Humon Comics

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Comments #9431511:


The wonderful world of PCOS 8 12, 11:30am


All of the links are to scholarly articles in peer reviewed journals. You aren't going to learn, or debate, an issue by being a science denier

I've read all these papers. I actually am a scientist working on diabetes, PCOS, and insulin resistance. I'm primarily focusing on PCOS and type 2 diabetes as my main research area is young adults who develop metabolic syndrome and impaired glucose tolerance, especially the lack of early warning signs.

Many PCOS and type 2 diabetics (including pre-diabetics) do substantial pancreatic damage to themselves before they are properly diagnosed, and further damage if they don't properly manage their condition. For young people this can mean a lifetime of complications, and eventual dependency on administered insulin.

The dietary composition bit is a big hot button issue. The ADA has long been advocating diets that are very "normal" because in the past most people with insulin sensitivity were older and permanent multi-decade life style changes just weren't in the cards. Unfortunately this advice is TERRIBLE for people who get PCOS or early onset type 2 diabetes and will be managing their diseases for the next 30-50 years.

You are definitely correct, weight loss, healthy eating, and exercise are things everyone should be doing. For people with metabolic disorders, however, it's a life or death issue. LITERALLY.

On glucose transport pathways - there are a few ways your body can metabolize glucose. Two thirds of your body's cells are myocytes (muscles) or adipocytes (fat). In the case of skeletal muscle and adipocytes insulin activates transport proteins in the cell membrane which allow glucose to be brought into the cell for processing and storage. In normal people insulin causes the insulin receptors to signal the glut-4 transporter proteins to take glucose into the plasma membrane of your cell where it is converted into glycogen, pyruvate, and fatty acids. In adipocytes this causes fat storage.

People with PCOS and type 2 diabetes have problems responding to insulin, so the glucose hangs out in their blood stream and often reaches toxic levels (>140mg/dl), which causes beta cell death in the pancreas.

Alternative glucose transport pathways are just ways to get glucose into certain cells WITHOUT insulin. It's important for diabetics and patients with PCOS because it's a way to lower blood sugar and avoid glucose toxicity. These pathways will NOT make you fat, because they are ways for your cells to immediately use glucose.

GLUT1 is mostly found in fetal tissues, but also in adult brain tissue. It is not insulin dependent.

GLUT2 is found mostly in the liver and pancreas and is bidirectional and not insulin dependent. When blood glucose is high the GLUT2 receptors in your beta cells can expose the beta cells to toxic levels of glucose, causing them to die. Since beta cells produce insulin, this means your insulin dependent glucose transport pathways will fail.

GLUT3 is primarily found in your neurons, and not insulin dependent.

GLUT4 is the myocyte and adipocyte pathway we've discussed and is insulin dependent.

Class II/III glucose pathways are not as well understood, but are not insulin dependent, and many exist in your primary muscle groups and are activated by exercise. They can help dramatically lower blood glucose.

Glucose is primarily converted directly into fat by healthy non-insulin resistant individuals, not people with diabetes or PCOS. Diabetes and PCOS will both inhibit the storage of insulin as fat due to the deactivation or retardation of GLUT4 pathways, which are the only pathways in adipocytes.

Being uninformed is one thing, spewing dangerous misinformation is quite another, that's why I was hard on Humon.

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