Ceramides: The Fat Linked to Diabetes

People with Type 2 diabetes are likely to have insulin resistance, which is when the body is not able to use insulin effectively. But studies are finding that a certain type of fat molecule, ceramides, plays a big role in the onset of diabetes. We take look at the science behind ceramides, their links to diabetes and insulin resistance, and discuss what you can do to about it.

Understanding Ceramides

Ceramides are one class of fatty acids under the sphingolipid family. A ceramide is made up of a fatty acid and a long-chain (called sphingoid) base. Ceramides can be stored in the muscles, adipose tissue, and the liver.

There are ceramides in food but diet is not the main source of ceramide. Rather, the body creates it through three major pathways.

  • First is called the sphingomyelinase pathway. This is where enzymes break down sphingomyelin (a type of sphingolipid) in cell membrane and release ceramide.
  • The second is the de novo pathway where ceramide is created from other molecules.
  • The third is called the “salvage” pathway. Here sphingolipids that are broken down are reused to form ceramide, through a process called reacylation.

Why Ceramides are Important

Ceramides, like other lipids, serve important functions in the body. They are an important part of the structure of cell membranes. They’re also signaling molecules and involved in many cell functions including cell growth, degradation, and others.

Ceramides are also found on skin tissue that, along with other fatty acids, form part of the skin barrier and helps prevent moisture loss. If you look at the label of lotion or moisturizer products, chances are it will list ceramide as an ingredient.

But Too Much Ceramides Create Problems

While they serve important bodily functions, the problem is when having high ceramide levels. Excess ceramides can be found when someone gains too much weight and a lot of bodyfat increases.

Accumulated ceramide can damage mitochondria, which are important parts of cells that create energy. The more damage to mitochondria can lead to metabolic syndrome and metabolic disease.

Many studies show that excess ceramides are linked to the onset of cardiovascular disease and diabetes.

Source: 2020 Field, Gordillo and Scherer

Cardiovascular Disease

Similar to cholesterol, ceramides are sticky molecules and can cause problems on the cardiovascular system when there’s too much. Ceramides are known to play a key role in the development of cardiovascular diseases including atherosclerosis, heart failure, and stroke.

Researchers from the University of Utah found that people with high ceramide levels in their blood were at least 3-4 times as likely to have a stroke or heart attack than those with lower ceramide levels.

This scientific review explored the role of ceramides and the development of atherosclerosis. Atherosclerosis is the buildup of cholesterol, fats and other substances (called “plaque”) in the arterial walls.

Diabetes

High ceramide levels have been consistently linked with the development of diabetes. People with diabetes are likely to have accumulated ceramides in muscles and/or high plasma ceramide levels, particularly those that are overweight and have insulin resistance.

What Does Ceramides Have to do with Diabetes?

When there is excess ceramides, it affects insulin signaling and transmission. Insulin is a hormone released by the pancreas and absorbs blood glucose into the cells. Without insulin, glucose stays in the blood and increases blood glucose levels.

Accumulated ceramides inhibit a protein kinase called Akt/PKB, which is an enzyme involved in the insulin signaling pathway. This negatively affects glucose uptake and glucose metabolism, contributing to insulin resistance.

Over time this can lead to elevated blood glucose levels and the onset of Type 2 diabetes and related health disorders.

How to Reduce Ceramides

With the science clearly showing health risks of high ceramides, lowering ceramide levels is a priority for people with diabetes and insulin resistance.

So how do you lower ceramides? The tried and true approach of diet and exercise.

Exercise

It may not sound fun but exercise is very effective in lowering ceramides. And the studies on this area clearly show the benefits of exercise on ceramide.

This study looked at the impacts of endurance training on muscle fatty acid metabolism in relation to glucose tolerance. The participants were people who are overweight and went through 8 weeks moderate-intensity training. The researchers found that the training improved glucose tolerance and total ceramides were reduced by 42%!

Exercise Helps Insulin Sensitivity

It’s also been established that exercise helps improve insulin sensitivity as explored in this scientific review. This helps counter the negative affects of accumulated ceramides and can prevent insulin resistance from developing.

Quick and Easy Exercises

We know it can be hard for people with diabetes to get motivated or find the time to exercise. But whatever the reason, it’s really important to simply start exercising. The good news is that there are many simple, quick yet effective exercises you can start with.

woman walking

Walking is a great option if you’re not very active or have mobility issues. Stationary squats or rocket jumps can burn a lot of calories and can be done anywhere.

And adding resistance bands to your exercises is a great way to ease into strength training and building muscle.

Whole Foods

There aren’t many studies on specific foods to lower or control ceramides. But you want to follow a diet that can help minimize weight gain because of increased body fat.

A diet of whole foods and watching your calories can help reduce or control body weight. In fact, choosing whole foods, like fruit and vegetables, over highly refined foods helped lower certain ceramides according this study.

cabbage

Cruciferous vegetables, like broccoli, cabbage and brussels sprouts, include sulforaphane which can help lower blood sugar by increasing glucose uptake from the bloodstream.

According to this study, sulforaphane has been shown to block a certain enzyme involved in ceramide synthesis of ceramides, which helped improve insulin sensitivity.

Watch Your Carb Intake

And of course you want to control your carbohydrates since glycemic control is critical for people with diabetes. Dealing with carbs and diabetes can be a challenge but thankfully there are plenty of low carb whole foods to choose from.

Developing Treatments

More and more studies are looking at medical treatments to lower or control ceramides directly. This 2010 study on obese mice used myriocin to slow or prevent the ceramide synthesis process as a way to improve glucose tolerance. And researchers are exploring new tools and methods to better detect ceramides, since they’re way less abundant than cholesterol.

We’re not aware of currently available treatments to lower ceramides for diabetes but research continues to explore this approach.

Summary

The research is clear that high ceramide levels is linked to developing diabetes and insulin resistance. Elevated levels of ceramides is can hinder insulin signals, which decreases glucose uptake and glucose metabolism. This contributes to high blood glucose concentrations that, over time, leads to diabetes and diabetes-related disorders.

While treatments to lower ceramide may be available in the future, diet and exercise are effective at lowering ceramides and things you can do now. Moderate intensity exercises was shown to significantly reduce ceramide and there are simple and convenient exercises that are perfect for people with diabetes. And eating a diet of whole foods, including cruciferous vegetables, is also very important for controlling blood glucose and improving overall health.

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