Question about the liver

Bellx15

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Just occurred to me recently:

As I understand it, under normal circumstances the liver converts excess glucose into glycogen for storage until needed. Presumably there is a limit to how much it can store easily?

So here's the question. Take my own case: I was downing litres of orange juice per day for the best part of a year, along with way too much beer. Eventually my liver would have been overwhelmed by the demand for glycogen storage space, and stopped taking in any more glucose, I assume. As a result, my BG would start to rise, with nowhere to go. At that point I had my blood levels tested at the hospital and they were, indeed, high.

But if all of that is about right, doesn't it follow that those high readings were at that stage temporary, fully reversible by cutting out the abuse? Isn't that just a storage problem, rather than permanent damage?

I am not asking anyone to say what actually happened with my body, but isn't this at least what could have happened?
 

Snodger

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Not sure I understand your question - yes, you're right, those high readings were temporary.
Constant high blood sugar damages other bits of your body though and that damage can sometimes not be reversed. To take an analogy - you could be running a machine using dirty oil and you can at any time clean it out and use clean oil. But the gunk in that oil might have already clogged the parts of the machine enough that they stop working, or don't work as well.

Is that what you were asking though?
 

phoenix

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it wouldn't have happened overnight. Developing T2 takes time. By the time you were suffering polydipsia as a symptom of diabetes then your blood glucose levels were already higher than they should be. The high glucose levels would be toxic to your beta cells exacerbating the problem.

As to what happens to excess carbs/sugars:
Your body will use excess glucose first. If you are taking in more calories than you need then fat will be stored as fat. If you are still taking in more than you need then excessive carbohydrate (after glycogen stores are full) will be converted to fat. It isn't a direct conversion and takes some calories to do it.
If you have 100 extra calories in fat (about 11 grams) floating in your bloodstream, fat cells can store it using only 2.5 calories of energy. On the other hand, if you have 100 extra calories in glucose (about 25 grams) floating in your bloodstream, it takes 23 calories of energy to convert the glucose into fat and then store it.
http://science.howstuffworks.com/enviro ... -cell2.htm
 

Bellx15

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Thanks, both. I'll just try to clarify:

I am trying to distinguish between a condition of diabetes, where damage has occurred, and a temporary condition in which the liver, and maybe the body more generally, is overloaded with glucose, so cannot store it as efficiently as before. As result, it accumulates in the blood. Physical damage v. temporary overloading.

My guess is that during my very high glucose phase my body was just overloaded, and couldn't clear the excess blood glucose so well, if at all. If that is the case:

1. Is that really diabetes, or just the road to diabetes?

If it is just on the road, I don't see how a diagnosis could be justified at that stage.
 

Bellx15

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phoenix said:
By the time you were suffering polydipsia as a symptom of diabetes then your blood glucose levels were already higher than they should be.

Just to clarify - I wasn't drinking a lot because of thirst, or polydipsia. It (excessive intake) led to high BG, rather than being a symptom of it.
 

Indy51

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I guess I'm wondering why you keep going around the subject of the how/why of your development of diabetes, as I thought it had pretty well been covered in your other thread about the definition of diabetes?

Even if you knew the cause with 100% certainty, there's nothing much you can do about it now except your very best to halt the progression as best you can, knowing that even if you don't stop the progression, the reasons why may well be outside of your control - eg. how many beta cells you have left, how much damage may/may not have already been done, etc.

I'm not a scientist, but my layman's understanding is that we are all born with a genetic heritage that predisposes us to certain diseases, conditions, whatever but that predisposition isn't a predetermined sentence. A whole heap of factors come into play - diet, exercise, lifestyle, food quality, environmental pollutants, our mother's health during pregnancy, etc. that may or may not finally 'flick the switch' and we end up with that disease/condition. I don't think developing diabetes would ever be something as simple as you drank too much orange juice or beer for 'x' amount of time.

If you haven't already seen this, I'd suggest you read Jenny Ruhl's article "You Did Not Eat Your Way To Diabetes", here:

http://www.phlaunt.com/diabetes/14046739.php
 

Bellx15

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Reasonable questions, which I will attempt to answer.

As in other areas of medicine, in the area of diabetes I have learned not to take the 'official' account unquestioningly. I agree with many people on this forum, for example, that official dietary advice is completely and utterly wrong. Regarding the diagnosis and development of diabetes, I continue to question. If things I am told don't seem to gel properly, I am especially keen to look into them a bit more carefully, and see what emerges.

