We need to talk about chronic stress... visceral fat... poor sleep.

[Rosie9876]

Speaking as a lay person, what I am gleaning, trying to understand and fix my Type 2 diabetes: So much of the discussion on this forum is on diet and lowering carbs to manage diabetes. But T2D is part of a metabolic or insulin resistance syndrome, and other factors impact it.

For a good while, I was baffled as to why my strategies of low carb and 16/8 intermittent fasting which I began in October 2024 weren't working as well. True, I have lapses, but I'd always had lapses - worse ones - and my body forgave and my HbA1c went down from 88 to 52 in 5 months. Then, in March, I noticed it started falling apart (not totally) when I had surgery with ensuing pain and a perhaps consequential health problem, which persists. Was chronic stress contributing to my raised glucose level? And poor sleep? No food after 6 p.m. began to make me feel very hungry, also waking me up. Plus, I have little subcutaneous fat, but my waist remains stubbornly large. I have to assume it is visceral fat. From what I read, it is this fat, not so much subcutaneous fat, which triggers insulin resistance and diabetes. It looks like these factors are driving up my glucose levels, even with my low carb diet.

So, I won't despair, but the task is harder than I thought. Anyone else in the same boat?

 

[dawnmc]

Absolutely, I got my hba1c down to 54 from 85, been type 2 for well over 12 years. Tried the lot, 5/2, 800 cals per day, quit alcohol, intermittent fasting, low carb etc etc, the only thing that has worked is exercise, running, lifting weights. My weight never shifted, kept losing and regaining the same 7 lbs. I'm at the point of giving up, but I get up again and carry on. And my hba1c will probably go back up when I stop exercising, p.s. I hate exercise.

 

[debs248]

I'm becoming more convinced that stress and other chronic health conditions have more effect on my BG than diet, which is disappointing because food is the easiest factor to control.

I have accepted that I will need medication to fix what my body can't heal by itself, fortunately I have had no bad side effects from any meds I've tried so far.

That doesn't mean I am going to abandon low carb/ intermittent fasting as they must be helping my overall health even if I won't achieve remission as a result.

 

[Melgar]

I believe its visceral fat that results in insulin resistance. It is associated with the accumulation of lipids in the liver. This lipid accumulation impairs insulin signalling and or it could also induce a systemic inflammatory response in the body. Systemic inflammation is known of cause insulin resistance.

There is also research on where the body stores its fat. Subcutaneous fat, ie fat around the hips and buttocks actually is a positive. The body is more likely to store excess fat in those areas rather than visceral fats in the abdomen - fat around the organs and in the muscles, which is a known factor in driving up insulin resistance and a risk factor for D2.

Chronic stress is associated with systemic inflammation. The body releases corticoids which drive up insulin resistance. As the body is in a fight or flight state your body gears itself ip for a burst of energy so releases glucose into the blood stream. If you suffer prolonged states of stress then your blood sugars may remain elevated.

Being in a stressful states for prolonged periods of time can also mean you change your lifestyle you may eat more, be less inclined to be active. Often we comfort eat when stressed out .

So these are risk factors in the development of D2 or factors that can make it difficult to manage D2

I will attach a couple of research papers for you.

https://pmc.ncbi.nlm.nih.gov/articles/PMC4038351/

https://pmc.ncbi.nlm.nih.gov/articles/PMC8971350/


Edited to add research papers on visceral and stress

 

[louisew2605]

I believe its visceral fat that results in insulin resistance. It is associated with the accumulation of lipids in the liver. This lipid accumulation impairs insulin signalling and or it could also induce a systemic inflammatory response in the body. Systemic inflammation is known of cause insulin resistance.

There is also research on where the body stores its fat. Subcutaneous fat, ie fat around the hips and buttocks actually is a positive. The body is more likely to store excess fat in those areas rather than visceral fats in the abdomen - fat around the organs and in the muscles, which is a known factor in driving up insulin resistance and a risk factor for D2.

Chronic stress is associated with systemic inflammation. The body releases corticoids which drive up insulin resistance. As the body is in a fight or flight state your body gears itself ip for a burst of energy so releases glucose into the blood stream. If you suffer prolonged states of stress then your blood sugars may remain elevated.

Being in a stressful states for prolonged periods of time can also mean you change your lifestyle you may eat more, be less inclined to be active. Often we comfort eat when stressed out .

So these are risk factors in the development of D2 or factors that can make it difficult to manage D2

I will attach a couple of research papers for you.

https://pmc.ncbi.nlm.nih.gov/articles/PMC4038351/

https://pmc.ncbi.nlm.nih.gov/articles/PMC8971350/


Edited to add research papers on visceral and stress

Yes I’m convinced chronic stress caused my diabetes. My diet was good (home cooking and low in processed carbs, with a waist size less than 50% of my height, and very active, A few years ago, my adult son was seriously ill and nearly died then suffered from ptsd and was suicidal. 6 phone counseling sessions from the NHS. I took it all on my shoulders, spending hours on the phone with him and not sleeping for 2 years. Then came covid and we couldn’t see him. Eventually after getting covid for the 2nd time after lockdown finished, I became seriously ill due to high sugar and ketones - I was isolating and drinking juice which I don’t usually drink and of course no activity. Straight onto insulin, first basal then adding bolus. I eat less than 60 carbs a day, I do loads of exercise and my hbac1 is 38. But I still can’t eat carbs, and i’ve accepted that I am not going to go into remission. I’m not going to try and lose weight, because I don’t need to. I’m a size 8 and my BMI is 23. If I lose weight, I just lose muscle. My dad was also a type 2 of healthy weight, very active and with a very healthy diet. It is what it is

