Learn more about diabetes

Diabetes: Take Control  print section

For most, diabetes is a frightening diagnosis. Most clients can still remember when they were diagnosed, and the feeling of losing control that came with it. But while the diagnosis is a daunting one, our aim at Lifestyle Center of America is to put you back in the driver’s seat. The truth is that there are aspects of diabetes that can be improved even for someone with type 1 diabetes. By making the best decisions on a daily basis, you can have tight blood sugar control and keep your diabetes from progressing. A medical professional can give you advice, but they cannot make the right choices for you. It is up to you and whether you take your medicine on time, exercise when you need to , or consume the right foods (low glycemic, low fat, high fiber). Therefore, the power to stop diabetes lies with you. Take control of your diabetes using lifestyle medicine.

The different types of diabetes  print section

The two most common types of diabetes are type 1, characterized by a non-productive pancreas and type 2, characterized by body cells resistant to the insulin pumped out by the pancreas. Approximately 95% of diabetes is type 2 diabetes, which is preventable, and perhaps even reversible in some cases.

Gestational Diabetes

Although not officially a TYPE of diabetes, gestational diabetes will develop in pregnancy. During the latter stages of pregnancy, insulin levels will increase. As the baby’s sensitivity to insulin increases, the mother’s resistance to insulin can increase. Generally speaking, gestational diabetes will reverse once the baby is born. While treatment in the form of lifestyle changes (diet and physical activity) works most of the time, some women may need  to take insulin to regulate very high blood sugars during this time.

Type 1 diabetes

Type 1 diabetes is diagnosed when the beta cells of the pancreas stop working properly and are no longer producing the insulin required by the body to get energy into the cells. In a still mystified turn of events, the body’s own immune system seems to attack the beta cells responsible for the production of insulin. The result is diminished or halted insulin production. Which means that the individual is dependent upon external insulin to stay alive. The person is then labeled as insulin-dependent.

In type 1 diabetes, the body’s cells are starving for insulin, which makes them insulin sensitive. One of the characteristics of a type 1 diabetes patient is natural thinness. Because there’s lack of natural insulin, very little fat is stored in the body’s cells.

However, if the diet of a type 1 diabetic is not controlled, their blood sugar will rise, requiring more insulin. In a normal, healthy adult, the pancreas will secrete 20-30 units of insulin a day. A person with type 1 diabetes should aim to use no more insulin than what the pancreas normally produces.  Yet in order to control higher blood sugars, more insulin is taken.  Higher insulin levels bring the expected results of increasing weight, cholesterol and blood pressure with them and soon the patient begins to look and act like a type 2 diabetic.

Type 2 diabetes

The pancreas of a person with type 2 diabetes produces insulin that cells of the body resist. Nearly 90-95% of all diabetes cases are labeled as type 2 diabetes.  In a normal healthy body, as food is digested in the body, the nutrients will supply energy to the cells in the form of glucose (blood sugar).  Insulin, is the key that unlocks the door to each of these cells allowing the glucose to get in. If a cell is sensitive to insulin, it will allow the key to fit in and unlock the gate. Resistant cells however, are so full of energy already that the locking mechanism is jammed and therefore the cell “door” cannot be unlocked.

In type 2 diabetes, although the body is producing adequate amounts of insulin, dependent upon how much energy is consumed by a person, the cells are resistant – locked shut because of an overabundance of sugar already in them.  Essentially the amount of energy in the cells is keeping any other energy from entering and the energy triggers more insulin production. The end result is a worn out pancreas that leads to dependence on insulin. However, if the problem can be addressed early on, before the pancreas is worn out type 2 diabetes can be reversed. The extra energy in the body is also stored if not used up, which is why so many type 2 diabetics are overweight. By losing the weight, the individual is helping the body burn the extra energy and take some of the load off the pancreas.