So because I am still unclear about the basis for my diagnosis, and cannot yet see how the information I have been given fits together, I am trying to make sense of things for myself. I was diagnosed soley on the basis of a couple of high readings, at the apex of my dietary deviation, and told that I would always be diabetic and that it would progress. However, I don't yet see any of that as being certain. I think most people under that regime would suffer heightened BG and glucose intolerance, diabetic or not. Here's an alternative story:

For most of my adult life I have had fairly high FBG, and over the long term it has not worsened; in fact, it has improved, as have my other blood factors. Then, for reasons I prefer not to go into, I started to abuse myself with a very high sugar and carbs routine, with no let-up for over eight months. Eventually I developed the familiar symptoms of high BG. Under this relentless barrage of glucose, my liver, etc., finally reached storage capacity, so that any carb intake caused my BG to rocket. My liver had reached capacity and couldn't cope with the glucose.

But so far there has been no evidence for physical damage. The overload was temporary and fully reversible. After a few months I have reduced all the readings to better than when the abuse started. There is no evidence that anything irreversible has occurred. I can say that I have a degree of glucose intolerance, but I probably always had that. For example, I have always reacted badly to starchy food in the daytime (get weak and drowsy).

So in short, I don't yet feel that I have a clear picture of my condition, and I want to find out more about it.
 

Snodger

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I'm always up there with anyone questioning authority but I'm not sure I understand exactly what you are questioning.

Bellx15 said:
Under this relentless barrage of glucose, my liver, etc., finally reached storage capacity, so that any carb intake caused my BG to rocket. My liver had reached capacity and couldn't cope with the glucose.
But as I understand it,
a) glycogen is a temporary storage solution for the body. If the liver's full, the extra energy gets stored as fat - not poured back into the blood. Non-diabetics can eat as much sugar as they like, and pack their liver full of glycogen, and it doesn't make their blood glucose rocket. So if you can't do that... then you are T2 diabetic... aren't you?
b) Insulin is used to put sugar into storage and it is made in the pancreas; it is accepted by your other body cells. In T1 your pancreas is broken and in T2 your other body cells are a bit broken. I'm not sure I understand the role of the liver in your theory. Are you saying that your liver was temporarily unable to recognise insulin, because it was full? Or are you disputing the role of insulin altogether?
c) you seem to be saying your liver is fine now and... what? therefore you aren't diabetic and can go back to eating carbs? Or are you saying you've always been glucose intolerant and thus must avoid overloading carbs? In which case, what's the difference between being T2 diabetic and glucose intolerant, for you, is it just a question of degree?
 

Bellx15

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OK - I am not claiming to have a complete understanding of any of this. I am just exploring possible alternative theories.

In response to your points:

a) If it is true that a non-diabetic could subject his body to that regime for eight months and still maintain a low BG, by readily storing fat as required, then yes, that makes me diabetic. I just wasn't aware that things were that clear-cut.

b) Expressed in those terms, I suppose I was speculating that with storage capacity completely exhausted, insulin would have no useful function. rather than any cells being damaged, I was thinking about there being no storage space left.

c) Yes; a question of degree. And also, if diabetes is invariably progressive, I would tentatively disqualify myself as a diabetic on that count.
 

paragliderpete

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Hi coming into this thread late. Looking at your question and thirst for knowledge about Diabetes. I'd suggest reading the following two books :-
Essential endocrinology and Diabetes by Holt and Hanly
Handbook of diabetes by bilous and Donnelly

Both will give you a better understanding of the subject, and help you understand the decisions your doctor will be making. They are both current medical reference books. They are comprehensive and will give you much more reading in the reference section.
they will certainly answer your current question in detail.
 

Bellx15

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Snodger

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Bellx15 said:
OK - I am not claiming to have a complete understanding of any of this. I am just exploring possible alternative theories.
yes, sorry if I came across a bit cold. I think it's totally fine to explore alternatives. That's how we find out useful things.

Bellx15 said:
a) If it is true that a non-diabetic could subject his body to that regime for eight months and still maintain a low BG, by readily storing fat as required, then yes, that makes me diabetic. I just wasn't aware that things were that clear-cut.
I'm not an expert but yes, I think it's relatively clear-cut. The healthy body is pretty amazing. Of course, the fat itself would then start to cause problems. In some people (although still not everyone) that extra fat would then start to contribute to insulin resistance (body cells not recognising the insulin very well and so not responding to it)
Bellx15 said:
b) Expressed in those terms, I suppose I was speculating that with storage capacity completely exhausted, insulin would have no useful function. rather than any cells being damaged, I was thinking about there being no storage space left.
You're quite right to speculate that there COULD be a disease in which the liver got overloaded with glycogen and stopped working, but for some reason human bodies don't seem to do that. The problems seem to focus on insulin production and reception/recognition.

