Tuesday, April 11, 2017

Type 2 Diabetes, a Dietary Disease #375: A New Year’s Eve Conversation, Part 2 of 2

Part 1 of this 2-part series (#374 here) relates how “Bruce” lost weight easily by “going off carbohydrates almost entirely” for two weeks. I met Bruce casually at a New Year’s Eve party and gave him one of my cards. He decided to check out my website, www.thenutritiondebate.com  and then to try Very Low Carb (VLC) eating. In our earlier conversation that evening, Bruce told me that in those first 2 weeks he had lost 10 pounds. The conversation continues here:
Dateline: January 14th (still later that evening)
You’re welcome, Bruce. Weight loss was my original motivation (in 2002) for eating VLC because, like yours, my doctor thought that being overweight was a cause of T2DMThey were both wrong, as Gary Taubes and many other experts in physiology and medicine have now exhaustively and conclusively proved. See my #5 here or Taubes's "Alternative Hypothesis" in "Good Calories-Bad Calories" (2008), a heavy but solid, evidence-based read.
An easier read would be, "What If It's All Been a Big Fat Lie," the New York Times Sunday magazine cover story of July 7, 2002, here: My doctor read this, tried it himself, and recommended the diet to me. That's when I got interested in low carb for weight loss. And, incidentally, it started the modern revolution in dietary science that so much of the orthodox profession continues to dismiss. That's why Taubes, who won the National Science Writers’ Association award 3 times, wrote GC-BC. Sadly, he was to be disappointed by the medical community’s response. 
Insulin Resistance (IR) is the cause of T2DM. It is also the cause of obesity, not the other way around. Insulin is the transporter of glucose in the bloodstream, and so long as there is enough glucose (from carbs) circulating in the blood, insulin remains elevated and blocks the alternative fuel, body fat, from breaking down to fatty acids to maintain energy balance . The body saves this fat, a more dense source of energy (9kcal/g vs.4 kcal/g for carbs and protein), for long fasts, including famine and winters (from a Paleolithic/historic perspective). I wrote about this in this post: The Nutrition Debate #308, “Introduction to What Causes Type 2 Diabetes,” here.
Since resuming my column a year ago December, my focus has been on "Pre-Diabetics," newly diagnosed Type 2s, and those who, like you, have been told they "might be Pre-Diabetic." The medical societies have been very slow to revise standards for diagnosis, but they have been doing it. They just haven't gone nearly far enough. There are many clinicians today who have, however, and many who just may (I don't know your values, and I'm not an MD) classify you unambiguously as Pre-Diabetic, or even a frank Type 2.
I hope you have a baseline A1c on a recent lab test, because it you stay on your VLC Way of Eating, you will see it drop, perhaps significantly, and perhaps even out of the range of Pre-Diabetic completely to below 5.7%. That should be your goal. "Normal," btw, is between 4% and 5%. Anything above 5% is a sign of Insulin Resistance.
I also hope you have a baseline metabolic panel or at least a lipid panel with which to compare your next lab tests. After doing this Way of Eating for awhile, my HDL more than doubled from 39mg/dl to 84mg/dl (comparing 15 average tests for both). And my triglycerides plummeted by two-thirds (from around 150mg/dl average to below 50 average. Both values have stayed there for many years now. My total cholesterol and LDL cholesterol have been stable and slightly lower. My latest test: TC 184; HDL 91; LDL 84; TG 46.
Google "Metabolic Syndrome." It is the precursor to and the “unifying hypothesis” for all these metabolic disorders. I wrote about it almost 5 years ago in an early column of The Nutrition Debate: Metabolic Syndrome.
BTW, after one day of eating VLC (a strict version of Low Carb, like Atkins Induction), before losing weight, I had a hypo and called my doctor who told me stop taking one anti-diabetic oral med. The next day he cut the other two in half and soon thereafter in half again, later eliminating the sulfonylurea completely. Now I just take Metformin.
Dateline: February 29th (6 weeks later)
I emailed Bruce to invite him to another party, our annual Winter Wing-Ding. He replied:
Hi Dan,
Thanks much for the invitation, but I am in Jensen Beach for January only.
Lost 40 pounds [my emphasis] and am taking One-a-Day “Silver” daily.


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