Type 1.5 diabetes

Between 10-15 % of adults diagnosed with type-2 diabetes turn out to have something different , called type 1.5 diabetes, also called slow-onset type-1 diabetes, or latent autoimmune diabetes in adults (LADA). At first, it looks and acts like type 2, even responding to some common type-2 oral medications. These patients look a little different from the average patient with type-2 diabetes, though. Their weight is usually normal, and their cholesterol and blood pressure are also usually within normal limits because they do not have the high insulin levels that cause such changes. Further testing, which may be ordered when the medications lose efficacy, often reveals little or no insulin resistance, which is why the oral medications used to decrease insulin resistance stop working. So the disease starts looking more like type-1 diabetes, in that it seems lifestyle choices (too much energy in , not enough energy out) are not the principle cause. And, like type 1, we see pancreatic beta-call function dropping off, but at a much slower rate (3 to 7 years, as opposed to 3 to 6 months).

We don’t’ know exactly why this happens, though we have ideas. Several studies have uncovered antibodies in these patients that attack beta-cells in the pancreas )not unlike the presumptive culprit in type-1 diabetes), caught right in the middle of the destruction (hence the terms slow-onset type-1 diabetes and latent autoimmune diabetes in adults). The cause could be environmental toxins and/or it might be a genetic disorder. Another intriguing possibility lies in prenatal conditions: Perhaps when such a patient was still in the womb, his or her mother took in too much energy without enough physical activity, which weakened the fetal pancreas, affecting its ability to function later in life.

No matter what the cause of type 1.5 diabetes, individuals with the problem will probably need insulin with time. If they follow the principles of lifestyle medicine, their blood sugars will be easier to control and they may avoid the problems that come from getting too much insulin. This will help ensure that this patient’s total insulin dosage per day is the same as that which is necessary for someone with uncomplicated type1 diabetes or even someone without diabetes. (A normal adult produces 20-30 units per day from the pancreas). 

Type 3 diabetes

Now, type-3 diabetes is really fascinating. In 2005, researchers at Brown University Medical School discovered what seems to be another, quite different type of diabetes. This one, which they deemed type 3, doesn’t affect blood sugar, but does have to do with insulin. Only the insulin involved here doesn’t come from the pancreas. The Brown researchers discovered that the brain makes its own insulin.  Brain cells produce tiny amount of insulin, enough to metabolize energy for normal brain functioning. It means that brain cells have their own sensitivity and resistance to brain insulin. Now, the most interesting (and still unproven) theory is that when things go awry with brain insulin, the brain suffers because of poor energy metabolism. The Brown scientists found a link between brain insulin resistance and Alzheimer’s disease.  Most diabetes experts agree that there is some kind of link between diabetes and Alzheimer’s disease. For example, people with type 2 diabetes have two or three times greater risk of developing Alzheimer’s disease.  The researcher have also discovered deposits of a protein in the pancreases of many type 2 diabetes patients that correspond to similar protein deposits from in the brain tissues of people with Alzheimer’s.

But more studies must be done to determine if there really is a type 3 diabetes, if a brain insulin-related central nervous system malfunction is at the root of the disease, or whether the effects of the more common forms of diabetes contribute to the death of memory cells, which is the basis for Alzheimer’s disease. We believe there’s enough evidence to posit that Alzheimer’s, one way or the other, is caused by too much energy in and not enough energy out.

Is insulin resistance the root cause of diabetes?  print section

For type 2 diabetes, (and those with type 1 diabetes that are requiring more insulin and gaining weight) insulin resistance is the culprit. During normal metabolism, as you consume food, the sugar travels into the system prompting the pancreas to release insulin. Insulin is the body’s butler to your cells: it opens up the door for the energy that the cell needs to enter the cell. The more starved for energy the cell is (imagine after running a race), the more desperate the cells are to have the energy present. Imagine however a lazy Sunday afternoon. It’s your day off, you haven’t done much, and as you sit watching TV, you glance at the evidence of your snack attack: empty Oreo package, bowl left with remnants of ice cream, soda can in hand, bag of chips in the other. All that energy has been processed, ringing the door bell, the pancreas has sent out the butlers (insulin) however, the cells refuse to let the butler open the door. Why? Well, they haven’t been working today. They’re still full of energy from the last meal. They don’t need any energy, therefore they’re not interested in letting the butler help them. Since the level of energy in the blood isn’t going down, the pancreas works harder…getting even more insulin out. But the cells are full. They don’t need any more food. This process occurs when too much energy is taken in and not enough energy comes out. When this occurs over an extended period of time, it leads to the cells being resistant to insulin overall. Think of it this way, insulin resistance is the lazy cells’ rejection of the insulin’s call to usher in energy.

