Learning About T2D and “The Egregious Eleven”

Over the years, the medical world has slowly peeled back layers of type 2 diabetes. Although diabetes can seem like a simple condition, it’s really not. There are actually a number of different ways your body works to keep your blood sugars in a safe range. In type 2 diabetes, these body organs or systems struggle to do their job.

Which organs are affected by type 2 diabetes?

Dr. Stanley Schwartz and a team of researchers highlighted 11 of these in a 2016 article in Diabetes Care. They are now coined “The Egregious Eleven.”  It’s a complex web that weaves back on itself multiple times. But, let me try my best to introduce you to a few of the Egregious Eleven.

Insulin resistance

Your brain, liver, fat, and muscle cells do not respond to, or use, insulin as well as they used to.1

Your brain

In type 2 diabetes, your brain is insulin resistant, which can affect your hunger hormones. That means you may not feel full after a meal and may overeat. It also releases less dopamine which can affect your concentration, also known as "brain fog."1

Your kidneys

In type 2 diabetes, your kidneys hang on to extra glucose instead of filtering it out into your urine, causing high blood sugars.1

Your liver

In type 2 diabetes, the liver is working overtime, releasing glucose into your bloodstream even when you don't need it. It is also insulin resistant.1

Your pancreas

By the time you’re diagnosed with type 2 diabetes, your pancreas has overworked for years. It’s been busy making extra insulin to make up for your body’s struggle to use insulin well (insulin resistance). Your body’s ability to make insulin becomes less over time. The signals your pancreas sends to the liver are faulty.1

Your digestion system (stomach/intestines)

In type 2 diabetes, your digestion hormone levels (also called incretin hormones) are low. This means, your body cannot respond to food the way it used to. You may eat a meal, but your liver is still releasing glucose into your bloodstream at the same time. Your pancreas doesn't send out enough insulin to move glucose from the bloodstream into the cells. Your brain doesn't get the signal you're full, so you eat more than you need. Your stomach/intestines digest things much more quickly, so your blood glucose rises more quickly after a meal.1

Chronic inflammation

In type 2 diabetes, your body struggles with inflammation. It’s almost as though your body is under stress at all times, even if you don't feel stressed.1

Keeping up with insulin

Many of these “problems” in the body are simply your body’s way of compensating for some of the changes that are happening before diagnosis. For example, when insulin resistance goes up, your body makes extra insulin to overcome that and allow your body to keep working. It’s only when your body can’t keep up this compensation that a diagnosis of prediabetes or diabetes comes into play.1

Phew! These are the simplest ways to describe these complicated concepts and processes. And it can still be confusing! You may have noticed that many are connected to each other - sending signals back and forth. Our bodies are truly amazing things—able to do so much we take for granted. Even in the world of diabetes!

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