EP005 - Diabetes Dirty Dozen - Part 4
Increased Lipolysis: What It Is, Why It Matters, and How to Fix It (Without Just Relying on Meds)
“The real problem isn’t just fat droplets—it’s what they break down into: diacylglycerols and ceramides that directly interfere with insulin signaling.” — Amber
Welcome to The Diabetes Podcast blog, where we rewrite the story of diabetes with real talk and real strategies. This is part 4 of our 12‑part series: “Anything Meds Can Do, You Can Do Better.” Today, we’re breaking down increased lipolysis in simple, clear language—and showing you what actually works.
What is increased lipolysis?
In short: increased lipolysis means your body is breaking down and releasing too much fat into the blood.
Those fats (free fatty acids) can leak into places they don’t belong—like your muscles, liver, heart, and pancreas.
Inside muscle cells, fat droplets form. These are called intracellular lipids.
Why does this matter?
In healthy people, muscles soak up most of the sugar (glucose) after a meal.
But when fat builds up inside muscle, it makes the “gates” sticky. Sugar can’t get in as well.
The real troublemakers are two toxic fat byproducts:
Diacylglycerols (DAGs): they turn on enzymes that block insulin signaling.
Ceramides: they stop GLUT4 (the sugar transporter) from moving to the cell surface.
Result: muscles say “we’re full,” sugar stays in the blood, insulin goes up, fat builds in the liver, and insulin resistance worsens.
Simple picture: Think of your muscles like a sponge. Sugar is water. When the sponge is coated in grease, water runs off. That’s insulin resistance from increased lipolysis.
How does this connect to fatty liver?
About 70% of people with type 2 diabetes also have fatty liver disease (non-alcoholic fatty liver disease, or NAFLD).
Free fatty acids flood the liver. Oxidative stress goes up. This fuels metabolic syndrome and higher blood sugars.
The good news: early fatty liver is often reversible if you act now.
How we get here (the timeline)
Chronic overeating, especially simple carbs + fats together, plus inactivity.
Fat cells get full; fat spills into muscle and liver.
Toxic byproducts (DAGs and ceramides) block insulin signaling.
Muscles resist insulin; sugar can’t enter; blood sugar rises.
Pancreas pumps more insulin; hyperinsulinemia builds.
Fatty liver, more inflammation, more insulin resistance. A tough cycle.
Are there meds for increased lipolysis?
Yes: Thiazolidinediones (TZDs), like pioglitazone (Actos) and rosiglitazone (Avandia).
How they work: They activate a receptor called PPAR gamma (a powerful metabolic switch in cell nuclei).
What PPAR gamma does:
Makes fat cells more insulin sensitive.
Encourages fat to be stored under the skin (subcutaneous), not around organs (visceral).
Increases GLUT4 expression in muscle and fat.
Lowers free fatty acids in the blood and reduces lipotoxicity.
Benefits seen in studies:
Better whole‑body insulin sensitivity.
Lower fasting free fatty acids.
Less liver fat.
In some high‑risk people, fewer recurrent strokes and heart attacks.
The downsides you must know
Fluid retention and heart failure risk: Because PPAR gamma also acts in the kidney, TZDs can cause sodium/fluid retention and increase blood volume. Not recommended in NYHA class III or IV heart failure. Use caution with any heart failure history.
Who’s at higher risk already: many with type 2 diabetes. Up to about 1 in 4 may have diagnosed heart failure; many more have early heart changes.
Bone loss and fractures: TZDs can push bone marrow stem cells to make more fat cells and fewer bone‑building cells (osteoblasts). Over time this thins bones, especially spine and hips. This is a major concern for postmenopausal women.
Weight gain: Over‑activation can increase fat storage.
Bottom line on TZDs
They can help the biology, but the risks are real.
For many people—especially those with heart failure risk or bone loss risk—behavior change is the safer, smarter long‑term path.
Can you fix increased lipolysis without meds?
Yes. And this is where you shine. You can improve PPAR gamma activity, reduce fatty liver, and increase insulin sensitivity with daily choices.
Food choices that help
Omega‑3 fatty acids:
Fatty fish (salmon, sardines), high‑quality fish oil (third‑party tested), chia seeds, ground flaxseed.
They activate PPAR gamma, lower inflammation, improve insulin sensitivity, and help the liver.
