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- The Starfish Story, Diabetes, and the Poorest Nation in the World
Even drops in the bucket make a difference
- Flying on Insulin
It has been 22 years since Air Canada pilot Steve Steele was grounded with type 1
- Following Dr. Bernstein on Holiday
A traveling couple tries to stick to low carbs
- Sleep Apnea and Diabetes
Here’s something to make you sit up and take notice (maybe 100 times a night): 23 percent of type 2s have obstructive sleep apnea.
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Diabetes Is Not A Disease Of Blood Sugar
3 December 2007
The views expressed by this author are his own and are not necessarily the views of this publication. Consult with your diabetes care medical team before making any changes to your diabetes regimen.
Diabetes is not a disease of blood sugar. It is a disease of insulin and, perhaps more importantly, leptin signaling. Until that truth is accepted, we will continue to see epidemic growth in type 2 diabetes and obesity, growth that underscores the inadequacy of current conventional medical treatment and the falsity of prevailing nutritional advice.
Elevated blood sugar is merely the symptom of diabetes, not its cause. The disease itself is one of metabolic miscommunication. Symptoms are manifestations of the way our body deals with a disease. For instance, a runny nose is a symptom, designed to cleanse the nose and sinuses of viruses and bacteria when one has a "cold." Taking a decongestant, because it inhibits the body's mechanism for dealing with the underlying disease, actually prolongs the infection.
Similarly, diabetes treatments that lower blood sugar by raising insulin levels actually worsen, rather than remedy, the underlying problem of metabolic miscommunication. Such a program just trades one evil for another. Elevated insulin levels are highly associated with and even causative of heart disease, peripheral vascular disease, stroke, high blood pressure, cancer, obesity, type 2 diabetes itself, and many other so-called diseases.
Know Thine Enemy
When it comes to diabetes, traditional medicine does not appear to know its real enemy. For two millennia, diabetes has been considered to be a disease of high blood sugar. Despite centuries of scientific progress, including the discovery of insulin and, more recently, leptin, that myth still prevails. The actual purpose of insulin is widely misunderstood even in the medical community.
The Main Purpose Of Insulin Is Not To Lower Blood Sugar
It may surprise both you and your doctor that insulin's main role is not to control blood sugar. The control of blood sugar is mostly in an upward, not a downward, direction. A few types of tissues and cells in our body, such as red blood cells, require glucose for energy. The rest, including our brain cells, prefer to burn either fat or byproducts of fat metabolism called ketones.
It is important, however, to always have a little bit of glucose dissolved in our blood. Because very little sugar was available throughout our evolutionary history, the goal was always to keep the sugar in our blood from falling too low.
Most starches and grains that turn into sugar are indigestible unless cooked, so the major source of sugar was fruit. That was available only seasonally, and even then we had to work to obtain it, thereby burning the sugar and preventing it from spiking very high. The hormones cortisone, epinephrine, norepinephrine, glucagon, and human growth hormone all raise glucose. These redundant mechanisms are in place to ensure that we always have some glucose available to the tissues that need it. Only insulin lowers glucose.
High Blood Sugar Was Rare
When our blood sugar did become elevated, it was a sign that we had more energy available than we could currently burn and that it would be a good idea to store the extra. Food was not always available: feast or famine was the rule for our ancestors. When blood sugar becomes elevated, it is a signal for insulin to be released so that it can direct the extra energy into storage.
A small amount of energy is stored as a starch called glycogen, but the majority is stored as our main energy supply—fat. Thus, insulin's major role is not to lower sugar, but to take extra energy when available and store it for future times of need. Insulin lowers glucose as a side effect of directing that extra into storage.
Insulin's purpose, however, may go far beyond that. It has been found that when insulin is kept low, either through diet or via genetic manipulation, animals live much longer and their rate of aging is significantly reduced. This is true in many different species of animals, from single cell yeasts to worms and flies, and studies show that it is likely to be true in primates as well.