Having read this, it’s much easier to understand now why simply taking insulin doesn’t get to the root cause. The root cause isn’t just blood sugars going haywire, but the equation of energy in must equal energy out being skewed. So then by using the energy that you are eating up, you can re-balance the equation and gain better control of you blood sugars. Check out some things you can do to restore the body’s energy balance. You can find more in-depth information in our book, The 30-Day Diabetes Miracle.

What should your numbers be?  print section

A healthy pancreas uses 20-30 units of insulin to keep blood sugars in the range of 70-140. Fasting levels (8 hours since eating) should be 70-99, and readings 2 hours after eating range 90-140. A bit of activity will lower blood sugars after meals.

Get off the insulin hamster wheel  print section

Chances are that you’re familiar with the ramifications of high blood sugar. You may remember your physician discussing “small blood vessel disease” with you. What it really boils down to is that too much sugar in the blood ends up clogging small blood vessels. And this leads to a whole slew of complications. Complications most people are familiar with when they hear the word diabetes: blindness, kidney failure, neuropathy, gangrene, which can lead to the most extreme complication of them all, amputation.

To prevent these complications your health provider has prescribed insulin to help keep your blood sugars low. But drugs themselves don’t erase the root cause of high blood sugars, and because of this dosages start going up. Pretty soon you may find yourself chasing food with insulin and insulin with food. You know what we mean.  Take insulin to cover a meal, then have to eat at a certain time to ensure that your sugars don’t bottom out, then you have to take insulin to cover what you’re eating, then again have to eat at a certain time. It seems like a never-ending battle.

But there is hope. Lifestyle medicine helps you leave the hamster wheel of insulin chasing food and food chasing insulin by showing you the importance of eating the right kind of food to complement your insulin usage and how to use activity to lower your blood sugars. It means you can have just 3 meals a day. You don’t have to take breaks all the time just to eat a snack, or cover your insulin with food. And it gives you the freedom of being back in control of your diabetes.

Are you on a weight loss rollercoaster?  print section

Type 2 diabetes is ruthless on your form. Whether being overweight at the diagnosis or not, by the time the individual has had diabetes for 5 years they have at least started a couple weight loss plans with no real results. Once the person starts taking diabetes, the weight loss becomes a mirage. That’s because insulin is a growth hormone. Simply put, the more of it you have in your system, the more weight you gain. If you’ve just had an, “I KNEW it!” moment, here’s another for you. We teach clients how to keep their blood sugars under control using as little medication and insulin as possible, making it easier for them to lose and maintain the appropriate weight. 

Heart disease: #1 enemy  print section

Diabetes acts as a double edged sword. On the one hand, high blood sugars lead to small blood vessel disease, but on the other hand, high insulin levels lead to large blood vessel disease. The bottom line is that too much insulin affects the heat itself. 65% of people with diabetes die from a heart attack or a stroke. The problem is that insulin is a growth hormone. The more you have in your system, the more weight you’ll gain. This is one of the reason why so many with type 2 diabetes are overweight. 

High insulin also corresponds with high blood pressure. This is related to insulin’s effect on the pliability of blood vessels (the less pliable, the harder to dilate, and the less dilated the higher the pressure). Insulin also makes the kidneys hand on to sodium, which leads to water retention. A combination of rigid pipes (blood vessels) and more fluid in the pipes leads to higher pressure.

High insulin also causes total cholesterol and bad (LDL) cholesterol levels to go up, while making good cholesterol (HDL) levels to go down. This collection of events increases your risk of heart attack and stroke dramatically.

