Connected Systems

Everything is connected.

No, this won't be a New Age rant on oneness with the universe. I'm speaking of the various systems in the body, which used to be put into boxes as if they operated on their own. There was the circulatory system, the nervous system, the respiratory system, the digestive system, and so forth, and many doctors specialized in one system or another.

Different processes were thought to take place in different systems. For example, gluconeogenesis (the formation of glucose from other compounds) was said to take place in the liver, and although it was mentioned that the kidney also performed some gluconeogenesis, this was mostly ignored. This approach made sense in the past, when measurement techniques were relatively crude, but today techniques have improved and it's even possible in some cases to measure what's going on in single cells.

So now, more and more, we're learning that the various organs have roles other than the main roles that have been known for decades, and the various systems are interconnected, sometimes in surprising ways. For example, not long ago, fat was considered just a way to store extra energy. It's now well known to secrete hormones too.

One recent study showed that a gut hormone interacts with brown fat to tell the brain that it's time to stop eating. The hormone, secretin, has been known since 1902, but its role was said to be to stimulate the pancreas to release bicarbonate to neutralize the acids coming from the stomach. Now it seems it has at least one other role. Mice injected with secretin had less appetite and increased the amount of heat the brown fat produced. Unless you're cold, heat is "wasted" energy, so increasing the amount of heat produced would mean they would gain less weight from the food they ate.

And a study of mast cells also revealed unexpected effects. Mast cells produce histamine, which is important in causing allergic symptoms, so many allergy sufferers take antihistamines. This study showed that histamine that goes to the liver, not the lungs or nose, also helps regulate ketogenesis (the production of ketone bodies from fatty acids).

It does this via a molecule called OEA (oleoylethanolamide). Previously, researchers thought OEA's role was to block hunger pangs. It does, but it also stimulates ketogenesis.

These complex interactions are one reason different people can react differently to various medications and diets. One person might have a difference in the mast cells and another might have a difference in the sensitivity of the liver to histamine and another might have a difference in some related but as-yet-unknown reaction in the same system. (I'm using the term "difference" rather than "defect" because sometimes a metabolic difference that is detrimental in one environment turns out to be beneficial in another.)

Hence we should never assume that what works for one person will work for us. Today we have so many tools to measure the various aspects of our diabetes that we can try something and then if it doesn't work try something else. No one diet or one drug or one exercise regime is best for everyone.

And we should remember that everything is connected. We shouldn't focus on just one system in our body and ignore the rest. They all talk to each other, and maybe healing an ingrown toenail will help our diabetes.