Low insulin is a signal that energy is scarce and that animals need to focus on maintaining and repairing their cells, so that they can outlive the famine and be healthy enough to reproduce at some future, more opportune time. Low insulin actually regulates the rate of aging and reduces the major symptoms of aging - diabetes, heart disease, obesity, osteoporosis, dementia, and even cancer. In short, low insulin is very healthy for you.
In healthy people, levels of insulin are largely determined by glucose (and amino acid from protein) levels. In insulin - using diabetics, however, insulin levels are also determined by how much insulin they are taking. Many have been told that what they eat does not matter as long as they take enough insulin to cover it. This couldn't be further from the truth. Consider two people of similar size with type 2 diabetes who have equivalent blood sugar levels but are taking different amounts of insulin. The person taking higher amounts of insulin will likely age faster and accumulate the "diseases" associated with aging, such as heart disease and obesity. Even their diabetes itself will worsen.
Yes, that person's diabetes will get worse. Why? Because most cases of type 2 diabetes are caused by overexposure to insulin. Just as you can no longer smell the odor in a smelly room after having been there for awhile, your cells become unable to "smell" the essential messages from insulin (and leptin) after they have been exposed to high levels of these hormones. This is called insulin resistance. Your body responds to this failure to "smell" insulin's signals either by producing higher levels of insulin and leptin or by requiring more to be injected to get the message across, contributing to a vicious cycle.
Most treatments for type 2 diabetes involve drugs that raise insulin or utilize actual injections of insulin itself. (The treatment of type 1 diabetes also generally requires excessive quantities of insulin.) The tragic result is that this conventional medical treatment for diabetes contributes to the complications and the shortened lifespan that diabetics experience. The real reason for poor outcomes in the diabetic population is not that diabetics need more education in proper therapy, as is often suggested in published reports. Rather, the major problem lies in what is being taught - that's what needs to be changed.
If you have lost the ability to smell a room, the best way to smell it again is not to make the smell stronger, which is analogous to taking or making more insulin. The best strategy is to walk out of the room and thereby re-sensitize your nose. Then, when you walk back in, you can smell the odor well again. This is how diabetes needs to be treated. We need to reduce, not increase, the levels of insulin, so that your cells can "smell" it better. The only way to do that is to get "more bang out of each insulin buck" by increasing insulin sensitivity. Contrary to what you have been told, there are no insulin-sensitizing drugs. Only changing your diet can re-sensitize you to insulin. Fortunately, diet works well enough to reverse most cases of type 2 diabetes, often completely.
The Role of Leptin
Diabetes is a disease of insulin miscommunication. Recognizing insulin's true purpose goes to the root of diabetes and other chronic diseases. Yet we can go even deeper. Insulin may not even be the most important hormone in diabetes or other chronic diseases of aging.
That honor may go to leptin. It appears that leptin, a recently discovered hormone produced by fat, is largely responsible for the accuracy of insulin signaling and whether one becomes insulin resistant (type 2) or not.
Leptin tells the body and brain how much energy it has stored in fat, whether it needs more (by saying "be hungry, make more fat"), whether it should get rid of some (by saying "stop being hungry"), and, importantly, what to do with the energy it has (reproduce or focus on repair of the body). It is largely leptin that dictates how much fat you store, especially in your midsection where it is so dangerous. How well leptin is heard is what sets your so-called "set point" of (fat) weight.
Recent compelling research reveals that two organs primarily determine whether you become a type 2 diabetic or not: the liver and the brain. It is their ability to listen to leptin that determines this. Leptin largely influences, if not controls, the manifest functions of the hypothalamus in the brain, including appetite, reproduction, thyroid function, adrenal function, and the sympathetic nervous system.
Fat, and leptin, strongly influence chronic inflammation and, therefore, the diseases associated with it, including heart disease, Alzheimer's, and diabetes. It appears now that rather than your brain being in control of your body, your fat, by way of leptin, is really in the driver's seat.
The Real Enemy Is Unrecognized By The Medical Community
By some estimates, diabetes has increased five to seven hundred percent in the past fifty years. Given that the increase occurred within the same generation, among people with essentially the same genetics, this statistic reveals that diabetes cannot be primarily a genetic disease. Something that we have been doing is obviously wrong and needs to be changed. That something is diet.
