Updated: June 2023
Many of my patients come to me with Type 2 Diabetes and a history of high triglycerides. Often, they are on cholesterol lowering medications such as statins.
Interestingly enough, the FDA has made it mandatory for a warning to be placed on labels of cholesterol lowering medications. The warning is in regards to the fact that statin medications can raise blood glucose levels.
High Hemoglobin A1C and Diabetes
This is very important because high blood glucose and hemoglobin A1C above a 6.4 are consistent with Type 2 Diabetes.
Therefore, statin medications increase someone’s risk of getting an actual disease! Type 2 Diabetes is no joke!
Diabetes does damage to the blood vessels and causes them to become leaky. That’s how diabetes damages the eyes, kidneys, decreases brain function and causes nerve damage in the feet.
All tissues throughout the body need oxygen more than they need anything else. An example would be that we can live without food for weeks, but can live without water for only 3-4 days. Water has oxygen in it: H2O
Red blood cells are made up of hemoglobin molecules. The importance of hemoglobin is that the iron in the hemoglobin binds oxygen and that is how your red blood cells carry oxygen.
What does High Hemoglobin A1C mean?
Hemoglobin A1C is also known as “glycosylated hemoglobin”. The term “globin” refers to the protein in the molecule. “Heme” stands for iron.
High levels of blood glucose (sugar in the blood) are very inflammatory because the sugar will attach itself to the hemoglobin molecule.
When sugar attaches to hemoglobin, it actually changes the physical shape of the protein in the hemoglobin molecule.
The easy way to think about it is to realize that sugar will stick to the molecule that is supposed to carry oxygen throughout the body and change its shape.
Once the red blood cells get loaded up with sugar that is stuck to the hemoglobin, the sugar doesn’t come off. It will stay there for the full 120 day life cycle of a red blood cell until it dies.
How Long Does it Take to Lower Hemoglobin A1C?
Due to the fact that the sugar won’t come off of the hemoglobin until the red blood cell dies, it can take about 3-4 months of healthy eating and exercise to change hemoglobin A1C on a grand scale.
The importance of lowering hemoglobin A1C can’t be overstated. High hemoglobin A1C means that you are getting low oxygen to tissues throughout your body.
A red blood cell that is loaded up with sugar, can’t carry as much oxygen.
Another thing about high hemoglobin A1C is that it is a marker of inflammation. The higher your hemoglobin A1C, the more inflamed you will be.
Are all Type 2 Diabetics Insulin Resistant?
I’m sure that there are exceptions but in my clinical experience the two go hand in hand. It makes sense when you think about it.
Type 2 Diabetes causes high levels of sugar to stay in the blood largely due to inflammation of the insulin receptors. The unused sugar goes to the liver where the liver stores it as triglycerides.
I think it is fair to say that most diabetics know that their triglycerides are high because their doctors have told them so. But, they don’t know what it really means, and they don’t know that it is a serious health problem.
They don’t know that the reason that they have zero energy and “don’t feel good” is because sugar is stuck to their red blood cells and can’t go into the tissues to produce energy.
What are HDL and LDL Cholesterol?
Almost always, when your triglycerides are high, your HDL cholesterol is low. I’ve seen thousands of blood work reports that validate my claim.
HDL cholesterol stands for “High Density Lipoprotein”. HDL is considered the “good cholesterol” because it is more dense. What makes it dense? It has more protein than LDL cholesterol.
LDL cholesterol stands for “Low Density Lipoprotein”. LDL is considered the “bad cholesterol” because it has more fat (less protein) than HDL cholesterol. LDL cholesterol is sticky and is considered atherogenic (can cause plaques and hardening of the arteries).
Interestingly though, both HDL and LDL cholesterol serve as antioxidants. Antioxidants protect tissues from free radical damage and also repair damaged tissues.
It’s just that HDL cholesterol is repairing tissues with protein where the sticky LDL cholesterol is repairing tissues with fat. But, they are still both repairing aren’t they? The question becomes: why and what are they protecting?
What Does this Mean to Me?
Could high total cholesterol, high triglycerides, low HDL cholesterol and high LDL cholesterol be as simple as a group of signs that the body is in an inflamed state of catabolic breakdown? Absolutely yes!
I see so many patients who work to improve their health and have their numbers get back into a healthy range naturally.
Remember, inflammation is the root of all disease. If you are very inflamed, your liver will make more cholesterol in every attempt to protect, limit and repair the damage.
How do Triglycerides Tie in?
Yes, high triglycerides are unhealthy, but what is it really a sign of? High triglycerides are a sign of a phenomenon called Insulin Resistance.
Hallmark Signs of Insulin Resistance are High Triglycerides and Low HDL Cholesterol
With insulin resistance, sugar is not getting into your cells. So you have an overabundance of insulin in the system because the pancreas is making more.
Your cells are seeing and recognizing the high insulin levels and telling the pancreas to stop making insulin.
Insulin is damaging to the receptors on the hippocampal (brain) cells. Insulin causes inflammation which makes the hippocampus unhappy.
How many people tell me that their total cholesterol is fine but their triglycerides are high? A lot! How many of those people tell me that their Dr. said that it wasn’t that big of a deal and to take some fish oil? A lot!
Once again, we are talking about prevention. We are talking about being as healthy as possible and staying that way for as long as possible.
Does Fish Oil Lower Triglycerides?
