Why a Type 2 Diabetes Page in a Heart-Health Site?

[Guest guest]

This whole website is much like this page. I find it

exceptionally informative and easy to understand. I know that those whom get the

digests

will not get these graphics nor the links. I found some of them so helpful that

I suggest that if it is at all possible to go to the website.

 

Why a Type 2 Diabetes Page in a Heart-Health Site?

http://www.health-heart.org/diabetes.htm

 

Well, both are related to nutrition and both can be prevented or helped by

the same foods and supplements.  Type 2 diabetes is normally preceded by decades

of slowly increasing insulin, blood sugar, and belt-size (.. and it is always

healthier to sit on your fat than have your fat sit on you).  Early

prevention is very effective but there come a point when insulin production

permanently

breaks down.  Smart nutrition (and portion control) can first prevent

overweight and diabetes, and eventually heart disease.

 

Both conditions are epidemic with 1 in 13 Americans and 1 in 3 of those over

age 60 developing 'adult' diabetes.  Most will develop heart, kidney, nerve

and blood vessel diseases for an amazing 1/4th of total health care costs! 

Other countries have similar increasing rates.  Later-in-life diabetes (during

pregnancy being a warning) is an eventual one-way track to heart disease.

 

What makes a diabetic?  Simply put: when your pre-breakfast blood sugar (

plasma glucose) gets over 126 mg/dL or 7 mmol/L.  Another measure is when 2

hours

after taking a dose of glucose the blood level is still over 200 mg/dL (11.1

mmol/L), with over 140 (7.8) starting to suggest a problem.  Pre-breakfast 95

(5.3) is good, under 36 (2) is seriously low blood sugar, while above 180 (10)

a safety-valve opens that sends glucose to the urine.  To confuse anybody, the

numbers changed from mg to the 18 times smaller mmole, they increase by 14%

between 'blood' and 'plasma' in syringe samples -but the numbers for 'blood

drop' and 'syringe-plasma' are similar.  However, it's the big picture that

counts, not the decimal points of the reading.  This is one area where a blood

test

is important since serious organ or foot damage (!) can happen early.

 

In early-age 'type 1' diabetes the body stops making insulin needed to

process sugar and starch.  Type 1 represents under 5% of total diabetes.  There

is

no cure and insulin, a protein, must be dosed by injection in relation to sugar

and starch intake.  Type 1 can possibly be prevented with vitamin B-3 in

people with declining insulin -which can show years before irreversible damage

[see ENDIT or here].

 

 

In the now exploding 'type 2' diabetes, which develops in obese kids or at a

more 'mature' age [Non Insulin Dependent Diabetes Mellitus, NIDDM or

maturity-onset], the problem is initially not a lack of insulin but body cells

became

insensitive (resistant) to its effects.  Increasing amounts of insulin try to

" push the gas pedal " but the system doesn't react (by taking fuel, glucose,

into the cells).  In type 2, blood-sugar and (therefore) blood-insulin both

become high which is a double problem.

 

This double problem is that:

1.) High insulin changes excess blood-sugar into fat [in blood and around the

belly, and it keeps it there].  Insulin makes and keeps you fat;

2.) High blood-sugar makes blood vessels and blood components 'sticky' and it

slowly destroys the structural proteins of your 'arterial tree'.

Both effects reduce blood flow to all areas of the body especially to the

feet, eyes and kidneys.  Fat, around the body or as triglycerides in the blood

does nothing to promote blood circulation.  Good circulation is

50%-of-good-health.  This is why weight control, " shaking-up-the-fat "

(exercise), a good

multi-vitamin with minerals and extra magnesium, omega-3 [?-3 or n-3] oils and

high-fiber, low glycemic index foods are all-important.  Unhelpful are high

omega-6 oils like corn, soy or sunflower while vitamin D works better than

insulin

drugs!  High waist size (belt length, regardless of your height) with high

blood triglycerides (fats), high sugar, high insulin and high blood pressure,

all

lead to ill-health.  This group of symptoms is known as Syndrome X, the

Metabolic Syndrome.

 

I remind you that this author is not a doctor and knows absolutely nothing

about your specific situation.  Keeping this in mind, here are some ideas that

will help you see the global picture of diabetes (kidney, leg, eye and heart

disease) more clearly.

 

 

1.  READ two pieces of literature.  First, the 2001 paperback Reversing

Diabetes by Dr. Whitaker.  His website is very commercial but his science is

truly

excellent: a vital $15 (US) book investment.  Second, for some science, read

the summary or partial text from the Nurses' Study by Harvard that found a 250%

greater diabetes risk in women eating the most rapidly absorbed, low-fiber

carbs.

The main " offending " foods are: flour, boiled, baked or fried potatoes, most

breakfast cereals and the like and noodles made from flour.  Regular noodles

made from durum-wheat semolina, gritty, hard, wheat core particles, like

couscous, are low glycemic but also low in fiber and nutrients.  Floury starches

and

carbs are high on the " glycemic index " as they rapidly shoot glucose into

your bloodstream for insulin to deal with, which eventually causes harm. 