 

[Melgar]

@louisew2605 high stress situations like going through trauma takes it's toll on our bodies. The situation with your son, must have been extremely stressful. Prolonged stress wreaks havoc on our bodies. Continuous adrenalin, being on high alert , not being in control of a situation, and no way out, all add up.

Fruit juices are not healthy. I grew up with my mum squeezing oranges out for the juice, but then came fresh orange juice. Fruit excluding berries are often full of sugar. I'm also thin, very fit with a bmi of 19. If reduce my carbs I lose weight. I also lost muscle when I tried the very low carb diet. So it doesn't work for everyone. Did they test your C-Peptides to see how much insulin your body is producing? Did they discuss NAFLD. We had a member who ate a lot of grapes, he was diagnosed with NAFLD due to the fructose content. Very low carb diets help a lot of members here. If they tested for C-Peptides and autoantibodies and ruled out T1, very low carb, high fat diets do work for a lot of people. Being on insulin, if you chose to go that route, you would need to consult your Dr.

 

[louisew2605]

@louisew2605 high stress situations like going through trauma takes it's toll on our bodies. The situation with your son, must have been extremely stressful. Prolonged stress wreaks havoc on our bodies. Continuous adrenalin, being on high alert , not being in control of a situation, and no way out, all add up.

Fruit juices are not healthy. I grew up with my mum squeezing oranges out for the juice, but then came fresh orange juice. Fruit excluding berries are often full of sugar. I'm also thin, very fit with a bmi of 19. If reduce my carbs I lose weight. I also lost muscle when I tried the very low carb diet. So it doesn't work for everyone. Did they test your C-Peptides to see how much insulin your body is producing? Did they discuss NAFLD. We had a member who ate a lot of grapes, he was diagnosed with NAFLD due to the fructose content. Very low carb diets help a lot of members here. If they tested for C-Peptides and autoantibodies and ruled out T1, very low carb, high fat diets do work for a lot of people. Being on insulin, if you chose to go that route, you would need to consult your Dr.

I drank that fruit juice when I was feeling so ill with covid, before I was diagnosed. I am on a very low carb diet of 60g, actually advised by my excellent diabetes nurse. I do not eat grapes, and I only ate them occasionally before being diagnosed. I only eat blueberries, strawberries and kiwi fruit and occasionally a small amount of melon. I didn’t have a c peptide test. I was checked for NAFLD, because I had an abdominal scan when I was so ill, as they were checking for cancer. No antibodies, nurse said I was just unlucky, and that I have insulin resistance. To be honest I’m on quite small amounts of insulin 6 basal and 6-9 bolus and metformin 1000mg. And that keeps my hbac1 at 38 which my diabetes nurse is really happy about. I’m extremely healthy otherwise. And that’s fine.

 

[Melgar]

As thin and fit diabetics, trying to control our blood sugars can be hard. Not everyone is TOFI (thin on the outside fat on the inside) . That seems to be the go to explanation. More research needs to be done. My C-peptides are low normal so I'm not producing lots of insulin which is an indicator of Insulin resistance, neither do I have a fatty liver. I just do not produce enough insulin. Type 2 is just a catch all for everyone whose diabetes is not autoimmune triggered. No matter the cause, even if nothing applies when it comes to lowering your blood sugars.

 

[Antje77]

I didn’t have a c peptide test. I was checked for NAFLD, because I had an abdominal scan when I was so ill, as they were checking for cancer. No antibodies, nurse said I was just unlucky, and that I have insulin resistance. To be honest I’m on quite small amounts of insulin 6 basal and 6-9 bolus

Did they test for all antibodies or just the GAD ones?
I'd want a C-peptide test in your case: Not overweight, being ill with ketones upon diagnosis, needing a low amount of insulin are all reasons to want to look into other possibilities than T2.

 

[louisew2605]

Did they test for all antibodies or just the GAD ones?
I'd want a C-peptide test in your case: Not overweight, being ill with ketones upon diagnosis, needing a low amount of insulin are all reasons to want to look into other possibilities than T2.

Yes they tested for all. I only need small amounts of insulin because of my low carb diet and high level of activity. If I eat more carbs, I need a lot more insulin. I’m sure they won’t give me a c-peptide test, why? it won’t change my treatment. My father was type 2, slim, fit with a healthy diet too.

 

[Antje77]

Yes they tested for all. I only need small amounts of insulin because of my low carb diet and high level of activity. If I eat more carbs, I need a lot more insulin. I’m sure they won’t give me a c-peptide test, why? it won’t change my treatment. My father was type 2, slim, fit with a healthy diet too.

I the UK I believe T1's do get better treatment, like CGM on prescription.