Question about the liver

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?

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.

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.

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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.

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.

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.

Thanks!

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.

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.