by Barbara Berkeley, MD
Diabetes is decimating us. This week, the CDC reports a sharp escalation in blood sugar problems, a rising tide of deadly disease. This should come as no suprise as this medical equivalent of global warming has been predicted for some years. What continues to be a surprise is the utter lack of concern about what is happening to us and to our children. Are we really so busy shopping, texting and watching America's Got Talent?
Let's get real. First and foremost, we medical types should stop using the term pre-diabetes.
Just as you can't be a little bit pregnant, you can't be a little bit diabetic. You either have a problem with your insulin system or you don't. For the one in three whose blood sugar is above normal, a problem has occurred in the body mechanism which is meant to keep blood sugar tightly controlled. If this problem has begun in you, go to your battle stations.
The blood sugar control mechanism relies on insulin, the hormone made by your body when sugar levels rise to somewhere above one teaspoon of sugar in your five quarts of blood. Under normal circumstances, the insulin made in response to this elevation will drive sugar out of the blood and into your cells (both working cells and fat cells). Getting the sugar out of your blood is a necessity because if it remains within the bloodstream it causes destruction to the vessels and to elements that travel in the blood itself.
Most people with elevated sugar have been asked to take a test called Hemoglobin A1C. They have been told that this test gives us docs an idea of average blood sugar over a three month period. Yet I find that few doctors take the time to explain what a Hemoglobin A1C test actually represents. Here's the truth: it represents physical destruction. The Hemoglobin A1C test looks at the amount of damage that sugar has done to red cells, the cells in your bloodstream which carry oxygen. Red cells are long lasting, remaining afloat in the blood for three months before they are plucked out by the spleen. Over that time, sugar sticks to the red cells and distorts them if levels have been too high. By actually measuring this physical distortion and destruction, we can get an idea of how high your sugar has been. And this is just one measure of the many ways in which sugar is directly destructive to your body.
Pre-diabetes represents an early stage on the diabetic continuum. Perhaps we intend to scare people with the pre-diabetes diagnosis, but I think that it often works in the reverse, allowing patients to feel that they've dodged a bullet and don't yet have a serious problem. I think we would do patients a service if we categorized diabetes by stages as we do heart failure, kidney disease and even obesity. Pre-diabetes would then become Stage One Diabetes, conferring the diagnosis rather than pretending that it doesn't exist.
It's my guess that we are becoming diabetic so rapidly because of a perfect storm. That storm would likely include two conditions : a change in our susceptibility to the disease and an environment that promoted development of the disease.
What are the reasons we might be more susceptible to insulin problems these days? Likely candidates include endocrine disrupting chemicals in our food and/or environment, the ingestion of small amounts of prescription drugs in our water supply, a change in our gut microbiome as the result of chronic antibiotic use in the animals we eat and in our own bodies, a diet that has overwhelmed a primal insulin system that has limited ability to regenerate itself, as well as multiple factors yet to be determined.
If we assume that we are susceptible to insulin dysfunction and that this susceptibility is COMMON then it becomes the height of foolishness to eat a diet that is dominated by foods that require the body to make insulin. Just for the new readers to this blog, those foods include: sugar, honey, high fructose corn syrup, other syrups, molasses, grain (including whole grain), things made from flour (including pasta, breads, and baked goods), cereals both hot and cold, popped grains like popcorn and popped rice, crackers, chips, tacos, tortillas, and potatoes.
Remember that the foods that dominate our diets are made by people who are out to sell products and these foods are not found in abundance in the natural world. With one in three of us walking around with faltering insulin systems, it's time to pay attention. What would you do if your radio station was blaring a tornado warning right now? You'd be taking shelter to save your life. Well, the nutritional tornado warnings are going off. Take shelter by severely curtailing your exposure to the foods that ask your body to deploy a system that is weakened and at risk: your insulin production system.
For more on diabetes and "pre-diabetes" see: Fasting Sugar 100