Feb 8, 2008
Are Insulin Resistance and Diabetes Really Reversible?
Diabetes is not reversible. And controlling your blood sugar with drugs or insulin will protect you from organ damage and death.
That is what the medical profession would have you believe.
But medication and insulin can actually increase your risk getting a heart attack or dying.
What you are not hearing about is another way to deal with this epidemic.
Today, I want to review in detail a new way to think about diabetes and next week I want to tell you exactly how to prevent, treat, and reverse it.
Let’s get started.
The diabetes epidemic is accelerating along with the obesity epidemic.
Type 2 diabetes, or what was once called adult onset diabetes, is an increasing worldwide epidemic affecting nearly 100 million people -- and over 20 million Americans.
We are seeing increasing rates of Type 2 diabetes, especially in children, which has increased over 1,000 percent in the last decade and was unknown before this generation. One in three children born today will have diabetes in their lifetime.
Yet this is an entirely preventable lifestyle disease.
In a report in “The New England Journal of Medicine,” Walter Willett, MD, PhD, and his colleagues from the Harvard School of Public Health demonstrated that 91 percent of all Type 2 diabetes cases could be prevented through improvements lifestyle and diet.
==> The Road to Diabetes Starts Early
Diabetes is often undiagnosed until its later stages. Insulin resistance, when the body becomes resistant to the effects of insulin, is primarily what causes diabetes.
When your diet is full of empty calories, an abundance of quickly absorbed sugars and carbohydrates (bread, pasta, rice, potatoes, etc.), the body slowly becomes resistant to the effects of insulin and needs more to do the same job of keeping your blood sugar even.
High insulin levels are the first sign of a problem. The high insulin leads to an appetite that is out of control, and increasing weight gain around the belly.
High levels of insulin are warning signs -- they precede Type 2 diabetes by decades.
Insulin resistance and the metabolic syndrome associated with it is often accompanied by increasing central obesity, fatigue after meals, sugar cravings, high triglycerides, low HDL, high blood pressure, problems with blood clotting, as well as increased inflammation.
These clues can often be picked up decades before anyone ever gets diabetes -- and may help you prevent diabetes entirely.
If you have a family history of obesity (especially around the belly), diabetes, early heart disease, or even dementia you are even more prone to this problem.
Most people know about the common complications of diabetes such as heart attacks, strokes, amputations, blindness, kidney failure, and nerve damage. Some may even know that it increases your risk of dementia and cancers and can cause impotence.
But most people don’t realize that insulin resistance or pre-diabetes can be just as bad causing heart attacks, strokes, dementia, cancer, and impotence -- decades before you get diabetes.
In fact many people with pre-diabetes never get diabetes, but they are at severe risk just the same.
==> Living in Harmony with Our Genes
We were highly adapted to a nutrient-dense, low-sugar, high-fiber diet rich in omega 3 fats. But when we eat out of harmony with our genes, we turn on genes that promote diabetes.
Take Arizona’s Pima Indians, for example.
They were thin and fit 100 years ago, living on a diet of over 70 percent carbohydrates. They ate high-fiber, unprocessed plant foods and they had no diabetes or obesity.
Now, in just one generation, they are nearly all obese and 80 percent have diabetes by the time they are 30 years old!
That’s because they are eating food that turns on all the wrong gene messages -- foods like sugar, trans fats, white flour, and processed foods.
==> Diabetes is Reversible: Diagnose Problems as Early as Possible
Diabetes and pre-diabetes ARE reversible.
New science shows that it’s possible, through an aggressive approach of lifestyle, nutritional support, and occasionally medications.
It is important to diagnose Type 2 diabetes early, but it is often not diagnosed until very late.
In fact, all doctors should aggressively diagnose pre-diabetes decades before diabetes occurs, and before any damage is done to your body. Damage begins with even slight changes in insulin and blood sugar.
Unfortunately, there is a continuum of risk from slightly abnormal insulin and blood sugar to full blown diabetes. This should be addressed as early as possible on the continuum.
In a recent study, anyone with a fasting blood sugar of over 87 was at increased risk of diabetes. The lowest risk group had a blood sugar less than 81.
Most doctors are not concerned until the blood sugar is over 110 -- or worse, over 126, which is diabetes. Therefore, I recommend early testing with anyone who has a family history of Type 2 diabetes, central abdominal weight gain or abnormal cholesterol.
Don’t wait until your sugar is high.
==> Testing for Insulin Resistance and Diabetes
The tests I recommend include the following:
- Insulin glucose challenge test with 2-hour glucose challenge, 75 grams measuring fasting, 1 and 2 hour blood sugar AND insulin. Your blood sugar should be less than 80 fasting and never rise above 110 or 120 after one to two hours. Your insulin should be less than 5 fasting and should never rise above 30 after one to two hours. I recommend this test for everyone over 50, and for anyone with any risk of insulin resistance, even children.
