Warning- This is a slightly longer article but well worth the read. As it is an important topic I am not adding any pics, memes or recipes.
Traditional Healthcare-
“ Oh my gosh. My sugar is too high. I have to get it down!”
“Oh my gosh. I have Diabetes. I need to stop eating fat and cholesterol!”
This has been the mantra since I was in medical training over 3 decades ago.
We now have more Diabetics and Pre-Diabetics than ever before and it is still growing.
For this substack article, when I discuss Diabetes or Pre-Diabetes I am referring to Adult Onset otherwise known as Type 2 Diabetes.
So I ask the question.
“How is the traditional advice of focusing so much on lowering sugar working out?”
I’ll give you my opinion. As always you may have your own.
The traditional advice is NOT working well.
Here is why I believe we need to change how we approach Diabetes.
Diabetes is NOT a sugar problem.
No- I am not lacking sleep, nor did I get hit in the head.
But I will say it again because it is the truth.
Diabetes is NOT a sugar problem.
Then what is Diabetes?
While at it, What is Pre-Diabetes?
You ready to hear it?
Are you sure?
Can you handle it?
Can you handle the truth about Diabetes?
Diabetes is a STORAGE problem.
Diabetes is a STORAGE problem.
I said it twice for good measure.
Have you ever asked yourself why it is mostly overweight and obese people who get Diabetes?
Elevated sugar, or Glucose as we measure it in blood, is a hallmark of Diabetes. But there are many other markers of Diabetes that occur earlier, much much earlier. If you are aware of these early markers you can then do something to prevent becoming Diabetic.
Why should you worry about Diabetes anyway?
Well, Diabetics have much higher risks of Hypertension, Heart Disease, Strokes, Cancer, Dementia along with many other issues too long to list.
So ya really don’t want to go there, to Diabetes I mean.
So now let me show you the mechanism I see occurring every day, that others seem to either not notice or ignore.
Let’s start by saying that our body will try and retain excess energy stores from the food we eat just in case we ever need it in the future. We store a very small amount as glycogen, perhaps a few pounds. We store most of the remainder as fat.
So excess fat calories can get easily stored as fat.
But excess carbohydrate calories also get stored as fat but they need the hormone Insulin to help get it stored.
The problem becomes when our body, really our fat cells, start sensing they can not store any further fat from carbohydrates. They are full. No room at the inn. One more straw and my back will break. I hope you get my point.
What happens then when we run out of fat STORAGE room yet we still eat an excess amount of carbohydrates?
Where does the fat get stored?
This excess fat starts getting stored around your organs, known as Visceral or Organ fat. This kind of messes up how these organs function.
Some examples of disease processes that result from excess organ fat include:
Obesity, Fatty Liver, Cirrhosis, Diabetic Retinopathy, Diabetic Nephropathy, Heart and Vascular Disease (fat deposits in your arteries), Dementia (Type 3 Diabetes)
There are more but I think you get the hint.
“Hey, but Doc. You said something about measuring sugar not really working. Can you get back to that?”
Sure I can.
Read closely and watch the progression.
Eat excess carbohydrates and blood sugar rises slowly but if you have room in your fat cells to store it, it easily and quickly goes there. No real rise in sugar other than perhaps right after you eat.
Continue to eat excess carbohydrates and you continue to fill up your fat cells.
Now you get to the point where your fat cells are beginning to rebel. Hey mon, we are running out of room. But you really like that bread and pasta so you ignore the fat cell warning.
What happens next?
Well now as you eat excess carbohydrates, it takes them longer to get stored. Not only does it take longer to get stored, but now some is getting stored in your organs as well.
Now what is occurring in your body that we can measure during these processes?
Ready for it??
Are you sure???
Here we go.
Excess dietary carbs get converted into Triglycerides. Elevated Triglycerides on your fasting labs can be an indicator of this. Triglycerides should be stored in your fat cells but remember that the fat cells are running out of room. They are resisting any more triglycerides from excess carbohydrates being stuffed inside. Ever heard the term Insulin Resistance???
So Triglycerides start rising and remaining high even while Glucose readings are still considered in the healthy range!
I mentioned Insulin.
Insulin helps the excess carbohydrates get stored. If you do not eat excess carbohydrates your insulin remains at a healthy lower level. But if you chronically eat excess carbs, and you run out of room to store them, your Insulin level remains elevated as it is still trying to find somewhere to store the excess carbs. Insulin levels will not lower until the job has been done.
So Insulin levels start rising and remaining high even when Glucose readings are still considered in the healthy range!
So we have two markers that are elevating, Triglycerides and Insulin, even before Glucose, that are signs of a Pre-Diabetic state. I hope you see that by continually storing excess fat it overloads the healthy mechanisms of how your body handles it. The result being an Excess storage state that becomes Diabetes.
But wait there is more!!
As your fat cells increase and you have more fat stored, we can measure this in the blood as Leptin. Leptin can mean many things, but in general the higher your Leptin the more fat you have stored in your fat cells.
There is another blood marker, Adiponectin, which is kind of like the opposite of Leptin. Adiponectin tells me “how much room remains in your fat cells to SAFELY store more fat”. So Adiponectin is a good marker, and higher levels generally mean you have more room remaining, and that you have NOT overloaded your fat storage capacity.
I like to do a calculation of Leptin divided by Adiponectin.
Optimal is less than 1.
Ok is less than 2.
The higher this number goes the closer you are to becoming Diabetic.
So now we have the following.
Elevated Triglycerides.
Elevated Insulin.
Elevated Leptin.
Lower Adiponectin.
Yet still have what is considered healthy Glucose levels.
But the above scenario is a Pre-Diabetic State. Yet most Traditional healthcare professionals will tell you that you are OK as your glucose level is OK.
But wait!
There is even more!!
As the Leptin rises and Adiponectin falls, as the Insulin and Triglycerides remain elevated, your excess dietary carbohydrates still need somewhere to go. This is when they start going into the organs. This is most noticeable visually as central belly fat. Your waist starts expanding. Your belt gets tighter. Your clothes appear to be shrinking???
For simplicity I will stick to your liver for this example. Your liver starts getting excess fat storage, i.e. fatty liver. Not a good thing to occur as your liver is your waste treatment center and is responsible for clearing and detoxifying toxins. Excess fat can kind of mess up that function.
I often see laboratory signs of fatty liver by elevations in your blood liver tests such as AST, ALT, GGT, and Ferritin. I also see an elevation in a marker called crp or hs-crp or c-reactive protein when both fat cells and liver cells are becoming overloaded with fat.
The higher these numbers go the closer you are to becoming Diabetic.
So now we have the following.
Elevated Triglycerides.
Elevated Insulin.
Elevated Leptin.
Lower Adiponectin.
Elevated liver function tests.
Yet still have what is considered healthy Glucose levels.
But the above scenario is a Pre-Diabetic State. Yet most Traditional healthcare professionals will tell you that you are OK as your glucose level is OK.
Get ready for what I am about to say now.
The above Pre-Diabetic state can occur for up to 10-15 years prior to developing elevated Glucose levels in your blood. But here is the kicker.
The Pre-Diabetic state is already harming your body, just as a Diabetic state would, even though your blood sugar levels are not yet elevated.
Now for another kicker.
All of this is reversible.
I will say this again.
All of this is reversible.
Not only is it reversible, but you can usually reverse this WITHOUT medications.
So by reversing this process you reduce your risks of developing Fatty Liver, Cirrhosis.
Diabetic Retinopathy, Diabetic Nephropathy, Heart and Vascular Disease (fat deposits in your arteries), Dementia, etc…
The traditional care for Diabetes starts much too late.
The almost singular focus on watching glucose levels works as well as buying tickets for the Super Bowl and getting to the game with a minute left to play. You missed your chance!
But as I said before, most of this is reversible.
We can rewind the recording and get you back to better health.
This is one of the things we do at the Institute for Medical Wellness.
Well, this has been long enough.
I am happy you made it to the end and that hopefully you now have something to think about.
As always comments and questions welcome.
I am considering having a further discussion of this topic in my Substack private chatroom. If you do not yet have the app downloaded for the chatroom, you can do so here.
Just some additional "Food for Thought": Perhaps sugar is not the problem.
White sugar uses 8 chemicals to process it from cane juice to sucrose+molasses, then adds an anti-caking agent. And if you want "brown sugar", why they just mix the two processed forms back together! The manufacturers will tell you that none of those chemicals remain
in the finished product. Sure.
And people today eat multiple "doses" of this in every meal, every snack, every drink, every day, every day of their life, often beginning with baby formula and ending with "Adult Nourishment" for the elderly.
Perhaps its not JUST the sugar (and carbs) that is the root cause of the problem, but also the residual chemicals and multiple frequencies of ingestion that affect our natural digestive metabolism as well.
This explains why so many people I know are surprised to discover they have type 2 after years of being "fine." And then, despite the drugs prescribed and the lifestyle management hacks involved, their health continues to dwindle.
I'm curious...having recently begun eating low-carb, I've already lost a few pounds (yay, me!). However, I need to take a fiber supplement, and I'm a bit anxious about missing out on nutrients (can I get all the phytonutrients needed for optimum health by eating "the rainbow" on just 1/4 of my plate?).
Do you think it would be possible for someone to eat low-carb to get their body back in balance and reach their target weight, and once there somehow transition to eating a la Dr. Mark Hyman's "Pegan" strategy without risking things like diabetes?
His plan, too, focuses on a low-glycemic load and sees insulin resistance as the root of all evil when it comes to health. But it calls for more plants in the diet.