Essentials of Glycobiology—Part 6 (Insulin Resistance)

Larry A. Law

Type 2 diabetes is a chronic disease that occurs when the body doesn't produce enough insulin or doesn't use insulin properly, leading to high blood sugar levels. This insulin imbalance prevents glucose from entering cells to be used for energy, causing it to remain in the blood. It is a disease of sugar, but most people are unaware of how a lack of  structural sugars associated with glycobiology can cause this disease. 

It's All About Sugar

The hormone insulin is designed to fit into or dock onto an insulin-receptor antenna (a glycoprotein—see picture below). When it does so correctly, a message is transmitted inside the cell which causes the metabolic pathway necessary to handle blood sugar to be turned on (GLUT4 gateway below). However, if sugars are missing on that glycoprotein antenna and insulin cannot dock on the receptor, the message will not be transmitted. Miscommunication occurs because the pancreas cannot get the cell to respond to the message to absorb the glucose in the blood. The pancreas reacts by making more insulin. It continues to try to get the cell's attention in a vain attempt that never works quite right. The receptor is not built properly, so it isn't working correctly. It can't accept the insulin into its docking station. This situation is known as insulin resistance, eventually leading to type 2 diabetes. Cell-to-cell communication breaks down and disease can result. The problem is not with the insulin or the pancreas. The problem is at the cellular level where glycoproteins are not being created properly. The key can only work if the lock isn't broken. Getting another key will not solve the problem. You have to fix the lock. Every disease (degenerative or autoimmune) that affects humans involves missing structural sugars (glycans).