How Obesity Causes Type 2 Diabetes

| April 10, 2012

If you have been following my blog posts over the last three months, you will know that type 2 diabetes is a condition that involves impaired glucose metabolism. That is why it is so important to keep your blood sugar level under control, in particular by avoiding those “high glycaemic load” foods that cause rapid rises in blood sugar.

What is less well known is that type 2 diabetes is also characterized by impaired fat metabolism. When blood sugar levels are high, the body does whatever it can to protect the brain and other vital organs from the toxic effects of too much glucose, initially loading it into muscle cells, then converting it to fat for storage in fat cells (or adipose tissue as the scientists call it).

We used to think of body fat as being like lard – an inert, white substance that we just lug around with us. We now know that fat is far from inert. In fact, adipose tissue plays a crucial role as an endocrine organ and secretes numerous bioactive substances, collectively known as adipokines, which have profound effects on our physiology. Obesity is now recognized as a chronic inflammatory disease in its own right, which profoundly affects carbohydrate and fat metabolism, immune function and cardiovascular disease risk.

Visceral fat, the kind that collects around your body organs, produces more adipokines than subcutaneous fat, the kind that lies just under your skin. The amount of visceral fat you have is a pretty reliable indicator of insulin sensitivity, impaired glucose tolerance, high blood pressure and high cholesterol and triglyceride levels.

The link between body fat and insulin resistance is becoming clearer

So, just how does being fat cause type 2 diabetes? The irony is that some of the adipokines produced by fat cells, such as the hormones leptin and adiponectin, are known to improve insulin sensitivity, suppress appetite, increase metabolic rate and increase physical activity. Your body is in fact trying to regulate itself and make you slimmer.

But, as the amount of adipose tissue increases, consistently high levels of adipokines in the bloodstream cause this control system to become overloaded. The receptors no longer respond, so your muscle cells become less sensitive (i.e. more resistant) to insulin and you don’t know when to stop eating, you can’t burn fat and you can’t find the energy to exercise. It’s a vicious circle. The result is insulin resistance, metabolic syndrome and, eventually, type 2 diabetes.

This is why controlling your weight is important in avoiding or managing type 2 diabetes. And it shows you why it is important to take action at an early stage, before your fat cells take over control of your metabolism. Of course, losing those extra fat stores is a good thing however heavy you are, but it is a whole lot easier to do if you don’t let it get out of hand.

There’s one kind of fat that actually helps you to lose weight!

The kind of fat that produces adipokines is called “white adipose tissue”, but there is another sort, called “brown adipose tissue” that until fairly recently was thought to be found only in infants. New imaging technology has revealed, though, that this special kind of fat cell is also present in most adults. What gives it its brown colour is its high concentration of mitochondria, the energy-producing centres inside the cells. Brown adipose tissue doesn’t just store fat, it actively burns it. The more brown fat people have, the less likely they are to be obese.

Now scientists at the University of California have discovered a protein that is able to convert white fat cells to brown fat cells. What is more, they have found that a class of drugs called PPAR-gamma ligands stabilise this protein, leading to its accumulation inside cells. This essentially “throws a genetic switch” and converts the white fat cells to brown – at least in mice.

The question remains whether it is possible to do this in people as well, and if so, how. The development of a safe and effective medication that can make this amazing conversion is probably still several years away. In the meantime, we shall have to rely on our old friends diet and exercise to help keep our weight down and keep type 2 diabetes at bay.

In my next blog post, I shall be looking at the role of free radicals and oxidative stress in diabetes. Oxidative stress is a damaging process that can attack the arteries, liver and other organs, but can be prevented or reversed by eating the right foods.

Wishing you the best of health,

Martin Hum
PhD DHD Nutritionist
for Real Diabetes Truth

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Bear in mind we are not addressing anyone’s personal situation and you should rely on this for informational purposes only. Please consult with your own physician before acting on any recommendations contained herein.


1. Rocha VZ, Folco EJ. Inflammatory concepts of obesity. Int J Inflam 2011; 2011:529061. Epub 2011 Aug 3.

2. Rabe K, Lehrke M, Parhofer KG, Broedl UC. Adipokines and insulin resistance. Mol Med 2008; 14(11-12):741-51.

3. Haruya Ohno, Kosaku Shinoda, Bruce M. Spiegelman, Shingo Kajimura. PPAR? agonists induce a white-to-brown fat conversion through stabilization of PRDM16 protein. Cell Metabolism 2012; 15(3):395.

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Category: Obesity and Weight Loss

Comments (2)

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