A fundamental mistake that many doctors make in treating diabetes is ignoring the negative effects of high insulin levels and associated insulin resistance while focusing only on treating the blood sugar.

But it doesn’t have to be that way. Our lifestyle medicine approach to diabetes helps you incorporate habits into your daily life that help manage blood sugars without needing to ad on extra insulin. Our goal is to keep your insulin levels to those of a healthy pancreas with as little medicine as possible.

Fiber: your key to tight sugar control  print section

Fiber is a diabetic’s best friend. Not really. Get this: fiber lowers the risk for heart disease, strokes, appendicitis and even some cancers. Ok, so the appendicitis isn’t really diabetes related, but it’s a nice side bar. And with heart attacks and strokes accounting for 65% of all diabetes deaths, fiber comes out a shining star! A high fiber diet can actually help patients with diabetes reduce their insulin intake, even when lots of fruits are eating. What makes fiber so great?

• Fiber does not contribute to raising blood glucose levels. It means that eating foods with a high fiber content will not raise your blood sugar as much as eating foods with a low fiber content. Example? A whole orange won’t raise your blood sugar as high as drinking orange juice.
• Soluble types of fiber increase thickness of the food in our stomach and slow down digestion and the time it takes to empty the stomach. This in turn slows the rate of absorption of glucose into the bloodstream. Eating a high fiber meal then  moves the glucose in the food slowly into the blood, keeping the rise in blood sugar after eating more gradual (no jagged spike like a mountain, a more curved slope, like a hill). And an added benefit? You’ll need less insulin to bring that blood sugar back down.
• Fiber decreases the amount of available carbohydrates in a given food. In other words, the more fiber in food, the less of the other kinds of carbs (starch and sugars) there are for you to worry about.
• Because the glucose in fiber is not digested and absorbed into the bloodstream, fiber does not in general provide calories. Yet we get a wonderful sense of fullness when we eat fiber-rich foods. We wind up eating less of everything else and therefore take in fewer calories.

Fiber is found only in plant based foods. There is no fiber in animal products (meat, fish, milk, cheese, eggs). We recommend at least 35g a day (average American gets only 10-15g).

Lower your blood sugars with activity  print section

At Lifestyle Center of America we show our clients how to use physical activity as medicine. We wish that we could take the credit for coming up with this, but the fact is that since the discovery of insulin in the 1920s there have been studies showing the importance of physical activity in the equation. How exactly does it work?

• Physical activity results in improved insulin sensitivity. It works to help insulin usher energy into the cells. For many people this translates into a reduction in their insulin or oral diabetes medicine dose. The more active you get, the better you train your body to deal with sugar.
• Physical activity coupled with moderate calorie intake is the most effective way to lose weight. And with weight loss, we again get increased insulin sensitivity and the nice result of being able to reduce insulin or oral diabetes medicine. Remember, insulin’s a growth hormone, so the less of it in yoru system, the fewer pounds you will gain. It’s breaking this cycle of insulin-chasing –blood-sugar-chasing-insulin that’s the real key to diabetes control and lasting weight-loss.
• Physical activity decreases the risk of cardiovascular disease. It can control hypertension, reduce overall cholesterol, LDL cholesterol and triglycerides; and raise HDL cholesterol.

Here are some practical things you can do to increase your activity. Strolling after meals for about 15 minutes will help improve your body’s cells sensitivity to insulin. (Check out how strolling combined with an increase in fiber consumed affects your blood sugars). Try to get some form of physical activity into your day, whether it’s walking, biking, swimming, golfing, playing sports. Chances are if it makes you break a sweat (without it being hot out or wearing too many clothes) it’s a good activity. Do that activity for a total of 60 minutes of day. Don’t worry, you can break those out into four 15 minute sections, or three 20 minute sessions, or two 30 minute sections…you get the drift. For more information on physical activity and a complete fitness plan, check out The 30 Day Diabetes Miracle.

