In The News  Where Are You on the Road to Type 2 Diabetes?  The frightening statistics regarding the escalating rates of type 2 diabetes continue. Based on the 2010 US population 79 million of us over the age of 20 have pre-diabetes or diabetes.  Given these numbers I think it’s time for a primer on type 2 diabetes. It saddens me every time I read, as I often do, someone posting on a chat line that they have just been diagnosed with diabetes. They are surprised and upset. Some admit that diabetes runs in their family and they are overweight or obese. I ask myself why are they surprised? We must do a better job educating people that type 2 diabetes is almost always preventable. Just because you have a family history of diabetes does not mean you can’t avoid it. You can but you need facts, a strategy and the earlier you start to prevent diabetes the better. Much of the following information and more can be found in Atkins Diabetes Revolution co-authored by me (Jacqueline Eberstein, R.N.) and Dr. Mary Vernon. This book is based on Dr. Atkins many years of practice diagnosing the stages of blood sugar imbalances that ultimately lead to diabetes and what to do about them. Diabetes is a Nutritional Wear and Tear Disease You are not perfectly healthy and then suddenly have diabetes. There is a progression from insulin resistance (the first stage) to full blown diabetes. Over time the insulin producing cells in the pancreas will be permanently damaged. This progression can take years. Once enough of the beta cells are lost insulin is required. During those years you have the opportunity to protect your beta cells from burnout if you know you are at risk and choose to do something about it. By the time you are diagnosed with diabetes you have been damaging your body for years. The latest numbers state that diabetes affects 25.8 million people (8.3% of the population). Of that number 7 million people already have diabetes but don’t know it.  Risk Factors for Diabetes: How Many Apply to You? Obesity-The heavier you are the greater your risk. However, it is still possible to get diabetes even at a normal weight especially if you have a family history. Diet-A diet high in poor-quality, high glycemic load carbohydrate foods can stress blood sugar and insulin ultimately causing diabetes. Sedentary lifestyle- Being a couch potato increases insulin resistance especially if you have a genetic risk for diabetes. It also makes it harder to maintain a healthy weight as you age and lose lean mass. Heredity-A history of diabetes on one side of your family increases your risk, both sides of the family is a double whammy. The sooner you take action to protect your insulin making cells the better. Don’t assume you’re safe if you don’t think you have a family history. Remember the many people who are undiagnosed. Ethnicity- African Americans, Asians, Hispanics, Native Americans and Pacific Islanders have a higher incidence of diabetes. Gestation Diabetes-If you are a woman who has had gestational diabetes you’re risk of diabetes in the not so distant future is high. Not only can you harm yourself but your baby as well. Click here for more info. Metabolic Syndrome (pre-diabetes)-Having 3 out of the 5 following signs means you already have pre-diabetes: high blood pressure, increased abdominal fat, high triglycerides, low HDL cholesterol and higher than normal blood sugars. You can learn a lot more here. Remember that having pre-diabetes means you are already damaging your body so take this diagnosis very seriously, please. Elevated blood sugar-If your blood sugar is already “a bit high” but not yet in the official diabetic range you are at risk. Make those lifestyle changes now. Abnormal lipids- High triglycerides and low HDL are major risk factors for diabetes. These occur when insulin levels are high. High blood pressure- High blood pressure and high blood sugar go hand in hand. Each is a warning sign of the same metabolic imbalance that leads to diabetes. Age- As we get older and our bodies have been stressed year after year our cells’ response to insulin or the body’s ability to produce an adequate amount is comprised. Dietary stress is an important contributor. Note that diabetes is occurring in kids, teens and young adults as never before because of the escalating rates of obesity in these age groups. The Road to Type 2 Diabetes What eventually leads to diabetes begins with insulin resistance of cells especially liver, fat and muscle cells. Insulin resistance means that cells are unable to respond to insulin properly. Even people with a normal weight based on BMI can have insulin resistance if they have a genetic susceptibility to diabetes. Here is the progression of insulin resistance to late stage type 2 diabetes as described by Dr. Robert Atkins. 1.      Insulin resistance of cells 2.      Insulin resistance with hyperinsulinism (the production of large amounts of insulin to control blood sugar levels) 3.      Insulin resistance with hyperinsulinism and reactive hypoglycemia ( unstable blood sugar) 4.      Insulin resistance and hyperinsulinism with impaired glucose tolerance (pre-diabetes) 5.      Type 2 diabetes with insulin resistance and high insulin production 6.      Type 2 diabetes with low or virtually no insulin production  It is important to remember that insulin is primarily stimulated by dietary carbohydrates. The same dietary carbohydrates that have been encouraged by US health authorities as the mainstay of a “healthy” diet. Given the results of this message (more obesity and more diabetes than ever) it is clear that this hasn’t worked except to benefit the food industry and drug companies. Keep in mind that once you have been diagnosed with diabetes there are a number of drugs your doctor will prescribe for you that you are expected to take for the rest of your life.  