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Every Month: a Review of Major Teaching Points

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A Power Program for Student Review

A Review of Teaching Highlights from Last Month

The 6-Month Program

  1. Biophysics Of Obesity
  2. Obesity...Cholesterol...Heart...Stroke
  3. Obesity...The Metabolic Syndrome
  4. Obesity...Insulin Resistance...Diabetes
  5. Diabetes Complications: Glycoproteinopathies
  6. Obesity...Feeling Sick and Liverish
Begin Countdown

Last month’s Teaching Patient Focus…on Twitter…was: The Metabolic Syndrome. It is reviewed for your convenience in this Countdown…

While visibly true that most American men over 40 have bubble bellies, it is invisibly true that half of them also have high blood pressures.

Called Essential Hypertension, it tends to be regarded casually and treated with tablets (often diuretics). Taking a daily pill is easier than reducing any bubble belly. The term ‘essential hypertension’ doesn’t mean necessary, but ‘unexplained.’ It is caused by an excess of circulating blood insulin retaining sodium and water. Think liver.

Fatty acids from visceral fat deposits (deep among loops of gut beneath the protuberant bubble, and deep within the abdomen) continually flood the liver. They choke liver cells into dysfunction, and this allows an excess of cholesterol and insulin to circulate independently in the blood.

A trim liver soaks up most of the insulin coming up into it from the pancreas, through the portal vein (along with nutrients from digestion and those pesky visceral fatty acids). Over months and years, so much fat collects in liver cells the they become swollen, inflamed, scar and die. It is a process that, unchecked, can destroy the liver.

Long before liver destruction, escaped insulin simply circulates in excess. Its presence promotes the transfer of glucose and amino acids into target tissues like muscle and fat, tissues that do not need such steady stoking. They begin to defend themselves against insulin’s input overload by partially blocking their response. This marks the official metabolic onset of Insulin Resistance.

Excessive blood insulin retains sodium molecules. They hold large numbers of water molecules (about 25 each) which plumps blood volume and raises blood pressure. An early sign of Insulin Resistance and The Metabolic Syndrome is a drifting blood pressure. Follow yours at the pharmacist’s blood pressure station…lose a little weight and watch it fall.

Your liver is the body’s Maestro of Metabolism. After a meal, the normal liver allows insulin to rise in the blood, to distribute glucose and amino acids into muscle and fat, for their use or storage. A normal liver also keeps the brain supplied with glucose at all times: overnight, between meals and during starvation. It can make glucose from the amino acids in protein.

The Metabolic Syndrome describes a kind of chemical stiffness…a slowing of nutrient processing. It emerged as an idea 50 years ago when patients with early diabetes of the kind called Type II, were found to produce 10 times more insulin than normal, not less. Resistance to the effects of insulin was postulated.

Currently, as if hypertension and a high cholesterol and diabetes were not trouble enough, the high insulin levels of a Metabolic Syndrome have been demonstrated to promote the growth of cancer. Studies show a 4-fold cancer increase in populations with bubble bellies. Finally, cancer cells cultured in the laboratory need insulin to grow, while normal cells do not.

In summary… excessive visceral fat leads to fatty livers which promote The Metabolic Syndrome for: a rise in blood pressure, cholesterol and blood sugar. As the TV says, it’s a good idea these days for Real Men, to have a heart-to-heart with their doctor about E.D…Exercise & Diet..I’ll bet that’s not what you were thinking.


This Month’s daily Teaching Patient Focus (on Twitter) is: Insulin Resistance & Diabetes