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Chain saw massacre!!!!
Bear with me on this...
So you take a chainsaw and you cut off the leg mid-thigh of a morbidly obese person and then do the same thing to a perfectly fit person that works out regularly - and compare the two limb afterwards. Take the limbs and turn them so that you look down the length of the cut end at the cross section. What you see in the morbidly obese person is that the limb is predominately adipose fat tissue with very little striated muscle. By very little, we're talking less than 10%. In the fit person, however, the limb may be as much as 95% muscle with little to no fat. You say well tell us something we didn't know...
Fine i will.
Turns out that sugars circulate in the blood in the form of glucose. Fat tissue does not have glycoprotein receptors on their surface that take in sugar out of the blood for its metabolism. Muscle cells do, however. The sugary blood circulates through the body and passes right on by the fat tissue without doing anything. In the case of a morbidly obese diabetic, the small amount of striated muscle tissue in the body is inadequate to account for all this glucose and the body becomes overwhelmed by it. The body produces insulin, a hormone that tells the muscle cells and the liver to take up these sugars so that the body doesn't go into what is called diabetic ketoacidosis, which can lean to coma and death if intervention is not taken. The problem with the morbidly obese is there isn't very much muscle there for insulin to work on, so people become what is called "insulin resistant". In these people, other classes of medications are needed, such as metformin, etc. that rely on other pathways to process and eliminate the overload of sugars, such as flushing it out the kidneys. This isn't so great, however.
Insulin whips the muscle cells to absorb absorb absorb! They absorb more than they really want to. Big hearty muscle fibers can probably tolerate this in the short and long run, but the tiny cells that make up the lining of micro arteries that nourish nerve fibers, organs, the eyes, brain, etc. become choked with the sugar load. Sugars act like glue in these structures, plugging them up. The result is that morbidly obese diabetics have a staggering amount or peripheral neuropathy, retinopathy, peripheral vascular disease, coronary artery disease, renal failure and stroke. In fact, diabetes is by far the number one cause of blindness, kidney failure (dialysis), limb amputation, stoke, and heart attack. The number two cause of these situations isn't even close. Diabetes is an absolute killer, much more scary than the chainsaw scenario I startled people with at the beginning of this conversation.
What can you do? Everyone on the planet needs to do resistance training and increase muscle. You cannot allow your percentage body fat to become overwhelming. Simply put, you need to lift weights and stay fit, its as simple as that. A combination of upper and lower body weight training twice a week, with a third day per week for cardio is the optimal. For those that are already morbidly obese, a combination of weight training and cardio, perhaps considering gastric bypass surgery, can be an option. Turns out that morbidly obese diabetics that undergo gastric bypass surgery are no longer diabetic on post operative day 1 after the surgery. Its that impressive.
Anyways, sorry for all this. Maybe there is one person out there that read this and something clicks in them that leads to healthy modifications that can go a long ways toward preventing them from becoming diabetic. In others, maybe they pass along the heads up and explain the dangers of diabetes to them. Good luck!