In the United States, 115 million people—or nearly one in three—have some form of diabetes or pre-diabetes.1 Of these people, 86 million have pre-diabetes, a condition in which blood sugar levels are higher than normal (about 100 to 125 milligrams per deciliter in a fasting state), but not yet high enough to be diagnosed as full-blown diabetes. And of these 86 million, 15 to 30 percent will go on to develop type 2 diabetes in the next five years.
Type 2 diabetes isn’t the only disease associated with pre-diabetes—a meta-analysis that included data from more than 900,000 people found that those with pre-diabetes have a 15 percent higher risk of developing cancer, particularly cancers of the liver, stomach, pancreas, breast, or endometrium.2
Why is diabetes becoming so prevalent? Because of our overconsumption of sugars, starches, and processed foods, which leads to high blood sugar levels, high insulin levels, insulin resistance, and being overweight (although you certainly can have type 2 diabetes without being overweight). An additional result is the inability to burn fat as your primary fuel, which keeps you stuck in an unhealthy loop.
The often-overlooked good news here is that type 2 diabetes is completely preventable and nearly 100 percent treatable—when you address the root cause, that is. Sadly, this is not the approach of most conventionally trained physicians.
Chances are, if your blood glucose levels are elevated and you consult with your doctor about it, you’ll be checked for diabetes, and there is a great chance you will be put on an oral hypoglycemic drug or even worse, insulin.
Your doctor will say that the purpose of taking these shots or pills is to lower your blood sugar. She may even explain to you that this is necessary because insulin regulation plays such as an integral role in your health and longevity. The doctor might add that elevated glucose levels are symptoms not only of diabetes, but also of heart disease, peripheral vascular disease, stroke, high blood pressure, cancer, and obesity. And she would be correct in all of that.
But would she go beyond that explanation to tell you what part insulin and leptin play in this process, or that when your body develops a resistance to leptin, you’re on your way to diabetes, if you’re not already there?
Probably not.
Conventional medicine has type 2 diabetes pegged as a problem with blood sugar control, but this is simply a superficial and deeply flawed understanding. The reality is that diabetes is a disease rooted in insulin resistance, which occurs when, as I discussed in Chapter 1, you have plenty of insulin circulating in your blood, to the point that insulin receptors become desensitized to it.
When this happens, your cells become resistant to insulin, which, as you’ll recall, is a hormone secreted by your pancreas that normalizes sugar levels in your blood. So when you are insulin resistant, your blood sugar levels tend to rise.
Those rising blood sugar levels can then trigger a disruption of leptin signaling. As I discussed in Chapter 1, leptin is a hormone produced by your fat cells that tells your brain you have enough fat stored and that you have eaten enough. It’s also involved in your immune system, your reproductive system, and regulating how much energy you burn.
There’s one more hormone that’s intimately involved with diabetes, and that is ghrelin. This hormone is secreted by your stomach lining and tells your brain that you’re hungry.
With a malfunction of leptin or ghrelin signaling, you may eat too much food for your activity level and rate of metabolism, resulting in weight gain and obesity. With obesity often comes a resistance to insulin, resulting in high blood sugar and a diagnosis of diabetes.
You can thank researchers Jeffrey M. Friedman and Douglas Coleman for discovering leptin and its role in the body in 1994. Interestingly, Friedman based its name on the Greek word leptos, which means “thin,” after he discovered that mice injected with synthetic leptin became more active and lost weight.
But when Friedman also found that obese people have very high levels of leptin in their blood, he realized that something else must be going on. And that “something” was that obesity can cause a resistance to leptin. Friedman and Coleman also discovered that leptin is responsible for the accuracy of insulin signaling and for your insulin resistance.
This is why “treating” diabetes by merely concentrating on lowering blood sugar and using drugs or insulin can be a dangerous approach. It simply does not address the foundational cause, which is metabolic miscommunication that’s going on in every cell of your body when you have insulin and leptin resistance.
Taking insulin results in even greater danger to type 2 diabetes patients, as it worsens their leptin and insulin resistance over time. The only known way to reestablish proper leptin (and insulin) signaling is through teaching your body to burn fat as your primary fuel. And I promise, your diet can have a more profound influence on your health than any known drug or modality of medical treatment.
When you bring your blood glucose levels down over the long term by adopting the low-carb, adequate-protein, and quality high-fat formula that the recipes in this book follow, you create the conditions for lipase (a pancreatic enzyme that breaks down fat) to be activated; ghrelin, leptin, and insulin levels to normalize; leptin and insulin resistance to resolve, and pre-diabetes and type 2 diabetes to be reversed.
To be sure that you’re helping all these important things happen, you’ll want to start measuring and tracking your blood glucose levels throughout the day so you can be sure it is indeed coming down over time.