 

P.S. Unlike some oils and proteins, no carbs are classified as " essential

nutrients " . **Ball-Park list**  Fiber and Glycemic Index (blue) of common

servings:

 

*Most fruits: 1-4 g 40-60

*Beans (cup, cooked): 5-14 g 35-50

*Broad(Fava) beans (cup): 9 g 110

*Large potato with peel: 6 g; 110

*Meat, eggs, fat & most dairy: 0 g low

*Most breakfast cereals: 0 g; 80-100

*Hot whole cereal: 5-10 g; 85

*Some bran cereals: 5-10 g; 40-50

*Donuts, regular breads: 0 g; 100-110

 

2.  INCREASE fiber-rich foods, especially ones that have not been processed

much, like " above-the-ground vegetables " , fruits, beans, whole kernel grains

(not finely ground) and, like for heart disease prevention, omega-3 oils (flax,

canola and fatty fish).  Fiber, especially soluble fiber (gel or pectin-like

fiber), is truly diabetes and heart healthy as it slows and regulates the speed

of the uptake of foods--which is what diabetes control is all about.  All

agree about the major benefit of fiber -and it's cheaper than a glucose test

strip.  Every 10 g/day increase in fiber reduces diabetes risk by up to 30%!

 

GLYCEMIC INDEX TRIAL

(the high index version of the same food is in brackets)

 

* Whole grain barley bread 58 (same, flour 100; like wheat flour bread)

* Semolina [grainy durum-wheat core] pasta** 57 (durum, ground to flour 100)

* Rice pre-boiled 65 (sticky rice 86)

* Whole kernel barley porridge 35 (same, barley flour 98)

* Whole lentils or red beans 36 (same, ground to flour 70)

* Whole white or brown beans 40 (same, flour 74)

These high or low foods were given to type 2 diabetics for 3 weeks.  Despite

being identical in fiber and chemical composition, the " less ground " -more

intact- foods reduced the amounts of glucose and insulin by 30% and a blood clot

promoting factor (PAI) by 50%.  A very important study (DiabCare; 1-1999;

abstract, PDF).

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3.  LEARN ABOUT low glycemic index foods and glycemic load.  Not all foods

release their sugars or starches at the same speed.  The slow release foods,

typically the least refined foods, have demonstrated benefits.  Here is a full

list of glycemic indexes.  A large portion of a high glycemic index food creates

a large glycemic load.  Not good.  The graph was simplified from AJCN, Feb.

2002.  The 45 minute long blood sugar peaks, from 15-60 minutes, were totally

identical, but the presence of intact

 

whole grain structure reduced the insulin that was triggered by 50% [!]. 

This lingering high " white bread insulin " lowered the 1.5 to 3 hour blood sugar

to below starting levels.  This causes cravings and jitters precisely because,

despite of low blood-sugar, insulin prevents you from using fat reserves to

satisfy such energy craving.  [And, logically, only sugar, flour, starch and

maybe alcohol can fix such craving --but not fat or protein].  Remember:

lingering insulin makes and keeps you fat, ratcheting fat into the cells --and

then

preventing its use for energy

 

 

The good news about fat is that it never raises either insulin or glucose. 

This allows you to burn fat from food and from storage, if not swamped by

insulin made for sugar or starch --so you lose weight.  Carbs make you make fat

especially when you have high-insulin, and regardless your starting weight

(AJCN,

Jan. 2003).

 

 

Protein raises insulin, as shown, but while up to ½ gets used like sugar,

protein doesn't raise blood glucose.  The only thing eaten here was 236 gr. (8

oz.) lean meat, providing 50 grams of protein.  Similarly, also fructose (50% of

plain sugar) has little effect on glucose but it raises insulin -and

cholesterol.  Notice in the last graph that type 2 diabetics have high fasting

(morning) insulin.  In type 2, the challenge is to keep insulin and glucose low.

 

4.  DECREASE YOUR WEIGHT if it is high: obesity leads to type 2 and heart

disease.  [skinny diabetics, those not producing the fat-maker insulin, lose

sugar-calories in the urine since they can't use sugar for fat or fuel.]  ALL

authorities agree with weight reduction benefits in type 2, as often blood-sugar

returns below the cut-off point [and technically you're cured].  As fat-cells

lose fats, there are relatively more insulin receptors active per unit of cell

surface and the system works better.  Moderate exercise (many benefits) and

cutting down on (tasty and well-deserved) calories are ways to normalize

weight.  Easier said than done.  Then there are changes in diet: try the wisdom

in

the books by Whitaker, Challem, Atkins and Willett (the 4 books in one frame in

the links list).  None of these books has all the answers but combined they

provide a wealth of information about how weight loss can be part of a pleasant

life-style.  Also, there's the Montignac diet --all low carb, high nutrient

approaches.  Pssst...: All obesity is stored fat, and you'll never lose fat if

you (over-)supply with carbs and refined cereals...

