The Invisible Cause of Type 2 Diabetes and Prediabetes (and Your Other Health Problems)

Dr Jedha, Host

Welcome wonderful people to another episode of Type 2 Diabetes Talk. Today, the time of releasing this podcast, March 25, 2025, is American Diabetes Alert Day. Essentially this day is aimed at raising awareness about the risks and symptoms associated with diabetes. We’ve talked about this in episode 50 and I’d highly encourage you to share that episode with any friends, family or colleagues that may think they’re at risk of prediabetes or diabetes, as we get into lots of the key risk factors and symptoms. Here on the podcast today, we’re going to dive into something else more important to you, The Cause of Prediabetes and Type 2 Diabetes, such a fascinating topic to explore and one that often gets overlooked, as no doubt it is complex.

The thing is, prediabetes and type 2 diabetes don’t just show up overnight. These conditions develop over years, sometimes decades, and are linked to something many people aren’t aware of: metabolic dysregulation.

In this episode, we’re going to explore what metabolic dysregulation is, its symptoms, why it’s at the root of prediabetes and type 2 diabetes and so many other related health issues that you may be experiencing, and most importantly, we’ll touch on how you can turn things around in the opposite direction and target the cause to reverse your metabolic dysregulation and rebalance everything once again.

02:43

Before diving in, I just wanted to mention for our members that our 4 Week Interactive Weight Loss Kickstarter Program begins April 1, and we’re starting to prepare for that now. And the great news is the stuff we’re doing in that program, looks to target metabolic dysregulation and what we’re covering today, using core strategies with proven results. So login to the members site to get all the resources and get involved in the program. If you’re not one of our members, head over to our website to learn more. We’ve actually got a great early bird offer available so go check it out and join us for this fantastic program. 

So, metabolic dysregulation? What is this exactly? 

Let’s break this down. Metabolic dysregulation happens when your body’s metabolism, the system responsible for converting food into energy, is out of balance. Think of your metabolism like your body’s engine. When it’s running smoothly, everything works in harmony—your energy levels, hormones, and cellular functions.

But what happens when this engine starts to falter? Well, it doesn’t just stop—it begins to sputter, leading to a range of issues that might seem unrelated at first. This is metabolic dysregulation.

Now, you might ask: “What does this look like in real life?” It often starts small: maybe you notice some weight gain, your blood pressure creeps up, or you’re told your cholesterol levels are off. These might seem like separate issues, but they’re actually symptoms of a deeper problem.

04:29

Symptoms of metabolic dysregulation include:

• Weight gain or obesity—your body is storing more energy than it’s burning.
• High blood pressure—a sign that your cardiovascular system is under strain.
• Cholesterol imbalances—like lower “good” HDL cholesterol, higher triglycerides or high VLDL.
• And then there’s insulin resistance—a silent player in this story, which we’ll dive into more very soon.

Other symptoms or associated conditions could include:

• fatty liver
• high inflammatory markers
• Polycystic ovary syndrome 
• elevated uric acid levels
• gallstones
• increased blood clotting factors
• digestive issues
• sleep apnea
• and the list goes on…

These issues tend to develop over time, over years in fact. And over time, instead of having one symptom, you may suddenly realize you have many symptoms, which again, may seem unrelated.

But here’s the key takeaway: these aren’t isolated problems. They’re interconnected, stemming from the same root issue—your metabolism is struggling to function as it should. 

05:44

Now that we’ve painted the picture, let’s zoom in on the invisible culprit driving this metabolic dysregulation, and that is, high glucose levels, high insulin levels and insulin resistance.

To understand why metabolic dysregulation occurs, we need to look at insulin. Insulin is a hormone produced by your pancreas, and its primary role is to help regulate blood sugar levels. When you eat, your body breaks down food into glucose, or sugar, which enters your bloodstream. Insulin’s job is to transport that glucose into your cells, where it can be used for energy.

But here’s the catch: your cells can only store so much glucose at one time. When your muscles and liver are full, insulin needs to find somewhere else to send the excess energy. This is where fat storage comes into play. Insulin helps store the extra glucose as fat, which is a normal process when it happens occasionally. However, when your diet is consistently high in sugar and refined carbohydrates, your body is constantly flooded with glucose. This means your pancreas has to produce more and more insulin to keep up. 

Over time, this leads to a condition called insulin resistance. Your cells become less responsive to insulin’s signals, making it harder for glucose to enter the cells. In response, your pancreas produces even more insulin to compensate. This creates a vicious cycle of high insulin levels, or hyperinsulinemia, and increasing insulin resistance. That’s right, you have plenty of insulin and that’s the issue, as you have hyperinsulinemia, or high insulin levels.

The combination of high blood sugar and high insulin is toxic to your body. It’s like pouring gasoline on a fire. This toxic environment damages cells, tissues and organs, leading to the wide range of symptoms and health issues we associate with metabolic dysregulation. Left unchecked, it progresses to prediabetes and eventually type 2 diabetes, along with an increased risk of complications like nerve damage, kidney disease, and cardiovascular problems.

