The End of Diabetes (2 page)

CHAPTER ONE

The First Step—Understanding Diabetes

Jane Gillian was an obese fifty-six-year-old when she became seriously ill and was hospitalized. She experienced an embolic stroke, paralyzing her left side, and, while at the hospital, they also found that she had severe diabetes. Jane had a family history of diabetes; both parents were overweight and diabetic. Her medical history included high blood pressure, high cholesterol, and placement of two medicated stents in her coronary arteries. When she was admitted to the hospital with an HbA1C of 9.6 and a blood pressure of 200/100, Jane was on two blood pressure medications as well as other prescription pills. She was placed on insulin and remained in the hospital for almost a month. Finally, she was discharged wheelchair bound and on two insulin injections a day for a total of 60 units daily plus eight other medications including three blood pressure–lowering medications.

A friend recommended Jane read
Eat to Live,
and one month later, she started the nutritarian diet. Her insulin needs soon tapered and then stopped. Her results on the high-nutrient diet were exciting. Three years later, Jane has lost a total of 117 pounds—her weight went from 248 to 131 pounds. Her HbA1C and glucose levels are in the nondiabetic range. She is no longer diabetic. Her cholesterol dropped from 219 to 152, triglycerides from 174 to 66. Her blood pressure, which used to run around 160/80 on the two blood pressure medications, now runs around 125/75 without any blood pressure medications. The best news of all is that Jane is no longer in a wheelchair and can walk on a treadmill set at a fifteen-degree incline for more than fifteen minutes.

D
iabetes mellitus is a chronic disease that causes serious health complications including renal (kidney) failure, heart disease, stroke, and blindness. As mentioned, this serious disease has seen a drastic increase in the number of Americans who are affected. The Centers for Disease Control and Prevention released a 2011 report stating that over 25 million Americans are currently plagued by diabetes. That's an increase of 15 percent, or 3 million people, in only two years and over 700 percent in the last fifty years. More than 40 percent of Americans aged twenty years and older have either diabetes or prediabetes according to a review of data from the 2005–2006 National Health and Nutrition Examination Survey. Approximately 30 percent of adults older than sixty have been diagnosed with diabetes, and its prevalence is the same in men and women.

Many people are either unaware that they are diabetic or are in a prediabetic state that will lead to diabetes within a few years. The standard American diet (SAD) causes susceptible individuals to develop diabetes. Unfortunately, most people in America are eating themselves into a premature grave. The American diet is at the core of our health care crisis, and diabetics suffer even more tragic medical complications, such as:

 

•  Heart disease—Death from heart disease and risk for stroke is three times higher for diabetics.

•  High blood pressure—75 percent of diabetics have high blood pressure (130/180 or higher).

•  Blindness—Diabetes is the leading cause of new cases of blindness among adults.

•  Kidney disease—Diabetes is the leading cause of kidney failure.

•  Nervous system disease—The majority of diabetics develop nervous system impairment such as reduced feeling in the feet, impaired digestion, and erectile dysfunction.

•  Amputations—Diabetes is the leading reason for limb amputations.

•  Cancer—Diabetes increases the risk of cancer, including a 30 percent increase in colorectal cancer.
1

 

Diabetes is also taking a huge financial toll on America. Our unhealthy eating habits may eventually bankrupt our nation. The average type 2 diabetic incurs $6,649 in health care costs directly attributable to diabetes per year.
2
More than half of Americans will have diabetes or be prediabetic by 2020 at a cost of $3.35 trillion to the U.S. health care system if current trends go on unabated, according to analysis of a report released by UnitedHealth Group. Diabetes and prediabetes will account for the largest percent of health care spending by the end of the decade at an annual cost of almost $500 billion—up from an estimated $194 billion in 2010 according to the report titled
The United States of Diabetes: Challenges and Opportunities in the Decade Ahead
.
3