 

 

5.  ABOUT DRUGS... there are drugs that " raise insulin " [sic], make it work

better or reduce blood-sugar by other means.  In later stages of adult-diabetes

[very high blood-sugar], injected insulin [at increased levels also a poison]

is often added to drugs taken by mouth.  On the surface this seems like good

strategy as blood-sugar and therefore the blood marker HbA(1c) become more

normal, for a while.  This marker " A-one-C " tells how many " frosted "

(sugar-damaged) red blood cells you have, evidently an important thing to reduce

(less

than 6% is normal).

 

The New England Journal of Feb. 7 2002 had a land-mark study about the

superiority of non-drug approaches: " Since current methods of treating diabetes

are

inadequate... The hypothesis that type 2 diabetes is preventable is supported

by observational studies and two clinical trials of diet, exercise, or both in

persons at high risk for the disease but not by studies of drugs used to

treat diabetes. "

 

The problem with drugs is that there are effectively no studies showing they

actually postpone grief and improve survival.  Many promising drugs and the

patients on them are no longer with us.  With drugs you can

" normalize-the-numbers " to make the lab report look better but there are few

studies proving that

this delivers a long-term health benefit.  Diabetes drug don't fix underlying

problems, have side-effects and decreasing effect with time.  Intuitively you

would think that any drug that lowers blood-sugar [or cholesterol or blood

pressure] should be beneficial but this is certainly not evident [uKPDS in BMJ

'01-10-13: 854; changed into recommendations but further debated here].  Ask

your doctor to explain this debate; it ain't easy for them either!  NEJM Sept.

9,

2004: the big new class of drugs in 20 years [with names ending on -azone (

Avandia, Actos, other) increase weight and promote congestive heart failure ...

while biguanide (metformin) and sulfonyl-urea (glipizide) harden the aorta;

sulfonyl-urea increases deaths.

 

Later-in-life, type 2, diabetes becomes a hard to manage " condition " with

much confusion and changing recommendations between individuals or expert

groups.  Mega-dollars are spent on and by each diabetic so the money interests

are

huge.  Adding to the confusion, fundamental understandings (like the role of

inflammation) are just starting to emerge.  It is a long way from studies to

medical consensus and even further to supermarkets and restaurants --where the

causes and solutions to diabetes and heart disease certainly lie.  On a lighter

note, there seems agreement (for people who are not driving, type 1, pregnant

or alcoholic) that " ...moderate alcohol consumption in the diet should not be

discouraged " [JClEndMet; 3-2002], the benefit of a drink-or-two, and now

there's coffee!

 

In California the doubled rate of type 2 diabetes in the 1990's was evidently

not caused by a lack of drugs but, just maybe, by more low-fiber

processed-foods [or by sitting in front of computers...].  But unlike your

computer, you

don't want your food to be fast.  You can slow down digestion with high

fiber-foods without the loss of taste or food appeal (you'd never know the

difference).  About 30 g of fiber per day, about double current intakes and

especially

the soluble mucus-like variety, is one of the main keys to heart, blood-sugar

and cholesterol health.  And so we return to the apple-a-day concept... [3.7g

fiber/medium size apple with skin].

 

<IMG SRC= " http://www.health-heart.org/ADA_logo.gif " WIDTH= " 100 " HEIGHT= " 55 "

BORDER= " 0 " DATASIZE= " 13  The 2002 recommendations are here but you'll find few

solutions and the

word " may " is used over 150 times.  In fact, they may be wrong that you should

eat at most 1 egg worth of cholesterol per day [if LDL-cholesterol is over 100

(2.6)] and eat about 10% of your energy as polyunsaturates (never before in

human history.., way in excess of the ISSFAL safe upper limit, and a probable

cause of type 2 diabetes as part of the Israeli Paradox).  Nuts are not a good

source of omega-3 oils, only walnuts are ... while avoiding saturated fat and

cholesterol will certainly not prevent diabetes.  Fact: even saturated fat -with

carb avoidance- may be helpful!

 

 

 

This 'avoid cholesterol and fat' advice was a marriage-condition of the

American Heart Association, an alliance to unify advice, yet fats used to be the

energy source of choice for diabetics.  Fat does not generate insulin or glucose

so you can see why this was, and fat per se does not cause obesity.  Diabetes

causes heart disease but heart disease never causes diabetes [this author in:

DiabetesInControl.com about cholesterol]. 

 

 

Too bad for diabetes prevention that the ADA caved-in to the AHA about fats

and the high glycemic index junk-cereals they endorse, like Cocoa Puffs & Count

Chocula.  The latest Lipitor cholesterol trial found no benefit in diabetics:

Lancet; April 5, 2003.

On a positive note, everybody agrees that weightloss, exercise and high fiber

intakes are good --about 50g/day, now that's a lot of fiber [ensure your

multivitamin has zinc].

 

Many groups suggest to follow your doctor's advice about drugs.  This may be

valid but only after you have both read and digested the book Reversing

Diabetes that deals with the many benefits of the non-drug approaches.  As in

any

such disease, why not keep copies of lab-reports (with MedlinePlus drug

descriptions) and start a file on yourself.  Knowledge is power, and unless you

convince yourself about benefits, changes tend to be temporary while with drugs

the

slide continues.   July 11th, 2006.