Thursday, June 6, 2013

Conquering Type 2 Diabetes: What the research shows part 1

Unless you live under a rock or are part of some hunter-gatherer tribe that has a computer lab you know someone with pre-diabetes or Type 2 diabetes.  In modern Western society, Type 2 diabetes is as ubiquitous as McDonald's and pharmacies, two establishments that see their fair share of Type 2 diabetics.  The sad part about this is that there seems to be enough research available to the general population that Type 2 diabetes should be completely avoidable.  It is my belief that if that vast majority of people took the research and used it to their advantage, most Type 2 diabetics could reverse the disease and everyone else could avoid it altogether.  That is not to say that this can help everyone, some people have done so much damage to their pancreas that they may be stuck taking diabetes drugs forever.  In other instances, people just aren't willing to change their lifestyle in a way that will prevent this largely reversible metabolic state.  For those people willing to put in the time and effort, this blog series should provide everything you need to know to conquer Type 2 Diabetes.  In this first part, we will provide a general overview of the plan.

What is Type 2 diabetes?

Type 2 diabetes is a metabolic disorder where high blood glucose is accompanied by high levels of insulin and cellular insulin resistance.  People with Type 2 diabetes tend to have an exaggerated blood glucose response to foods, particularly foods high in carbohydrate.  Over time, consistently high blood glucose levels cause damage to the organs and tissues of the body.  This can lead to blindness, neuropathy(Nerve pain), heart disease, and Alzheimer's to name only a few.

Type 2 diabetes is diagnosed in a couple of ways.  It used to be primarily diagnosed with fasting blood glucose levels, which is a test of your blood glucose level after not eating for 8 hours.  A fasting blood glucose level between 100 and 124mg/dL is considered pre-diabetic and fasting blood glucose above 125mg/dL is considered diabetic.  The problem with using fasting blood glucose levels as the primary means of diagnosing Type 2 diabetes is that you can have a normal fasting blood glucose reading but still have an abnormal blood glucose response to food, called the postprandial glucose response.  The more appropriate test given now is called your A1c, or hemoglobn A1c.  Your A1c is basically a 3 month average of your blood glucose levels determined by your level of glycated hemoglobin, hemoglobin damaged by sugars in the body.  An A1c below 7% is considered in the healthy range.

Once diagnosed with Type 2 diabetes, the best means for controlling progression of the disorder is via lifestyle intervention.  I believe very few people know this and the ones that do are not given enough of a slap upside the head to realize it's serious business.  A good portion of people are also looking for the easy way out and immediately go the pharmaceutical route rather than change what they are doing, which is more than likely causing the problem in the first place.  Whatever the reason, one of the dumbest things you can do health-wise is to go after the symptoms rather than the root causes of the problem.  This can be broken down in to 3 steps and will be covered in three separate blogs.

Fixing your gut

Of every step you are going to need to take to win the battle of Type 2 Diabetes, this one is the toughest.  Not only will it require you to avoid many of the foods you love to eat, it will require you to change your entire approach toward food.  Most of us look at what we eat as a way to provide energy and resources to our body.  While this is certainly a big part of it, the research also shows we need to consider the inhabitants of our guts as well., aka your gut bacteria.  These little guys aren't just freeloaders along for the ride, they provide many useful functions that we are dependent on for optimal health.  In addition, people with Type 2 Diabetes almost have a signature microbiota, another name for the inner society of bacteria that reside in your gut.  This signature microbiota can lead to a greater energy harvest from your food, gut inflammation, an inability to repair gut damage, and a host of other problems seen in Type 2 diabetes.

Most people who try to tackle Type 2 diabetes go immediately to a low carbohydrate diet.  While it may be a good idea to reduce carbohydrate intake initially while your mechanism to control blood sugar is faulty, realize this is merely a symptom.  We want to reduce carbohydrate to prevent your blood glucose from skyrocketing, but going to low on carbohydrates can actually make the problem worse.  Instead, you want to focus on eating the right types of carbohydrates to heal your gut, establish a healthy gut microbiota, and give you long lasting energy throughout the day.  Once you do this it may be possible to eat small amounts of foods that once caused major blood glucose fluctuations without any problem.  To what extent this is possible is more than likely individual and dependent on how much damage you've done.

Lifestyle factors

There are many lifestyle factors that can push your blood glucose and insulin levels high.  Most of these lifestyle issues will have a negative impact on your stress response.  One of the major roles of your stress response is to mobilize glucose to provide your muscles with energy to fight or flee.  Study after study has shown that people with Type 2 diabetes have higher levels of stress hormones in their body than people with normal blood glucose control.  This is because their stress response becomes altered in a way that always puts them in flight or flight mode.  In the lifestyle factors section we will discuss the effects of each factor on blood glucose control as well as techniques you can use to get yourself moving in the right direction.  It is important to note that we will cover physical activity in this section but exercise in the next.  Physical activity and exercise are two separate things and should be viewed in that way.  Most people get all of their physical activity in the form of exercise at the gym which is completely inadequate.

Exercise/Supplements

There are many benefits to exercise.  In Type 2 diabetes, exercise can be used as a "condiment" that allows you to speed up progress as well as have a little more flexibility in your diet.  In the same way, certain supplements can be used to improve nutritional deficiencies that are common in Type 2 diabetics. However, most people put most of their effort in to these two areas, treating them as if they are the main course rather than a condiment.  Putting most of your efforts in to the main dish(Diet and lifestyle) while using the condiments to optimize your results is the best approach to battling Type 2 diabetes.  In this section we will look at the best types of exercise to perform as well as supplements you may need to take to beat Type 2 diabetes.

Conclusion

Over the course of the next 3 blogs we will use research as our guide to learn how to fight Type 2 diabetes.  The vast majority of people who follow this advice will get their blood glucose levels in check if they are out of whack or will avoid Type 2 diabetes altogether if they are just looking to be healthy.  Whether you have Type 2 diabetes or not, this will more than likely be a significant lifestyle change, so let's get started.

Part 2: Diet 
Part 3: Lifestyle