[00:00:00] Speaker A: This is episode number 251 of Better Blood Sugars with Delane, Md.
Welcome to Better Blood Sugars with Delane, MD, where you can learn strategies to lower your blood sugars and improve your overall health. I'm your host, Doctor Delane Vaughn. Ladies, if you know you're capable of doing badass things at work and for your family, but you're confused and frustrated with why you can't seem to stop eating the chocolate cake, this podcast is for you. Let's talk.
Hey there, and welcome to the podcast. Thank you for joining me today. Thank you for your interest in your health. Thank you for deciding to spend a few minutes with me today to learn some things that hopefully maybe are new and interesting to you.
Today we are going to talk about the liver and how diabetes and insulin resistance and the liver play together. I don't know whether the egg came before the chicken in that situation, but either way, there's definitely an interplay there, and there's an impact that insulin resistance and its effect on the liver has on other organs, on other things in our body.
The chemistry, the biochemistry behind this is pretty rich and thick and maybe even a little heavy. I find it, um, you know, the difference between gluconeogenesis and glycogenolysis and glycogenesis and all of these things, like the difference between all of these different biochemical mechanisms can be confusing. So I'm not diving really deep into that. This is not a chemistry lesson. You don't. There's not going to be a test at the end, but I think hearing what the under or kind of the, you know, end product is with some of these, um, effects on the liver and some of the effects that the liver has on the rest of the body is important for you to understand so that you understand your body and you also understand why it's important to fix this. Why is fixing insulin resistance so important? It's not just that you're going to see an a, one c of less than seven and get your doctor off your back, or an a, one c of less than 6.4 and get your doctor off your back, or an a, one c of less than 5.6, and you know, you're going to feel really good, because your numbers are normal. It's not just that you. Yes, that is part of it, but it's not the only thing that's happening. And so seeing how it impacts other chronic conditions, chronic diseases that you have, so you can kind of figure out the bang that you're really getting for your buck by fixing your insulin resistance. Previous podcasts this month have talked about insulin resistance and hypertension and insulin resistance and cholesterol or dyslipidemia. So I think that kind of seeing this last part, and it's not really the last part, there's, again, there's a great book by Ben Bickman, b I k m a n, why we get sick. Great book. Talks about all the different chronic conditions that you will chase with medications only fixing a symptom and never fixing the problem. It talks, this book specifically talks about all of the different conditions that insulin is really the root cause of and how fixing that part is going to improve all sorts of different aspects of your health.
So we're going to talk about that today. We're not going to dive real deep into it. It's going to be a real brief discussion. I feel so prep yourself for that. I hope that it will be a brief discussion, and I don't ramble on and on and on, but I hope that you get some new information, and I hope you find it helpful, and I hope you really do see the importance of fixing this part of your health, this insulin function within your body.
Before we get started, I do want to let you know there is going to be a training webinar on June 21 at 09:00 a.m. Central time. So that's 10:00 a.m. Eastern time. 08:00 a.m. Mountain time. 07:00 a.m. Pacific time. It's a Friday morning, June 21. I'm going to be teaching all that there is to know about fasting and how to use fasting as a tool for seeing better blood sugars. This will be the second training session that I've done in the Better Blood Sugars Basics series. The first one was on using plans, and this one is going to be how to use fasting as a strategy. I'm going to discuss why insulin resistance develops and how it causes your diabetes. I'm going to talk about how fasting improves that. We're going to talk about different fasting regimens. We're going to discuss and develop a individual fasting plan for you so that you can come away from this training webinar with a four week plan for seeing better blood sugars. It can be that fast.
[00:04:41] Speaker B: Okay.
[00:04:42] Speaker A: The fee for this webinar is going to be dollar 59. It is going to be a game changer for you to start seeing better blood sugars. You're going to be able to register at ww dot delanemd.com forward slash fast path.
[00:04:57] Speaker B: Wow.
[00:04:57] Speaker A: I hadn't tried to say that before, but that's kind of a tongue twister, so it's delaney. Ddelanemd.com fastpath f a s t p a t h. If you have any questions, send me a message.
[email protected]. I'm happy to answer any questions or get you registered.
Okay, so let's talk about your liver and insulin resistance. Last week, we talked about dyslipidemia, and dyslipidemia, or high cholesterol does occur because of the impact that insulin resistance has on your liver. What will happen invariably is your liver will not process cholesterol appropriately. It will emphasize, overemphasize, over, exaggerate, I don't know, overproduce the cholesterol, the ldl, the fats in our bloodstream that tend to be associated with heart disease and cardi or cerebrovascular. So strokes and heart attacks. Okay. So your liver will preferentially produce too much of the fat that creates heart disease and stroke.
