It's Complicated

 What makes cells live or die. 

I need to keep this explanation somewhere where I can find it again. Part of the reason I want to keep this is because it explains insulin resistance. Doctors have known for years that type 2 diabetics are insulin resistant, but the mechanics of insulin resistance has been a mystery for years. The ADA is still unable to explain insulin resistance, however there are some signs they are accepting dietary changes as a positive step. It appears they still rely heavily on adding more insulin to treat insulin resistance.

Link: ADA Insulin Resistance

So now enters an explanation which I may or may not be able to fully explain.

In the past we have been taught to fear saturated fat. Some Doctors are still terrified of the saturated fat in red meat (Beef), eggs and butter. They tell T2 diabetics to stay away from these foods, and tell them to eat all kinds of grains, starches, complex carbohydrate, beans, rice, etc.

What these Doctors fail to understand is that excess Carbohydrate is very readily converted into a Saturated fatty acid, C-16 Palmitic, via a process known as De Novo Lipogenesis. People on very high carb diets can’t properly burn fat in the mitochondria. High levels of maloynl-Coa (from the constant high glucose-high insulin) inhibit CPT-1 which is necessary to transport the long chain fatty acids into the inner membrane of the mitochondria to be used in beta-oxidation, which leads to acetyl-Coa

They also don't understand that on a Low-carb diet, the saturated fat that enters into your mouth via the diet, is primarily used for fuel (energy), what is not used for energy is stored back into fat cells and is metered back out into the circulation.

SFA Ceramides

What needs to be measured is the amount of Saturated fatty acids that remain in the blood, that remain in the circulating triglycerides, in the lipoproteins carrying the cholesterol in your body. Measure the difference between both diets, Low-Carb and Low-fat. You will find a big difference.

Excess saturated fatty acids in the blood, in the circulating lipids, make endogenously produced Saturated Fatty Acid (SFA) Ceramides. Excess SFA Ceramides do 3 main things inside the human body. SFA Ceramides are fat-derived molecules, They're signaling molecules.

-Excess SFA Ceramides cause insulin resistance in all cells/tissues.

-Excess SFA Ceramides cause inflammation, they are pro inflammatory.

-Excess SFA Ceramides increase the rate of cell death (Apoptosis).

S1P Rheostat

There is a Thermostat inside the human body known as The Ceramide/Sphingposhine-1- Phosphatase (S1P) Rheostat.

S1P is also a fat-derived molecule, it has the opposing effects of the SFA Ceramides.

-S1P molecules are very insulin sensitizing.

-S1P molecules are anti-inflammatory.

-S1P molecules are pro-survival, they slow down the rate of cell death.

The hormone Adiponectin controls this Ceramide/S1P Rheostat.

There are 3 different molecular weight forms of adiponectin, low (LMW), medium (MMW), and high (HMW). You need enough of the high molecular weight form (HMW) to activate 2 adiponectin receptors, AdipoRon 1 & AdipoRon 2.

Once these 2 adiponectin receptors are activated, they activate a Ceramadise activity which converts the excess SFA Ceramides to the opposing fat-derived molecule, Sphingposhine-1- Phosphatase (S1P).

Hyper-insulin-emia (excess levels of insulin circulating in the blood relative to the level of glucose) causes an increase in the intra-cellular biosynthesis of SFA Ceramides (bad---pro-inflammatory, increase cell death rate).

One more thing....Hyper-insulin-emia, constant high blood levels of insulin, changes the molecular weight of total adiponectin from high to low. You will not have enough of the high molecular weight form adiponectin in the plasma to convert the excess SFA (bad) Ceramides to S1P (good).

*Explained by Jeff Cyr from the Facebook group "Way of Reversing Diabetes - WORD"

References:

Adiponectin is the most abundant hormone in our body, it's made in our fat cells, and secreted by our fat cells. It is produced mainly in the high molecular weight form. It is made in 3 molecular weight forms, low-medium-and high.. https://www.scientia.global/dr-philipp-scherer-adiponectin-bodys-fat-controller/"

https://pubmed.ncbi.nlm.nih.gov/28271033/

Link: Cell Metabolism

I feel like I understand this even better now. I can see how adding insulin to an already insulin saturated body that is insulin resistant causes cell death. I have a friend who is on insulin. She eats carbs to balance her insulin, and takes insulin to counteract the carbs. Her health is going downhill. So much to learn....keep learning!!!!