- The hemoglobin A1C is an important measure of glycated hemoglobin, which can be an early indicator of sugar problems. It measures sugars and proteins combining into glycated proteins called AGEs (advanced glycation end products), like the crust on bread, or the crispy top on crème brule. These create inflammation, oxidative stress throughout the body, and promote heart disease and dementia and accelerating aging. The hemoglobin A1C should ideally be less than 5.5. Anything over 6 is considered diabetes.
- Lipid profiles are important. An HDL or good cholesterol level under 60 and triglycerides over 100 should make you suspicious of insulin resistance. An HDL under 40 and a triglyceride level over 150 usually means diabetes.
- An NMR lipid profile identifies the size of your cholesterol particles. With insulin resistance or Type 2 diabetes, you develop small LDL and HDL cholesterol particles. They are much more dangerous than larger particles and lead to increased risk of atherosclerosis or heart disease.
- High sensitivity C-reactive protein is a measure of inflammation, one of the classic conditions that is both the cause and result of insulin resistance and diabetes. It should be less than 1, and is often associated with diabetes. In fact, anyone with a high C-reactive protein has a 1,700 percent increased risk of getting diabetes.
- Homocysteine is often abnormal in people with diabetes. It is a measure of folic acid deficiency. It should be between 6 and 8.
- Fibrinogen measures your risk of clotting, which can cause heart attacks and strokes. It is also a sign of inflammation and is associated with insulin resistance and diabetes. It should be less than 300.
- Ferritin levels are often elevated. It is a nonspecific marker of inflammation associated with diabetes. It also can mean an overload of iron in the body. It should be less than 150.
- Uric acid should be less than 6. Higher levels indicate problems with insulin resistance. This can lead to gout, which is related to insulin resistance and Type 2 diabetes.
- Elevated liver function tests result from insulin resistance. This is the major cause of fatty liver and elevated liver function tests in this country. This is entirely due to sugar and carbohydrates in our diet that cause fatty liver, liver damage, and even cirrhosis.
These are tests any doctor can perform and are covered by insurance. I have included the interpretation with my written blog so you can know exactly where you should be.
That’s all for today.
In next week’s blog, I will tell you how to prevent, treat, and even reverse diabetes. I have seen this hundreds of times in my patients and there is no reason you can’t achieve the same thing if you apply these principles.
Till then, remember what Michael Pollan said: “Eat food. Not too much. Mostly plants.”
Now I’d like to hear from you…
Have you been diagnosed with pre-diabetes or diabetes?
Have you been told that it is irreversible?
What steps have you taken to prevent diabetes?
Please let me know your thoughts by leaving a comment below.
To your good health,
Mark Hyman, M.D.
- Olshansky SJ, Passaro DJ, Hershow RC, et al.A potential decline in life expectancy in the United States in the 21st century. N Engl J Med. 2005;352(11):1138-1145.
- International Diabetes Federation. Diabetes prevention. Available at: http://www.idf.org/home/index.cfm?node=264. Accessed July 20, 2006.
- Beckman JA, Creager MA, Libby P. Diabetes and atherosclerosis: epidemiology, pathophysiology, and management. JAMA. 2002;287(19):2570-2581. Review.
- Wald NJ, Law MR. A strategy to reduce cardiovascular disease by more than 80%. BMJ. 2003;326(7404):1419.
- Franco OH, Bonneux L, de Laet C, Peeters A, Steyerberg EW, Mackenbach JP.The Polymeal: a more natural, safer, and probably tastier (than the Polypill) strategy to reduce cardiovascular disease by more than 75%. BMJ. 2004;329(7480):1447-1450. Review.
- Textbook of Functional Medicine, Gig Harbor, Wash: Institute for Functional Medicine; 2006. Chapter 7, page 60-61.
- Reaven GM.The metabolic syndrome: is this diagnosis necessary? Am J Clin Nutr. 2006;83(6):1237-1247.
- Grundy SM. Does a diagnosis of metabolic syndrome have value in clinical practice? Am J Clin Nutr. 2006;83(6):1248-1251.
- Montonen J, Knekt P, Jarvinen R, Aromaa A, Reunanen A. Whole-grain and fiber intake and the incidence of type 2 diabetes. Am J Clin Nutr. 2003;77(3):622-629.
- Garg A. High-monounsaturated-fat diets for patients with diabetes mellitus: a meta-analysis. Am J Clin Nutr. 1998;67(3):577S-582S.
- Hu FB, Manson JE, Stampfer MJ, et al. Diet, lifestyle, and the risk of type 2 diabetes mellitus in women. N Engl J Med. 2001;(11):790-797.
- Pollan M. The Omnivore’s Dilemma. New York: Penguin Press; 2006.
