Extracts

National guidelines currently cling onto the belief that a healthy, balanced diet must contain a lot of carbohydrate and not a lot of fat. But the evidence is suggesting that this is not the case at all. The reverse is likely to be true, more fats from real food sources and restricted carbohydrates.

Slightly more troubling is the notion that the high carbohydrate model can be extended to diabetes, which is a condition of carbohydrate intolerance. If you have a carbohydrate intolerant body, why on earth would you feed it carbohydrates? Most of the old school would reply with ‘because it is a major food group and is essential’ (which of course it isn’t) as if it was as obvious as the fact that the sun goes round the earth. But now there is new thinking on this which is getting good results. A paradigm shift is imminent. But the old paradigm has dug its heels in. Big time. Some influential scientists have made the age-old mistake of seeing their speciality as a fact, not a current best-fit, and have become high priests of their own quasi-religions. Business has of course moved in to exploit an opportunity. As long as the old paradigm can be propped up, that will be the case. But in the end the new paradigm will replace the old one. It is the order of things.

Unless they have diabetes, or are close to someone who has, clinicians would find it difficult to imagine what us diabetics go through on a daily basis. For example: forgetting if we have taken our insulin doses; running out of supplies; eating out and forgetting insulin, or worse, injecting early and the food arrives late; feeling hypo and having no glucose; just not feeling right and wondering if it is due to glucose or not; being drunk and not knowing if the morning after is a hypo or hangover; re-using needles or injecting through clothes to be discrete. Life as a diabetic is a constant struggle, trying to master the almost impossible dark art of carbohydrate counting and medication balance. Mini-hypos are not uncommon, but dangerous ones are rare. I have had hypos regularly for 20 years, but I’ve only been caught out twice, when I needed help, and both were due to my stupidity.

However, despite some of the best medical care in the world, I was not doing as well as I would have liked. My HbA1c was creeping up and my insulin doses were increasing. The thing was though, it really was not lack of effort. But the nuancing of the advice in my medical consultation made me think it might be. Was I simply not trying hard enough, (or was that just my paranoia)?

Extract from Chapter 5 – Diabetes Unpacked, by Dr Ian Lake

Only two groups of people get Type 2 diabetes (T2DM): drug addicts and performance athletes.

It is neither the addict nor the athlete’s fault for becoming diabetic. Remission is possible, but the burdensome responsibility of remission lies solely in the hands of the diabetic and can occur only once they understand why they became diabetic in the first place. I cannot help diabetics to become non-diabetic, but I can help diabetics to help themselves to become so.

Carbohydrates are an endorphin releasing drug, not a hunger satisfying food.

You cannot have T2DM if you do not consume carbohydrates. And just as with alcohol, opioids and nicotine, it matters not how the drug enters your face – whether as a simple sugar or as a complex starch, nor how fast it enters. What matters is how much and how often. Irrespective of the form it takes at entry into your mouth, by the time it enters your bloodstream, it can only be glucose, galactose or fructose.

Because treatment is usually based on glycemic index principles, almost all T1DM have an additional Type 2 component added into the complexity of their disease. There is no reason a T1DM patient should not be managed according to carbohydrate abstinence principles. In our experience, this approach achieves the most sustained degree of tight glycemic control and the most effective way to stabilise medications at very basal levels.

Typically a person with T2DM consumes more than 75-90% of their total daily calories in the form of carbohydrates. The pattern of consumption is more like smoking than real meals. Not only is the total fraction of carbohydrate calories excessive, the pattern of consumption follows endorphin needs rather than somatic nutritional needs. Diabetics typically have more than 15-20 consumptive events per day, mostly in the form of carbohydrate snacks or drinks that pattern daily endorphin activation requirements. A snack is always an emotional event, never a nutritional event, and “hunger” is the need for an endorphin release through eating or drinking rather than a need to consume nutrients based on a somatic nutrient deficit.

Extract from Chapter 4 – Diabetes Unpacked, by Dr Robert Cywes

High blood glucose is the most obvious clinical feature of the Type 2 Diabetes Mellitus (T2DM), but it is only a symptom of disease and not the disease itself. So, what is T2DM? What causes it? What is the etiology of T2DM?

This is a crucial question. Without understanding the cause, it is impossible to devise a rational treatment. T2DM is accepted as a disease of excessive insulin resistance, which causes the high blood glucose readings that characterise the disease. This immediately suggests an important conundrum. If the problem is high insulin resistance, then why is treatment entirely directed towards correcting the high blood glucose?

It is far more logical and effective to treat the insulin resistance. To do so, we must understand what causes insulin resistance.

Over a period of years, you move from pre-diabetes, to diabetes taking a single medication, then two then three and then finally large doses of insulin. Here’s the thing. If you are taking more and more medications to keep your blood sugars at the same level, your diabetes is getting worse!

The blood sugars got better with insulin, but the diabetes got worse. This unfortunately happens to virtually every patient. The higher dose of medications only hides the blood sugar by cramming it into the engorged body. The diabetes looks better, but actually is getting worse.

What happens over ten or twenty years? Every single part of the body just starts to rot.

This is precisely why T2DM, unlike virtually any other disease, affects every single part of the body. Every organ suffers the long- term effects of the excessive sugar load. Your eyes rot – and you go blind. Your kidneys rot – and you need dialysis. You heart rots – and you get heart attacks and heart failure. Your brain rots – and you get Alzheimer’s disease. Your liver rots – and you get fatty liver disease and cirrhosis. Your legs rot – and you get diabetic foot ulcers. Your nerves rot – and you get diabetic neuropathy. No part of your body is spared.

Medications and insulin do nothing to slow down the progression of this organ damage, because they do not eliminate the toxic sugar load. We’ve known this rather inconvenient fact since 2008. No less than 7 multinational, multi-centre, randomised controlled trials of tight blood glucose control with medications (ACCORD, ADVANCE, VADT, ORIGIN, ELIXA, TECOS and SAVOR) have all failed to demonstrate reductions in heart disease, the major killer of diabetic patients. We pretended that using medications to lower blood sugar makes people healthier. But it’s only been a lie. All because we’ve overlooked a singular truth. You can’t use drugs to cure a dietary disease.

Extract from Chapter 3 – Diabetes Unpacked, by Dr Jason Fung