December 5, 2019 the US FDA is aware of low levels of NDMA in foreign countries metformin diabetes drugs. February 3, 2020 the FDA is checking metformin lots from different manufacturers and has not issued a recall. May 28, 2020 FDA laboratory testing shows levels of NDMA above their  acceptable intake limit in several different manufacturers lots of the extended-release (ER) formulation of metformin.

For this reason, the FDA is being proactive, this is the start of the FDA metformin recall 2020. Important to realize, the FDA is in contact with 5 companies to recommend they voluntarily recall their products(1).

What is NDMA?

NDMA – nitrosamine impurity N-Nitrosodimethylamine is a common poisonous impurity (contaminant) in water and food. Above all, this includes dairy products, vegetables, cured and grilled meats. However, according to the FDA everyone has exposure to some level of NDMA. Nonetheless, medical authorities and international scientists do not expect it to cause harm at low levels after consumption.

Surprisingly, the acceptable daily intake limit for NDMA in the U.S. is 96 nanograms. Genotoxic substances such as NDMA may increase the risk of cancer after exposure above acceptable levels and over long periods of time. Furthermore, a person ingesting NDMA at-or-below the acceptable daily intake limit every day for 70 years will not have an increased risk of cancer(2).

In summary, over the limit, metformin ER in question may cause cancer at a faster rate than expected. On the other hand, under the limit and you will be fine.

Metformin Recall

As of July 13, 2020 the companies in the recall are:

• Lupin Pharmaceuticals, Inc.
• Granules Pharmaceuticals, Inc.
• Apotex Corp.
• Teva Pharmaceuticals USA Inc.
• Marksans Pharma Limited, India
• Amneal Pharmaceuticals LLC.

Repackagers in the recall are:

• Avkare (repackager for Amneal) – All lots
• PD-Rx Pharmaceuticals (repackager for Amneal) – All lots
• PD-Rx Pharmaceuticals (repackager for Marksans) – All lots
• The Harvard Drug Group (repackager for Apotex) – One lot (T-02134)
• Preferred Pharmaceuticals (repackager for Marksans) – Four lots (J0119M, K1419L, K2719J, A0220H)

The FDA highly recommends that if you are taking ER metformin on the recall list, to continue until a doctor or pharmacist gives you a replacement. In fact, you know how dangerous it could be to stop taking medication without talking to your doctor. Additionally, the FDA testing has not found NDMA in the immediate release (IR) metformin(3).

Lastly, the FDA is working on locating the source of the NDMA impurity, hopefully they find it soon.

What Is Metformin?

Metformin, initially an extract from the French lilac and for over 60 years used as a medication to lower glucose(4). Metformin is a Biguanide which is a class of medications in use to treat type 2 diabetes and other conditions. Many companies manufacture metformin and is a common drug used to lower blood glucose that occurs during digestion.

Additionally, a safe, low cost first-line treatment for prediabetes, type 2 diabetes, polycystic ovarian syndrome (PCOS), and gestational diabetes. In comparison to other diabetes drugs that work by increasing insulin production, metformin does not. At some point if metformin is not working, then you may need insulin if you cannot control your blood sugar.

Too much insulin may increase your risk of having low blood sugar (hypoglycemia). However, very high blood sugar is as dangerous as very low blood sugar. Metformin taken alone will not increase insulin production, therefore will not increase your risk of low blood sugar(5).

In general, some diabetes drugs cause weight gain, but metformin does not. In essence, doctors like metformin because it may help people lose weight and lower cholesterol. Weight loss is one of the best ways to manage diabetes and keep blood sugar under control.

What Does Metformin Do?

Metformin mainly interacts with your small intestine, liver, and muscle through multiple mechanisms of actions. In the small intestine, metformin acts by reducing the rate of glucose into your blood. This reduces the net amount of glucose that enters your blood from food, postprandial – after a meal(6).

In general type 2 diabetics suffer from increased endogenous glucose production (EGP) – the production of glucose by the liver. Lowering the rate at which the liver exports glucose into the blood is a strategic way to keep blood sugar down(7). Lower the rate at which the liver exports glucose into circulation, therefore decreases the rate of EGP.

In effect reducing EGP, means less glucose enters the blood from your liver, helping to lower blood glucose. In your muscle, the molecular action of metformin is not clear to medical experts. Even though, scientists have observed that metformin treatment results in the activation of a signal known as AMP-activated protein kinase (AMPK).

This activity increases as cellular energy stores decrease, as a result this enzyme has been shown to stimulate glucose uptake into skeletal muscle(8).

Metformin Information

Here is some trivia, 120 million people have a prescription for metformin because it is considered a safe drug(9).