Bellx15 said:
c) Yes; a question of degree. And also, if diabetes is invariably progressive, I would tentatively disqualify myself as a diabetic on that count.
I wouldn't say that it was invariably progressive at all. Certainly it's not with Type 1: we conk out and that's it, we can't make insulin. We don't get progressively worse at making insulin, because we don't make any at all. (Some of us develop insulin resistance as well, but that's slightly different). But I would also say it's not invariably progressive with Type 2 either. Some people do control it with diet for the rest of their lives. You can call that a form of 'diabetes' or you can call that 'impaired glucose intolerance' but either way it's not the same as the healthy person whose body responds efficiently to whatever foods they eat. You won't get that ability back again, whatever you do, so as far as that goes you are permanently diabetic - even if you are able to keep off medication.
 

Bellx15

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Yes, thanks for that explanation.

I am still a bit unsure, though, especially about insulin resistance. The picture I get from various sources is that T2D commonly involves at least quite a lot of insulin being produced, but insulin resistance being the main culprit, in that it amounts to reduced sensitivity. As a result, the blood accumulates unwanted glucose (and insulin) concentrations.

Is it then a fact that because of reduced insulin sensitivity the body is unable to detect the surfeit of insulin in the blood, and so fails to respond adequately to lay down as much adipose fat as it normally would?

Sorry - still a beginner. But I have read from various sources that insulin resistance, in itself, can be reversible.
 

mbudzi

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I'm Type 1 - so my pancreas has conked out. However the conking out process takes a while. In laymans terms (the only way I get to grips with this stuff) is that my immune system is slowing killing off the insulin producing cells. So it can appear to be a gradual thing - but it isn't reversible.

I haven't read very widely about Type 2, but some of what I have read has also made me wonder if Type 2 can't be reversed, afterall there is pre-diabetes and they turn that back from the brink - so couldn't type 2 just be something further along a spectrum?

Assuming that you did want to test that out, the cure may be harder to manage than the disease ... I'm thinking Newcastle Diet and avoidance of all transfats (which appear to be in almost every processed food that require fat).

Thanks to the person who recommended the book - its on my Christmas wish list! The more I understand the easier this is all going to be.
 

Bellx15

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Well, just to be as clear as possible (and I fully admit that I am still groping in the dark to an extent), it seems to me that the definition of diabetes makes it an umbrella concept to cover a multitude of sins. I should say, too, that my thoughts are only about type 2.

If someone on a normal diet and exercise regime has a normal FBG reading, but spikes too high after meals, I would say they are glucose intolerant, not diabetic. Someone with a high FBG would be diabetic. That is according to how I would use the words. Let's just talk about these two conditions as GI and DM for now.

GI in Type 2 is commonly caused by insulin resistance (IR). Typically, the glucose receptor cells in the liver, muscles and fat cells are not taking in enough blood glucose, so the BG level rises out of control. The liver doesn't recognise this, and so it continues to dump glucose, making things even worse.

But what causes insulin resistance? Lack of exercise, poor diet, and genes. IR develops as the receptors become choked full of stored glucose, and can't handle any more. That's how I understand it, at least.

So here is what I believe happened to me. After consistently abusing my body over an extended period with sugars and fruit juice my liver, muscles and fat cells became engorged with Glucose/glycogen. Added abdominal fat also hindered the further processing of blood glucose. I developed serious insulin resistance and therefore glucose intolerance. Things got so bad that even my FBG was seriously elevated. There was nowhere for the blood glucose to go, and the liver was dumping away regardless. I had high FBG, glucose intolerance, and early morning dumping syndrome. In short I was drowning in glucose.

Now, after months of a sensible diet and exercise regime, I have a consistently normal FBG. I am still glucose intolerant, though. My interpretation of this state is that my liver and muscles are less full of glucose now, so can maintain the correct FBG level, and my liver is no longer full of glycogen and unable to detect excess blood glucose, so it has stopped unwanted dumping. I'm still not properly cleaned out, though, so it doesn't take much glucose intake to start things clogging up again. that's why I would fail a GTT.

So I feel that I have reversed a major component of the health disorder - the consistently high FBG ( and also pre-meals BG) has been eradicated and it is now normal. That is because my glucose receptors are now freed up to do their job.

That's my interpretation, but if you go with the official definition of diabetes I would have to say I am diabetic, even though my FBG and pre-prandial BGs are normal. I am pretty sure I would fail the GTT. Using the official definition of diabetic just lumps everything together and obscures the details. So yes, I think I have reversed something (FBG) simply by getting back to a healthy lifestyle. Whether I can improve my GT is another question, which I am hoping to be able to answer in due course.
 

Snodger

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Bellx15 said:
I have read from various sources that insulin resistance, in itself, can be reversible.
yes, good point. Some people who are overweight get get insulin resistance because of the excess fat. So in effect they are diabetic when they are fat and just in the at-risk group when they are thin.
Also - just thought of another one - some people get insulin resistance when they are pregnant, and once they have the baby they are back to normal.

But, still, compared to totally non-diabetic people, these at-risk groups are still nearer the 'diabetic' end of the spectrum, because they need to keep an eye on things in a way that totally healthy people need not do.