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I am at risk of type 2 diabetes – give me more IAP please

Posted by Dr Sandy on in Diabetes | 469 Views | Leave a response

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Could a “missing” enzyme be the cause of type 2 diabetes ?

intestinal alkaline phosphotase IAP picking up endotoxin

Endotoxin, a bacterial waste product is partly to blame for the inflammation of obesity, but why is it accumulating ? There is a lack of IAP to clean it up.

For years, we’ve been told type 2 diabetes  “starts” with obesity……………

As the science has expanded, it has become clear, obesity and type 2 diabetes, is associated with low  grade inflammation.

So what causes the inflammation ?

One theory……………. UNHAPPY fat cells.

Now, unhappy fat cells can be cry babies.  But, there are people who are morbidly obese, with contented fat cells and normal weight individuals, who are ON FIRE.

So, fat cells aren’t responsible for ALL the inflammation.

A leaky gut

Which leaves UNHAPPY gut cells, specifically the cells that line the gut, as another potential source of this INFLAMMATION.

Okay, okay – unhappy might not be the right word.  The problem is when the gut becomes leaky.

Being an enterocyte is a tough job

The gut is an interesting place – if you think of your body as donut, the gut IS THE HOLE in the middle.  It’s outside and inside at the same time.

The cells lining the hole, the enterocytes – have their work cut out for them.

These little guys have to keep the bad things out and let the good things in.  Unfortunately for them – GOOD and BAD is not black and white.  And, getting things in, is not just simply a case of opening up the gate, things have to be PROCESSED.

And PROCESSING depends on exactly what has arrived.

And in every bite, there is good, bad and ugly.

Processing bites

Now to be fair, it is a team effort.  The gut cells get a lot of help and support from the immune system and some of the bacterial residents.

Some……………… NOT ALL.

Remember, there are a trillion or so bacteria, jostling for a bite to eat and a place to sleep.  

The majority are good neighbours – doing there bit to help process the food.  But, there are always rough characters.

And, anytime you have a crowd – wastes accumulates.

Waste NEEDS to be picked up

One particularly troublesome bacterial waste product, is lipopolysaccharide, better known as LPS.   It not something the bacteria produce, deliberately – but when bacteria that belong to the gram negative clan, roll out their sleeves and get busy.  They leave LPS behind.

When this LPS is not picked up timeously……………..inflammation can happen.

Metabolic endotoxemia

The reason,  the LPS doesn’t sit tight, it can slip past the layers of cells lining the gut and get INSIDE.  Once in the blood vessels, the immune system goes “crazy” –  they’re thinking INVASION etc, thus this LPS causes inflammation !

Now, this is one, of many of the metabolic problems of people with metabolic troubles.

Could it be THE PROBLEM ?

The clean up crew 

Intestinal alkaline phosphatase or IAP, should sweet through the gut and clean up .

IAP is a pretty tough enzyme, it persists all the way down the GIT tract.

All the way down i.e. it appears in the POOP.

Looking for intestinal alkaline phosphatase – IAP

A researcher from MH Samorita Medical College in Dhakar,  set out to quantify how “on the ball”, the IAP clean up crew was, in type 2 diabetics.

POOP samples were collected, from Bangladeshi residents, with the help of a team of local doctors.  The patients were all between the ages of 30 and 70 years.

  • 202 people (63 male and 139 female) were diabetic.  These people either had fasting blood glucose levels higher than 7  mM or were taking diabetes meds.
  • 445 people (114 male and 331 female) were healthy.

The IAP poop data, was then correlated  with metabolic health.

Note : The people in the study all belonged to the same ethnic group and were eating what they liked i.e. they were not following a restricted diet of any kind.

Type 2 diabetes a picking  up problem

In people with type 2 diabetes, the clean up crew was short staffed.

On average, people with type 2 diabetes had 50 % less, IAP in their poop.

correlation of IAP levels with metabolic health

IAP levels in type 2 diabetic patients versus healthy controls. Copyright Madhu S. Malo

So what………… isn’t this just another thing that’s gone awry in type 2 diabetes ?

High IAP  was protective

This patient population, was not the typical patient population studied in the West – there was little to no obesity. The average weight of the healthy people was 59.3 ± 0.5 kg, while the diabetes weighed in at 59.6 ± 0.7 kg.

In fact,  only their total cholesterol levels, LDL and fasting glucose levels were significantly different.

With the big difference coming in fasting sugar levels. 4.4 mM versus 8.0 mM.

To all intents and purposes, the diabetics were “normal” except for the fact that the clean up crew, was short staffed.  When the numbers were crunched, it was found for every  25 U/g decrease in stool IAP, there is was a 35% increased risk of diabetes.

Is IAP  the straw that breaks the camels back ?

Give me more IAP please

Could be.

The science is pointing to something in the gut, being the trigger.

At this stage,  “we” don’t know why the IAP level is lower,  but having more seems push the odds in your favour –  and who doesn’t what the odds tipped in their favour.

Especially when you realize, IAP levels are responsive to what you eat.

A quick list of some of the nutrients known to stimulate IAP release… calcium, Vitamin K1 and K2, saturated fat,  several spices and omega-3.


A High Level of Intestinal Alkaline Phosphatase Is Protective Against Type 2 Diabetes Mellitus Irrespective of Obesity.  EBioMedicine (2015) 2:2016–2023. Madhu S. Malo.

Further reading

omega 3 helping the gut clean up crew

A little house keeping in the colon, will help stop inflammation

Endotoxemia (LPS) is contributes to the low grade inflammation associated with obesity – but it shouldn’t be circulating, house keeping should sweep it away

too much insulin not too little tn

The diabetes timeline doesn’t start with TOO MUCH FAT

The story of diabetes is always written like this…. you put on weight, become insulin resistant, then eventually diabetic. But, this diabetes timeline is WRONG.

insulin in crowd

Gut bacteria influence whether insulin is part of the in crowd

In insulin resistant peeps, the resident bacteria have ganged up and decided, insulin is NOT COOL. Since body cells, don’t want to break social protocol………….

Want to discover more ways to create BETTER BODY CHEMISTRY ?

Posted in Diabetes | Tagged endotoxemia, fat cells, IAP, intestinal alkaline phosphatase, leaky gut, lipopolysaccharide, low grade inflammation, LPS, obesity, type 2 diabetes

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