Metformin is available as

• Tablets in Immediate Release : 500, 850, and 1000 mg.
• Tablets in Extended Release:  500, 750, and 1000 mg.
• Liquid Solution: 100 mg/ ml.
• Generic versions of immediate release and extended release formulations.
• A prescription from your doctor, do not prescribe for yourself or others.

Storage of metformin ideally, is at room temperature between 20 C to 25 C (68 F to 77 F).

Brand names for metformin in the US include:

• Glucophage
• Glucophage XR
• Glumetza
• Fortamet
• Riomet

Metformin Side Effects

In comparison to other diabetes medications, metformin is very mild in side effects. The most common side effects of metformin are related to stomach disorders, like:

• gas.
• upset stomach.
• nausea.
• diarrhea.
• cramping.
• Long term use of taking metformin may block vitamin B12 absorption in the body. Talk to your doctor about whether you may need vitamin B12 supplements(10).

You can limit these side effects by:

• Starting with a low dose like 500 mg and slowly over weeks increase to a daily maximum of 2500 mg. Work with your doctor, eventually, the goal is to give your body time to adjust to the medication.
• Taking metformin with food will help you feel less sick or nauseous.
• Take an Extended Release (ER) version rather that the Immediate Release (IR). In effect, the goal is to have the medication slowly release into your body over a period of time. For this reason it makes it easier on your stomach and digestive system.

Severe Side Effects

People with kidney issues or heart problems should not take metformin since in rare cases it can cause lactic acidosis. Although the risk is very low it could be fatal(11).

Warning

In general metformin has a good safety profile and is well tolerated. However if you combine metformin with insulin or sulfonylureas, talk to your doctor about side effects such as low blood sugar. Important to realize, report any changes or unusual symptoms to your doctor when you’re combining metformin with other medications.

My Experience With Metformin

I did not have a good experience with metformin and within the first month of use, I stopped using it. The most notable side effect was diarrhea which I could not handle, so I quit using it. I was at a point where I would cringe at the thought that it was time for me to take it.

When you are at this point where the drug is not working, immediately talk to your doctor about another solution. I went one step further and started to do research on changing my lifestyle, I have never looked back. Of course you now know that I have my type 2 diabetes under control without medication.

In reality, metformin is a drug that has so much potential, but use it for as long as you need it. You can manage type 2 diabetes through a proper diet and lifestyle.

Summary

Finally, for those of you taking the Metformin ER check with you doctor and pharmacist to ensure your medication is OK. Additionally, check the FDA website as they post updates when they happen. Over the NDMA limit and you are at risk for cancer, under the limit and you should be fine.

After all, your short and long term goal is to control and normalize your blood sugar and insulin resistance. Let Food be thy medicine and medicine be thy food, see my reading list.

One last thing, I appreciate you reading the post, please let me know what you think in the comments.

References

1. Several companies voluntarily recall extended release metformin
2. Information about Nitrosamine Impurities in Medications
3. FDA Alerts Patients and Health Care
4. Metformin: An Old Drug with New Applications
5. Metformin: Current knowledge
6. The mechanisms of action of metformin
7. Mechanism by Which Metformin Reduces Glucose Production in Type 2 Diabetes
8. Metformin Increases AMP-Activated Protein Kinase Activity in Skeletal Muscle of Subjects With Type 2 Diabetes
9. Microparticulate and nanoparticulate drug delivery systems for metformin hydrochloride
10. Pharmacological Approaches to Glycemic Treatment: Standards of Care in Diabetes – 2019
11. Metformin
12. Amneal metformin label
13. Apotex metformin label
14. Lupin metfromin label

The post FDA Metformin Recall 2020 appeared first on Controls For Diabetes.

So what is the link between Coronavirus and diabetes?

Novel Coronavirus  Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) Coronavirus 2019 (COVID-19)

In fact, a likely source of the Coronavirus was a wild animal food market, “wet market” in Wuhan City, China. Specifically, it formed from a bat coronavirus and mutated to a Pangolin Coronavirus. Then again, mutated in the reservoir of the Pangolin, through zoonosis passed on to inoculate (infect) a human.

To point out, zoonosis is an infectious disease that spreads from non-human animals to humans. Finally, the coronavirus reached the perfect host, a human, mutated, multiplied and became Coronavirus-2019 (COVID-19). In general, after a person talks, sneezes, or coughs, the Coronavirus can be transmitted by air droplets.

At the same time, the distance can range from 3 to 6 ft (1 to 2 m) away. For this reason, this is why we must practice “social distancing”. Similarly, touching hands on certain surfaces and then touching the mucus membranes (T-zone) can spread the virus.