In order to prevent this, we have to change the way we approach diabetes—and we must emphasize prevention. Earlier this year, the editors of the
Lancet
medical journal called it a “public health humiliation” that diabetes, a largely preventable disease, has reached such epidemic proportions. In reference to this year's ADA national meeting, the journal reported, “. . . there is a glaring absence: no research on lifestyle interventions to prevent or reverse diabetes. In this respect, medicine might be winning the battle of glucose control, but is losing the war against diabetes.”
4

These authors are correct—this is a public health humiliation because type 2 diabetes is both preventable and reversible. The SAD of refined grains, oils, sugars, and animal products is at the root of the crisis. Using drugs to keep glucose under control in individuals who continue to consume this diet will not prevent diabetes complications. The cure for type 2 diabetes is already known—removing the cause can reverse the disease.

 

Understanding the Cause

Every cell in the human body needs energy in order to function. The body's primary energy source is glucose, a simple sugar resulting from the digestion of foods containing carbohydrates (sugars and starches). Glucose from the digested food circulates in the blood as a needed energy source for our cells.

Insulin is a hormone produced by the beta cells in the pancreas, an organ located behind the stomach. Insulin bonds to a receptor site on the outside of cells and acts like a key to open a doorway into the cell through which glucose can enter.

When there is not enough insulin produced or when the doorway no longer recognizes the insulin key, glucose stays in the blood rather than entering the cells. So diabetes is the rise of glucose in the bloodstream due to a relative lack of the insulin that is responsible for the transfer of glucose from the blood into the tissues or cells. Normally as we eat and the glucose rises in the bloodstream, insulin-producing cells in the pancreas sense the glucose rise in the bloodstream. They then secrete the appropriate amount of insulin to drive the glucose into the body's tissues, lowering the level in the bloodstream back to an appropriate range.

 

 

When a person has type 2 diabetes, the amount of insulin produced is insufficient to lower the glucose level to normal; the level of glucose in the blood remains too high. In type 1, or juvenile, diabetes, the beta cells in the pancreas have been destroyed, so the body does not produce insulin at all. In type 2, or adult-onset diabetes, usually the body is not adequately responding to the insulin being produced. Fat on the body coats the cell membranes and impedes insulin function. The pancreas produces more and more insulin in response, but over time as the pancreas struggles with the extra workload, it eventually loses the fight and becomes unable to meet the unnaturally high demands. As insulin production starts to falter under the increased demands, the glucose in the bloodstream starts to rise. In both cases, with type 1 or type 2, insulin lack or insulin insensitivity, the glucose rises in the bloodstream. If it gets high enough, it also spills over into the urine. Initial symptoms of diabetes include frequent urination, lethargy, excessive thirst, and hunger.

The body will attempt to dilute the dangerously high level of glucose in the blood, a condition called hyperglycemia, by drawing water out of the cells and into the bloodstream in an effort to dilute the sugar and excrete it in the urine. It is not unusual for people with undiagnosed diabetes to be constantly thirsty, drink large quantities of water, and urinate frequently as the body tries to get rid of the extra glucose. This creates high levels of glucose in the urine.

 

Saving the Life of Type 1 Diabetics

Only about 10 percent of diabetics are type 1, also called childhood onset (or juvenile) diabetes because it typically begins in childhood. Type 1 diabetes refers to a disease in which the beta cells in the pancreas that produce insulin are destroyed by the immune system, usually early in life. When the body's immune system mistakenly targets our own cells instead of a foreign substance, it is called an autoimmune reaction. The causation is complicated and comes about partially as a result of an antibody reaction against a viral protein that mistakenly attacks the beta cells in the pancreas.

In this form, the body produces almost no insulin. It is characterized by a sudden onset and occurs more frequently in populations descended from northern European countries compared to those from southern European countries, the Middle East, or Asia. Type 1 is also called insulin-dependent diabetes because people who develop this type need to have daily injections of insulin.

