Recall that we just discussed how insulin enhances fatty acid synthesis in the liver. Once these additional fatty acids are converted to triglycerides, they are taken up by lipoproteins (eg VLDL proteins - very low density lipoproteins), released into the blood, and seek a place to store them.

So far so good as the triglycerides cannot be absorbed by the fat cells. So while you may have enough triglycerides in your blood, you won't actually store fat. until lipoprotein lipase comes into play. Once it is activated by insulin, lipoprotein lipase breaks down these triglycerides into absorbable fatty acids, which are quickly and easily absorbed by fat cells, converted back to triglycerides there, and remain in fat cells.

5. Insulin blocks the use of glycogen.

The black side of insulin (as growth hormone)

1. Excess insulin destroys arteries.

Excess insulin causes clogging of the arteries because it stimulates the growth of smooth muscle tissue around the vessels. Such cell reproduction plays a very important role in the development of atherosclerosis, when there is an accumulation of cholesterol plaques, narrowing of the arteries and a decrease in blood flow. In addition, insulin interferes with the blood clot dissolution system by raising the level of plasminogen activator inhibitor-1. Thus, the formation of blood clots is stimulated, which clog the arteries.

2 Insulin raises blood pressure.

If you have high blood pressure, there is a 50% chance that you are insulin resistant and have too much insulin in your bloodstream. Exactly how insulin affects blood pressure is still unknown. Insulin itself has a direct vasodilating effect. In normal people, the administration of physiological doses of insulin in the absence of hypoglycemia causes vasodilation rather than an increase in insulin levels. blood pressure. However, under conditions of insulin resistance, hyperactivation of the sympathetic nervous system leads to the appearance of arterial hypertension due to sympathetic stimulation of the heart, blood vessels and kidneys.

3. Insulin stimulates the growth of cancerous tumors.



Insulin is a growth hormone, and its excess can lead to increased cell reproduction and tumors. Obese people produce more insulin, because it is the excess of insulin that causes obesity, so they are more likely than people with normal weight to develop cancerous tumors. In people tall insulin production is also increased (the higher the growth, the more insulin), so the risk of getting cancer is higher. These are statistics and well-known facts.

On the other hand, if you reduce the production of insulin in the body, the risk of developing cancerous tumors will also decrease. In animal experiments, it was found that long, regular breaks in food also reduce the risk of developing cancerous tumors, even if the total number of calories in the diet of animals is not reduced, in other words, after these breaks they are given plenty to eat. In these experiments, it was found that infrequent meals lead to a steady and permanent decrease in blood insulin levels.

4. Hyperinsulinemia stimulates chronic inflammation.

Hyperinsulinemia stimulates the formation of arachidonic acid, which is then converted into inflammation-stimulating PG-E2 and the amount of inflammation in the body increases dramatically. Chronically high insulin levels or hyperinsulinism also causes low adiponectin levels and this is a problem as it increases insulin resistance and inflammation.

Adiponectin is an adipose tissue hormone that maintains normal insulin sensitivity, prevents the development of diabetes and reduces the risk of cardiovascular disease. Adiponectin plays an important role in energy regulation, as well as in lipid and carbohydrate metabolism, lowering glucose and lipid levels, increasing insulin sensitivity and having anti-inflammatory effects. In obese people (in particular with abdominal obesity), the daily secretion of adiponectin, during the day, was reduced.

Chronobiology of insulin.

Snacking and fat burning

And the second phase continues as long as there is a glucose stimulus in the blood. That is, the existing insulin is released first, and additional insulin is produced (insulin is secreted by the b-cell from the precursor (precursor) - proinsulin). Restoring the rapid phase of the insulin response improves blood sugar regulation in diabetics: fast growth insulin levels are a good thing in and of themselves.

Snacking and snacking have a very negative effect on insulin regulation. In response to a snack, insulin rises in 2-3 minutes, and returns to normal in 30-40 minutes.




In experiments on mice, it was found that if they are fed every other day, they live longer and do not get sick. When mice are not fed for 24 hours in a row throughout their lives, and in the next 24 hours they are given food to satiety, then, compared to mice that are fed 3 times a day daily, they, firstly, do not lose weight by eating when there is food, secondly, they never get sick, and thirdly, they live one and a half times longer than those mice that eat regularly 3 times every day. This fact is explained simply - mice that eat less often produce less insulin than those that eat often. Please note that eating less often does not mean less, because there is no difference in the number of calories, the weight of both mice is the same.

Insulin and stress.

Insulin and aging.

Insulin resistance is a manifestation of increased TOR activity, since excessively active TOR causes insulin resistance. So in both cases, increased TOR activity is to blame: is it caused by insulin or is it manifested as insulin resistance.

Insulin sensitivity.

Conclusion.