08:05

Essentially, metabolic functions throughout your body become compromised, which is why all sorts of symptoms arise, all seemingly unrelated, and yet, all related. Let’s look at a few of those symptoms we mentioned earlier. 

Weight gain or difficulties losing weight – as we just mentioned, your body can only handle so much glucose/sugar in the bloodstream so if insulin can’t push it where it can be used for energy, your body will push it into fat stores and your body will have difficulty burning any fat so weight loss becomes very difficult. 

High cholesterol levels – insulin plays a role in fat metabolism and the production of fatty acids in the liver that contribute to abnormal cholesterol levels – primarily high triglycerides and high LDL cholesterol, because high triglycerides leads to higher VLDL – very low density lipoproteins and these are small dense LDL particles that contribute to heart disease. 

Insulin resistance also promotes an increased accumulation of fat in the liver (non-alcoholic fatty liver disease or fatty liver), which can lead to liver inflammation and damage. The liver performs many major roles in our body to keep us healthy, so if the liver is off balance, many other aspects of our health will be too. 

High blood pressure – insulin resistance causes sodium retention in the kidneys so blood pressure can rise. Insulin resistance is also associated with increased sympathetic nervous system activity, which can further contribute to high blood pressure by increasing heart rate and constricting blood vessels.

The combination of high glucose, high insulin and insulin resistance has a major impact on our metabolism, triggering a cascade effect throughout the body. 

Interestingly, the medical model doesn’t look at these symptoms as being interconnected but just treats one symptom. Your doctor discovers you have high cholesterol, here’s a statin for that. You have elevated blood pressure, here’s a beta-blocker for that. Oh and now you have high glucose, here’s a glucose-lowering medication for that. That’s the medical model. Try to treat the symptom, or rather, try to mask the symptom because the reality is, those symptoms don’t go away, and before you know it, your medication dosage is going up or you’re on another medication. While medications can be useful sometimes, most often they are not the solution. Quite simply because they are masking symptoms and not getting to the cause of the issue. 

11:36

The traditional model of thinking was, and often still is, that high insulin occurs after a person has insulin resistance and the insulin resistance causes obesity and diabetes. So for example, it was thought that the pancreas was releasing more insulin to overcome the insulin resistance. Certainly, this does happen once a person has insulin resistance, but researchers started to question how this would occur, and since no plausible mechanism has been suggested, they started looking at the direct contributions of the hormone insulin itself. 

Research suggests that insulin itself is the invisible cause. High insulin is the key signal that insulin resistance is developing. Insulin resistance doesn’t come before high insulin but the other way around. High insulin or hyperinsulinemia comes before insulin resistance, obesity, prediabetes and type 2 diabetes. A concept that is not yet widely recognized. 

So where does this high insulin come from? A primary driver is the “modern” Western diet, which is commonly filled with low quality foods high in sugar and refined carbohydrates and many food additives. It also occurs due to overeating, many of us just eat way too much these days, and coupled with that, sedentary lifestyles. Environmental toxins are said to play a role. Changes in the liver that reduce insulin clearance can occur. In some cases there could be defects in pancreatic β-cells or genetic factors. But it really does come down to diet and lifestyle factors in the large majority of cases. And interestingly, as we’ve explored in recent episodes on dietary guidelines, episodes 62 and 64, it’s only been since the dietary guidelines were introduced in the 1980s that ultraprocessed food consumption has become increasingly dominant worldwide, now representing around 60% of most people’s daily food intake. 

What’s interesting is that researchers suggest insulin resistance develops as an adaptive response of the body to maintain normal blood glucose and prevent low glucose because high levels of circulating insulin can damage and injure critical tissues. So if we were eating all this additional sugar, refined carbs and food additives and the pancreas kept pumping out insulin and all this extra insulin was getting into our cells, it could cause major, major damage to our system. So of course, that makes sense – the body is very intelligent at trying to protect itself, it develops insulin resistance as a protective mechanism, despite the fact that this can lead to a variety of symptoms and health conditions.

14:55

The crazy thing is, in a medical setting we are overlooking an incredibly important aspect that could in fact prevent people from even being diagnosed with prediabetes, or help people gaining weight to lose weight more easily, and that is insulin. Insulin issues are the invisible cause of obesity, prediabetes and type 2 diabetes. We focus only on blood glucose and measuring the A1c to diagnose people with prediabetes and type 2 diabetes for instance, when we could be testing fasting insulin levels to help provide a clearer picture of a person’s overall metabolic health and diagnose the issues before they get anywhere near a prediabetes or diabetes diagnosis. Studies have shown that a high fasting insulin level is a primary predictor of an impending prediabetes or type 2 diabetes diagnosis. And certainly, for someone with obesity, understanding that underlying mechanism could help to change their perspective on what to do about their diet and lifestyle. Look, I’m not going to go into the fasting insulin test here but I’ll leave some extra resources in the show notes for those who may be interested. And if you know a person, a loved one or colleague with risk factors but they don’t yet have diabetes, encourage them to get a fasting insulin test. While doctors don’t routinely test this, you can request it, so again, find more info on this in the show notes. 