[00:06:04] Speaker B: Okay.
[00:06:06] Speaker A: It's a liver issue that's causing that. Maybe you're overeating it in your diet, but even if you lower the amount that you eat in your diet because of the impact of insulin resistance on your liver, you will still have too much of that fat. Okay? So you have to fix that insulin resistance component. I talked about that last week. If you're interested, go back and listen to that podcast. I am going to talk a little bit at the end of this podcast about how meds just don't create the changes we're looking for and some of the evidence behind statin therapy. And how beneficial is statin therapy, really?
So I want to talk a little bit. I want to start, I guess, with non alcoholic fatty liver disease. Insulin resistance causes non alcoholic fatty liver disease. And what this is, is we will see so how this looks clinically. We do your yearly labs, and we look at your, um, liver enzymes, and we see that your liver enzymes are too high. That's how it looks in practice. Like, what's going to happen? You're going to go in for your, uh, yearly physical. We're going to do a comprehensive metabolic panel. We're going to look at your electrolytes and at your kidney function and your liver function, and we're going to see your liver enzymes are a little elevated. And then we're going to be like, oh, we better look into this. Did you get too much tylenol? Do you drink too much? What is it? Do you have an autoimmune liver disease. We're going to go, oh, what could this be? And we're going to send you for an ultrasound or possibly a ct scan.
[00:07:40] Speaker B: Of your abdomen, but probably an ultrasound.
[00:07:43] Speaker A: And what we're going to see is non alcoholic fatty liver disease or fatty infiltration of the liver or hepatostiatosis. We're going to see some changes in the amount of fat that has been deposited in your liver.
[00:07:59] Speaker B: Okay?
[00:08:00] Speaker A: That's how this works. And then we're going to say, wow, you have fatty liver disease. You should cut down on what you eat and lose weight. And that's what we're going to do. And we're not going to do anything else. We might say, hey, let's recheck that, uh, ultrasound in two years. So this is the funny thing about medicine, about western medicine. And again, I don't want anybody to think that I'm bashing on physicians or nurses or pharmacists, every single one of them. Some of them have horrible beds and manners, but I've yet to meet the one that's like, interested in doing the wrong thing or that's interested in not taking care of their patients. They're all interested in taking care of you. They want to help you. They're just using information that is wrapped up in this, in the medical system, okay? And what that means is that pharmaceutical companies, big pharma and hospitals, and again, hospitals are full of good people, but they don't make money unless you're sick.
That's just what runs the western medical system. So it's not that they're interested in healing your body. They're interested in figuring out what medication goes with your symptoms and your lab findings. And they have yet to find a medication that fixes insulin resistance. And since we don't have a medication for that, they don't give you a med. They don't really worry about it. They don't talk about it because they don't have a med to prescribe you and then give you increasing doses until we get the results that we want. Right? That's what we do with blood pressure. You have high blood pressure, we give you a med. And if that med doesn't work, we give you another med. And if that doesn't work, we give you another med until we bring your blood pressure into a range. That's just the way the system is set up with insulin resistance and non alcoholic fatty liver disease. There is no med for us to give you and then watch your numbers come down. So what do we say? Eh, change some lifestyle stuff.
[00:09:56] Speaker B: Good luck.
[00:09:57] Speaker A: We'll watch it again in two years. That's all there is to do.
[00:09:59] Speaker B: Okay?
[00:10:00] Speaker A: And again, I'm not trying to bash on the system. It's just the way the system is set up. If there is not a med to give you, they don't know what to do with it. We, in our medical training, have minimal, minimal training. We're talking out of four years. We're talking a few hours of lifestyle modification and coach training. Only a few hours. That's just all that we're given. This is not a major, you know, this changing of your lifestyle is not a major component of the way the western medical system is set up. Okay?
[00:10:33] Speaker B: We diagnose a disease, and we give you a med. That's the way the system is set up. There's not a med to give for this, so we don't give a med for it. We're like, maybe we watch it. Certainly non alcoholic fatty liver disease can progress into cirrhosis of the liver. And so we want to watch that carefully. But that takes a long time, usually, or at least that's what we've noticed, that it takes a long time. And so we just watch it over. Every couple of years, we do another swim over your liver and see if there's any progression.
