Retrospective #237: “…the ‘why’ behind my broken blood sugar.”

A loyal reader and faithful correspondent recently wrote to me that she was “always looking for the ‘why’ behind [her] broken blood sugar.”  I replied explaining the predisposition of some genomes to Insulin Resistance (IR), the predicate and the mechanism by which we slowly develop Type 2 diabetes. It begins with impaired glucose tolerance, advances to impaired fasting glucose, then progresses through beta cell failure and increased IR and full-blown Type 2 diabetes.

This “why” and “how,” however, is irrelevant, if we are already Type 2s. The fact is, if we were genetically susceptible and we ate a diet very high is sugars and processed carbs, as we were told, we became diabetic. It is instructive only to learn "what" to do to treat it effectively. The real question, then, is, "why" don't we change what we ate?

The “who” for this is all those who are 1) diagnosed Type 2s or 2) diagnosed (and undiagnosed) Pre-diabetics. The latter includes all those whose fasting blood glucose values have been between 100 and 125 on two consecutive lab tests or whose A1c’s are ≥5.7% and <6.5%. (Bear in mind that this A1c standard is the ADA’s lax measure; pioneer diabetologist Dr. Richard K. Bernstein and many other specialists regard an A1c of 5.7% to be full-blown Type 2.

If you’re either a diagnosed Type 2 or Prediabetic, you have a choice: 1) follow doctor’s orders: lose weight (if you’re overweight), eat the “healthy low-fat, high-carb diet” he or she likely prescribes, as defined by the Dietary Guidelines for Americans, the ADA, the AHA and the AMA, and take the medications your doctor prescribes while he or she monitors your progressively worsening condition. That’s not an unfair characterization. That is THEIR EXPECTATION.

Alternatively, if you’re either a diagnosed Type 2 or Pre-diabetic, you can lose weight (if you’re overweight), eat a “healthy low-carb, high-fat diet,” and take minimal or no medications while your doctor monitors your improving health (weight, blood pressure, lipids). As Michael Eades, M.D., commented on his popular Protein Power blog some years ago, "...the low-carb diet is the best way to shed weight and improve health for the vast majority of people."

The USDA’s one-size-fits-all low-fat, high-carb diet just doesn’t make sense for Type 2 diabetics or Pre-diabetics, (or anyone for that matter). It is the reason that we as a population, whether Pre-diabetic, Type 2 diabetic or not, are fat and getting fatter. It is how you fatten pigs and cows on the feedlot! Carb loading is how animals in the wild prepare to survive a long, hard winter when food is in short supply. You do too! You put on fat by eating grains, whether they’re “whole grains” or not. By the way, that “whole grain” loaf of bread with toasted whole grains on the outside? Those grains were brushed on and made sticky and brown using high fructose corn syrup (HFCS) or molasses.

My faithful reader and correspondent knows all this of course. It was just “wistful” thinking on her part (LOL). So, I am not writing this for her. I am writing this for those of you who still rely on your doctor to manage your diagnosed or undiagnosed Type 2 diabetes or Pre-diabetes. Read the Nutrition Debate #235: “Self vs. medical management of T2DM.” Self-management (under a willing doctor’s care) can avert the serious complications of Type 2 diabetes, both Micro and Macrovascular, including, ahem, men, erectile dysfunction. And lose weight and get off most meds to boot.

If you are officially or unofficially Pre-diabetic – with a fasting blood sugar between 100 and 125 – or with an A1c that is rising to or above 5.7%, you have a chance now to do something about it…BY CHANGING WHAT YOU EAT.

If you currently eat according to the government’s Dietary Guidelines for Americans, a one-size-fits-all prescription, and you’re a woman, you are eating about 300 grams of carbohydrate a day. That’s 60% of a 2,000 calorie a day diet. 60% is the Daily Value (DV), or Referenced Daily Intake (RDI), formerly called the “Recommended Dietary Allowance” (RDA), on the Nutrition Facts panel on packaged, processed food products. If you’re a man, you are eating 375 grams of carbs a day (60% of a 2,500 calorie a day diet). This is the high carb diet that the government recommends you eat.

I know. That’s shocking, but it’s a fact. The names have changed, but the percentage hasn’t. According to our USDA, we (all of us!) are supposed to be eating a diet that is 60% CARBOHYDRATE. Of course, you don’t have to do what the USDA tells you to do. You can take charge of your own health. Why not try 20% carbs (100g/day)? Can you do that?