Gastric bypass without surgery  print section

One of the most successful treatments in diabetes to date has been gastric bypass surgery. The surgery works by forcing the body to consume smaller amounts of food in order to experience extreme weight-loss. Notice that the real results for diabetes come as the pounds are shed. Weight loss is key to attaining better insulin sensitivity (the body cells heading the call of insulin and taking in energy instead of rejecting it). And in turn insulin sensitivity leads to weight loss. The interesting factor is that gastric bypass is essentially a surgically induced lifestyle change. You don’t need the risky, costly surgery to get the results that patients attain from the surgery. By changing your daily life you can and will stop the progression of diabetes. And an added bonus is that you won’t have to spend the money, take the risks involved in the surgery or require hospitalization. You can do it all from home.

3 things you can do to stop diabetes  print section

Stopping diabetes requires realizing that the choices you make affect your disease. The most powerful intervention for diabetes is a changed way of life. It’s about digging out the root cause of diabetes instead of just medicating the symptoms. Here are the optimal choices you can make for preventing, stopping, and even reversing diabetes:

1. Reject the Standard American Diet and move toward adopting a PLANT-BASED DIET. This means limiting animal products such as meat, dairy, and eggs. The idea here is to avoid animal fat and protein, as well as concentrated calories, all of which are associated with most of our chronic diseases, including diabetes. We suggest a high carb diet (about 65% of the right kind of carbs – Northern fruit, above-the-ground vegetables, whole grains, beans, legumes, nuts and seeds, etc).  This diet is very high in fiber, and fiber is your friend: it doesn’t raise your blood sugars, it doesn’t add calories, yet it makes you feel full. The diet provides you plenty of protein, so don’t worry. You should also eat “breakfast like a king,” meaning load up to the fuel your body and brain needs early in the day, and reduce or eliminate the evening meal, both for calorie restriction and for lowering morning (“fasting”) blood sugars. Also – it’s a myth that people with diabetes need to eat six times a day. Learn more about how a completely plant based diet (vegan diet) is better for type 2 diabetics than the diet recommended by the American Diabetes Association.
2. Reject exercise prescriptions based on the myth of “No pain, no gain,” and adopt a sensible ACTIVITY PLAN. Remember that exercise is medicine – you can stroll after meals and see your blood sugar go down. Plan to stroll for 10 minutes (you can walk 5 minutes in one direction and then re-trace your steps back to your original spot. Two hours after each meal, check your blood sugar reading. If your reading is over 140 walk for another 10 minutes. Wrok towards including more physical activity into your day: you can park your car where the RVs park, and walk to the store; take the stairs instead of the elevator; visit the furthest bathroom/water fountain from your office. By "exercising" in 10 minute bursts after each meal and when blood sugar is high you accumulate approximately 30-60 minutes of exercise a day. Isn't that different?
3. Reject the idea that it’s too late to change your behaviors and adopt the RIGHT ATTITUDE. This means training your brain to make some big changes and make them stick. You can do this in a few key ways, including getting in touch with answers to the vital question, “good health – for what?” Realize why you want to get better (e.g. to be around for your grandchildren, or to climb a mountain). It’s good to be clear about your goals (e.g. to conquer insulin resistance and lose weight), to set specific target behaviors to reach those goals (e.g. strolling after meals and adopting a more plant-based diet), and make time and devote resources to reach the goals. Learn to “mind the gap” in your thinking between stimuli (like seeing a donut) and your potential responses (either eating the donut or deciding not to). In short, be honest with yourself – evaluate where you are with your health and how you got there. Is this what you want? Get out of the groove you are in before it becomes your grave.

What’s possible  print section

The results you can have in stopping the progression of your diabetes are related to how far your diabetes has already progressed. It’s important to find out if it is still progressing, and start the journey to stopping diabetes before it stops you.  You can listen to audio files of what clients have been able to accomplish on our plans. You can read their success stories. Or you can check out our “results you can expect” page.

Are you ready to take the next step in stopping diabetes?