Recognizing a Diet Related Disorder  Moving through these stages takes time. Once stage 3 is reached and people become intolerant of carbs enough they develop an unstable blood sugar. Blood sugar highs and lows can occur a number of times during the day. The body’s stress response is called upon to normalize blood sugar, causing symptoms that affect quality of life or may require medication. Unfortunately, this stage is not recognized by many including the medical profession. Numerous symptoms that people seem to think are common are diet related.  This is what happens:    Carb consumption = increased blood sugar = increased insulin secretion = increased body fat = low blood sugar = low energy and mood swings = carbohydrate cravings  Unstable blood sugar can cause many symptoms. Some of the more common are: ·   Irritability, headache or other symptoms before meals or if food is delayed ·   Symptoms relieved by eating ·   Difficulty falling asleep or staying asleep ·   Slow starter in the morning ·   Wake with a headache ·   Numerous emotional symptoms-anxiety, worrying, mood swings, flashes of temper etc ·   Blurred vision, lightheadedness, tremors ·   Palpitations, irregular heart beats ·   Preoccupation with food esp. carbohydrate foods ·   Cravings  Prevention of Type 2 Diabetes  A good prevention strategy is to avoid over-stressing your pancreatic beta cells-the cells that produce insulin. Since carbohydrate foods are the primary drivers of insulin it makes sense to control both the quality and quantity of carbohydrate foods. This will allow you to normalize your weight and save those vital pancreatic cells from burnout. Research done on properly designed restricted carbohydrate diets support this. This is also the way our ancestors ate long before the processed vegetable oils, fake unnatural fats and packaged foods became ubiquitous in the US diet. Don’t wait until your doctor tells you are pre-diabetic. Remember your goal is to protect the insulin making cells in your pancreas before it is too late.  People with Diabetes Die Sooner from All Causes  Most people with type 2 diabetes die of cardiovascular disease. However, before CV disease takes a life a person with diabetes can lose their eyesight, develop macular degeneration, get Alzheimer’s, lose limbs, suffer from painful nerve damage and require dialysis because of kidney failure. People with diabetes are at a higher risk of a number of types of cancers as well as a shortened life span. Death can occur from any cause sooner in someone with diabetes than a person who does not have diabetes.  Words of Advice  I did not write this article to scare anyone unnecessarily but to give you facts and a strategy to avoid diabetes as I have. I have a family history of diabetes and had a severely unstable blood sugar in my early 20’s even though I was normal weight. My diet all of my life was high in carbs. I just couldn’t control them. It was in 1974 when I began working with Dr. Atkins that he recognized what was wrong with me and he made sure I knew what I could do about it. Since them I have followed an Atkins Lifestyle. I have him to thank for still being diabetes free. I want to pass that knowledge on to others. If you find this information to be useful please pass it on to family and friends. If you have a family history of diabetes-restrict carbs. If you have symptoms of an unstable blood sugar-restrict carbs. If you have metabolic syndrome- restrict carbs. If you crave carbs or can’t control your intake- restrict carbs.  The Solution  This is not the place to provide all of the info you need to learn about how to adopt a low carb plan. There is no short term solution. To learn how to make a permanent lifestyle change educate yourself fully about how to control your carb intake and find the correct amount of carbs to re-balance your metabolism. There are a number of books including Dr. Atkins’ New Diet Revolution, Atkins Diabetes Revolution and the newest The New Atkins for a New You that are chock full of information you need to be successful. For a brief introduction review the Atkins Approach here.   A Word of Caution  If you already have diabetes there is much you can do to stay healthier. To learn how to change your diet, especially if you take blood sugar lowering medication, read Atkins Diabetes Revolution to safely make the transition to a low carb diet and better blood sugar control and a longer, healthier life. Because controlling carbs can be a powerful tool, do not cut your carb intake without consulting your physician to adjust medications. If you take the same amount of medications with a lower carb intake you are at risk for a severe low blood sugar reaction. The information presented on this site is in no way intended as medical advice or as a substitute for medical treatment. This information should be used in conjunction with the guidance and care of your physician. Consult your physician before beginning this program as you would any weight-loss or weight-maintenance program.  Those of you on diuretics or diabetes medication should proceed only under a doctor’s supervision as changing your diet usually requires a change in medication dosages. As with any plan, the weight-loss phases of this program should not be used by patients on dialysis or by pregnant or nursing women. As with any weight-loss plan, we recommend anyone under the age of 18 follow the program under the guidance of their physician.