Hypothesis: Could Excessive Fructose Intake and Uric Acid Cause Type 2 Diabetes?
Richard J. Johnson, Santos E. Perez-Pozo, Yuri Y. Sautin, Jacek Manitius, Laura Gabriela Sanchez-Lozada, Daniel I. Feig, Mohamed Shafiu, Mark Segal, Richard J. Glassock, Michiko Shimada, Carlos Roncal, and Takahiko Nakagawa
Endocr Rev published 16 January 2009, 10.1210/er.2008-0033
This is a really great article about the link between our consumption of fructose and the development of diabetes and an absolute must read. They present a lot of data (about 300 references) regarding the effects of fructose in the body. Most notably, fructose enters the cells through transporters different from glucose. It is also phosphorylated in a non-regulated mechanism once it enters the cell. This leads to a rapid depletion to ATP in the cell creating an pseudo-ischemic situation. This is especially prevalent in the liver and may be responsible for fatty liver.
The fructose also competes with glucose as a substrate in the Krebs cycle. The authors also note that fructose does not lead to hyper-insulinemia. This may have some good effects but also leads to a lack of activation of satiety centers in the brain leading us to eat more.
The article also has a great deal of epidemiologic evidence showing increased rates of diabetes in populations that consume the highest amounts of sugar.
To read the full article click here. I've also summarized the article on my website so you can click here for a summary (username/password is the same as my notes section).
Overall, a must read article. I just spent the entire day trying to avoid HFCS...it is impossible.