Type 2 Diabetes, a Dietary Disease #327: “Just by changing what I ate…”

Doctors treat Type 2 Diabetes by focusing on its salient symptom: high blood sugar. What they tell you is to “eat right, exercise and lose weight,” but then they treat you with oral antidiabetic medications.  But that’s why you went to the doctor, right? For him or her to “treat” your pre-diabetes or type 2 diabetes; to take care of you; to write a script to make you “better” (or at least to manage your condition)? That’s their job, right?

But high blood sugar is only a symptom!!! So is being overweight or obese. They are not the cause of Type 2 Diabetes; they are only associated with it. But, the doctor tells you to lose weight and take the pills anyway. And when you don’t lose weight and your high blood sugars persist, your type 2 diabetes inevitably progresses.

Did you ever wonder why doctors don’t treat the cause of Type 2 Diabetes? They know that the cause of Type 2 Diabetes is Insulin resistance (IR). Why don’t they treat that? Or tell you how you became IR? Well, I’ll tell you.

First you probably have a genetic predisposition. Some of your genes have come to “express” an intolerance for carbohydrates. How? By eating too many of them for too long! (The government has told you to since 1977.) Type 2 Diabetes (IR) takes many years to develop but, for some people (the genetically predisposed), it inexorably leads to Insulin Resistance. And Insulin Resistance means that you are now to some greater or lessor degree intolerant of carbs.

The mechanism is, when you overload your digestion/absorption system with glucose, which is the breakdown product of all carbohydrates, insulin, the hormone responsible for transporting those glucose molecules to your cells, is likewise in overload mode, and the level of insulin in your blood rises. This results in a slight resistance to its uptake, and that resistance, over time (years of overeating carbs at every meal), creates a vicious cycle.

Besides developing Insulin Resistance, what happens when you eat too many carbs at every meal and your blood insulin levels are in a constantly elevated state? Well, insulin, besides being the glucose-transporter hormone, is also the fat-storage hormone. See, the brain (where all these thing are regulated in a place called the hypothalamus), thinks that if you have an elevated blood insulin, you have a ready source of glucose (carbs) for energy (e.g., ripe fruits and vegetables), so it doesn’t have to use its precious fat stores (around your waist). So, it “starves” you and sends you a hunger message to go out and pick more fruit. It can conserve your body fat.

That’s the other function of insulin: fat synthesis and storage. It enables your body to make fat and store it for when you really need it (famine, winter). It still thinks you live in the Stone Age. So long as you have an elevated blood insulin, from constantly eating carbohydrates (combined with insulin resistance), and glucose availability either from food-by-mouth or some stored in your liver (glycogen from the carbs you ate yesterday), it won’t switch over to fat-burning mode. And you’ll be hungry.

But let’s face it. Your doctor isn’t going to tell you this. He or she would have to admit that the advice you’ve been getting for the last forty or fisty years to eat 55% to 60% carbs has been all wrong. My doctor did, however, inadvertently. He thought that being obese was a cause of Type 2 Diabetes, and he knew my blood sugars were out of control even though I was loaded up with antidiabetic meds. More than anything, he wanted me to lose weight.

Then, one Sunday morning in July 2002, on the cover of the New York Times Magazine, my doctor saw a big, sizzling rib-eye steak with a pat of butter on top. He read the article, “What If It’s All Been a Big Fat Lie,” tried the diet himself, lost 17 pounds in a month, and said to me, “Have I got a diet for you…” The first day on it I had a hypoglycemic episode (low blood sugar) and the next day another. In less than a week he took me off one antidiabetic med and had twice reduced the other two by half. Later I totally eliminated one of those and today take just metformin.

And I did all of that “JUST BY CHANGING WHAT I ATE…”  PS: I also lost 170 pounds.