- Phillips C, Lopez-Miranda J, Perez-Jimenez F, McManus R, Roche HM. Genetic and nutrient determinants of the metabolic syndrome. Curr Opin Cardiol. 2006;21(3):185-193.
- Jenkins DJ, Kendall CW, Marchie A, et al. Type 2 diabetes and the vegetarian diet. Am J Clin Nutr. 2003;78(3):610S-616S. Review.
- Salmeron J, Hu FB, Manson JE, et al. Dietary fat intake and risk of type 2 diabetes in women. Am J Clin Nutr. 2001;73(6):1019-1026.
- Gross LS, Li L, Ford ES, Liu S. Increased consumption of refined carbohydrates and the epidemic of type 2 diabetes in the United States: an ecologic assessment. Am J Clin Nutr. 2004;79(5):774-779.
- Gannon MC, Nuttall FQ, Saeed A, Jordan K, Hoover H. An increase in dietary protein improves the blood glucose response in persons with type 2 diabetes. Am J Clin Nutr. 2003;78(4):734-741.
- de Mello VD, Zelmanovitz T, Perassolo MS, Azevedo MJ, Gross JL. Withdrawal of red meat from the usual diet reduces albuminuria and improves serum fatty acid profile in type 2 diabetes patients with macroalbuminuria. Am J Clin Nutr. 2006;83(5):1032-1038.
- Chandalia M, Garg A, Lutjohann D, von Bergmann K, Grundy SM, Brinkley LJ. Beneficial effects of high dietary fiber intake in patients with type 2 diabetes mellitus. N Engl J Med. 2000;342(19):1392-1398.
- Triggiani V, Resta F, Guastamacchia E, et al. Role of antioxidants, essential fatty acids, carnitine, vitamins, phytochemicals and trace elements in the treatment of diabetes mellitus and its chronic complications. Endocr Metab Immune Disord Drug Targets. 2006;6(1):77-93. Review.
- Henriksen EJ. Exercise training and the antioxidant alpha-lipoic acid in the treatment of insulin resistance and type 2 diabetes. Free Radic Biol Med. 2006;40(1):3-12. Review.
- Coyne T, Ibiebele TI, Baade PD, et al. Diabetes mellitus and serum carotenoids: findings of a population-based study in Queensland, Australia. Am J Clin Nutr. 2005;82(3):685-693.
- Jiang R, Manson JE, Stampfer MJ, Liu S, Willett WC, Hu FB. Nut and peanut butter consumption and risk of type 2 diabetes in women. JAMA. 2002;288(20):2554-2560.
- Bhathena SJ, Velasquez MT. Beneficial role of dietary phytoestrogens in obesity and diabetes. Am J Clin Nutr. 2002 Dec;76(6):1191-1201. Review.
- Klein S, Sheard NF, Pi-Sunyer X, et al. Weight management through lifestyle modification for the prevention and management of type 2 diabetes: rationale and strategies. A statement of the American Diabetes Association, the North American Association for the Study of Obesity, and the American Society for Clinical Nutrition. Am J Clin Nutr. 2004;80(2):257-263. Review.
- Rosmond R, Dallman MF, Bjorntorp P. Stress-related cortisol secretion in men: relationships with abdominal obesity and endocrine, metabolic and hemodynamic abnormalities. J Clin Endocrinol Metab. 1998;83(6):1853-1859.
May 5, 2007
Diabetes drugs 'unjustified'
Friday, 27 Apr 2007 13:02
Taking prescription drugs to prevent diabetes is "impossible" to justify, researchers have claimed.
Instead, US scientists say, people at risk of the condition should use equally effective lifestyle changes such as weight loss and physical activity.
A recent trial found that the drug rosiglitazone reduces the risk of diabetes in people likely to develop it.
But writing in the British Medical Journal (BMJ), researchers from the Mayo clinic in the US and McMaster University claim that "aggressively marketing" the drug as a preventative method "will bring harms and additional costs while the benefits for patients remain questionable".
Research outlined in the BMJ found that modest weight loss and physical activity can bring a 58 per cent reduction in risk of diabetes.
Although several trials have assessed the ability of drugs to prevent diabetes [glitazones], none have shown evidence of improving outcomes important to patients, the US team claims, and evidence has emerged of a number of serious side-effects of the drugs.
"If clinicians offer patients glitazones to prevent diabetes, they are offering certain inconvenience, cost, and risk for largely speculative benefit," the researchers write today.
"Lifestyle changes are clearly at least as effective as glitazones and can be implemented considerably more cheaply."
They conclude: "Clinical use of glitazones to prevent diabetes is, at present, impossible to justify because of unproved benefit on patient important outcomes or lasting effect on serum glucose, increased burden of disease labelling, serious adverse effects, increased economic burden, and availability of effective, less costly lifestyle measures."
