The REAL Epidemic - Type 2 Diabetes
This information is not meant to diagnose or prescribe. Please seek appropriate advice from your health-care provider.
Do you remember the old Jackie Gleason and his trademark "How sweet it is"?
How sweet it is can lead you straight into insulin resistance and Type 2 Diabetes.
I have yet to meet anyone who wants to have Type 2 Diabetes, yet, as you will see, many of us are headed that way, even if we think we eat healthfully and are doing alright.
I have yet to meet anyone who wants to have Type 2 Diabetes, yet, as you will see, many of us are headed that way, even if we think we eat healthfully and are doing alright.
Insulin resistance is usually where the story starts
The cells in your body need glucose for fuel. Glucose is derived from the food you eat. Insulin from your pancreas is supposed to latch onto the glucose to escort it into your cells.
In insulin resistance the cells of your muscles, fat, and liver are unable to accept the insulin-glucose units, which leads to increasing amounts of glucose circulating through the body.
This is hyperglycemia.The pancreas responds by pumping out more insulin to try to get the glucose into the cells.
If this is allowed to continue, the body cells may become more resistant and hyperglycemia can become insulin resistance. If left unaddressed, insulin resistance can lead into type 2 diabetes.
Frightening Statistics
When do statistics stop being boring and become scary? When we’re talking about prediabetes and type 2 diabetes!
Currently, one in three Americans is prediabetic.1 That translates to 38% of Americans between the ages of 18 and 65, and 48.8% of American adults over the age of 65.
While those statistics are staggering, the trajectory of the prevalence of type 2 diabetes follows closely on their heels. Picture this. In 1980, the prevalence of T2D was 3.5%. That increased by 2014 to 9.1%, and is projected to be 13.9% by 2030.
Full well 90-95% of diabetics in America are type 2.2
Type 2 diabetes is currently the seventh leading cause of death in the world, causing 1.6 millions deaths each year.3
But there is good news. Nine out of 10 cases4 of T2D are preventable or reversible if it has not progressed too far.
Symptoms5
Insulin resistance, the precursor to type 2 diabetes, has many symptoms6
- Extreme thirst
- Feeling hungry even after a meal
- Increase or frequent urination
- Tingling sensations in hands or feet
- Feeling more tired than usual
- Frequent infections
- Evidence of high blood sugar levels in lab tests
Type 2 diabetes has many common symptoms, some of which are shared with Insulin Resistance.
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- Increased thirst
- Frequent urination
- Increased hunger
- Unintended weight loss
- Fatigue
- Blurred vision
- Slow-healing sores
- Frequent infections
- Numbness or tingling in the hands or feet
- Areas of darkened skin, usually in the armpits and neck
How to Increase the Risk of Developing T2D7
Being overweight or obese is a critical risk. Specifically, though, excess fat stored on the abdomen rather than on the hips and thighs increases the risk of developing T2D significantly. Waist measurements can be a good guide for assessing fat storage tendencies. In men, a waist measurement of more than 100 cm or 40 inches, and in women a waist measurement over 90 cm or 35 inches is a dire warning. (Childhood obesity is increasing the prevalence of T2D in the under 18 crowd.)8
Having a sedentary lifestyle is another risk factor. Daily physical activity, as little as walking for 30 minutes per day, can help to control weight, use up excess glucose, and improve insulin sensitivity.
If a parent or sibling has type 2 diabetes, the risk of other family members developing it is significant.
Some ethnicities are also more likely to develop T2D. At particular risk are Blacks, Hispanics, Native Americans (First Nations People), Asians and Pacific Islanders. All are more likely to develop T2D than Caucasians.
Having elevated blood lipids (especially if the high density lipoprotein is low and/or triglycerides are elevated) increases the risk of developing T2D as well.
T2D is a greater risk for people over the age of 45.
People who are diagnosed with prediabetes9 often develop T2D. If insulin resistance is not managed, it only takes about five years, on average, to become T2D.
Even pregnancy can increase the risk of developing T2D. Women who developed gestational diabetes during pregnancy or who gave birth to a baby weighing over 4 kg (9 lbs) are at greater risk.
Female hormones can also play into this. Women who are diagnosed with Polycystic Ovary Syndrome (a condition of unbalanced hormones causing irregular menstrual cycles, excess facial and body hair, and obesity) almost always have insulin resistance/T2D at the root of the problem.
Co-morbidities
Several health conditions, including the following list, can happen alongside 10 T2D or as a result of it.