MONITORING YOUR BLOOD SUGAR LEVELS
Knowing your blood sugar level helps you understand precisely how your body is working. The wonderful aspect of this is that you don’t have to go to the doctor; you can do it in the convenience of your own home and for less than 25 cents a reading. This is largely due to the tens of millions of diabetics that have driven the cost of this test way down.
Please don’t become intimidated by this process. Remember, tens of millions of diabetics do this every day. By finding your blood sugar, you will have a powerful tool to help you burn fat for fuel. It will also insulate you from ever developing diabetes and having to regularly do this test for the rest of your life.
Initially you will test your blood glucose levels twice a day:
But remember that this is only until you are able to burn fat for fuel. Once you achieve this metabolic flexibility, you will not need to test yourself unless you get off the program or are curious.
Seeing your blood glucose numbers will give you real-time insight into how your food choices affect your blood sugar; accordingly, regularly testing your levels will help motivate you to continue to choose foods that fit the low-carb, moderate-protein, high-fat model, as these types of food will help bring your readings down over time.
When you first start eating this way, you can expect to see your glucose numbers jump around quite a bit—rather than get alarmed by an unexpectedly high number, focus on the trend over a couple of weeks and months. You’ll know you’re on the right track when you can see your numbers trend downward and become more stable. This means that your pancreas isn’t having to work so hard to produce so much insulin, and that your insulin receptors will get a chance to regain their sensitivity since there won’t be so much insulin floating around anymore.
In order to test your blood glucose, you’ll need to buy a few items:
Because there are so many people with diabetes in the United States, all these supplies are readily (and inexpensively) available on Amazon or at your local drugstore or discount department store (such as Target or Wal-Mart) without a prescription.
Once you get your readings, you’ll want to record them somewhere. If you prefer paper and pencil, keep them in a notebook or jot them down on a calendar. I recommend logging them into the online diet and health tracking tool Cronometer.com, which I cover in more detail in Chapter 5. Whichever method you choose, seeing your numbers trend downward over time is incredibly gratifying and motivating.
You’ll also want to monitor your fasting insulin level, which is every bit as important as your fasting blood sugar. Although you need a blood test from a doctor’s office to do it, the information it gives you about your insulin sensitivity is worth the hassle. Your fasting insulin level should be less than 4. The higher your level, the worse your insulin sensitivity is.
ADDRESS YOUR DIET
As I mentioned earlier, most of the food people eat these days skews metabolism toward insulin resistance and type 2 diabetes. Most Americans are burning glucose as their primary fuel, which elevates blood sugar, promotes insulin resistance, and inhibits your body’s ability to access and burn body fat—hence, the connection between obesity and diabetes.
Healthy fat, meanwhile, is a far preferable sort of fuel, as it burns much more efficiently than carbs. One of the most important dietary recommendations is to limit net carbs (total carbohydrates minus fiber) and protein, replacing them with higher amounts of high-quality, healthy fats. A key way of preventing diabetes is to keep your net carbs below 50 grams per day.
Keep in mind that the only way you’ll know how many total carbs, fiber, and net carbs you eat is to accurately measure them. The simplest way of doing this is to use an online nutrition tracker and to weigh your food with an inexpensive electronic digital kitchen scale (see Keep Track of Your Carbs and The Importance of Logging Your Meals to learn more about my favorite online food tracker, Cronometer.com).
Another important component is to boost your fiber intake considerably. Research shows that people with high intakes of dietary fiber have a significantly lower risk of obesity and diabetes.3 Aim for at least 50 grams of fiber per day. Foods that are particularly good sources of fiber include almonds, berries (eat only a handful to keep net-carb consumption down), broccoli, brussels sprouts, cauliflower, chia seeds, flax seeds (ground), green beans, hemp seeds, and psyllium seed husk. I discuss fiber intake in more detail.
ADDITIONAL WAYS TO CONTROL BLOOD SUGAR, NATURALLY
Although changing your diet is the most powerful way to treat pre-diabetes and type 2 diabetes, there are many other approaches that will support your efforts and help you reap even greater health rewards:
IN SUMMARY
Type 2 diabetes is a fully preventable, reversible condition that arises from faulty leptin signaling and insulin resistance. It is possible to control or reverse your diabetes without drugs by recovering your insulin and leptin sensitivities. The only known way to reestablish proper leptin and insulin signaling is through proper diet and exercise. There is NO drug that can currently accomplish this, and I doubt that one will ever exist in the lifetime of anyone reading this!
The good news is that you don’t have to be a part of the diabetes epidemic. The tips, recipes, and dietary guidelines included in this book can help you avoid becoming a dismal statistic!