We must conquer type 2 diabetes - opinion

For most of the last month, Jewish people worldwide have been celebrating the High Holy Days, which means food – lots of food. Even the fast day of Yom Kippur means plenty of eating before and after the fast. It is a time of eating traditional, delicious food, which also means a more sedentary existence with a lot of entertaining and sitting. 

Unfortunately, the food choices consumed usually lead to health problems of many varieties. It’s a time of eating foods laden with saturated fat and cholesterol, with the overconsumption of animal proteins such as meat, chicken, and fatty fish. It’s also a period where fatty and sugary desserts are consumed frequently.

All of this can contribute to processes that lead to chronic diseases, such as heart disease, Western cancers, high blood pressure, Alzheimer’s, and type 2 diabetes.

There may be no disease more misunderstood than type 2 diabetes (T2D). But before we get to that, it is important to realize just how prominent this preventable disease has become and what its ramifications are.

According to the Centers for Disease Control in the United States, 10.5% of the US population has T2D and another 34.5% have prediabetes. These numbers represent a frightening upward trend. According to the World Health Organization, the total number of people with diabetes is projected to rise from 171 million in 2000 to 366 million in 2030. 

High glucose in your blood stream can cause damage to blood vessels and nerves, potentially bringing catastrophic results including heart disease and stroke, nerve damage, kidney disease, neuropathy, eye disease, gum disease, along with sexual and bladder problems. In addition, many type 2 diabetics get fatty liver disease.

Preventing and treating type 2 diabetes

In order to both prevent and treat T2D in a successful way, we need to have a basic understanding of the cause of the disease.

If you ask anybody what causes T2D, the common response is the word “sugar.” While high glucose in the blood is certainly a result of diabetes, consumption of sugar is not the main cause.

Dr. Neal Barnard and his colleagues at the Physicians Committee for Responsible Medicine have thoroughly investigated the causes of T2D as well as the best ways to prevent and reverse the disease. “Many people believe type 2 diabetes is a result of eating too much sugar, but it’s a lot more complex than that,” they say.

“Insulin is a hormone secreted from the pancreas in response to rising blood sugar levels after we eat. Insulin then acts as a key to “unlock” the cells so that the glucose can move from the blood into the cells, where it can be used to produce energy. Most of the glucose gets taken up by our muscle and liver cells.

“Too much fat stored inside our muscle and liver cells, as well as elevated free fatty acids in the blood and the resultant inflammation, prevent these cells from functioning normally. For example, when there is too much fat inside our muscle cells, they are less responsive to insulin and become insulin resistant, which means they take up less glucose, leading to higher levels of glucose in the blood. This can be due to consuming too many calories in total and too many calories from saturated fat.”

So, it’s not so much the sugar, but the fat that is the main culprit! What Dr. Barnard is describing is insulin resistance. 

That leaves the question: What are the standard treatments for T2D and do they work? Typically, a doctor will prescribe one or more medications to regulate blood sugar. 88% of people with T2D are taking multiple medications. Aside from insulin, there are now 11 classes of medications for use in treating the disease. Many are grossly expensive.

In 2022, a respected medical journal, The Journal of Family Practice, published a supplemental edition in cooperation with the American College of Lifestyle Medicine. This should be a must-read for every practicing family doctor to help his/her patients recover better from all chronic and autoimmune diseases.

During my reading of the T2D section, I was shocked to discover that a meta-analysis of data from 13 randomized controlled trials revealed that all intensive glucose-lowering treatments had no effect on all-cause mortality, instead leading to a 43% increase in death from cardiovascular events. Yes, you read that correctly, a 43% increase in death from cardiovascular events. 

So, if the standard treatments are not as effective as we thought, what can we do? Dr. Barnard has conducted several studies and cited other studies that clearly demonstrate how lifestyle changes, primarily switching to a whole food plant-based diet and minimizing oils, can prevent diabetes, arrest the progression of the disease, and even roll it back into remission. It sounds fanciful, but it really does work.

Over the last several years, many people have come to my clinic frustrated after carefully following diets recommended to them by dietitians or their endocrinologist. They are taking medication yet their A1C, the primary marker of blood glucose, stays stubbornly high. If you watch advertisements on American television, they talk about getting an A1C to 7% using medication. That may be a slight improvement, but that’s still diabetes.

I have seen with my own eyes that after people switch to our program or similar disciplines, they reverse this dreaded disease and often times put it into full remission. Amazingly, it sometimes happens in less than one month. I have personally watched people with an A1C of well over 7% stop using medication and ultimately lower it to under 5%—all with lifestyle changes.

It is important to note that there are other compounds present in certain foods that have also been linked to an increased risk of type 2 diabetes. These include nitrates and nitrites, which are natural compounds that are commonly used to preserve meat; heme iron, which is the type of iron in meat, eggs, and dairy products; and advanced glycation end products. None of these are present in whole plant foods.

As I have written in the past about heart disease, we have the prevention, and we even have the cure. We simply need to implement it. Medicines can certainly serve an important purpose in the short term. But to truly conquer type 2 diabetes – a disease that shortens life and greatly diminishes its quality – we must implement the lifestyle changes that studies have overwhelmingly shown to be the single most effective treatment. It is imperative and will “add hours to your days, days to your years, and years to your lives.”

The writer, a wellness coach and personal trainer with more than 25 years of professional experience, is a member of the International Council of the True Health Initiative and a member of the board of Kosher Plant Based. He is director of The Wellness Clinic and can be reached at alan@alanfitness.com.