Almost 50 percent of North Americans will eventually develop diabetes or pre-diabetes (National Diabetes Statistics Report, CDC, 2020), because we eat too much and exercise too little. This is sad because you can prevent and treat most cases of type II diabetes (insulin-resistant diabetes) by:
• getting fat out of your liver and muscles (Clin Diabetes Endocrinol, June 5, 2020;6(9):), and
• increasing the size of your muscles with resistance exercise (BMJ Open, Oct 6, 2020;10(10).

What is Insulin-Resistant Diabetes?
Everybody’s blood sugar rises after they eat. If it rises too high, sugar sticks to the outer membranes of cells. Once there, sugar cannot get off until it has destroyed that cell. To prevent blood sugar from rising too high after you eat, your pancreas releases insulin, which lowers blood sugar by driving sugar from the bloodstream into muscles and liver. Your muscles and liver can store only a relatively small amount of sugar in their cells, and no other cells in your body can store significant amounts of sugar.

Sugar that remains in your bloodstream is quickly converted to fatty triglycerides. Then your good HDL cholesterol carries the triglycerides into your liver and muscles. As your liver fills up with fatty triglycerides (fatty liver), it is unable to accept any more sugar from the bloodstream and you become insulin resistant, which means that you are diabetic. Your muscles normally can also accept some sugar from your bloodstream and the larger and stronger your muscles, the more sugar they can store. Most cases of diabetes are caused by high blood sugar levels caused by too much fat in the liver, and muscles that are too small and weak to store much extra sugar and fat.

Hand Grip Strength Linked to Who Will Become Diabetic
A group of 3350 non-diabetics were classified by their hand grip strength divided by their body weight, and followed for five years (Annals of Medicine, Sep 3, 2020, 52(8):471-478). Hand grip strength was inversely associated with an increased risk for diabetes and abdominal obesity. Other studies show that strong hand grip strength is associated with reduced risk for heart attacks (Lancet, 2015;386:266–73). Having weak hand grip strength is also associated with high blood sugar, high cholesterol, high triglycerides, and low good HDL cholesterol, all markers for diabetes (Am J Prev Med, 2016;50:677–83; Diabetes Metab Syndr Obes, 2018;11:227–40; J Strength Cond Res 2020;34:995–1000). Excessive fat in muscles by itself can cause insulin resistance (Diabetes Care, 2007;30:2264–70; Circulation, 2009;120:1640–5).

My Recommendations
Insulin resistance and most cases of diabetes and prediabetes are caused by excess fat in the liver and muscles, and by small and weak muscles. You can find out if you have excess fat in your liver by getting a safe and inexpensive test called a liver sonogram. Insulin-resistant diabetes is also indicated by:
• having a blood sugar level greater than 145 mg/dL one hour after eating a regular meal,
• having a fasting blood sugar greater than 100 mg/dL, or
• having a HbA1c greater than 5.8.

Type II diabetes can often be cured by getting fat out of the liver and muscles, and by exercising to make larger and stronger muscles. You can get fat out of your liver by following an anti-inflammatory lifestyle:
• avoid sugar-added drinks and foods
• avoid red meat, processed meats and fried foods
• avoid smoking, drinking alcohol, and recreational drugs
• eat lots of fruits and vegetables
• try to exercise every day
If you have a large belly, you should also severely restrict all refined carbohydrates such as those found in bakery products, pastas, and most dry breakfast cereals.

More Vegetables, Less Diabetes
Signs of a Fatty Liver
Resistance Exercise You Can Do at Home