To clarify, the T-zone is your eyes, nose and mouth (mucous membranes).

Coronavirus Symptoms

In reality, the incubation period of COVID-19 is 2-14 days. As a result, the CDC says you can experience symptoms such as fever, cough, or shortness of breath. On the other hand, is it the Coronavirus or are there other underlying factors, increasing your susceptibility?

In fact, most people will have a mild to moderate case, which means cold symptoms to a bad flu. Similarily, COVID-19, causes milder symptoms in about 80 percent of cases, while the remainder are severe or critical.

However, if COVID-19 worsens and inflammation develops. Then, patients might start out with a fever and cough that progresses to pneumonia or worse. Identically, COVID-19 seems to follow other virus patterns like SARS and MERS.

3 Phases of SARS

All things considered, after the SARS 2002 outbreak, the WHO reported that the virus attacked the lungs in three phases.

Phase 1

Phase 1, is the viral replication phase, usually lasts for about a week after symptom start. In fact, viruses will increase in respiratory secretions (droplets), stool and urine. In any event, the start of an infection, the coronavirus rapidly spreads and invades the lungs.

At this instant, Chest X-rays and computed tomography (CT) scans show slowly progressing lung damage.

Phase 2

Phase 2, is the immune hyper-reactive phase, damage to the lungs is a result of the body’s immune system. In essence, the body tries to fight the virus and sends immune cells to repair the lung tissue. But sometimes your immune system goes crazy and these cells destroy everything in it’s path, including healthy tissue.

In fact, studies have shown that many COVID-19 patients develop pneumonia in both lungs, accompanied by shortness of breath. Finally, fever may increase, oxygen may decrease, pneumonia or development of adult respiratory distress syndrome (ARDS) will occur. Furthermore, dead cells clog up the lungs, and pneumonia worsens.

Surprisingly, rather than healing, there is more damage to the body from the immune system response. For this reason, a storm builds, known as a Cytokine Storm Syndrome causing self inflicted immune system response damage.

Phase 3

Phase 3, is the pulmonary (lungs) destruction phase. For the most part, fever has usually disappeared unless there are other infections. However lung damage may continue or progress towards a honeycomb-like pattern on a CT scan. Furthermore, these lesions are present in those affected by COVID-19.

In effect, permanent injury and fibrosis (scarring) of the lung will set in and the patient may die. However, as a result of respiratory failure some may need ventilators or may recover with lung damage. Consequently, not all patients go through three phases.

In fact, 25 percent of SARS patients suffered respiratory failure, the signature of severe cases. In summary, this holds true for people who are older or have impaired immune systems.

Mortality (Death Rate)

Overall, globally, 3.4 % of reported COVID-19 cases have died. In comparison, the seasonal flu kills fewer than 1% of those infected(1). Death Rate = (number of deaths / number of cases) = probability of dying if infected by the virus (%).

The rate may be lower because they didn’t include the asymptomatic (milder cases) and not reported. The rate is changing daily and will not reflect the posted rate. In detail, go here for the latest daily statistics.

“It’s going to get worse before it gets better,” says Donald Trump. In essence, this is no ordinary flu, it is much more aggressive.

Comorbidity

Comorbidity means the incidence or presence of at least one condition or disease. Since, those suffering serious effects have pre-existing conditions. In fact, if you have a pre-existing condition then the risk of death is around 10 %; correspondingly, risk of critical illness increases to 40 % if you contract Coronavirus.

Surprisingly, statistics show that diabetics have a 7.3 % higher chance of fatality than someone with no condition. On the other hand, people with no other known conditions have a 0.9 % fatality rate(2). Not managing high blood sugar will lead to so many other chronic complications and possibly death.

Above all, you need to take care of yourself or help a loved one to manage their diabetes.

Diabetes Risk

In fact, high blood sugar is toxic which causes problems in every single cell in your body. Since uncontrolled diabetes is a condition of impaired immunity and risk factor. In addition, infection may increase susceptibility towards COVID-19 and worsen the outcome.

In particular, according to the International Diabetes Foundation (IDF), older people and diabetics can become severely ill with COVID-19. People with diabetes who develop a viral infection are harder to treat due to fluctuations in blood glucose levels. Additionally, diabetes (high blood sugar) complications will almost always make the condition worse.

A compromised immune system means a longer healing period because the virus thrives in elevated blood sugar. Another factor related to Type 2 Diabetes and Metabolic Syndrome are inflammatory conditions related to excessive insulin. In fact, this chronic, systemic inflammation known as insulin resistance predisposes you to complications from infection.