For the past fifty years, Americans have followed (at least partially), the high complex carbohydrate, low saturated fat diet recommended by the American Dietetic, Heart, and Diabetes Associations. (The term "complex carbohydrate, low fat" is an oxymoron: most of those "complex" carbohydrates, such as potatoes, rice, cereals, pasta, and breads, rapidly turn to sugar. That excess sugar (glucose) then rapidly turns into long-chain saturated fatty acids—palmitic acid, or "palm oil." ) Concomitant with those dietary recommendations, diabetes and obesity have skyrocketed to become one of the worst epidemics the world has ever seen. Eating a high "complex" carbohydrate, low saturated fat diet for health and longevity has been shown to be wrong. Minimal common sense would say to try something else.
Diabetes Is A Disease Of Nutrition
We must eat a diet that maximizes the accuracy of insulin and leptin signaling, allowing cells to better listen to their life-giving messages. The need for those hormones to "yell" to be heard must be reduced, so that the levels of insulin and leptin become lowered.
What we need is a diet emphasizing good fats, reduced non-fiber carbohydrates and starches, and moderate, not high, protein. Such a diet will greatly improve and even completely reverse type 2 diabetes, heart disease, hypertension, many other chronic diseases of aging, and perhaps even aging itself. Many of my patients have been able to totally eliminate their use of drugs, including insulin. Following those guidelines will let you, and your genes, be the best that you can be.
"The Rosedale Diet," published by HarperCollins, is the first book to associate the new biology of aging, insulin, and leptin with dietary changes to treat and even reverse the chronic diseases of aging, including diabetes, obesity, and heart disease. Dr. Rosedale has partnered with a researcher at the University of Colorado to form a diagnostic laboratory to accurately measure critical parameters of metabolism, including leptin and insulin, to research new measurable genetic regulators of aging, and to bridge the gap between current scientific knowledge and clinical application of that knowledge. His website is http://advancedmetaboliclabs.com/
For other articles from this month's special Insulin issue, see:
"In My Opinion: There is No 24-Hour Basal Insulin"
"Why Smaller Shots of Insulin Get Absorbed Faster, Peak Sooner, and Are Out of Your System Quicker"
"Insulin For Type 2 Diabetes: Who, When, And Why?"
"Why Basal-Bolus Insulin Therapy May Be The Best Choice for Type 2 Diabetes"
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Comments
Thank you, Dr. Rosedale, for explaining diabetes in a way that finally makes sense! I've read and reread your article several times so that I can take it all in. You have put it all in a "nutshell" for me!
Great article!
Question: How do you explain how a young, lean, athletic, healthy eater can be insulin resistant, suffer from hypoglycemia, and later develop type 2 diabetes? If fat produces leptin, and leptin causes inflammation and diabetes, then how does a lean person produce too much leptin? If diabetes is caused by eating too many carbs, how does a person who eats moderate to low carbs develop diabetes? I understand that low carbs can control diabetes, but that seems to be treating the symptoms rather than the cause. What causes a young, lean person to suffer from hypoglycemia and insulin resistance in the first place? Do some people naturally produce too much leptin and too much insulin even though they are thin? Are some people more intolerant of carbohydrates to the extent that they must eat far less than the normal person? Do these people then become overweight more easily as they age? I can understand how anyone can eat their way to diabetes, but others develop diabetes even while exercising and eating right. Some people have to work very hard at keeping their blood sugars under control.
Another question: How does stress and sleep deprivation affect lectin and insulin levels. Studies show that sleep apnea and sleep deprivation can cause diabetes. Could the diabetes epidemic be caused by everyone working too hard, not sleeping enough and having no time to relax?
Thanks for this educative article! It makes a lot of sense. Will start reading more about leptin.
I'm not sure its as simple as leptin vs insulin or carbs vs fats. I think that many factors are at play, one of them being genetic predisposition. I know I broke all the rules,disregarded the warning signs and didn't heed the advice my father gave me. He passed away from the complications of T2 diabetes, but it took 40 years for it get the better of him. In the meantime he lead a reasonably healthy life. So,now that I know I'm not immune and despite my family having a history of the disease, I intend to beat it and not take it lying down.
