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How to Prevent Type 2 Diabetes

Preventing Diabetes 1-2-3

1. Better awareness of the consequences of waiting until it’s too late.
2. Better understanding about how the body works.
3. Better monitoring with more advanced analysis of lab tests.

1. Sixty percent of US deaths are caused by heart attacks & strokes (~800,000 per year) -Centers for Disease Control

Prevalence of Diabetes (US)

• 24 million Americans have diabetes, 57 million more have pre-diabetes.
• 23% of people over 60 have diabetes
  35% over 60 have pre-diabetes.

-National Institute of Health

• Pre-diabetes is the disease casued by high blood sugar, from 100 to 125 mg/dL. (A1C>6)
• Diabetes is when the same disease gets bad enough to require medication; when blood sugar consistantly exceeds 126 mg/dL. (A1C>6.5)

40% of U.S. adults over age 40 have pre-diabetes or diabetes.

-US Dept. of Health and Human Services

"Many pre-diabetics develop type 2 diabetes within 10 years."

-National Diabetes Information Clearinghouse

"If current trends continue, an astonishing 35% of children born in 2000 will develop diabetes."

-California Center for Public Health Policy

Pre-diabetes (glucose >99mg/dL) Causes Heart Disease

"Recent research has shown that some long-term damage to the body, especially the heart and circulatory system, may already be occurring during pre-diabetes."

-American Diabetes Association

Pre-diabetics are 34% more likely to die from cardiovascular disease than healthy individuals.

• Risk of cardiovascular mortality increases continuously with glucose levels, and is elevated even at levels below that used to identify pre-diabetes.
• Elevated glucose on hospital admission, predicts poorer prognosis for heart attack patients.

-Understanding-PreDiabetes.com

Diabetics are 200-400% more likely to die from cardiovascular disease.

• In 2004, 86% of diabetics over age 65 died of a heart attack or stroke.

-Centers for Disease Control, National Diabetes Fact Sheet

High Blood Pressure

• Impaired neurochemical control mechanisms, and damage to blood vessels, cause high bloods pressure.
• 75% of adult diabetics have high blood pressure or use prescription medications for hypertension.

-Centers for Disease Control, National Diabetes Fact Sheet.

Nerve Damage

• 60 to 70% of diabetics have some form of neuropathy.
• Pain, tingling, or numbness in the arms, hands, legs and feet
• Weakness and muscle loss
• Inflammation and thickening of connective tissue causing higher incidences of carpal tunnel syndrome, Dupuytren's contractures of the hand, and plantar fascitis.

  More Nerve Damage

  • Indigestion, nausea, diarrhea, constipation, difficulty swallowing.
  • Irritable Bowel Syndrome- causing poor nutrient absorption due to impaired blood flow to intestines.
  • Increased susceptibility to infections,
    especially of the ear, nose, throat, lungs, urinary tract, vagina and skin.
  • Vaginal dryness.
    • Up to 40% of type 2 diabetics will suffer from kidney failure.
    • The time span from diabetic kidney injury to renal failure is ~5-7 years.
    • 350,000 Americans have end-stage kidney disease, 67,000 die each year.
    • 78,000 are currently waiting for a transplant.
    • "The rising incidence of diabetes...has reduced the number of potential donors."

    -National Kidney Foundation

    

    Dialysis

    4 hours/day, 3 times/week.

    Dialysis diet:

    • Reduce all fluid intake to avoid swelling
    • Avoid high potassium foods like avocados, bananas, kiwi, apricots, beets, cantaloupe, melons, nectarines, oranges, pears, spinach, tomatoes, yogurt.
    • Avoid high phosphorus foods like milk, cheese, dried nuts and peanut butter.
    • Eat as much protein as you can.
    • Basically eat a high protein, high carbohydrate diet with little vegetables, fruit or dairy.
    
    
    

    Foot Amputations

    
    2004: 71,000 diabetics lost parts of their feet.
    

    Diabetic foot ulcers

    

    
    
    

    Loss of Eyesight

    • 5.3 million people in the US have diabetic retinopathy.
    • Over 60% of type 2 diabetics will eventually develop it. 21% have retinopathy at the time of diagnosis.
    • Diabetic retinopathy is the second most common cause of adult blindness.
    • 8,000 people lose their sight from diabetes each year in the US.

    Diabetic retinopathy

    
    
    

    Increased Cancer Risk

    JAMA, January 2005:

    • A study of more than 1 million South Koreans suggests diabetes can raise the risk of developing and dying from several types of cancer, including digestive-tract tumors.
    • The highest risks for developing cancer and dying from it were found in people with the highest blood sugar levels.
    • Diabetics were 30 percent more likely than those without it to develop, and die from cancer.
    
