Monday, December 23, 2019

Retrospective #310: Newly Diagnosed Type 2? What’s Next?

It’s now been 33+ years since I was diagnosed a Type 2 Diabetic (in 1986), so I’ll admit I don’t have a recollection of what happened next. My guess, though, is that what I was told then is not much different from what a newly diagnosed Type 2 or even a Pre-Diabetic is told today. Only the names and classes of drugs have changed.
First, I’m pretty sure I was scared. After all, I was told I had a disease – a life-long, progressive disease – and that it would require medical treatment for the rest of my life. I was also told, I’m sure, that I should lose a lot of weight. That was daunting enough, so I’m pretty sure my doctor didn’t tell me that I would eventually “progress” to injecting insulin and that I would probably die from one of the micro or macrovascular complications of the disease. That was the way it was then, and sadly still is today, if you follow the medical establishment’s treatment protocol.
Of course, losing weight, following my doctor’s recommendations, was my responsibility. Prescribing medications was his. He, like all doctors then and now, was lacking in nutrition training, but probably offered me some “helpful” advice: “eat less and exercise more.” He probably suggested I follow the one-size-fits-all Nutritional Guidelines for Americans’ “eating pattern” to eat a restricted calorie, balanced diet and do some “regular exercise” for 30 minutes a day, 5 days a week. But my doctor knew from long experience with obese Type2 patients that I would fail to lose the weight on that “diet and exercise” program. Not to worry; he had a prescription pad and could write another “script” as my condition worsened. My guess is you are already well familiar with this “establishment treatment protocol” scenario.
Like most doctors, then and now, my doctor was under the mistaken impression that I was obese because I ate too much and didn’t exercise enough. My doctor thought that my obesity led to and was a major contributing factor, perhaps even “the cause,” of my Type 2 diabetes. The truth is: it was the other way around. The underlying condition of my Type 2 diabetes, Insulin Resistance, is what caused my obesity. For an explanation of the mechanism of this metabolic pathway, read “Retrospective #308: What Causes Type 2 Diabetes?” Or a good book: Gary Taubes’s “Why We Get Fat and What to Do About It,” or Volek and Phinney’s “The Art and Science of Low Carbohydrate Eating.”
So, my doctor thought that if I reversed my weight gain, he could slow the rate at which my progressive disease would worsen. And it would be good as well for my general health, blood pressure, etc. My doctor also thought that by prescribing medications to help me control my blood sugar, he would be helping me to control my diabetes and thus likewise “delay the complications.” My doctor, regrettably, was misguided here too, as he was taught to treat diseases by treating the symptoms; my doctor didn’t understand and therefore couldn’t treat the cause of Type 2 diabetes.
The cause, Insulin Resistance, was precipitated when certain of my genes “expressed” themselves after a long history of eating a diet that was too heavily composed of carbohydrates, especially highly processed carbohydrates (including sugars). Since the 1960s, all Americans have been told by the American Heart Association to reduce their intake of fat, in particular saturated fat and dietary cholesterol. In 1977 a Select Congressional Committee issued Dietary Goals, and in 1980 the USDA and HHS jointly produced the first Dietary Guidelines for Americans. In 1990, Congress followed with the Nutrition Facts panel on processed foods. Then and NOW, incredibly, the Nutrition Facts panel calls for a diet of 60% carbohydrates, 10% protein and 30% fat. These ratios are excellent for fattening feed lot livestock for market.
These government interventions were a huge (no pun intended), nation-wide uncontrolled experiment. Now, after half a century, we see that it was a catastrophic failure, leading to an epidemic of obesity and Type 2 Diabetes even in very young children. If you are now a member of this failed low-fat (VERY HIGH CARB) cohort, consider addressing the cause: highly processed carbohydrates.  To avoid “challenging” your “expressed” genes, with the goal of improving your Insulin Sensitivity, consider modifying the macronutrient ratios in your diet. To lower both your weight and your blood sugar, reduce the carbs dramatically, increase the protein slightly, and raise the dietary fat. Get off the livestock fattening program. Start with 20% carbs, 20% protein and 60% fat. Just start with breakfast and see how you feel; perhaps 2 or 3 eggs and 1 or 2 strips of bacon. No toast! No juice! How do you feel? Are you hungry before lunch?

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