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Type II diabetes can become a trap if you get into a certain pickle with weight and insulin dependency. Not all Type II diabetics ever start using insulin -- in fact most are treated with diet, exercise, and oral medications. However, some of us, especially with the current obesity epidemic in America and other countries around the world, get to a point where we must also be treated with insulin.

This particular solution, however, contributes to a new problem, which is fat-induced insulin resistance. The way my doctor explained it to me is that the requirement for additional insulin comes from the overabundance of fat cells in the body, and too few muscle cells.

I imagine the problem like this: These fat cells are greedy little buggers, which actively work against the insulin the body makes. The oral medications help to a point. Some of them suppress the effect, and some of them enhance the body's ability to make additional insulin. Still, if a person's body has enough additional fat, the oral medications can't do enough to handle the load and insulin injections are needed.

Well, the insulin resistance problem can also increase a person's propensity to put on more weight, so that can make the problem worse still. The downward spiral with health continues. All of this is theory, but from what I've read there is some medical evidence that the spiral may start way back in the genetic makeup of the person. In fact, the insulin resistance may cause type II diabetes, which in turn is made worse by increased insulin resistance. You can read more on the Wikipedia, in this article: http://en.wikipedia.org/wiki/Insulin_resistance.

So what's the solution? The medical solution that is often recommended when this spiral is created is bariatric surgery, which you may know as the old gastric bypass. Because my weight and health meet all the guidelines for this surgery, my doctors tell me I am a cinch for being approved to have the surgery. The way they say it, I get the impression most people are happy to hear that they qualify for bariatric surgery. I'm not one of those people, however.

I didn't like the idea of using a permanent solution to a temporary problem. I believe the solution for me is to get into motion and to build muscle. While fat is insulin resistant, muscle eats blood sugar for breakfast even when it is just sitting still. That's why muscle is so warm to the touch.

When I imagine the rest of my life, I'd prefer to see myself pumping iron at 85 on a weight machine in the basement instead of worrying about how to fit my high protein and high vitamin diet into a stomach pouch the size of a thumb. In other words, I'd rather take the slower solution that requires more work than the quick fix with the longer lasting permanent consequences.

I am not a doctor. I am a diabetic with a big weight problem coupled with a big insulin resistance problem. My own conversations with my doctor, and my readings on the subject have convinced me that the correct approach for me is to build muscle, to shed weight, and to tackle the problem without surgery.