Okay, so which is it? A Dietary Disease or a Lifestyle Disease? It’s both, of course; diet is a part of Lifestyle. But why then is Establishment Medicine comfortable with calling it a Lifestyle Disease and not a Dietary Disease? They would tell you that lifestyle includes such things as doing 175 minutes of exercise a week (which while good, isn’t necessary) and giving up smoking (which while also good, isn’t relevant to diabetes). Forget the epidemiological studies that show an association with Type 2 Diabetes. That’s demographic, not causal.
Exercise is a great habit to have. It builds muscle, keeps you fit, and if you’re a Type 2 or even Prediabetic, it improves your insulin sensitivity. But it’s not necessary. Eating fewer carbs, thereby secreting less insulin, also improves your insulin sensitivity. “Insulin causes Insulin Resistance,” as Dr. Jason Fung recently blogged.
No, Establishment Medicine probably doesn’t want to call Type 2 a Dietary Disease for a number of reasons:
1) Some clinicians simply don’t know. I know that’s hard to believe, but I’m afraid it’s true. It’s called “tunnel vision.” See #365, to be posted in two weeks, “The Dual Pincers of Clinical Practice Guidelines.”
2) If you understood that Type 2 Diabetes and Prediabetes are Dietary Diseases, then the “treatment” would be a changed diet, not pills and injections… and you could still advocate for exercise and secession of smoking. Ah, but then it would be a less persuasive and perhaps a less effective argument if it was not linked to the avoidance of Type 2 Diabetes. And, if you didn’t have a prescription to write, the patient would feel “cheated.” The patient wants you, oh omnipotent dispenser of scripts, to “cure” this pernicious disease for them.
3) If Type 2 Diabetes and Prediabetes are acknowledged to be Dietary Diseases, caused by the dietary advice that Government Dictocrats have mandated and Medical Establishment has peddled for the last 55 years, then your doctor, if he or she were to tell you to change your diet to almost the exact polar opposite of what he or she has been telling you to eat over these many years, they would look pretty silly or just stupid. And the general public, and your doc’s patients in particular, would lose confidence in these omniscient demigods.
4) The ADA used to say that low carb diets were not safe. Then, the evidence from controlled trials proved them wrong. Then they said they were safe for a limited time only; then the evidence proved that wrong too. Then they said – actually, they’ve said all along – that low carb diets were too difficult to follow. That’s true for some, but certainly not true for many others. Others found them easier to follow than a low-fat, calorie- restricted, “balanced” diet because weight loss without hunger was possible. And followers of low-carb, high- fat diets, besides keeping the weight off, had better glucose control and better lipid (cholesterol) profiles!
No, it’s easier to see the patient, take a blood sample, and then tell them (in a phone call or a note with your lab test) that, “Your sugar is a little high; we’ll have to monitor that.” And when you continue to eat the same prescribed “balanced” diet, and exercise as you were told, and your blood sugar goes higher still, the doctor will tell you, as Tom Hanks related to David Letterman, “You’ve graduated; you’re now a Type 2 Diabetic.”Well, what did you expect? You continued to do the same thing and yet you expected a different result? Type 2 Diabetes is a Progressive Disease. Insulin Resistance is a Progressive Condition. Insulin Resistance = Type 2 Diabetes. Insulin Resistance = Carbohydrate Intolerance. The only effective treatment for a Dietary Disease is a different diet. The only effective treatment of Type 2 Diabetes is a Low Carbohydrate Diet. Not “watching your blood sugar” as it progressively worsens. Not treating this symptom – an elevated blood sugar – with a drug that will force your pancreas to secrete more insulin and thus eventually wear out and destroy it. Type 1 Diabetes is a disease of too little insulin. Type 2 Diabetes is a disease of too much insulin. The best way to treat your pancreas, and thus save it, is give it a break! Eat a low carb diet!