As I said above, high triglycerides are a sign of insulin resistance and it is a big deal! Fish oil is important because it helps limit the damage but fish oils aren’t going to fix or repair the source what is causing high triglycerides.
The overall reason why triglycerides get elevated with blood sugar dysregulation is because when the liver sees more sugar and insulin in the blood it makes more triglycerides.
Nearly all elevations in triglycerides are going to be because of sugar metabolism issues.
More about Catabolism
I’ve talked about catabolism and catabolic processes in other articles. When LDL, cholesterol, and insulin are high, those are signs of a catabolic process.
A catabolic process occurs when the body is inflamed. Basically, the oxidative stress from free radical damage causes the body to cannibalize itself from the inside out.
Because of this, catabolism produces mitochondrial breakdown which causes disease and all of the other things that I work with in my practice.
An important point is that there are different stages of insulin resistance. From time to time, a few people tell me that they don’t have blood sugar dysregulation and that this topic doesn’t apply to them. Wrong!!!
Is Insulin Resistance Serious?
Hypoglycemia, prediabetes, and Type II sugar diabetes are all forms of sugar dysregulation and have different levels of insulin resistance associated with them.
A healthy looking teenager with no “health problems” could still be insulin resistant and on their way to health problems and future disease as a result.
In fact, it is plausible that a newborn infant could be born with insulin resistance depending on the health and dietary decisions by the expecting Mom.
By default of lack of exercise, poor dietary decisions, etc… most people deal with a form of insulin resistance. Of course, the severity is different for various patients but it is there and damages the body (and brain) over many years.
Remember, disease takes decades to develop. Disease doesn’t just happen overnight.
Type 2 Diabetes and Insulin Resistance
Type 2 diabetes increases your risk for getting Alzheimer’s Disease.
Insulin resistance is a spectrum disorder. On the outside of cells we have 300 to 500 receptors. These receptors are sensitive to insulin.
When there is glucose circulating in the blood, the glucose goes into the beta cells in the pancreas. The beta cells in the pancreas produce insulin as a result.
It’s all about that Sugar, bout that Sugar – and Insulin…
The more sugar you have in the blood, the more insulin you will have being released into the blood.
When you eat food, sugar goes up in the blood. When sugar goes up in the blood the beta cells in the pancreas release more insulin. Sugar has to get into the cells to go to the mitochondria so that they can produce energy.
But, sugar doesn’t go straight into the cells. It has to be invited by the insulin. When the cell needs energy it will attract insulin to it.
The insulin will dock on the receptor just like a boat going into a boat dock and it will open the gate which allows the sugar to go inside the cell and go to the mitochondria so that it can produce energy.
What Two Factors Cause Insulin Resistance?
There are two things in general that can cause the insulin receptors to become resistant to insulin.
- When the receptors see too much insulin. That is when someone is not paying attention to their diet, eating too much sugar (or foods that turn into sugar such as breads, pasta, soft drinks, cookies, cakes, and fruits high on the glycemic index, etc…) and the kinds of things that create spikes and dips in blood sugar throughout the day.
- Low-grade inflammation over time. Generalized inflammation can come from infection or other health problems. Even if someone is eating a healthy diet and they have low-grade inflammation, they will develop to inflammation in the insulin receptors and the receptors will begin resisting the insulin.
Once they resist the insulin, the sugar levels go up and that’s what creates the sugar spikes. Since the insulin can’t open the gate for the sugar to go into the cells, the sugar doesn’t have anywhere to go, so there is more in the bloodstream.
More sugar in the bloodstream causes the beta cells in the pancreas to release more insulin. More insulin and more sugar stimulates the liver to create more triglycerides.
So, high triglycerides are a hallmark sign of insulin resistance.
Now you see why I spend a lot of time talking about sugar – insulin – cholesterol – triglycerides – adrenal glands – brain health – circulation – liver function, etc… It is all tied together!
What Diet will Reverse Insulin Resistance?
Working to regulate blood sugar is they key. Decreasing inflammation of the insulin receptors is important. Eating anti-inflammatory foods helps a lot. So does staying away from fruits that are high on the glycemic index.
It’s all Related
All of the body systems are dependent on each other. All it takes is for one thing to throw the others off and the sad part is that the number one culprit is sugar (both simple and complex).
I did some repetition here, but I felt that it was important because most people need to read something more than once for it to sink in.
Also, most people don’t have a degree in cellular physiology, biochemistry, or human anatomy and may be hearing some of these terms for the first time.
I feel that the important take home from this article is that the body is a complex organism. Indeed, a true miracle.
When a person is in a state of insulin resistance, certain processes will take place that will break down the body and lead to poor health.
It’s like a dog chasing its tail. Running around in circles over and over again. So, what state do you want your body to be in?
Do you want to be in a poor state of health where you are making frequent trips to your Dr. or the emergency room?
Or, a state of good health so that you are protecting your heart, brain, and blood vessels and hopefully preventing disease? To me, the choice is easy.
Take this Seriously
Obviously, most of my patients are in various stages of disease by the time they get to me. Why does it have to be this way?
Don’t wait until you are between 60-90 years old to decide to become healthy. Sure, improvements can be made during the various stages but why wait?
Why would you wait until you are going blind, have kidney failure, have cognitive decline, or have neuropathy in your feet from nerve damage to become motivated?
Now is the time. Prevent! Prevent! Prevent!
That way you can hopefully live a long, healthy, and happy life.
Happiness is Health,
Dr. Keith Currie