Diabetes UK, the country's largest organisation working on diabetes, has said that lifestyle changes are key to reducing the number of people with diabetes.
"Eating a healthy, balanced diet and taking regular physical activity is essential in managing and, in some cases of type two diabetes, preventing the condition," said Jemma Edwards, care advisor at Diabetes UK
"The more people we can get that message to, the more cases of type two diabetes we hope can be prevented through simple lifestyle changes."
May 11, 2006
The Diabetes Epidemic
by Dr. Jim Carey, PhD
For all the government hype about a potential Bird Flu epidemic, it's amazing they're not addressing the Diabetes Epidemic in America. Here in Georgia nearly 8 percent of adults have type-2 diabetes, and diabetes costs Georgians $4 Billion in medical costs and lost productivity every year. Nationally, diabetes accounts for 11% of all health care spending.
Diabetes is the 6th leading cause of death in the United States, and it is estimated that for every person that dies from diabetes, the disease contributes to the death of two more.
Many others live with the devastating consequences of the disease, which includes kidney failure, blindness, leg amputation, heart attack and stroke.
Also alarming is that cases are up 133% over the last eight years.
Type-1 diabetes, also called juvenile or insulin-dependent diabetes, begins almost exclusively in children and usually lasts a lifetime. Type-2 diabetes, the most common form, is the form that's exploding across America. While there is probably a genetic component to the disease, it's main component is "environmental," that is, excess body fat, which makes the body "resistant" to insulin.
Type-2 diabetes used to be a rarity in children; now children with type-2 diabetes account for as much as two-thirds of new cases.
Risk Factors for Diabetes
Obesity: A body mass index (BMI) greater than 27 increases the risk of diabetes. To calculate you BMI, go here: http://nhlbisupport.com/bmi/.
Apple Shape: There is an increased risk of diabetes in African American, White and Latino women with a waist measurement over 35 inches and men with a waist measurement over 40 inches. The limits are lower for people of Asian background.
Ethnic Origin: There is a higher risk for African Americans, Latinos, Native Americans and Pacific Islanders.
Childbirth: Having had a baby weighing more than 9 lbs. at birth increases risk.
Age: Risks increase after age 45.
Family History of Diabetes.
Early Symptoms of Diabetes
You may be at risk if you experience any of the following:
Unusual Weight Loss
Sources: Lawrence Phillips, MD, former program director of the General Clinical Research Center at Emory University, Atlanta, Frank Bowyer, Pediatric Endocrinologist, and the National Institute of Health.
Prevention and Treatment
One of the things that amazed me when I was Director of Creative Health Institute was how well, and quickly, diabetes responded to a living foods lifestyle. I saw people stabilize their blood sugar at normal levels often within days of arriving at the Center, and have heard testimonies from people who have been off of insulin, or any other diabetes drugs, for over 20 years.
This includes both type-1 and type-2 diabetes. Type-1 takes longer to treat, and some type-1 diabetics never do overcome their dependence on insulin. But type-2 diabetes usually responds in a matter of days as people adopt raw living foods and regular exercise as a lifestyle.
Like any disease, the best treatment is prevention. That's why, at 51 years old, I adopted the living foods lifestyle. To see my before and after photos, visit http://chidiet.com/news/LivingFoodsNews20060429.htm#whatraw.
Sergei Boutenko overcame his diabetes with the living foods lifestyle 12 years ago. Victoria Boutenko tells the story in her book, Green for Life (http://chidiet.com/books.htm#Green), and her video, Greens Can Save Your Life (http://chidiet.com/tapes.htm#v64).
Victoria Boutenko wrote a good article about the living foods lifestyle and diabetes in her April newsletter: http://chidiet.com/news/RawFamilyNewsletterApril2006.htm.
Do your kids refuse to eat anything that hasn't danced on TV? Children learn by watching their parents, so setting a good example of healthy eating is important, the Nemours Foundation says. Children who participate in family meals are more likely to eat more fruits and vegetables, and less likely to snack on unhealthy foods. They are also less likely to indulge in smoking, drug and alcohol abuse: http://news.yahoo.com/s/hsn/20060418/hl_hsn/healthtipgetyourkidstoeathealthy.
On getting outside and getting more exercise: http://chidiet.com/news/LivingFoodsNews20060429.htm#nature.
Diabetics Need Intense GREENS! How to Easily Use the PRIMAL Nutrients in Cereal Grass Juices to Build Your Blood, Banish Infections, Regenerate Cells and Heal Diabetic Wounds!: http://www.rawfamily.com/articles/DiabeticWarrior.pdf.
Aimee Perrin would love to communicate with other diabetics or former diabetics who are on a raw food diet: chiDiet.com/news/LivingFoodsNews20060304.htm.
Content and comments expressed here are the opinions of Care2 users and not necessarily that of Care2.com or its affiliates.
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