What is the difference between Sugar in Blood and Sugar in Urin? Please help.
What is a diiference between Sugar in Blood and Sugar in Urin? My Mother had Type 1 Diabetes, will i also get ?
There are multiple fallacies in this article. Why does it not surprise me that they are being used to sell yet ANOTHER diet book??? And why does the whole "Medical Community" have it wrong yet Dr. Rosedale has it right? Give me a break--I won't be buying the book until I see some outcomes first!
I just met someone in my office who is obese, 40 year old, african american woman with diabetes. I know she takes insulin shots and everyday she drinks at least one can of root beer (45 grams of sugar) and one can of lemonade ( with real sugar). this really bothers me and i've given her fruit but she claims that she needs the sugar for a lift or something. Her stomach is hugely distended and lately she has been emitting a order like something is rotting. what is this all about and am i wrong to be concerned?? what can i do??
when do we get an answer??
Hi Susie,
Tell her you know someone (me) who has had great success on the Low GI diet (google it & print her something) which is based on the work of Australian scientists. It is easy and effective and her cravings will disappear within a couple of days.
Great article above, and even if it has 'fallacies' in it, we need more independent thinkers to start new trains of thought.
>> Great article above,
>> and even if it has
>> 'fallacies' in it...
It would be interesting to know what this anonymous writer considers to be those 'fallacies'.
I, too, wonder if this is simply another degree of hype to sell another diet book. Where can the author point us too for research findings to support his position?
Ed Newbold
Columbus, OH
Our health is in our own hands. Thanks to all who think and rethink the known and wonder what is possible. We need all kinds of information and great thinkers to improve how we live. We all maintain the choice to be accept, challange or deny new ideas. Keep your mind and heart open - you may live longer.
Mair
I happened upon this site almost by mistake this morning, looking for nutritional data on grapefruit. I then discovered a link to Dr. Rosedale's article. Here we go again: another doctor that has seemingly had a divine revelation whereby the whole medical community is wrong and he is miraculously right. It was bound to happen. It happens all the time.
But one has to wonder when some of the advice given to type 2 diabetics seems incoherent. The way I see it, I don't care if my spleen, my pancreas, my liver of whatever other organ is causing my type 2 diabetes. The bottom line for me is I can no longer manage to eat anything containing carbs. I take oral medications and inject 2 shots of insulin a day. Even when avoiding carbohydrates like the plague, I get readings in the 300s when I wake up after fasting 12 to 14 hours.
Pretty soon, I'll be eating styrofoam and distilled water. Worse yet, my readings will STILL be high. Yet, a registered distitian recently told me it would be OK to eat 2 slices bread for breakfast every day. Is she crazy? I don't eat that much bread in a month. At any rate, I have become accustomed to the fact that my body no longer processes carbs.
People who are allergic to peanuts just plain can't eat peanuts. It's not my case but thinking this fact through, I get to the realization that I can't process carbohydrates and I'll keep avoiding them like the plague. It probably won't bring me any kind of benefit but at least, I won't have purchased another useless book by a divinely inspired author. I have enough of those to start my own diabetic library.
S. Forest
I am a 56 year old who has had type II diabetes for the past 6 years. I do believe this article has good points. I have tried the Atkins diet for the past 2 years which caused me to lose weight, thus improve control of my type II diabetes. Realistically, diet and exercise is the key to type II diabetes control. And by diet, I mean LOSING weight. Dr. Rozen has a point, you can't treat type II diabetes like type I, and it is a very different disease than type I juvenile diabetes. Insulin resistance doesn't mean you have a lack of insulin, just that it is not doing it's job.
So we as diabetics need to work on insulin sensitivity, making our bodies more capable of using the insulin, like losing the excessive fat in our bodies and exercising. It does work. I don't know about a cure, but it will inprove your blood sugar readings.
