In Retrospective #437, “Heading toward the cliff,” I
described how standard clinical practice 1) treats type 2 diabetes as a
progressive disease of insufficient insulin (not unlike type 1 diabetes) and 2)
typically uses both oral and injected medications to “activate your body to
release its own insulin.” This is still done with sulfonylureas, which should
have fallen out of favor as documented
in #437. However, a new once-a-week injectable medicine promises
to do the same – to “activate your within” to “release its own
insulin.” That’s a bad idea!
Why? Because it is a medication that is designed to address a
symptom of type 2 diabetes, an elevated blood sugar, and thus is a
treatment TWO degrees removed from the CAUSE of the disease: INSULIN RESISTANCE.
This treatment increases insulin either from “your within” (your pancreas)
or, as the disease progresses (as you doctor believes it will), direct
injections of insulin. To be sure, increasing insulin will lower your blood sugar… but at what cost? You’ve exhausted your pancreas and
become an “insulin dependent” type 2. That is the WORST thing you can do!
A better treatment, just ONE degree removed,
would be to take a medication that suppresses unneeded/unwanted glucose
production by the liver and improves your insulin sensitivity (the opposite
of Insulin Resistance). That medicine is Metformin.
If the dosage is titrated (started as a low dose and slowly increased), the gut
tolerates it well. It has virtually no other side effects and some salutary effects (longevity) not yet
fully understood.
By lowering glucose production and facilitating glucose
uptake at the cellular level, treatment with Metformin accomplishes the same
goal (lowering blood glucose) without
putting any stress on your already overworked pancreas. This treatment is thus one
degree closer to the cause of your type 2 diabetes: INSULIN RESISTANCE.
The best treatment, a DIRECT treatment, then,
would be one that doesn’t cause your blood glucose level
to rise in the first place. But, remember, if you’re a typ2e 2 or
prediabetic, you have Insulin
Resistance. Because of a genetic predisposition and eating for many
years a diet very high (60%+) in carbohydrates, especially
refined and processed carbs and simple sugars, your body developed
resistance to the glucose transporter hormone, INSULIN.
Refined and processed carbs like flour and starches are the
worst; they’re almost all glucose. At least cane sugar is half glucose and half
fructose. But fructose is processed by the liver to become either glucose, or
if your liver is full of stored glucose (glycogen), your body converts it via
lipogenesis to fat. Besides added
pounds, this produces its own set of problems, including NAFLD, non-alcoholic
fatty liver disease, or worse, NASH, non-alcoholic steatohepatitis.
So, if you’re a type 2 or prediabetic, how do you prevent an
elevated blood glucose? Clue: It’s NOT a drug, so your
doctor can’t write a script for it. It’s
a patient-directed treatment.
Don’t eat foods that digest quickly and easily to glucose. If you
don’t eat foods that digest to glucose (carbs), your blood “sugar” cannot
become elevated!
Those foods would be 1) the refined and processed foods and
the so-called “complex” carbohydrates (a criminal misnomer if ever there was
one). They are just long-chain glucose molecules which break down to simple glucose
when digested; and 2) the simple sugars, like sucrose (cane sugar), lactose (as
found in milk and yogurt).
As bad as table (cane) sugar is, (and honey and maple syrup
and agave), most yogurts are worse, especially the non-fat ones. In place of
fat, sugars and other carbs are added, and
then fruit syrup and fruit, both virtually 100% “sugar.” If you
question this, ask yourself, does fruit contain any of the other two
macronutrients, protein or fat? If not, it is 100% carbohydrate (sugar). And
breads! Besides, flour (a highly
processed carb), and water, the third
ingredient in almost every loaf of bread is sugar. Even those “sprouting” breads are maltose, a disaccharide
(double sugar).
So, what are your options: 1) WORST: 2 steps
removed. You can beat up your pancreas by taking a sulfonylurea or a
once-a-week injectable that does the same thing, or 2) BETTER: 1 step
removed. You can take Metformin to suppress unwanted glucose, or 3) BEST:
directly address your Insulin Resistance.
You can eat fewer carbs, to keep your blood glucose level lower and stable, and
avoid having to take more meds and face the “the dreaded complications.”
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