    
    

    Erectile Disfunction

    
    • Excess blood sugar damages the nerves and blood vessels of the penis.
    • 50% of men with diabetes will suffer from erectile dysfunction within ten years of diagnosis.

    -Canadian Diabetes Association

    
    
    

    Alzheimer's

    Diabetics diagnosed before age 65 have more than double the chance of developing Alzheimer's disease

    -January 2009 issue of the journal Diabetes

    Mental Impairment

    Even mild Diabetes, well controlled, slows mental function"

    - January 2009 Neuropsychology

    
    
    

    Dental disease

    45-year old diabetic
    
    Nearly one-third of diabetics have severe periodontal disease with loss of attachment of gums to teeth of 5mm or more

    -Centers for Disease Control, Diabetes Fact Sheet 2007

    
    
    

    No Cure for Diabetes

    • There is no drug that can restore the ability of your pancreas to produce insulin properly again.
    • There is no drug that can reverse insulin resistance.

    "Controlling" Diabetes

    None of the standard medical treatments (Glucophage, Metformin, Glyburide, Glucotrol, Tolinase, insulin shots, etc.), will stop the progression of diabetes, nor protect you from it's complications, only delay them.
    
    Where does all the glucose go?
    • "I'm overweight, but my glucose levels are normal, so I can eat all the starch I want, right?"
    • "I'm insulin dependent, bit I keep my blood sugar under control. When I eat carbs, I just take more insulin."
    Translation: I'm going to keep swinging at that pancreas until it gives out. Meanwhile, I'll maximize inflammation throughout my body to promote every form of chronic disease.

    Slowing the Decay

    Even with the best medication available, the stress on your Pancreas, kidneys, liver, heart, blood vessels and nerves will continue...until one of these organs or systems just can't take it anymore.
    
    
    

    Prevention (conventional wisdom)

    • Eat less fat!
    • Exercise more!
    • Avoid sugar!
    • Take these drugs (to lower glucose, cholesterol, and blood pressure)!
    ...how's that going?
    
    

    National Diabetes Information Clearinghouse (NIH):

    Insulin resistance is a condition in which the body produces insulin but does not use it properly.
    
    What causes insulin resistance?
    
    Scientists have identified specific genes that make people more likely to develop insulin resistance and diabetes. Excess weight and lack of physical activity also contribute to insulin resistance.
    
    
    

    Incidence of Diabetes Nearly Doubles in Just Ten Years

    November 2008:
    
    The rate of new cases of diagnosed diabetes rose by more than 90 percent among adults over the last 10 years.

    -Centers for Disease Control

    What changed (in the last 10 years)?
    
    
    

    What Causes Insulin Resistance?

    Why would your cells, which are dependent on insulin to deliver fuel (glucose) to them,
    which is essential for life...
    
    Why would they RESIST that?
    
    
    

    What would cause YOU to resist something?
    
    ...something that's essential for your survival?
    
    ...something that your life depends on?

    
    
    Water...is essential for life ...could you imagine resisting water?
    
    
    

    What if you've had ENOUGH already?

    Insulin resistance is caused by
    
    TOO MUCH INSULIN!

    
    
    

    Where does the insulin come from? (The pancreas).
    
    What causes your pancreas to secrete too much insulin?

    
    
    Is it the fat?.... Does eating too much fat cause my pancreas to secrete too much insulin?
    
    Is it the Protein?.... Does eating too much protein cause my pancreas to secrete too much insulin?
    
    

    What causes your pancreas to secrete any insulin?
    

    (Carbohydrates).

    
    What kind of carbohydrates causes insulin production?
    

    (Every kind of carbohydrate causes insulin production).

    
    
    

    All Carbs cause insulin resistance?

    • Bad carbs cause excess insulin production every time you eat them, because they breakdown into glucose faster than your body can burn them... unless you're vigorously exercising.
    • All carbs eventually become glucose. So if you consume more than a modest amount on any given day, even whole grains and brown rice and beans, will cause excess insulin production, over-stimulate insulin receptors, and become fat.

    What causes your pancreas to secrete too much insulin?

    
    (bad carbs)
    

    So what causes insulin resistance?

    
    (sorry, but it's the bread)
    
    
    
    

    Grains, Starches and Sugar

    
    ... all cause over-stimulation of insulin receptors.
    
    
    
    

    American Diabetes Association:

    Eat more servings of grains, beans, and starchy vegetables than any of the other foods
    
    

    Why are so many "experts" apparently oblivious to this?

