I just read that diabetes is now the #3 cause of death in the United States and is #1 in Mexico. If you don't have diabetes or pre-diabetes, I'm sure you know plenty of people who do. At the request of a reader, I'm going to explain what diabetes is and how we get it.
The first thing to understand is that there are two main types of diabetes, type 1 and type 2, and that these are actually different diseases with different causes. Most people have type 2 diabetes which is a lifestyle disease and this is the one that has become very common. Type 1 diabetes is an autoimmune disease. Let me explain more about each of these.
An autoimmune disease is a condition where the body attacks its own tissues. In the case of type 1 diabetes, the tissue being attacked is the beta cells of the pancreas. The pancreas is an organ located near the stomach and it has cells that make pancreatic enzymes that flow thru the pancreatic duct into the small intestine to help digest your food. The beta cells are the ones that make the hormone, insulin, which is secreted directly into the blood stream in response to glucose (blood sugar) and moves the glucose into the cells so it can be used for energy.
As the beta cells are attacked, there is less and less insulin produced. Because the cells aren't getting glucose to use for energy, the person becomes tired. The blood sugar is high so the kidneys start dumping the sugar into the urine. This pulls more water into the urine so the person becomes dehydrated; they are thirsty and producing large quantities of urine. The extra sugar in the urine and the blood creates an ideal environment for bacteria to grow so infections become more common. The body starts using fat for energy and the fat is broken down into ketones. This is okay until the level of ketones becomes very high causing ketoacidosis. The ketones cause the breath to have a distinctive odor. I've heard this called a "fruity" odor but it actually smells like acetone (think of the smell of nail polish remover containing acetone). When the body is no longer producing any insulin and the person is in full blown ketoacidosis, this eventually leads to death. People who have type 1 diabetes have to inject insulin. Prior to the discovery of insulin, people with this condition all died.
People with type 1 diabetes who don't get enough insulin to balance the carbohydrates in their diet (which are broken down into sugar) can develop these symptoms and ketoacidosis but it can be reversed with insulin. If they give themselves too much insulin for the amount of carbohydrates they eat, they can go into insulin shock and even pass out, a medical emergency that can be reversed with the administration of glucose. So, there needs to be a careful balancing of dietary carbohydrates and insulin.
Type 1 diabetes often occurs after an infection or some sort of stressor. Autoimmune diseases have also been linked to intestinal permeability and problems with the gut microbiome (the bacteria that live in the intestinal tract which are necessary for life).
Type 2 diabetes is a very different disease. There is no shortage of insulin and in fact, people with this condition often have high levels of insulin. The problem is insulin insensitivity. The person eats carbohydrates, their blood sugar goes up, the body cranks out lots of insulin in response but the insulin doesn't work so the blood sugar stays high and the person starts to develop the same symptoms as the type 1 diabetic who has a lack of insulin.
Type 2 diabetes is often associated with obesity. It also tends to run in families so has a genetic component. Let's take a look of how this could develop. A person who has the genetic component to develop type 2 diabetes is eating the standard American diet. This means they are getting a lot of sugar (which is added to most processed foods) and lots of flour (which is broken down into sugar by your body). Their body responds by putting out lots of insulin. This moves the sugar from the blood into the cells. The cell has more than it needs for its energy requirements so it converts it to fat and stores it. Meanwhile, the blood sugar has dropped so the person becomes hungry. They eat again and the cycle repeats itself. Insulin can cause weight gain and eating carboydrates stimulates the release of insulin. Over time, the person develops insensitivity to the insulin and the blood sugar rises.
We have been told to eat a low fat diet with lots of whole grains. What has been the result? We have gotten fatter and fatter and diabetes is rampant. We have been told that sugar does not cause diabetes. We have relied on the information coming from government agencies that are heavily influenced by agribusiness who want us to buy those processed foods full of sugar, grain and processed vegetable oils.
The medical model for treating type 2 diabetes is to control the blood sugar with drugs. Under this model, diabetes is a progressive disease requiring more and more drugs over time. And if a person continues to eat the standard American diet, this is what will happen. The diabetes will get worse until the pancreas begins to fail and then the person ends up on insulin.
I propose that we treat the underlying problem of insulin insensitivity. How? By drastically cutting the carbohydrates in our diet. Quit eating processed food. Stop eating sugar. Give up grains (you can use almond and coconut flour instead of wheat flour). Diabetes can be reversed using a ketogenic diet of very low carbohydrates, moderate protein and high fat. This way of eating also leads to weight loss. I'll be glad to tell you more about that in another post. Meanwhile, here is a video of a doctor who uses this same approach to treating diabetes. https://youtu.be/da1vvigy5tQ
Janet L Black, RN, FNP,