Type 2 diabetes and prediabetes are mainly a disease of insulin resistance not insulin deficiency. This means that these patients actually have higher level of insulin than the average individual. In this disease, the cells become resistant to the effect of the insulin. One of the basic functions of insulin is to transport glucose into the cells. Due to the resistance, the blood sugar level increases as glucose is not transported into the cells and it remains in the blood stream. As a compensatory mechanism, the pancreas secretes more insulin trying to overcome the resistance which causes the level of insulin to be elevated in nearly all patients with Type 2 diabetes mellitus.

Our adipose (fat) cells are in a continuous turnover. Every day we build new fat in a process called lipogenesis and we use some fat for energy production in a process called lipolysis.

These two processes should be in a tight balance to keep our weight stable.

It was estimated that in 10 years, all our human fat is completely turned over.

Increased insulin levels lead to sustained lipogenesis or in other words continuous creation of new fat. Insulin also prevents fat loss; referred to as lipolysis which simply means that the fatty acids are released from the fat cell to be used by the rest of the body for energy production. It is the primary mechanism for utilization of fat.

Insulin inhibits lipolysis in the fat cells by decreasing the transcription of the enzyme adipose tissue triglyceride lipase. This enzyme that breaks down the fat in the fat cells into free fatty acids to be used.

Having high insulin level in the patient of type 2 diabetes mellitus due to insulin resistance inhibits lipolysis which makes weight loss from fat virtually impossible.

The only way to be to lose weight in the patient with type 2 diabetes is to treat the insulin resistance and to bring the elevated insulin level back to normal to allow lipolysis to take place.


The Metabolism Clinic is established as the destination for weight loss and reversal of diabetes. Based in Charlotte, North Carolina. www.themetabolismclinic.com