Role of skeletal muscle in diabetes remission/control

[mhtyler]

As I work towards what I hope will be remission of my type 2 diabetes I have asked myself the question, "what is the difference between someone without diabetes 2, and someone who has achieved remission. There seem to be 3 issues:

1. Skeletal muscles are diabetics more insulin-resistant than normal people.
2. People with diabetes 2 appear to have lower personal fat thresholds (Prof Roy Taylor's concept).
3. Some people with T2DM can't recover pancreas function

For the moment, I'm going to ignore 2 and 3 and focus on 1. 1/4 of T2DM not only have skeletal muscle more insulin-resistant, but also have sarcopenia. Just at the moment (he said with some confidence) I have sarcopenic obesity. For those not familiar, sarcopenia is muscle wasting, and we all know what obesity is. It means I'm weak and fat. I had a serious epiphany after seeing a video on youtube by an MD named Ted Naiman. He's a doctor in Seattle, Wa. USA, and he's also a bodybuilder. He did a video...and it's not hard to find, comparing someone with T2DM and bodybuilders. Odd? No, amazing. His theme is that T2DM people and bodybuilders are exact opposites. A bodybuilder is someone who works to build as much lean mass on their bodies as possible while reducing fat as much as possible. OTOH a T2DM person has worked to lay on as much fat as possible while minimizing their muscle mass. His point is that T2DM is a metabolic disorder, and the fix is to get a bodybuilder's metabolism. I then looked for more info on youtube about using resistance training to control diabetes. VERY LITTLE has been said, written, or researched on this. However, I did come across several bodybuilders with Type 1 diabetes who not only swear by it to help control their sugar, but can't understand why this isn't embraced more as a solution in the diabetic world. For me, I'm in the middle of fast weight loss, so I've suspended weight training until I reach my goal, but I'd be interested in comments.

 

[Drummer]

Hello @mhtyler.
Since diagnosis and going low carb I have lost a lot of fat - I was just about spherical - and in the last few years I have become stronger and gone back to earing money servicing and repairing kitting machines.
Once a year I go to the local Arts University where they have three departments with knitting machines and each year since diagnosis I have noticed that I can move them around more easily, and I am no longer exhausted by the work.
I knew about low carb diet long before diagnosis, as I knew that carbs made be feel unwell - but my road to diabetes was signposted by all the advice I got to eat 'healthy' carbs, rather than that fad diet that was going to kill me with all the red meat and fat it contained.
The advice acted rather like a black hole, as the closer I got to eating a 'perfect' diet according to the standard advice handed out the greater its effect on my metabolism and the worse my diabetes.

 

[PerSpinasAdAstra]

These are worth a read if you fancy wading through it and have the time.

Role of skeletal muscle in insulin resistance:

Role of Skeletal Muscle in Insulin Resistance and Glucose Uptake

The skeletal muscle is the largest organ in the body, by mass. It is also the regulator of glucose homeostasis, responsible for 80% of postprandial glucose uptake from the circulation. Skeletal muscle is essential for metabolism, both for its role in ...

www.ncbi.nlm.nih.gov

Stand out point - skeletal muscle is responsible for 80% of postprandial glucose clearance - i.e. - the lower your muscle tissue insulin resistance levels (and presumably glycogen stores) the faster your blood glucose levels should go down after eating.

Role of fatty acids and exercise in muscle insulin resistance:

Skeletal Muscle Insulin Resistance: Roles of Fatty Acid Metabolism and Exercise

The purpose of this review is to provide information about the role of exercise in the prevention of skeletal muscle insulin resistance, that is, the inability of insulin to properly cause glucose uptake into skeletal muscle. Insulin resistance is associated ...

www.ncbi.nlm.nih.gov

Stand out point - long periods of either aerobic or resistance exercise can improve insulin sensitivity in muscle tissue, and the effect lasts for a considerable period of time after exercise.

The conclusion I've drawn is that full body resistance training is beneficial, even if not much muscle growth occurs (which would of course be nice) and that long periods of aerobic exercise has similar benefits. Ideally, I personally hope to both build some muscle and to work it daily to help my body dump glucose into muscle tissue quickly after eating, which can't be a bad thing.

 

[mhtyler]

These are worth a read if you fancy wading through it and have the time.

Role of skeletal muscle in insulin resistance:

Role of Skeletal Muscle in Insulin Resistance and Glucose Uptake

The skeletal muscle is the largest organ in the body, by mass. It is also the regulator of glucose homeostasis, responsible for 80% of postprandial glucose uptake from the circulation. Skeletal muscle is essential for metabolism, both for its role in ...

www.ncbi.nlm.nih.gov

Stand out point - skeletal muscle is responsible for 80% of postprandial glucose clearance - i.e. - the lower your muscle tissue insulin resistance levels (and presumably glycogen stores) the faster your blood glucose levels should go down after eating.

Role of fatty acids and exercise in muscle insulin resistance:

Skeletal Muscle Insulin Resistance: Roles of Fatty Acid Metabolism and Exercise

The purpose of this review is to provide information about the role of exercise in the prevention of skeletal muscle insulin resistance, that is, the inability of insulin to properly cause glucose uptake into skeletal muscle. Insulin resistance is associated ...

www.ncbi.nlm.nih.gov

Stand out point - long periods of either aerobic or resistance exercise can improve insulin sensitivity in muscle tissue, and the effect lasts for a considerable period of time after exercise.