    They're still hypnotized by the myth of the low fat diet:

    If your body is full of fat, and your arteries are full of fat, and your blood is full of fat, then you muct be eating too much fat!"

    "Count Calories! Cut fat!"

    • Counting Calories and cutting fat make you hungry.
    • The first thing a hungry person on a low fat diet usually reaches for is some form of grain, starch or sugar.
    • Weight loss on a low fat diet always comes back.

    Very few people get fat from eating too much fat.

    Too much grain, starch and sugar:

    • Makes almost everyone fat.
    • Causes insulin resistance.
    • Causes type 2 diabetes.
    
    
    

    The Hunter-Gatherer in You

    
    
    A primary cause of death for our ancestors, for hundreds of thousands of years, was starvation.
    We evolved to ability to store carbs as fat to survive periods of famine.
    

    Homo Erectus

    • Our basic metabolism has been around for about 2 millions years.
    • For the first 1,990,000 years, there were no bagels, no pancakes, no bread, no pasta, no orange juice, no cheerios.

    How many grains do we really need?

    
    
    Dinner, for most of our physiological existence, has been mainly meat, fish, veggies, fruit and dairy.
    
    
    

    The Agricultural Revolution

    (10,000 years ago)

    • Created cheap calories on a massive scale, which fueled the development of modern civilization.
    • The very first grain-based diets also fueled the development of modern disease.

    Early Grain Based Diets:

    
    
    Ancient Egyptians ate mostly stone-ground whole wheat bread, fruit, vegetables, occasional meat and olive, safflower, flax seed and sesame oils.

    When thousands of Egyptian mummies were compared to the remains of hunter-gatherer societies:

    The Egyptians had:

    • Shorter lifespan
    • More heart disease and clogged arteries.
    • More prevalent obesity, particularly abdominal obesity.
    
    
    

    Insulin is a fat-storage hormone.

    • Insulin stimulated by excess carbohydrates aggressively promotes the accumulation of body fat.
    • Insulin simultaneously tells your body not to release any stored fat for energy.
    • Excess carbs not only make you fat, they also make sure you stay fat.

    Insulin causes hunger.

    • Excess insulin after eating too many carbs, depresses your blood sugar.
    • This causes you to feel ravenous, moody, shaky, and "ready to crash".
    • Which creates intense cravings for more carbs.

    Carb Addiction

    • Anytime you consume something that causes intense cravings for more of it, that's an addiction.
    • Carb addiction tricks us into thinking that we need lots of grains and starch.

    Hormones out of balance

    • Grains, starches and sugar also disrupt the hormonal system your brain uses to manage your appetite.
    • Fat Cells release a hormone called Leptin, that tells your brain to release fat.
    • Bad carbs make your brain resistant to Leptin, so it thinks you're starving.
    • This creates carb addiction.

    Hormones compel addiction

    
    
    If you experience cravings, "cutting back" won't break the addiction.
    
    Eating "a little less" bad carbs can be a lot like doing a a little less heroin.
    
    
    

    Restoring Hormonal Balance

    • The only way to restore the proper function of your appetite hormones is to temporarily eliminate grains, starch and sugar from your diet, to force your body to burn fat for energy again.
    
    
    • Eating lots of vegetables during this process, so that you feel full after each meal, also helps reset your hormones.
    
    

    

    • Great overview of carb addiction and how to control cravings.
    • Dr. Mercola's diet recommendations in back are stricter than necessary.
    
    
    

    Take control of your health.

    • Know the risk factors
    • Get tested regularly
    • Do whatever it takes to keep your blood sugar and triglycerides under control, without becoming dependent on drugs.

    Greatest risk factors:

    • Over age 45
    • Overweight (see BMI chart)
    • Family history of diabetes, or cardiovascular disease
    • High blood pressure (>140/90)
    • High triglycerides (>150 mg/dL)
    • High glucose (>99 mg/dL)

    Waist Size increases risk

    • Men with a waist size of 40 inches or more are 12 times more likely to develop type 2 diabetes.
    • Risk is tripled for 36" to 38" waists, and 5 times greater for 38" to 40" waists.

    If you have any ONE of these HIGH RISK factors:

    • Do a no-grain diet for 60 days to reset your hormones, overcome carbohydrate addiction, and start burning fat again.
    • Get support to control cravings.
    • Gradually reintroduce small amounts of grains and starch until cravings return.
    • Keep your glucose below 95.
    
    
    

    The A to Z Weight Loss Study

    Woman assigned to follow the Atkins diet, which had the lowest carbohydrate intake, lost more weight and experienced more favorable overall metabolic effects at 12 months than woman assigned to follow the Zone, Ornish, or LEARN diets.