As a 31+ year, juvenile onset, I love this article. It further supports Dr. Bernstein's assertions. And since Dr. Bernstein is a >60 year juvenile onset diabetic, engineer and doctor I've been supportive of his techniques. My A1C is consistently 5.1 but I dream of the day I get below that 5.0 mark and match my ADA Board Buddies' 4.7. My body says it's worth the effort.
i had gestational diabetes 12 years ago. since then every time i have mentioned to my doctor my struggle to lose weight and exercise she would give glib answers yet always end with " when you get diabetes..." over the decade my sugars have been up and down but lately have moved into the "diabetic" range. sadly it was last august when my father died in ireland and my trip home was horrendously stressful, i returned to canada with a wildly bloated stomach - inflamation - and it was my chriopractor/accupuncturist who accurately diagnosed and treated it. i had also put on several pounds and of course i was grieving and depressed. i went into my doctor and drew attention to my stomach, weight gain etc and her response was to recommend anti -depressants! no blood work done - nothing. only until three months later at my yearly checkup do we find that my sugars are elevated.....quelle suprise. and i try to point out my experience that too much stress in my life and chronic insomnia where i could tell when cortisol was racing through my body, she would just return my insights with a blank dismissive look.
i am SO fed up with western medicine and it's lack of prevention and this article today makes great sense to me. it gives me the hope and belief in myself that western medicine and my current and soon to be ex-doctor unhappily suck out of me.
"What we need is a diet emphasizing good fats, reduced non-fiber carbohydrates and starches, and moderate, not high, protein."
I have a newsflash for the good doctor. The type of diet he recommends is EXACTLY the type of diet currently recommended by the American Dietetic, Diabetes, and Heart Association. He obviously has not looked at the recent guidelines for these organizations. But, I guess if there were no controversy, there would be no reason to buy his book. Hmmmm.
The differences are in the definitions of 'reduced' and 'moderate.' To me 225g carb is not 'reduced' enough for my metabolism.
I'm a 44 yrs male. I had a physical the other day, and my fasting blood glucose registered 106. I'm extremely fit, low body fat, HDL 67, LDL 74. I'm a marathon runner who has been eating a lot carbs, Is it possible that it has effected my blood glucose eventhough I fasted the required 8 hours before the test.
What's interesting about this article is the way he describes his diet -- which differs from what his book says. His diet, as described in his book, is far more Atkins-like than what he makes it sound here.
Take cytomel to prevent and treat diabetes. Insufficient thyroid hormone can both cause and aggravate diabetes. Dr. Broda Barnes noticed as far back as the 1940s that some diabetes complications are the same as hypothyroid symptoms. Active thyroid hormone, or T3, levels are inversely related to insulin resistance, i.e. the more active thyroid hormone, the lower the insulin resistance. Exercise increases T3 levels, and exercise improves and prevents diabetes. Surgery, shock or stress all cause the body to convert less thyroxine, or T4, the thyroid hormone produced by the thyroid gland, to the active form, T3, by deiiodination, and result in lower levels of active thyroid hormone in the body, hence the phenomenon of postsurgical insulin resistance. That's why transplant patients are and must be treated with thyroid hormone in order for the transplant to work. So how does stress precipitate diabetes? By reducing the production of active thyroid hormone in the body, just like exercise increases it. How much money do you think the medical establishment would lose if it went to preventing and treating diabetes with cheap thyroid hormone? When I got my doctor to prescribe me some T3 active thyroid hormone, my non-fasting blood sugar after eating breakfast was 71. I tried it on a diabetic relative,and his need for insulin immediately decreased. The increase in diabetes in the population has been after the medical industrialists stop diagnosing and treating low thyroid hormone by symptoms, and instead went to blood tests which use an arbitrary reference range. A lab tests 100 people, cuts off 2.5 percent at either end and the middle is considered within the reference range. It's completely unscientific and has nothing to do with reality. God helps those who help themselves, readers.
I HATE articles like this that refer repeatedly to "Diabetes" when they are clearly referring to Type II. Sometimes I think it would be a real service to all diabetics (but particularly Type I) if they just gave the diseases truly different names. As the author points out, high blood glucose is just a symptom (albeit a critical one). The mechanism of diseases and the key treatments are very different.
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