17:11

So you might be wondering, okay if insulin is at the core of the issue, how do I deal with that? 

As we established at the start, prediabetes and type 2 diabetes don’t just show up overnight. These conditions develop over years, sometimes decades, and while it may seem like you have a whole list of symptoms or conditions, these are all just red flags to us that something needs to change. 

And the good news is this process is not irreversible. By addressing the root cause—high glucose levels, high insulin levels and insulin resistance—you can restore your metabolic health and prevent further damage. 

So, how do we begin addressing what seems to have now become a very complex problem? Your whole body is seemingly out of whack and everything has gone off balance. What on earth are you meant to do? 

Firstly, relax and breathe. Regardless of how messed up your body may seem, the body is very intelligent and has an amazing capacity to heal and recover when given the right environment to do so.

The first and most important step is to focus on nutrition. Look, I specialize in nutrition and when it comes down to it, nutrition is really such a powerful tool because it literally is the fuel for our body. What you eat plays a highly significant role in either exacerbating or healing metabolic dysregulation. Eating foods high in sugar and refined carbohydrates, and processed foods – that’s not nutrition for your body. In fact, a large majority of so-called foods available to us are not in any way healthy or even fit for human consumption, especially in the amounts we eat them. The reality is, we need to get as much junk and crap out of our diets as possible. Choose whole foods, nutrient dense natural foods that your body was designed to eat – this is what will help reset your metabolism.

Focusing on whole, unprocessed foods is key. This includes plenty of non-starchy vegetables, quality proteins like eggs, fish, meats and poultry, and healthy fats from sources like avocado, olive oil, and nuts. These foods provide the nutrients your body needs to function optimally without overloading it with excess energy that needs to be stored as fat. Of course, focusing on lowering carbohydrates is incredibly important. An eating plan that contains 300g of carbohydrates per day is going to raise blood sugar levels, raise insulin levels and worsen insulin resistance. Whereas a lower carb intake of 50-100g per day is going to lower blood sugar levels, lower insulin levels and improve insulin function. 

Another critical aspect of reversing metabolic dysregulation is managing portion sizes and meal timing. When first diagnosed, we generally recommend eating 3 balanced meals, and snacks during the day if you need them. Later once you get settled into a routine that your body has adjusted to, you can start experimenting with your meal timing. Try limiting your snacks, don’t graze all the time. If you’re grazing all the time, chances are you are not really hungry and you need to practice more mindfulness around your eating to rein in those habits. Try not to eat late at night, so no snacking or limited sweets after dinner, which in many cases is also just a habit and not really hunger. And experiment to see if you can limit your eating window to within 10 hours a day, so have breakfast at 8am and dinner at 6pm. You don’t need to eat from the moment you get up to the moment you go to bed. Of course, there can be other things but fundamentally, these simple principles will help you lower blood sugar, lower insulin levels, decrease insulin resistance and reverse your metabolic dysregulation. 

Lifestyle changes can of course extend beyond food. Incorporating regular physical activity is another powerful tool to improve the way your body uses glucose. And addressing stress and ensuring adequate sleep are often overlooked but vital components of metabolic health. 

We cover a lot of this stuff across various episodes so be sure to listen in to learn more. And if you’re one of our members, you have countless resources and support at your fingertips to navigate each step of the way through the process of reversing your health back to normal. 

The key is not to overcomplicate things. No matter where you are in your journey, simply start. Or, simply add or alter one additional thing and you’ll be progressing forward. 

By taking these small consistent steps—improving your diet, staying active, managing stress, and sleeping well—you can begin to reverse metabolic dysregulation, and these simple things can and do target the invisible cause of obesity, prediabetes, t2diabetes and other things. The magic pill is nutrition. It’s an incredibly powerful tool that can heal and restore balance to your body. I know from years of experience. No matter how broken you may feel or seem, miraculous things can happen with the right nutrition plan. So again, no matter where you are in your journey, simply start. Or, simply add or alter one additional thing and you’ll be progressing forward. 

Just to mention again for our members, that our 4 Week Interactive Weight Loss Kickstarter Program begins April 1, and we’re going to be using some core strategies to target metabolic dysregulation. We’re in preparation to start on April 1 so head in to the members site to get all the resources and get involved in the program. If you’re not one of our members and want to get involved, head over to our website to learn more, we’ve got a great early bird offer available with extra bonuses so don’t miss out on joining us. 

Well, let’s leave it at that today. 

See you next week. 

Dr Jedha, over and out.