Polyphenols (eat the rainbow):
Dark berries, leafy greens, green tea (EGCG), coffee, onions and apples (quercetin), cocoa/dark chocolate, turmeric/curcumin, red wine in moderation (resveratrol).
These support insulin signaling and reduce inflammation.
Fiber and short‑chain fatty acids:
Beans, legumes, vegetables, whole grains, flaxseed, chia.
Your gut ferments fiber to short‑chain fatty acids, which improve metabolic flexibility and help PPAR gamma in gut and fat tissue.
Monounsaturated fats (MUFAs):
Olive oil, avocados, almonds, walnuts.
Improve lipid metabolism, reduce inflammation, and support insulin sensitivity.
Quick fat guide you can use
Saturated fats are usually solid at room temp (think bacon fat, shortening). These tend to be shelf‑stable but are not your daily go‑to for insulin sensitivity.
Monounsaturated fats are liquid at room temp (olive oil). Better for metabolic health.
Nuts: Whole nuts look solid because of their structure, but their oils are mostly liquid MUFAs. Tip: Natural nut butters should separate—oil on top is normal. If it doesn’t separate, it likely has added oils or stabilizers.
Exercise that works
Aerobic exercise:
Walking, light jogging, cycling, swimming. You can talk while doing it.
Improves insulin sensitivity even without weight loss and boosts GLUT4 to help sugar enter muscles without insulin.
Resistance training:
Builds muscle so you can store more glucose in muscle and burn more at rest.
Strongly supports bone health by stimulating osteoblasts. This is critical for postmenopausal women.
Aim to lift safely and progressively. Use weights, machines, or bands.
Why exercise is a double win
It boosts GLUT4 to pull sugar into muscles.
It improves mitochondria (your cellular “powerhouses”).
It enhances PPAR gamma effects in muscle and fat.
It helps reverse fatty liver and improves insulin resistance—even if the scale hasn’t moved yet.
How much weight loss helps?
As little as 5–10% body weight loss can make a big difference for fatty liver and insulin resistance.
But remember: Even before weight loss shows up, the right foods and daily movement start improving your biology.
Your simple next steps this week
Pick one food action:
Add 1–2 Tbsp ground flaxseed daily.
Instead of butter, use extra‑virgin olive oil or avocado oil at one meal.
Drink green tea in the afternoon.
Add a cup of beans or lentils 3–4 days this week.
Pick one movement action:
Walk 20–30 minutes most days.
Do two resistance sessions this week: squats to a chair, wall push‑ups, rows with bands or light weights.
Make it stick:
Schedule it. Pair it with a habit you already do (after breakfast, after work).
Keep it easy. Consistency beats perfection.
Key takeaways
Increased lipolysis means too much fat in the blood, spilling into muscle and liver, blocking insulin signaling.
Toxic fat byproducts (DAGs and ceramides) jam the locks so sugar can’t get into muscle—even along the helpful GLUT4 pathway.
TZDs turn on PPAR gamma and can help biology, but they carry risks: fluid retention/heart failure, bone loss, and weight gain.
You can flip many of the same switches with food and exercise:
Omega‑3s, polyphenols, fiber, and MUFAs.
Aerobic exercise and resistance training.
Early fatty liver is often reversible. Start now. Small steps count.
We’re here to help you turn this into action. Remission is real. Your healthiest chapter starts now. If you want support, coaching, and a plan that fits your life, contact us at [email protected].
Take courage! You can do this, and we can help.
Disclaimer
The information in this blog post and podcast is for educational and informational purposes only. It is not medical advice, diagnosis, or treatment, and it does not replace a one-on-one relationship with your physician or qualified healthcare professional. Always talk with your doctor, pharmacist, or care team before starting, stopping, or changing any medication, supplement, exercise plan, or nutrition plan—especially if you have diabetes, prediabetes, heart, liver, or kidney conditions, or take prescription drugs like metformin or insulin.
Results vary from person to person. Examples, statistics, or studies are shared to educate, not to promise outcomes. Any discussion of medications, dosing, or side effects is general in nature and may not be appropriate for your specific situation. Do not ignore professional medical advice or delay seeking it because of something you read or heard here. If you think you are experiencing an emergency or severe side effects (such as persistent vomiting, severe diarrhea, signs of dehydration, allergic reaction, or symptoms of lactic acidosis), call your local emergency number or seek urgent care right away.
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