Understanding the Development of Type 2
Diabetes
Protect yourself from misleading information that abounds
on the subject of diabetes.
By Joel Fuhrman, M.D.
The heavier you are, the greater your risk of developing
type 2 diabetes. For certain susceptible individuals, even
a moderate
amount of excess fat on the body can trigger diabetes. Your
body’s cells are fueled by glucose. When you have excess
fat
on your body,the extra coating of fat around your cells
makes it difficult for the hormone insulin to transport
glucose into the cells.To overcome this problem, your body
produces additional insulin,which is manufactured by your
pancreas. Adult diabetes
is a disease of insulin resistance, not one of insulin deficiency.
Dangerous weight gain As little as five
pounds of excess fat
on your frame can inhibit the ability of insulin to carry
glucose into your cells. When you have twenty pounds of
extra fat, your pancreas may be forced to produce twice
as much insulin. With fifty or more pounds of excess fat
on your frame, your pancreas may be forced to produce six
to ten times more insulin than a person who is lean.
What do you think occurs after ten or twenty
years of overworking the pancreas? That’s right, it becomes
exhausted and loses the ability to keep up with the huge
insulin demands. As time goes on, even though your overworked
pancreas
may still pump out much more insulin than a thinner person
might need, it won’t be enough to overcome the effects of
your disease- causing body fat.
The pancreas’s ability to secrete insulin
continues to diminish as the diabetes and the overweight
condition continue year after year. Unlike with type 1 (childhood
onset) diabetes, total destruction of insulin secreting ability
almost never occurs
in type 2 (adult onset) diabetes. But the sooner a type
2 diabetic loses the extra weight causing her diabetes,
the greater the likelihood that she will be able to maintain
a functional
reserve of insulin-secreting cells in her pancreas.
Taking insulin is dangerous for type 2 diabetics
The damage caused by higher than normal insulin production
(as a result of excess body fat) begins years before a person
is diagnosed
as being diabetic. Excess insulin promotes atherosclerosis,
which in turn leads eventually to heart attacks and strokes.
Findings from numerous studies have shown
that hyper-insulinemia promotes atherosclerosis even in
non-diabetics. In diabetics, the effects of excess insulin
are even worse. In a study of 154 treated diabetics, the
prevalence of blood vessel disease was greatest in those
with the highest levels of insulin. It made
no difference whether the insulin was endogenous (self-produced)
or exogenous (taken by injection).
Quite a few studies illustrate the dangers
of giving insulin to adult diabetics. When these patients
are given insulin—compared with those given metaformin Glucophage)—the
risk of death from heart attacks tripled.
Additional problems
When you give an adult diabetic who has been suffering from
the
damaging effects of excess insulin for years more insulin
to drive her sugar level down, you create additional problems.
Giving the diabetic patient insulin increases appetite,
which causes significant weight gain (often more than 20
pounds), which makes the patient more diabetic. Thus, the
administration of insulin creates a vicious cycle that cuts
years off a person’s life.
Exposure to insulin in injectable form can
create a blood vessel wall injury that is an early step
in the formation of atherosclerotic lesions. Insulin both
blocks cholesterol removal and delivers cholesterol to cells
in the blood vessel walls, accelerating the creation of
atherosclerotic plaque. Simply put, it increases
the risk of cardiac death.Almost 80 percent of all deaths
among diabetics are due to atherosclerosis, particularly
coronary artery disease.
Since the level of insulin in your blood
is a good predictor of your risk for heart attack, and since
a tape measure around your waist is nearly as good a predictor
of insulin levels, it makes sense to remember the ancient
saying,“The longer your
waistline, the shorter your lifeline.”
Although an elevated cholesterol increases
mortality somewhat in the non-diabetic, a diabetic’s risk
for death increases fivefold for each twenty points that
cholesterol is elevated above normal.The bottom line is
this: if you have diabetes or know
anyone with diabetes, they must get rid of their diabetes
and not merely “manage it.” Do not rely on standard drug
methods of treating diabetes, especially injecting more
insulin. An aggressive approach based on nutritional excellence
is the only effective way to reverse this dangerous condition.
A tough situation
Conventional diabetologists are in a bind. They know that
high glucose levels accelerate aging of the eyes and kidneys,
leading to devastating complications such as kidney failure
and blindness. They want to prescribe aggressive insulin
therapy to
get patients’ blood sugars down.The problem is they also
are aware that the extra insulin accelerates atherosclerosis
(which leads to heart attacks) and weight gain (which eventually
makes patients more diabetic).
Tightening blood sugar control with insulin
is risky business.
Diabetologists engaging in this conventional medical practice
are endangering their patient’s lives. The risks are so
great, I consider it malpractice to start giving insulin
to type 2 diabetics without offering the option of treatment
utilizing nutritional excellence.
Dangerous advice
The American Diabetes Association and most dieticians and
physicians offer dangerous advice to the diabetic. They
give lip service to weight reduction and cholesterol lowering,
but since the diets they recommend are ineffective at achieving
substantial
weight loss and sustained ideal weight, even these recommendations
are generally worthless.Typical diabetes care focuses on
general glucose control, by monitoring blood glucose to
determine when it is necessary to change insulin dosages
and when glucose-lowering medication is warranted.
Here is a policy statement from a physician
organization dictating diabetic care: “It is nearly impossible
to take very obese people and get them to lose significant
weight. So, rather than specifying an amount of weight loss,
we are targeting metabolic control.” This is doublespeak
for—”Our recommended diets don’t work, so we just give medications
and watch patients deteriorate.”
Most effective approach
How can diabetics safely lower the high glucose levels that
are slowly destroying their bodies? How can they lower their
lipids and blood pressure, lose weight, and avoid taking
dangerous drugs,such as insulin and sulfonylureas? They
need to adopt a diet based on nutritional excellence.
Fortunately, the best diet for good health
and longevity is also
the best diet for diabetics. It is a diet with a high nutrient
per calorie ratio, as carefully described in my book, Eat
To Live. When you eat a diet consisting predominantly of
nature’s perfect foods—green vegetables, beans, eggplant,
tomatoes, mushrooms, onions, garlic, raw nuts and seeds,
and limited
amounts of fresh fruit, it becomes relatively easy to eat
as much as you want and still lose your excess weight. In
my experience, those who follow my nutritional recommendations
find that their diabetes disappears astonishingly fast,
even before most of their excess weight melts away.
Predictable success
I have achieved marked success with diabetic patients and
the success at becoming “non-diabetic” or almost “non-diabetic”
regularly occurs on the Eat To Live program whether the
patient follows a strict vegan diet or not.I describe the
diet-style as a “vegetable- based” diet because the base
of the pyramid is vegetables, not grains. Even though most
animal products are excluded, it is not necessary to adopt
a completely vegan diet to achieve the goals.
I offer patients the choice of adding two
servings a week of lowfat fish, such as tilapia, flounder,
sole, and scrod, as well as an eggwhite omelet, once or
twice each
week. A few servings of very lowsaturated- fat animal products
each week can be interspersed with the vegan meals without
diminishing the results achievable from the vegetable- based
diet.
Warning/Disclaimer
No one who is taking medication should make dietary changes
without the assistance of a physician, as medication adjustment
will be necessary to prevent excessive lowering of the blood
sugar level, or hypoglycemia. Because Dr. Fuhrman’s diabetic
reversal program is so effective, it is even more important
to consult with a knowledgeable physician who is familiar
with medication reduction and its gradual discontinuance.