So this insulin resistance leads to this accumulation of fat, and that is twofold. One, you know, the insulin resistance leads to an increased production of free fatty acids, and then that gets deposited into the liver. It also leads this kind of turns into, you know, a tail chasing game, right? Or, like, a snowball effect, probably more than a tail chasing game. What happens is we have too much glucose, which makes too much insulin and too much insulin and affects the liver by making it make too much glucose and release it into the bloodstream. Okay? It causes the liver to kind of dysfunction, to malfunction, malfire, misfire, and then you lead to too much glucose in your bloodstream. And that, of course, sends a message to your pancreas to make more insulin, which causes more insulin resistance, which is going to cause your liver to make too much blood sugar. So it kind of turns into the snowball effect that really gets away from us.
It also leads to the production of free glucose from free fatty acids and proteins, even when you're not eating a huge amount of protein. So that can happen with insulin resistance in the liver. And then there's this lipid accumulation in the liver. What happens here is that anytime lipids or adipose, adipocytes, fat anytime these accumulate anywhere, after a certain threshold, they turn this adipocyte, this fat collection turns inflammatory. It happens everywhere. Anywhere that fat is accumulated, it will hit a certain threshold, and it will start calling in inflammatory markers, and then it starts releasing inflammatory cytokines, inflammatory messages in the body. Okay? So that leads to this liver inflammation, which is what we're picking up on your enzymes. Okay? We've. I've spoken about this on the podcast before, and I'm never interested in fat shaming anybody. I don't think anybody has any guilt or shame in any excess adipose tissue that they carry on their body. When our food manufacturers are allowed, and I don't mean to get all so foxy here, but hang on for just a moment. When our food manufacturers are allowed by the government to make food that we become addicted to, and then, in turn, overeat, because they want to make money, the food manufacturers want to make money, and then that, in turn, causes us to accumulate too much adipose and turn inflammatory. It's nobody's like, there's no shame. There's no human being that should carry any shame in their brain for this. It is not because you are broken. It's because the food that we eat makes us sick. And food manufacturers are allowed to make that food in an addictive way so that they can make more money when you overeat it. Okay? So please do not. There is no fat shame here at all. But the fact of the matter is that when adipose accumulates in our body, it releases inflammatory markers, and that leads to inflammation in our liver. It leads to inflammation of the liver, and that's this steatohepatitis that we're seeing, right? This fat liver inflammation. Steato is fat hepatitis. Liver itis is inflammation. Okay, so there's this inflammation of the liver that is occurring from the fat that's accumulating in your liver, and that fat turning inflammatory. All right? So that is a big driver of nonalcoholic fatty liver disease, and it's caused from this insulin resistance. Then there are other outside the liver effects, because the liver is inflamed and sick, it turns down, it stops, it has a decrease in its protein synthesis. So this means that there are proteins, immune proteins like that, fight off infection that are released into our blood by a healthy liver. But when the liver is under the effectiveness of insulin resistance, we have less of these proteins being released, and then there's immune dysfunction related to that. So people who have non alcoholic fatty liver disease and insulin resistance, and we have known this at the time of COVID we learned very clearly that insulin resistance is very, very tightly tied to for immune function.
This is part of the process there. The insulin resistance leads to immune dysfunction by the decreased production of immune proteins. And we don't have the ability to have the initial response to fight off infections.
Then there's also hormone dysregulation. I think that this is huge. A lot of the women that I work with have either had polycystic ovarian syndrome, have polycystic ovarian syndrome is relevant because they want to get pregnant and they can't or are postmenopausal or perimenopausal.
The effect that insulin resistance has on our liver and then impacts our hormones is huge.
When the liver is sick with insulin resistance, remember, it's not making its typical proteins that it makes. One of these proteins is called a sex hormone binding globulin. Globulin is just a fancy name for protein, sex hormone binding globulin. And when that is not produced, it allows an overload of androgens in the female system, and that leads to an imbalance of our hormones that causes our ovaries to start producing tons of follicles, and that leads to polycystic. Right. Follicles look like cysts on ultrasound.
[00:16:55] Speaker A: And so that's where it got its.
[00:16:57] Speaker B: Name, polycystic ovarian syndrome. And it's because we have too much free testosterone floating around in the woman's system, and that then leads to our ovaries making too many follicles, and that leads to even more testosterone and less estrogen. So we get. Our bodies just get a lot of whack. Our hormones just get a lot of whack. If you are a perimenopausal woman, your hormones are also out of whack by this system. It's just that you're not having as many ovary like cystic issues, and you're not having infertility associated with it, because most of us around menopause are wanting to make more babies. So this hormonal dysregulation that we see, we talk about the low estrogen effect that we have as women who are perimenopausal. A lot of it is because we have this overarching testosterone signal going on.
