Diabetes – Lymphatics

“How Diabetes Affects Lymphatic Vessels”

from Diabetes in Control newsletter, August 2015  LINK

  • “We now know for the first time that when individuals have type 2 diabetes, the walls of their lymphatic vessels are defective and become increasingly permeable, or leaky,” Scallan said. ”  (Note: This is an over-statement, as the study was done in mice, not yet confirmed in humans.)
  • The findings have significant meaning for those with type 2 diabetes, who are already at risk for the trappings of metabolic disease. “Based on an emerging body of literature, we expect that the degree of lymphatic barrier dysfunction in diabetic mice is sufficient to reduce lymph flow, thereby trapping lipids and cholesterol in the tissue,” the authors state. “This effect is likely significant, because inhibiting lymphatic transport of cholesterol bound to high-density lipoprotein from the tissues to the liver exacerbates atherosclerosis. Further, these findings link lymphatic endothelial dysfunction to lymph leakage, which leads to tissue adipose deposition, obesity, fibrosis, and inflammation.”  “

“thereby trapping lipids and cholesterol in the tissue”

“these findings link lymphatic endothelial dysfunction to lymph leakage, which leads to tissue adipose deposition, obesity, fibrosis, and inflammation”

Scallan JP, Hill MA, Davis MJ. “Lymphatic vascular integrity is disrupted in type 2 diabetes due to impaired nitric oxide signaling.” Cardiovascular Research. 1 Aug 2015. 107(3):89-97.

NOTE: if cholesterol is thus trapped in tissues with impaired lymphatic flow, this may be a partial explanation for the observed phenomenon that sometimes people’s blood cholesterol can go up when they are undergoing weight loss on an LCHF eating plan. In type 2 diabetes or those with pre-diabetes or insulin resistance, switching from the usual North American eating pattern to an LCHF plan will quickly lower elevated blood glucose levels (note, in some individuals some medication may be needed for this) and bring elevated insulin levels lower. These two changes may allow recovery of lymphatic function, thus bringing the excess cholesterol back from the tissues, for handling by the liver (this is speculation, not researched yet). Under this speculation, that returning cholesterol would show up in the blood test results, but should be expected to reduce over some months as the improved lymphatic flow does it’s normal jobs.

Also Note: fatty tissue itself contains cholesterol, so a similar situation applies regarding blood cholesterol levels during active substantial weight loss. As the contents of fat cells are mobilized out, some of that will be cholesterol, which will go into the blood stream on it’s way to being metabolized by the liver.

Further NOTE: the medical significance and the interpretation of the medical impact of this will vary for individual circumstances and also there would be considerable debate among medical professionals as to whether any medical intervention would be warranted in this situation, or just wait out this transition period.

See also re: brain and “glymphatics”

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