    -JAMA, March 2007

    Effects of Low-Carbohysrate versus Conventional (low fat) Weight Loss Diets in Severely Obese Adults:

    Low-carbohydrate diet:
    • Triglyceride levels decreased more
    • HDL (good) cholesterol remained higher
    • A1C levels improved more

    -Annals of Internal Medicine, May 2004

    Mediterranean Diet

    A new study from Italy shows that people with type 2 diabetes who ate a Mediterranean diet rich in vegetables and whole grains with at least 30% of daily calories from fat (mostly olive oil) were better able to manage their disease without diabetes medication than those who ate a low-fat diet with no more than 30% of calories from fat (with less than 10% coming from saturated fat choices). After four years, researchers found that 44% of people on the Mediterranean diet ended up requiring diabetes medications to control their blood sugars compared with 70% of those who followed the low-fat diet.

    Effects of Alcohol on Diabetes

    Here are some ways that alcohol can affect diabetes:
    While moderate amounts of alcohol can cause blood sugar to rise, excess alcohol can actually decrease your blood sugar level -- sometimes causing it to drop into dangerous levels. Beer and sweet wine contain carbohydrates and may raise blood sugar. Alcohol stimulates your appetite, which can cause you to overeat and may effect your blood sugar control. Alcohol can interfere with the positive effects of oral diabetes medicines or insulin. Alcohol may increase triglyceride levels. Alcohol may increase blood pressure.
    
    
    

    "What if I feel just fine?"

    • Insulin resistance and pre-diabetes usually have no symptoms.
    • People may have one or both conditions for several years without noticing anything.

    -National Diabetes Information Clearinghouse (NIH)

    
    
    

    What part of your body is made of carbs?

    What part of a chicken, or a pig, or a cow, or any other animal is made of grains, starch and sugar?
    
    None.
    The cells, organs and tissues of your body are made of protein and fat.
    
    Carbs are merely for fuel. You need a little bit of fuel, all day long.
    
    
    
    

    When carbohydrates are absorbed after a meal...

    • A little bit goes directly to your brain.
    • A little bit more goes to your muscles.
    • Several bites get stored in your liver to keep you going until your next meal.
    • All the rest gets immediately converted to triglycerides, and transported (by insulin) to adipose tissue for storage (as fat).

    Spaghetti Effect

    Your cells need fuel to function, and they can get their fuel in the form of sugar or fat. However, your body must burn all of the available sugar first before it turns to burning fat. So let's say you eat a big plate of pasta (which turns into sugar in your body) along with a small amount of olive oil and meatballs (fat and protein). Your body must first burn off all of that pasta, and whatever can't be burned off will eventually be stored as fat. The fat you just ate, meanwhile, also goes into your fat tissue.
    
    
    

    Some of us need LOTS of grains, starch and sugar

    
    
    
    

    How much fuel do you think this activity requires?

    
    
    
    

    Good Carbs: Vegetables

    

    Good Carbs: Fruits, Nuts

    

    Good Carbs: Beans

    

    Good Carbs: Real Whole Grains

    
    
    
    

    Not-so-good Carbs:

    
    Everything made from "whole wheat" flour turns into fat, almost as fast as Wonder Bread or plain spaghetti.
    

    Good carbs require chewing

    • Milling, grinding, cooking, and processing, make ALL carbs more likely to spike your blood sugar, which is why "whole wheat" anything is not much better than a cookie or a piece of cake.
    • Liquid carbs are the worst of all. Most fruit juices are not much better than soda.
    • Beer is full of bad carbs. It's all Liquid sugar.
    
    
    

    One Soda a Day Increases Risk 85%

    Women who drink one soda a day were 85% more likely to develop type 2 diabetes.

    -Harvard School of Public Health, 2004

    
    
    

    Bad Carbs: Cereal, White rice

    
    
    
    

    Really Bad Carbs: Bagels, Pasta, Potatoes, Muffins, Bread

    
    
    
    

    Fat slows absorption of sugar

    Grains, starch and sugar eaten with minimal fat get absorbed quickly, which spikes your blood glucose and insulin.
    
    This is one major way low fat diets make you fat.
    
    Always eat some (good) fat with any bad carbs: Olive oil, avocado, cheese, butter
    
    
    
    
    
    

    Preventing Diabetes 1-2-3:

    Better monitoring with more advanced analysis of lab tests.