The conclusion I've drawn is that full body resistance training is beneficial, even if not much muscle growth occurs (which would of course be nice) and that long periods of aerobic exercise has similar benefits. Ideally, I personally hope to both build some muscle and to work it daily to help my body dump glucose into muscle tissue quickly after eating, which can't be a bad thing.

I appreciate the reading, and I will absolutely look at all of it. Prof. Taylor has said that in normal people 30 per cent of of blood sugar from a meal is handled not by the liver, but by skeletal muscle over a period of 5 hours. In a diabetic individual however, who started life with insulin resistant skeletal muscle, the per centage could be as low as zero. He has also said, that his reversal program has no effect on the insulin resistance in skeletal muscle. Therefore, his program ignores it and focuses on the two areas in can impact; the liver, and the pancreas. Fair enough. However, Dr Naiman, who I quoted earlier and who is also a bodybuilder has said, "what if you had an unlimited amount of muscle mass to absorb glucose as it entered your blood stream?" In other words, what if you had a bodybuilder's metabolism, instead of a diabetics'? There are type 1 diabetic bodybuilders, but I don't think there are ANY type 2 diabetic bodybuilders. Those guys have to scarf down huge amounts of calories to maintain their builds. BTW, when Dr Naiman talks about building muscle to absorb sugar he means fast twitch type 2 muscle. There are two basic types of muscle in the human body; type 1 slow twitch, and type 2 fast twitch. The former is very efficient and is great for things like distance running. However, type 2 fast twitch is what bodybuilders are trying to gain. Type 2 muscle is good for short bursts of energy like lifting, and its VERY inefficient ...it is in fact a glucose gas guzzler. Therefore, when doing resistance training, you want fewer reps and heavy weights. You need to convince your body that if you don't get bigger muscles the bear is going to get you next time. I believe it may be possible to overcome the natural skeletal muscle insulin resistance that type 2 diabetics have through bodybuilding. Its a theory I plan to test after I am through the Newcastle protocol.

 

[PerSpinasAdAstra]

Those guys have to scarf down huge amounts of calories to maintain their builds. BTW, when Dr Naiman talks about building muscle to absorb sugar he means fast twitch type 2 muscle.

This is an issue that I can't find any good answer to. If you were to wave a magic wand and have a body builder's physique overnight, you would need to greatly increase your calorie intake. Unless you're eating massive amounts of protein and fat (which each may raise their own health concerns) you would need to up your carb intake. That implies that your pancreas would need to produce more insulin to handle those extra carbs, and that may be problematic in itself for a Type 2 diabetic.

Prof Taylor's weight loss approach to targeting fat in and around the liver and pancreas is clearly effective, however it is not at all clear that pancreatic function returns to a normal, completely healthy level following the elimination of that fat. If this document (link below) is all true, then pancreatic dysfunction in a Type 2 diabetic can begin as early as 12 years before diagnosis. It that's the case, and I assume conditions vary greatly from person to person, then building too much muscle mass may actually be unhelpful for blood glucose control as it may necessitate greater levels of insulin production than a dysfunctional pancreas can handle. I have no idea if it's better to build and try to keep enough muscle to maintain sufficient strength and mobility into old age, or if it's better to try to build glucose-guzzling larger muscle mass.

Defining and Characterizing the Progression of Type 2 Diabetes

www.ncbi.nlm.nih.gov

 

[mhtyler]

This is an issue that I can't find any good answer to. If you were to wave a magic wand and have a body builder's physique overnight, you would need to greatly increase your calorie intake. Unless you're eating massive amounts of protein and fat (which each may raise their own health concerns) you would need to up your carb intake. That implies that your pancreas would need to produce more insulin to handle those extra carbs, and that may be problematic in itself for a Type 2 diabetic.

Prof Taylor's weight loss approach to targeting fat in and around the liver and pancreas is clearly effective, however it is not at all clear that pancreatic function returns to a normal, completely healthy level following the elimination of that fat. If this document (link below) is all true, then pancreatic dysfunction in a Type 2 diabetic can begin as early as 12 years before diagnosis. It that's the case, and I assume conditions vary greatly from person to person, then building too much muscle mass may actually be unhelpful for blood glucose control as it may necessitate greater levels of insulin production than a dysfunctional pancreas can handle. I have no idea if it's better to build and try to keep enough muscle to maintain sufficient strength and mobility into old age, or if it's better to try to build glucose-guzzling larger muscle mass.

Defining and Characterizing the Progression of Type 2 Diabetes

www.ncbi.nlm.nih.gov

Weight lifters eat high protein, which is the only thing that builds muscle, so carbs aren't an issue, but being able to process more of them is a positive side effect, and as I said many Type 1 diabetics use weight lifting to help control their sugar. You are absolutely right about the pancreas issue though, and it's an issue that weighs on me heavily. I won't know for sure if mine is recovering for several months. Only about 40-45 percent of those in his program recover normal pancreas function...at least in the time frame of his studies. Most of those people have had diabetes for less than 10 years although there are outliers in both directions. You might want to have a look at his counterbalance study. Nevertheless, Sarcopenia is a huge and unaddressed issue with type 2 diabetes, but I have noticed that there is an increased interest in resistance training, however small compared to the huge focus on fasting.