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Over the years, as molecular tools to manipulate the insulin gene and receptor have become available, evidence has been accumulating against the insulin resistance based theory. For example, when people knocked down insulin receptor in muscle, the expectation was that insulin levels in the body would go up and if not, sugar levels should go up; but neither of these was seen. In another set of experiments in animals as well as humans suppression of insulin production in an insulin resistant state was expected to increase blood sugar.
Doves, Diplomats, and Diabetes
But , after suppressing insulin production, the ability of cells to respond to insulin increased rapidly and blood sugar levels remained normal. Therefore the belief that insulin resistance and the inability to meet the rising insulin demand cause type 2 diabetes is now seriously under question. The myth of obesity and diabetes being related at a genetic level is also exposed in the same way. Much of the beliefs are breaking down now, that is why we need an alternative thinking. The book compiles the results of all the experiments which make a strong case against the current beliefs about the origins of type 2 diabetes.
Doves, Diplomats and Diabetes - Diabetes Research
What is your alternative interpretation of type 2 diabetes, what do you think causes the disorder? I think the role of behavior in diabetes research has not been addressed well in the past and this is where we need to focus our efforts to be able to contain this and, possibly, other metabolic disorders. People knew for a long time that behavior has something to do with metabolism but the link was mostly through an ill-defined term called stress and anything that could not be explained was generally put under the category of stress.
So the real understanding of how and why behavior is linked to metabolism or to immunity was not coming forth. I could see that the hawk and dove model, with roots in game theory, can throw light on it. Hawk and dove are two behavioral strategies and they are such that they can coexist in a population.
Some individuals are aggressive hawks and other individuals are aggression avoiders doves.
And they coexist in a dynamic way in a society so that none of them have any all time advantage. Some people choose to behave in a specific way, as a response, other people choose a different strategy which is complementary or contrasting this, in such a way that this imparts different kinds of advantages to different people. This is how different personalities develop over evolutionary time.
Personality is not just about decisions taken by the brain, personality is about the endocrine system, immune system, muscle, the way the gut behaves; personality is about the entire body.. This is independent of calorie intake or body fat.
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There are complex interactions between the different organs of the body, the cognitive as well as the non-cognitive part of the brain. All of this is in a network. Today, people are talking more and more about networks at a sub-cellular level, at systems level, protein-protein interactions level, transcriptional level, but what is missing here is behavior as a component of these networks. The reason why the networks have evolved this way, for eg, why a single molecule has so many functions is because these functions are behaviorally related to each other.
Each behavior, or a behavioral syndrome, is related to several neuroendocrine pathways and metabolic pathways. You cannot keep behavior out and try to understand metabolism. That is not possible. Behavior is an integral part of the metabolic pathways in the body and therefore a number of things are behavior driven. If behavior is a part of the network, we could have behavioral deficiencies, in a similar manner as dietary deficiencies.
This is a concept that is highlighted in this book. In short type 2 diabetes and a number of other disorders are behavioral deficiency disorders.