That's one way I always want to point out, that there is the way that the liver moves free fatty acids through it. The sick liver does this differently. And then there's changes in glucose metabolism, both glycogenesis and glycolysis and gluconeogenesis, that happens. And this change in that glucose metabolism also adds for men, for male counterparts, adds to testosterone deficiency.
Their testosterone isn't produced appropriately. Their receptors don't sense it appropriately, and we have this effectively low testosterone effect. In addition, when there is extra, again, adipocytes, right, like the negative impact of the over accumulation of fat cells on our body.
Societally, we call this being fat. I hate that term. I think it's extra excess.
It's excess energy that we've stored on our body in the form of adipocytes. Okay? So when we have extra adipose tissue, which is fat tissue, what ends up happening is that the adipose tissue makes a hormone called leptin. Leptin is supposed to tell your brain that we have fat, right? Like, fat is here, we're in the house. You don't need to eat more. You don't need to go and hunt and gather anymore. But we've talked about this in the past on the podcast. When we have too much leptin in our system, our brain stops listening to it. It becomes leptin resistant the same way that we become insulin resistance resistant. And in fact, if you have insulin resistance, you should assume that you also have leptin resistance. Okay? But in men, when we have too much leptin being produced, like, the overproduction of leptin actually turns down the testosterone production at the testicle level. Okay? So, like, there's all of this interplay between insulin resistance, insulin, or non alcoholic fatty liver disease. So the effect of insulin resistance on our liver, the effect of insulin resistance on our fat, causing us to make too much fat, which then causes us to make too much leptin. And then we have this misfiring and this malfunctioning of our hormones, this hormone dysregulation. Okay, so, again, I know I've talked about this a little bit in this podcast, that there are no meds that treat this. There are no meds that will cure the insulin resistance in your liver. The only thing to do is to really change the things that you're eating so that you can decrease your production of insulin and let those cells heal up. And that just takes time. But you have to consistently change the way you're eating.
I talked about statins last week and how, you know, there's no monostatin you can throw on a bad diet and think that it's okay to keep eating junk. Right? And that same note.
You there, you know, statin therapy. Also, you know, he's talking about putting it in the water. Right. But statin therapy has a very low impact on extending your life. So even if you take statins and normalize your cholesterol level, there is no extension of your life. When we look at it over a long term, you know, statins have been available since the 1980s, and we've not seen significant life extension associated with statin therapy. Studies, when you look at them, are a couple of weeks, like two weeks to a few months, like three months.
That is the extent that you are going to see elongation of your life using statin therapy. Okay. Polycystic ovarian syndrome, we do a really good job of treating the symptoms, but we don't do a great job of actually curing it. And even the treatment of it, it doesn't get great results.
So that is kind of what I wanted to talk about today. We do not see, there's certainly no medication to treat non alcoholic fatty liver syndrome, liver disease. So again, we have to really change our diet. And that, you know what I always promote. Listen, ladies, if you truly believe there's some genetic tie, there's something outside of your control that's creating disease in your life. Any of these diseases, any of these chronic diseases, that's fine. You're still going to have to clean up your diet. And I think the best way to treat any chronic disease in this country is to fix your lifestyle choices. Fix your dietary choices, start exercising, start sleeping, start managing your stress, start fixing those lifestyle choices, and then whatever disease still exists. We live in a world we are graced to live in a world where there are meds to help you out. Fix the lifestyle stuff, and you can medicate whatever's left. That's what I want.
That's what I do help women with. So if you have any questions about that, send me a message, delaneandelainmd.com. We'll get on a call, we'll talk about what we can do. I do want to, before I close this out, talk about medications. If you have been medicated for your diabetes, please be careful making the dietary changes that I recommend in these podcast episodes. You have been medicated for the way you've eaten in the past, and if you change the way you eat, you're going to need to change your medications. I need you to call your physician or your provider that's giving you these meds. Find out how they want you to share your blood sugars with them and how they intend to share medication changes with you. Okay? If you don't do that, you can get very sick, the kind of sick that looks like death. So I don't want you getting in that situation. So please call your doctor so you can be safe. If you could do me a favor and rate this podcast on your podcast player, that would be awesome. Nine out of ten Americans have insulin resistance, so everybody needs to hear that they don't have to live sick for the rest of their life. And that's what this podcast is dedicated to. The more people who rate it and review this podcast, the more it gets put in front of others. So if you could do that for me, I'd be eternally grateful. Lastly, keep listening. Keep avoiding the foods that make you sick. Keep making choices for your vitality, your longevity, and your health. I'll be back next week. Bye.