Approximately 80 percent of our at-rest energy is used by the brain. Under normal situations, the body can only function on glucose; however, when there is insufficient insulin, the brain and other tissues are unable to utilize the glucose in the bloodstream. When the body is unable to utilize glucose stores normally, free fatty acids will rise in the bloodstream. The body can make ketones from these fats, and then the brain and heart can use the ketones as an emergency fuel, when unable to get sufficient glucose. Glucose and ketones build up in the blood and can have devastating consequences. For example, type 1 diabetics are more prone to developing ketoacidosis, which can be life threatening if left untreated, leading to coma and death. Ketones are moderately elevated in blood and urine during fasting or significant carbohydrate restriction, but they can get to dangerously high levels in decompensated or untreated type 1 diabetes. Ketosis (high ketones in the blood) and ketoacidosis can occur in type 2 diabetics in some circumstances as well. It is the combination of the high glucose level in the blood along with the high level of ketones that can lead to dangerous acidosis and dehydration.

Type 1 diabetes is not caused by weight gain or obesity, and people with type 1 diabetes will always require insulin to prevent serious issues with high blood sugar (hyperglycemia) and other life-threatening conditions. Even so, a superior nutritional diet is essential for health and longevity of a type 1 diabetic, and even though excess body fat is dangerous for everyone, it is more dangerous for the type 1 diabetic.

I am often asked, “Is your program appropriate for type 1 diabetics? Will insulin be required forever, no matter what?” The answer to both questions is yes. Unlike a type 2 diabetic, if you are a type 1 diabetic, you can never stop taking insulin entirely. However, after adopting this high-nutrient dietary approach, you will need much less insulin, in most cases about half as much as before, following the typical ADA approach. The need for less insulin is not the only major reason for type 1 diabetics to follow this diet style. The vital reason is that it can save a type 1 from serious health complications later in life.

I have helped several patients with type 1 diabetes completely recover from their condition by flooding their body with micronutrients, fortifying their immune system, and resting the pancreas. This opportunity, however, is only available when the disease is just starting, usually in an adolescent or young adult. This is the exception, not the rule. Unfortunately, most type 1 diabetics have to live with the disease for the rest of their lives.

But here's the important news: With conventional care, the long-term outlook for a type 1 diabetic is dismal. More than one-third of all type 1 diabetics die before the age of fifty. This does
not
have to be the case. Type 1 diabetics need not feel doomed to a life of medical disasters and an early death sentence. Type 1 diabetics can lead a normal life and have a better-than-average life expectancy. It is true that type 1 diabetics are more sensitive to the damaging effects of the SAD diet, but if they eat a vegetable-based diet with plenty of beans, nuts, and seeds, they are no longer at risk for heart disease.

Scientific studies reveal that death due to early-onset heart disease in type 1 diabetics is linked to insulin resistance. That means weight gain, poor dietary choices, and therefore the need for excessive amounts of insulin is dangerous for type 1 diabetics. But when type 1 diabetics follow my nutritional advice, they require substantially less insulin and take it in physiologic dosages—the amount of insulin will not be excessive and will not hurt them.

Type 1 diabetics can have healthy, normal, and long lives. The typical health tragedies that befall type 1 diabetics are the result of the combustible combination of American food and excessive insulin use, a fire fueled by physicians and dieticians whose nutritional advice unfortunately remains in the dark ages.

By adopting this high-nutrient approach, type 1 diabetics lower their insulin needs and no longer have swings of highs and lows. Glucose levels and lipids stay under control with minimal insulin. Requiring less insulin while still having excellent glucose readings is the goal. The simple truth is that the reason why type 1 diabetes leads to heart attacks and other life-shortening ailments is the excess insulin required by a low-nutrient diet, not the diabetes itself.

It is not type 1 diabetes that causes such negative health consequences. Rather, it is the
combination
of the diabetes and the typical nutritional “advice” given to patients—advice that requires them to take large nonphysiological amounts of insulin to maintain favorable glucose readings. Insulin itself promotes the development of atherosclerotic plaque, the foundation of heart disease and heart attacks. Insulin increases appetite and promotes fat storage and weight gain, thus furthering insulin resistance. This is particularly exacerbated by the high glycemic and excessive caloric load in conventional diets.