    HbA1c

    • Glucose binds the hemoglobin continuously during the life span of a Red Blood Cell (120 days). HbA1c is therefore proportional to average blood glucose, all day long, for the past 2-3 months.
    • The daily peaks in glucose after meals cause the most damage to blood vessels and nerves.

    A1C predicts risk

    "Every percentage point drop in A1C can reduce the risk of microvascular complications (eye, kidney, nerve damage) by 40%"

    -Center for Disease Control and Prevention, National Diabetes Fact Sheet, 2007

    A1C test

    • According to ADA, normal A1C is 4-6%
    • But the goal for medical management of diabetes is 7.0%... Why?
    • If reducing your A1C by 1% lowers your risk of eye, kidney and nerve disease by 40%, then why wouldn't your physician want to get it down to the normal range?

    Drug-induced Hypoglycemia

    • When you take drugs to lower your glucose, your body can no longer control glucose levels on its own.
    • If you skip a meal, the drugs could force your glucose too low, resulting in severe hypoglycemia.
    • Severe hypoglycemia can be fatal.
    • "Metformin doesn't cause hypoglycemia"

    ACCORD Trial

    February 6, 2008: The National Heart, Lung and Blood Institute, which sponsors the ACCORD (Action to Control Cardiovascular Risk in Diabetes) Trial, announced that it has stopped the intensive treatment program targeting normal blood treatment program targeting normal blood glucose values and an A1C less than 6 percent. The incentive participants in ACCORD are now being switched to the standardtreatment program (targeting A1C of 7-7.9%) because of an increased death rate, in the intensive treatment program.

    American Diabetes Association

    There is no A1C threshold below which there will be a serious side effect in most people with diabetes. Many people with diabetes have no adverse consequences even with A1C levels in the normal range (4-6%).
    
    (But, due to the small risk of fatality, the standard treatment target remains 7.0%. This is one reason why diabetics on medication still end up eventually getting the usual complications)
    
    
    

    A1C Home Test

    
    Avoid getting tagged with a pre-existing condition
    

    Glycemic index

    • Measures the peak and duration of elevated glucose after eating a specific food.
    • Diabetics are recommended to eat low glycemic foods, even if their post-meal glucose is under control.
    • You can measure the glycemic effect of any food on YOU.

    

    

    Low energy and sugar cravings

    Anything that causes low energy can help cause diabetes:
    • Adrenal fatigue
    • Anemia
    • Low thyroid
    • Fibromyalgia
    • Chronic infections
    • Vitamin and mineral deficiencies
    
    
    

    Science-Based Nutrition: Comprehensive Testing and Pro-active Analysis

    

    Heavy Metal Toxicities and Mineral Deficiencies

    
    
    
    

    Benefits of Nutritional Testing

    Many other chronic health challenges can exacerbate diabetes:
    • Hypothyroidism
    • Heavy Metal Toxicity
    • Fibromyalgia
    • Irritable Bowel Syndrome
    • GERD
    • Anemia
    • High Cholesterol
    • Heart Disease
    • High Blood Pressure
    • Depression
    • Chronic Fatigue Syndrome
    • Alzheimer's Disease
    • Parkinson's Disease
    
    
    

    Case Study:

    56 year-old female presented with diabetes, fatigue, decreased appetite, declining vision, memory loss, diarrhea, and abdominal pain.
    
    Initial test results:
    • Glucose - 309
    • A1C - 11.8
    • Triglycerides - 345

    Nutrients recommended:
    Beta carotene, Calcium MCH, Chlorella, Chromium, Vitamin E, Gymnema leaf extract, Vanadyl Sulfate, Lipoic Acid, Fish oil, Monolaurin, Niacinamide, Selenium, Vitamin B6, Zinc.
    
    Three month follow up test results:

    • Glucose - 109
    • A1C - 6.1
    • Triglycerides - 136
    
    

    Benefits of Nutritional Testing

    Diabetes itself is but one of many chronic diseases that result from the gradual breakdown of normal, cellular healing and repair mechanisms. Most of these conditions can be prevented, and maybe even reversed, with proper testing and nutritional support.

    

    Science-Based Nutrition

    Diagnostic testing for early signs of sub-clinical stress on your heart, liver, kidneys, pancreas, thyroid, immune and other systems, followed by safe, effective supplementation of depleted vital nutrients, such as specific forms of vitamins, minerals, essential fatty acids, antioxidants, and other concentrated plant-based foods can change your life now, and prevent you from spending your golden years drooling in bed while someone else changes your diapers.

    
    
    Seeing the difference that proper nutrition can make in peoples lives is the most rewarding part of my practice.

    -Todd J. Binkley DC

    
    
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