[stingraycharles]

I’m not very well versed in this terminology, what does a “good fasting blood sugar” mean? Does that mean that generally speaking, your blood sugar remains relatively stable / low? Eg a person eating mostly meat and no sugar?

[evol262]

It means that you aren't insulin resistant and it actually does its job.

[mbesto]

Ya, I'd like to understand this too. How do you manage this? And do obese people generally have this problem (hence the correlation, but not causation)?

[PuppyTailWags]

Since obesity is often caused by a poor diet/lack of exercise maybe that causes obesity and also causes insulin resistance, not that poor diet/lack of exercise causes obesity causes insulin resistance. So you can be fat off salad and be ok and also be thin off canned chili and not ok.

[evol262]

There aren't people who are fat from salads, except for the loosest definition of the word.

Weight gain is caused by an overconsumption of calories, barring a narrow range of medication side effects.

Insulin tells your body to uptake glucose into cellular bodies. If glycogen stores aren't depleted (in the liver from normal/basal metabolism, in muscular tissue from activity) and there's nowhere for it to go, it's converted via de novo lipogenesis and stored in adipose tissue. If there's no free room, new fat cells are created. Lipogenesis and the creation of new adipose tissue are not instantaneous processes.

Insulin resistance is because your body has continued to see that blood glucose is high because it cannot be taken up quickly enough, so it sends out more insulin. As high circulating levels become more normal, the alpha channel on the insulin receptor requires more insulin to activate a signal transduction pathway to open the GLUT4 transporter for glucose.

Very strictly, excess blood glucose causes insulin resistance. That excess blood glucose is caused by caloric overconsumption, which causes obesity. It is not the inverse.

Carbohydrates have poor satiety, so when the stomach is empty (fats and proteins have a longer processing time in the stomach), ghrelin is released, which stimulates hunger, and the person eats again. Probably more simple carbohydrates, possibly before the previous ones have been taken up by cells.

Caloric overconsumption -> obesity

Insulin resistance is a side effect here, one which is seen because simple carbohydrate consumption is part and parcel of obesity in the western world. It's very hard to become clinically obese without cheap sugar. The same mechanisms (overconsumption of calories) cause obesity and insulin resistance, so they're two sides of the same coin.

[mrandish]

Well said. I was almost T2D then lost >100 pounds with strict keto going from terrible BMI to ideal and my N=1 experience fully supports your explanation.