jlink
Saturday, February 29, 2020

Type 2 diabetes is thought of as a disease that is marked by elevated blood sugar that leads to many complications that are disabling and/or life-threatening. While this is true, it is important to understand that elevated blood sugar is a symptom and not the cause of the disease. Many describe Type 2 diabetes as a progressive disease, meaning that once you are diagnosed with it, you should expect it to get worse and worse. But this is not true. As Dr. Jason Fung has demonstrated with a large patient population, Type 2 diabetes is a reversible diet disease.

If Type 2 diabetes were a progressive disease, we would not expect to hear of people who actually get better. But we know that people who have successful bariatric surgery (surgeries that are aimed to treat obesity) often are “cured” of their diabetes. The good news is that with dietary modifications, the same successful result of “cure” can be achieved.

While diabetics have elevated blood sugar, the disease process occurs because there is excess glucose in the body. However, the standard treatments for diabetes are using medications to lower the blood sugar. It was thought the elevated blood glucose is what causes all the diabetic complications because microcirculation in the kidneys, eyes and nerves are affected by the elevated glucose. So by aggressively lowering the glucose, it was thought that this would prevent diabetic complications. The only problem is that several studies including the ACCORD study showed that strict diabetic control did not reduce diabetic complications including heart disease, kidney disease and diabetic retinopathy (eye disease). Treating the blood sugar is a symptomatic treatment that will make the blood work look better; however, these treatments move the sugar from the blood to the tissues so the complications continue to develop.

Type 2 diabetes develops when there is excess glucose in the body, usually from a bad diet. While the primary culprit is excess sugar, our dietary regimen of increased carbohydrates, especially processed flours, leads to spikes in insulin as the body tries to clear out the sugar from the blood and liver. Think of insulin as yelling at the liver and other tissues in the body to take up the sugar and clear it out. As one gets these spikes repetitively the tissues stop listening to the yelling. This is insulin resistance. When insulin resistance develops, more insulin is needed to get rid of these sugar spikes. The increased insulin leads to increased fat production. The first site for fat storage is the liver, otherwise known as fatty liver disease. Eventually, the liver fat capacity is approached and the fat is transported to the other organs. One of those organs is the pancreas, which produces insulin. When the fat is sent to the pancreas, insulin production is impaired, the glucose level rises higher and the body has lost the ability to lower the glucose with insulin.

These problems are especially compounded when insulin is given. While insulin will help transport the sugar from the blood to tissues, the increased sugar in the tissues can lead to tissue damage. But insulin also tells the body to store fat so insulin will lead to weight gain. Besides the increased risk of heart disease and other diseases, the increased fat leads to further insulin resistance, which further worsens the diabetes. Also, the sugar is now in the tissues which will contribute to diabetic complications.

I noted above that bariatric surgery has been shown to ‘cure’ diabetes mellitus. Unfortunately, this treatment has risks associated with any surgery including infections, bleeding and treatment failure. When successful, the surgery leads to weight loss and reversal of diabetes, but recurrent obesity is not uncommon. The good news is that the same result can be achieved without surgery. As noted, Type 2 diabetes results from excess sugar in the body. By reducing your sugar and carbohydrate intake, you give your body a chance to clear out some of the accumulated sugar in the tissues. It is especially important to eliminate sucrose (table sugar), high-fructose corn syrup (a commonly added sweetener for many beverages and other processed foods) and processed flours, which is present in most baked products in the supermarket. This is because these foods create the largest spike in blood sugar, which stimulates greater insulin production.

Intermittent fasting and extended fasting can have dramatic effects on weight loss and reduction of visceral fat (the fat around the organs including the liver and pancreas). As opposed to caloric reduction diets which lead to reduced metabolism and regaining any weight lost, intermittent fasting leads to reduction of visceral fat without the decreased metabolism. By reducing the visceral fat, the insulin resistance improves and the glucose stores can start to get cleared from the body. There is less need for medication and the blood sugar improves. Intermittent fasting can include skipping breakfast and/or lunch on a daily basis or fasting for 36 hours every other day such as not eating on Sunday, Tuesday and Thursday. Extended fasting for two days or more is another way to enable your body to use your own fat for your nutrition so your body is in effect, digesting your own fat and gradually curing your insulin resistance. Before initiating a fasting program, it is advised to consult a physician, especially if you take medications for diabetes that affect your blood sugar.

Another great way to reduce your visceral fat is by taking bioidentical hormones. Estrogen and progesterone for women help reduce your visceral fat. Women gain an average of 10-15 pounds during menopause, and this is all fat which contributes to increased insulin resistance. replacing estrogen and progesterone helps reduce that fat and reverses the menopausal weight gain. Also, thyroid function tends to decrease during menopause which leads to further reduced metabolism and increased fat with resulting increased insulin resistance. Optimizing thyroid function will lead to reduced visceral fat and improve insulin resistance.

For men, testosterone levels reduce by about 1 to 2%/year after age 40. This leads to increased fat. A vicious cycle begins because the increased fat leads to further decreased testosterone levels and increased insulin resistance. By administering testosterone, that vicious cycle can be reversed with reduction of visceral fat and improved insulin resistance.

In summary, Type 2 diabetes is often thought of as a progressive disease but this is not true. Type 2 diabetes is a reversible diet disease. By reducing or nearly eliminating carbohydrate intake, especially simple sugars and processed flours, you will have less need for insulin so your visceral fat will be reduced. This fat loss can be accelerated with strategic intermittent fasting that enables you to maintain your energy level by digesting your own fat. This is achieved without the decreased metabolism seen with calorie reduction diets (which is why they don’t work). Another way to reduce visceral fat is with bioidentical hormones for men and women which helps you feel great while losing weight. Next time someone tells you Type 2 diabetes can’t get better, take heart because you now know they are wrong.


Dr. Slaten is a wellness physician specializing in regenerative pain treatments and lifestyle counseling. He is certified in advanced bioidentical hormone replacement. You can learn more at his website www.njhormones.com.