What’s in a name: insulin resistance, metabolic syndrome, syndrome X, obesity, pre-diabetes, adult-onset diabetes, type 2 diabetes. These are all essentially one problem; some vary by severity but all can have deadly consequences. The diagnosis and treatment of the underlying causes that drive all these conditions are actually the same.
Diabesity is a more comprehensive term to describe the continuum from optimal blood sugar balance toward insulin resistance and full-blown diabetes. If you answered yes to any of the questions in the quiz here, you may already have diabesity.
Nearly all people who are overweight (over 70 percent of adult Americans) already have “pre-diabetes” and have significant risks of disease and death. They just don’t know it. Even worse, while the word “diabesity” is made up of the concepts of obesity and diabetes, even those who aren’t overweight can have this problem. These are the “skinny fat” people. They are “underlean” (not enough muscle) instead of “overweight” and have a little extra weight around the middle, or “belly fat.” Currently there are no national screening recommendations, no treatment guidelines, no approved medications, and no reimbursement to health care providers for diagnosing and treating anything other than full-blown diabetes. Think about that. Doctors are not expected, trained, or paid to diagnose and treat the single biggest chronic disease in America, which, along with smoking, causes nearly all the major health care burdens of the twenty-first century, including heart disease, stroke, dementia, and even cancer. But here is the good news—there is a scientifically proven solution that I have mapped out for you in this book.
Our current medical practice has not caught up with our knowledge. In 2008, the American College of Endocrinology and the American Association of Clinical Endocrinologists gathered twenty-two experts and reviewed all the scientific data on pre-diabetes and diabetes. They heralded a wake-up clarion call for individuals, the health care community, and governments around the world.1 Their conclusions were as follows:
The diagnosis of pre-diabetes and diabetes is arbitrary. A fasting blood sugar over 100 mg/dl is considered pre-diabetes, and a blood sugar over 126 mg/dl is considered diabetes. However, they found these cutoffs don’t reflect the whole spectrum of risk—including heart disease, cancer, dementia, stroke, and even kidney and nerve damage—which starts at much lower numbers, numbers most people consider normal.
The DECODE study of 22,000 people2 examined the continuum of risk measured not by fasting blood sugar, but by blood sugar after a big sugar drink (the best way to diagnose the problem). The study found that even starting at blood sugar levels that were perfectly normal (95 mg/dl), there was a steady and significant risk of heart disease and complications well below the accepted abnormal of less than 140 mg/dl for pre-diabetes and long before people reached the diabetic cutoff of 200 mg/dl.
Bottom line: Even if you have perfectly normal blood sugar, you may be sitting on a hidden time bomb of disease called diabesity, which prevents you from losing weight and living a long healthy life. Insulin resistance is the major cause of aging and death in the developed and most of the developing world. This book will help you identify and reverse this explosive situation for yourself. It also lays out a comprehensive action plan for greater collective action to solve this problem individually and collectively by getting healthy together.