Canadian HR Reporter

F E A T U R E S 22 www.hrreporter.com B E N E F I T S REVERSING THE INEVITABLE Diabetes could actually be a preventable, reversible condition that does not have to result in high personal and financial costs for both workers and employers, and can be addressed through a systematic, evidence-based lifestyle approach, says Brendan Byrne of the Wellness Garage DAVE, a 57-year-old retired para- medic, came to us for help on a hot summer day, sweating and slightly winded. He had read online that people were reversing diabetes with keto diets and was looking for help. His Type 2 diabetes was long-standing and severe, he had been on insulin for more than 20 years and he was on an insulin pump using more than 200 units per day. Even with this, his glycated hemoglobin was 11.9 per cent (the target is seven per cent) and his C-peptide level, a marker of his pancreas' ability to produce insulin on its own, was very low. Dave, but there was also encouraging research about diabetes reversal. Roy Taylor from Newcastle University and his team have systematically developed the Twin Cycle Theory of metabolic dysfunction. Proven through a series of experiments, the theory demonstrates that diabetes is a disease of energy overload, a story of how the body tries and fails to accommodate increasing storage of energy and how each person's threshold for decompensation is different. Energy, of course, comes from food, and is essentially processed through two different pathways: glucose or fat. Both energy systems have buffers against overload. The glucose system has a small but immediate buffer through the storage of glucose as glycogen in muscle. The fat system has an immense capacity to buffer excess energy through the storage of fat in subcutaneous adipose tissue. And, of course, the fat system can buffer the glucose system. With prolonged periods of energy overload, these buffers begin to break down. Muscle inactivity results in lower capacity to store glycogen in muscle, resulting in more energ y being converted into fat. Our ability to store fat in subcutaneous tissue eventually hits a limit and fat begins to be stored in places where it was not meant to be stored. Fat also begins to build up in other non-fat cells (ectopic fat), which results in insulin resistance. Muscle takes up less of the glucose from dietary carbohydrates, causing more of this glucose to be converted to fat in the liver. Ectopic fat in the liver also results in insulin resistance. This, in turn, causes Chronic, progressive disease Conventional wisdom would tell us that there was no hope for Dave to reverse his condition on his own. Medical textbooks characterize diabetes as a chronic, progressive disease that can, at best, be slowed by a combination of lifestyle and medications. Medical treatment leads to very little remission. The general progression of diabetes is such that by nine years after diagnosis, less than 25 per cent of diabetics remain on one medication, and after 10 to 12 years, more than 50 per cent are on insulin. The odds were not encouraging for GENDER, BODY WEIGHT FACTOR INTO DIABETES RATES 2.3 million Number of Canadians (7.3 per cent) aged 12 and older with diabetes 20.2 Average number of years Canadians with Type 1 diabetes have been living with their diagnosis, compared to 12.2 years for Type 2 diabetes 8.4% Percentage of males with diabetes compared to 6.3% for females 13.7% Prevalence of diabetes among obese Canadians, compared with 6.8% for overweight Canadians and 3.6% for those with a normal weight the pancreas to release more insulin both in response to meals but also at baseline in order to control the liver's production of glucose and maintain normal fasting blood sugars. Eventually, ectopic fat finds its way into the pancreas and affects insulin production. At this point, insulin production plateaus and can no longer control blood glucose levels. Once fasting blood sugars reach seven millimoles per litre, we call this Type 2 diabetes. Taylor describes this as a "metabolic vicious cycle" that repeats and progresses from weight gain to insulin resistance to abnormal blood sugars all the way to full-blown diabetes. Reversing the cycle Our individual propensity toward insulin resistance and diabetes is variable and depends on our ability to accommodate energy overload; in other words, our personal fat threshold. Some people are able to gain more weight and stay healthy, while for others, a small amount of weight gain leads to fat storage in the wrong places (muscle, Source: Statistics Canada

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