In other words, not only will cuts take longer to heal but any conditions like infections and inflammation. Equally important, normalizing your blood sugar and insulin is the key to reducing inflammation and is critical to survive COVID-19. Furthermore, diabetes is a heterogeneous condition, as a result, not all diabetics will have poor outcomes.

Factors Affecting Outcome

• How long have you had diabetes?
• Degree of hyperglycemia, (how high is your blood sugar?)
• Other chronic complications and acute comorbidities (for example hypertension, neuropathy, and retinopathy)

Can Dogs Get Covid-19?

Apparently dogs can get covid-19 as the virus can be passed from human to animal. Although this is the first case, the dog apparently had cancer and also had trouble breathing it did eventually die(3).

Non infected Diabetics

• Monitor and control your glucose
• Try to remain stress free, because stress will increase glucose levels
• Keep yourself hydrated, drink water, coffee or tea
• Ensure you have a good supply of medications, in case you need to quarantine
• Go out for food, gas or other necessities as needed
•  Do not change your lifestyle, this is not a good time to start exercising vigorously and restrict carbohydrates
• Practice social distancing
• Reduce the curve
• Have all relevant contact details
• Make sure you have access to enough food
• Ensure you can correct a hypoglycemic situation, fresh fruit like an apple or banana works great
• If you live alone, have a contact number of a friend and doctor if you get ill
• Have a plan so that if you do become infected you will be ready.

Infected COVID-19 Diabetics

• If you show flu-like symptoms (fever, cough, difficulty breathing), seek medical support and treatment immediately
• Follow medical support advice, try to manage optimal glucose levels.

How To Stay Safe

In the long run, for people with diabetes, it’s important to take precautions to avoid the virus if possible. In brief, keep a social distance of 6 feet and do not gather in groups of more than 10. To emphasize, you will hear this from health officials everyday, wash hands regularly and avoid touching your T-zone.

Stay home as much as possible, isolate yourself, now is the time to act. On the whole, the IDF and ADA encourage diabetics to keep informed of the latest developments. For this reason, watch for daily updates and advice from local, federal and reliable news sources.

Video

Additionally, have a look at this video from Ninja Nerd Science, he discusses the epidemiology, pathology and diagnosis of coronavirus.

Finally, declared as a pandemic, COVID-19 continues to ravage people’s health. As a result, thousands have been victimized by this mysterious illness. At the same time, as the virus spreads so does the misinformation. In these learning times, we need to separate fact from fiction, so you can take steps to safeguard your health.

After all, it’s not the end of the world YET! Have faith and pray for people to use common sense. Keep Safe and Stay Healthy.

Above all, thanks for reading and I appreciate your comments.

References

1. WHO Director-General’s opening remarks at the media briefing on COVID-19 – 3 March 2020 – World Health Organization, March 3, 2020
2. https://www.worldometers.info/coronavirus/coronavirus-age-sex-demographics/#pre-existing-conditions
3. https://www.nationalgeographic.com/animals/2020/07/first-dog-to-test-positive-for-covid-in-us-dies/

Images courtesy of  NIAID-RML

The post Coronavirus and Diabetes appeared first on Controls For Diabetes.

How To Test For Insulin Resistance

In a normal test for diabetes a doctor will advise a patient to get a HgA1c. In many cases, diabetes may not be detected if it is at or under the normal limit. Insulin resistance is a metabolic condition that requires a higher amount of insulin to push sugar and fat into cells. There is no single test to determine insulin resistance. So, how to test for insulin resistance?

Before we delve into the tests, you may want to check with your insurance to ensure they are covered. Otherwise, no surprises, you need to pay for them and fortunately they are not that expensive. Hence, these tests are necessary to determine insulin resistance and diabetes.

What Tests Do You Need?

Understand the background of the tests will help you provide information to your doctor for the tests you need. As a result, a combination of the tests will help determine insulin resistance.

Fasting Glucose

A sample of blood is taken after a 10 to 12 hour fast and a good marker for detecting diabetes. Reading levels above 95 mg/dL (5.3 mmol/L) indicate insulin resistance. Although fasting glucose may be normal many people can still have significant insulin resistance and pre-diabetes.

Fasting Insulin

Fasting insulin is an inexpensive test but unfortunately, not often ordered by doctors. Anyone with insulin resistance will often have a higher than normal fasting insulin level. Thus, fasting insulin is a good screening test for detecting insulin resistance.

• Normal fasting insulin is between 3 to 8 uIU/mL (18 to 48 pmol/L).

C-Peptide

C-Peptide is a blood test, to determine how much insulin your body is producing.  Is a molecule, released in conjunction with insulin and matches it molecule for molecule. