Paradox of Disease and Diabetes

Occasionally I encounter such an excellent post by members of other diabetes groups that I just have to share verbatim. One such post is from Otoniel Santiago, a Facebook member, who does not have a blog of his own but has given me permission to share what he wrote. It is as follows:

Consider the following conditions: Gluten Intolerance, Lactose Intolerance, and Alcoholism.

All these conditions have something in common. Their commonality stands in the fact that certain foods are eliminated in order to provide relief or resolve the condition.

Let’s take a closer look:

1. Gluten intolerance: doctors immediately recommend eliminating gluten. In other words, a gluten-free diet. (i.e., wheat, barley, rye, and possibly oats)
2. Lactose intolerancw: doctors immediately recommend eliminating dairy. In other words, a dairy-free diet. (i.e., ice cream, cheese, milk, or any product containing dairy)
3. Alcoholism: treatment is to avoid all alcoholic beverages.

So, why isn’t Type 2 diabetes treated the same?

The American Diabetes Association’s (ADA) mantra for type 2 diabetics (T2D) is to get blood sugars into the normal range at all cost. As I mentioned before, this is based on the acknowledgement that high blood sugars are the primary cause of diabetes. High blood sugars are a symptom of the disease not the condition itself.

If we know that the primary factor in increasing blood sugar are carbohydrates, why do still recommend between 45g and 60g of carbohydrates per meal? This is like treating alcoholics by telling them that drinking less alcohol at every meal will help them control their alcoholism.

Ludicrous! Nobody in their right mind would recommend this.

Still, we continue to provide the same recommendation. You don’t have to take my word for it; the ADA says this in their own website.

“A good place to start is at about 45-60 grams of carbohydrate at every meal. You set a limit for your maximum amount of carbohydrate to eat for a meal, and with the right balance of physical activity and medicine, if you need it, can help to keep your blood sugar levels in your target rate.”

Consider this advice: if you ate a hamburger just with the bun you would be eating 30g of carbohydrates which have a glycemic index of 61. Meaning it releases glucose at a faster rate than a Snickers bar (glycemic index 51)! If you want to take a closer look, go to the Harvard website and search glycemic index.

In case you are wondering what the glycemic index is, it is defined as the value assigned to a food based on how slowly or how quickly that food can increase blood glucose (sugar) levels.

This is beyond the point. What I am trying to say is that high insulin resistance is the underlying cause of the disease. With almost 90% of the population of the United States suffering from T2D and more than 50% of them taking insulin to control their blood sugars, it doesn’t make any sense to give more insulin to individuals with high insulin already.

Just as having too little insulin can lead to major health problems, including death ( for type 1 diabetics), high levels of insulin (expressed as high blood sugar) can lead to major complications such as those found in T2D patients (blindness, kidney problems, heart disease, erectile dysfunction, fatty liver, and death, to name a few).

Controlling sugars does not prevent long-term complications. For example, a recent study from Diabetes Care showed that despite tight blood sugar control it did not reduce the occurrence of heart attacks and progressive damage to kidney function.

Still the ADA says: “Balancing the food you eat with exercise and medicine (if prescribed) will help you control your weight and can keep your blood glucose in the healthy range…this can help prevent or delay complications. Many people with diabetes live long and healthful lives.” The paradox!

Our focus needs to change from treating the symptom of high blood sugars to targeting the elephant in the room—high insulin levels—aka “insulin resistance.”

In other words, if you will, we could call T2D “Glucose Intolerance” based on this slight information. And, if you were the doctor on the other side of your patient, what would you recommend?

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