- Obesity
- Endothelial dysfunction - large blood vessels on the surface of the heart constrict
- Vascular inflammation
- Dyslipidemia/hyperlipidemia
- Cardiovascular complications/cardiovascular disease
- Hypertension
- Depression
- Thyroid gland diseases
- Chronic obstructive pulmonary disease
- Atherosclerosis
- Stroke
And those disease processes can have serious ramifications as listed below.11
Nerve damage also known as neuropathy can be a result of elevated blood sugar. Symptoms include tingling, burning pain, and numbness which usually starts at the fingertips and tips of the toes and moves upward.
Nerve damage can affect the heart and lead to irregular heartbeat; the nervous system, causing nausea, vomiting, diarrhea, or constipation; and the penis, causing erectile dysfunction.
Elevated blood sugars can lead to chronic kidney disease or irreversible end-stage kidney disease, which can be fatal.
Diabetics are more likely to develop cataracts, glaucoma, retinal problems, and blindness.
Bacterial and fungal infections of the skin as well as darkened patches of skin in the armpits and neck are common in T2D.
Simple cuts and blisters, when left untreated, often heal slowly and run the risk of becoming dangerously infected, which can lead to amputation.
Hearing impairment is more common in diabetics.
Obstructive sleep apnea, which may be the result of excess weight, is often a problem.
Type 2 diabetics have an increased risk of Alzheimer’s and other dementia disorders.
Medications
The medical world prescribes any of a variety of medications to control blood sugars, often without offering dietary and lifestyle advice - at least, this is what I’ve seen among my clients. The drug category of choice is metformin (also known as fortamet, glumetza, glucophage, glycon, riomet).
It is my opinion that these meds can be used to stabilize blood sugars and ‘buy time’ to implement diet and lifestyle changes. Sadly, many people simply find it easier to ‘pop a pill’ than make the necessary changes and end up relying solely on the medication to ‘take care of’ their blood sugar issues.
Reported side effects 12 of these meds include nausea, vomiting, diarrhea, heartburn, and anorexia.
Prevention
As mentioned earlier, type 2 diabetes is reversible in nine out of 10 cases.
So, what can be done?
The diet is critical. It is imperative to eliminate foods that are high in refined carbohydrates. That includes anything that has sugar, high fructose corn syrup, or anything ending in ‘ose’ on the ingredient list.
A diet that has good-quality proteins, lots of lower carbohydrate vegetables, and some fruit, especially berries and apples, can have a strong impact. Some people with T2D are able to consume whole grains without upsetting their blood sugar levels, others are not.
Get active. 150 or more minutes of walking, running, swimming, or cycling, spread out over at least three sessions per week, is a good starting point. It is best to not let more than two days in a row go by without engaging in some physical activity.
Additionally - avoid long periods of inactivity in a day. Sitting for long stretches of time, even if you do get 150 minutes of activity in a week, increases your risk of T2D - so get up and move for a few minutes every half hour.
Optimizing your body weight can reduce your risk of developing T2D significantly. Only 12%13 of people who are diagnosed with T2D are at their optimal weight. Working to improve your body composition can delay the progression from prediabetes to T2D and can reduce the risk of developing T2D.
How to find out if you are at risk
You need to know where you’re at, so start with getting so blood work done annually. At the very least, ask your doctor for the following lab tests (he or she will know what these abbreviations stand for):
1) HgA1C
2) fasting glucose
3) total cholesterol, HDL, LDL
4) triglycerides
5) ALT
6) AST
It has been my experience that if any of these test results come back ‘out of range’ most doctors simply give prescription medications and say ‘fix your diet’. That’s it. Nothing more constructive.
What to do if you are at risk
As my clients will attest, when they bring these out of range test results to me, we get to work with the necessary dietary and lifestyle modifications. It is not unusual for us to have these numbers in the healthy range, the threat of medications thwarted, and health obviously improving, in under six months.
Type 2 diabetes is a largely preventable condition, which means the resulting co-morbidities are largely preventable. If you’re already started sliding toward insulin resistance or type 2 diabetes or have a diagnosis, it is often reversible and then controllable. In either situation, making and maintaining the right changes can lead to better health.
If you’d like support in learning how to get your insulin resistance or Type 2 Diabetes under control using diet, lifestyle, and natural means, reach out to me.
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Footnotes:
1 https://www.cdc.gov/diabetes/data/statistics-report/index.html
2 https://www.cdc.gov/diabetes/basics/type2.html
3 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6659216/
5 https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/symptoms-causes/syc-20351193
6 https://www.healthline.com/health/diabetes/insulin-resistance-symptoms
7 https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/symptoms-causes/syc-20351193
9 https://www.medicalnewstoday.com/articles/317375
10 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6659216/
11 https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/symptoms-causes/syc-20351193
12 https://www.nhs.uk/medicines/metformin/side-effects-of-metformin/
13 https://www.medicinenet.com/script/main/art.asp?articlekey=161160