Insulin Resistance, Prediabetes and Type 2 Diabetes. Part 2: Chronic Calorie Excess

In the first installment of this series, we defined the various disorders that comprise the larger category of disordered glucose metabolism. We also noted that glucose metabolism affects a large majority of Americans, but that for the most part, it is reversible. 

If you missed part 1 of this series, I would encourage you to read that before continuing. In Part 2 we will examine the impact of chronic calorie excess and how that fits into the development of disordered glucose metabolism.

 

Designed for Scarcity

Human beings are designed for scarcity, not plenty. As a species, this is both a great advantage and significant disadvantage. We have evolved to protect ourselves against famine, but not against all-you-can-eat buffets. Being designed for scarcity means we are very good at – frustratingly good at - holding on to calories. And it is this fact that sets us up for diseases related to calorie excess.  

Disordered glucose metabolism – which includes the continuum of insulin resistance, prediabetes and type 2 diabetes – is one of the disease states brought on by chronic, cumulative calorie excess.  

And here’s an important fact: REGARDLESS of whether those excess calories come from protein, carbs or fat.  

Nutrient Storage Depots

Excess nutrients are stored in our bodies – but not all is equal.  

Importantly, we have no storage capacity for excess protein. This is why - unless we are also pursuing endurance and resistance training - stuffing ourselves with protein bars and chicken will do little to help us lose weight or build muscle. Instead, all that excess protein will be quickly and efficiently turned into… glucose.  

We have limited storage capacity for excess glucose. The two main storage sites are the liver and skeletal muscle. But flood your body with excess protein that gets turned into glucose, or highly processed carbs with lots of added sugars, and you quickly overwhelm that storage capacity. Excess glucose gets turned into… fat.

And here’s the rub: we possess unlimited storage capacity for fat. Fat allows us to squirrel away the energy we might need in the future, in a highly concentrated format, and in endless amounts. 

Oh the Places You’ll Go

Not only can we store fat in endless amounts. We can also save it in endless places.

The first place we store fat is under the skin. This is called subcutaneous fat.  Subcutaneous fat might not look fantastic, but generally speaking, this fat is metabolically inert. It doesn’t do much. It just sits there, ready to be used up when famine hits.

Eventually, as we continue to consume more calories than we expend, our capacity to store fat under the skin becomes exhausted, and we start storing fat in other places in our bodies. Around the heart, in muscle, and within and between the various organs in our abdomen.  

It is this fat – the non-subcutaneous fat – that is toxic and causes all sorts of mayhem. Because this fat is NOT metabolically inert. It releases various hormones and inflammatory compounds, negatively impacting health on a broad scale.

Fat around the heart can cause your heart to become stiff and contribute to the development of heart failure. Fat in muscle, which is basically marbling, impairs strength and inhibits the muscle’s ability to store glucose. Meanwhile, fat in the liver and pancreas is central to the development of insulin resistance, prediabetes and type 2 diabetes. 

Personal Fat Threshold

Our capacity to store fat under the skin is highly individualized. There are people who qualify as obese and yet their blood sugar control is fine. Those people are very good at accumulating fat in their subcutaneous spaces, sparing the liver and pancreas.  

There are others who don’t look particularly overweight but already have type 2 diabetes. These folks are born with more limited subcutaneous fat depots and start laying down fat everywhere else – including the liver and pancreas - earlier.  

The point at which you switch from accumulating fat subcutaneously and start storing it in other places is referred to as your “personal fat threshold”.

 

Bottom line?  

Excess calories, regardless of source, are efficiently turned into fat deposits and preferentially stored subcutaneously. Once you exceed your personal fat threshold and those deposits start showing up in the liver and pancreas and everywhere else, the stage is set for glucose dysregulation and the diseases that follow.   

In Part 3 of this series we will go over why fat accumulation in the liver and pancreas is so central to the development of insulin resistance, prediabetes and type 2 diabetes.  

 

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