New Study Shows Elevated Levels of Insulin as a Drive to Type 2 Diabetes

Increased production of insulin rather than insulin resistance is shown to occur in the first place of type 2 diabetes progression, supported by the high levels of free fatty acids in the blood.

Basic view on the mechanism of how type 2 diabetes occurs may change as per the results produced by the researchers at the University of Gothenburg, Sweden, published in the journal EBioMedicine.

Diabetes is one of the most common diseases, that affects an estimated 500,000 people in Sweden. Large numbers of undetected type 2 diabetes cases exist thereby exposing them to an increased risk for several serious conditions, such as cardiovascular disease (which may result in heart attacks and strokes).

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‘Diabetes is one of the most common diseases that is debated over for its disease progression. The high levels of free fatty acids (FFAs – products of fat cell metabolism) after the overnight fast in the blood are shown to trigger insulin release even at a normal blood sugar level in the morning, with no insulin resistance in fat cells. This supports the idea that increased production of insulin (rather than insulin resistance) occurs in the first place – a newer view on the basic mechanism of type 2 diabetes.’

Numerous researches have been carried underway for almost 50 years to solve the puzzle of type 2 diabetes & its progression (debate on which comes first – insulin resistance or elevated insulin levels?) and link to obesity. Thus present study demonstrates the connection of type 2 diabetes with obesity.

The amount of free fatty acids (FFAs – products of fat cell metabolism) in a body depends upon its adaptation to the increased adiposity in a person. These high FFA levels in the blood after the overnight fast is known to trigger insulin release even at a normal blood sugar level in the morning, without an overt uncompensated insulin resistance in fat cells, thereby affirming the increased production of the insulin in the first place.

This contradicts the idea of the dominant hypothesis – that the pancreas steps up its insulin production because the cells have already become insulin-resistant, and blood sugar then rises.

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The team extensive examined samples (under varying conditions) of 27 selected research subjects (nine of normal weight, nine with obesity and normal blood sugar, and nine with both obesity and progressed type 2 diabetes)to compare the metabolism and gene expression in adipose (fat-storing) tissue and the levels of blood sugar, insulin, and FFAs in their blood.

FFAs may Trigger Insulin Production

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It was observed that the people with obesity but not diabetes had normal blood-sugar levels comparable to the healthy individuals of normal weight.

"Interestingly, the nondiabetics with obesity had elevated levels of both free fatty acids and insulin in their blood, and those levels were similar to or higher than the levels we were able to measure in blood from the participants with both obesity and type 2 diabetes," says Emanuel Fryk, a resident doctor specializing in general medicine and doctoral student at Sahlgrenska Academy, University of Gothenburg, who is one of the study's first authors.

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A similar pattern was also confirmed in a population study based on blood samples taken from 500 people after an overnight fast. The link between free fatty acids and insulin thereby suggests that the fatty acids are connected with insulin release. They are shown to contribute to increased insulin production when the blood sugar levels are normal on an empty stomach.

However, the study recommends the need for additional researches to confirm the findings.

"Our hypothesis is that the free fatty acids increase in the blood because the adipose tissue can't store the excess energy anymore. We believe, in that case, it could be an early sign of incipient type 2 diabetes. If our findings are confirmed when other research methods are used, there may be a chance that some specific fatty acids could be developed into biomarkers. But that's a long way off". "There are many factors that contribute to the progression of type 2 diabetes, but it's our lifestyle that has, in absolute terms, the largest impact for most people. Our study provides another argument that the most important thing you can do to slow diabetes progression is to change your lifestyle early in the progression of the disease before blood glucose is elevated", says Fryk.

Source-Medindia