Do Carb-Heavy Eaters Get Diabetes?

[Leo_Bloom]

@Chief_Pedant

Too much sugar makes you fat.

Too much fat is associated with diabetes mellitus.

In between the two are a number of other factors including your genes.

A while back my endocrinologist told me that the majority of diabetes patients in Europe are thin.

FWIW.

[DSeid]

@KarlGauss

I missed the edit window but had wanted to say that the effect of exercise to reduce insulin resistance and improve insulin sensitivity is a function of the time elapsed since the last bout of exercise. So, even someone who had achieved a great reduction in their insulin resistance by virtue of exercise, will find that their insulin resistance returns to earlier levels if they postpone their next bout of exercise for too long.

The bottom line is that exercise-induced improvement in insulin sensitivity is an acute phenomenon and is not due to long term muscle (or cardiovascular) fitness or strength. The same degree of improvement in insulin resistance will follow from one hour of exercise as it does after one year of exercise.

I apologize for being so pedantic but I must again qualify that statement.

There are acute changes on insulin sensitivity and in those somewhat insulin independent glucose uptake mechanisms that are short term and mostly fade by 48 hours after exercise. And there are long term training effects (pdf) that prevent insulin resistance from occuring.

As the insulin-sensitizing
effects of an acute exercise bout are short-lived and
persist for only 48 h if another bout of exercise is not
undertaken (Ivy et al. 1983, Etgen et al. 1993, Wojtaszewski et al. 2002), the pertinent question is ‘can
exercise training prevent the insulin-resistant state that
precedes type 2 diabetes?’ The resounding answer is
‘yes’ (for reviews, see, Goodyear & Kahn 1998,
Albright et al. 2000, Hawley 2004, Hawley & Houmard 2004). Here we summarize evidence to show that
exercise training produces metabolic adaptations that
result in sustained improvements in whole-body and
muscle insulin sensitivity. …

Beyond the biochemical mechanisms discussed in that review are the probable effects of the changes in body composition that regular exercise produces (decrease in central obesity and increase in fat-free mass) and the anti-inflamatory aspects. (Although to be precise at this point we cannot say which is chicken and which is egg, just that the changes are correlated.)

Such statements do not contradict your claim; they merely expand it. Increasing sensitivity and preventing resistance are not exactly the same thing. Treating established resistance requires ongoing regular exercise and if stopped the effect stops. Preventing resistance from developing or progressing OTOH is achieved with regular exercise and the resistance thus prevented does not suddenly occur upon cessation of exercise for a few days or weeks.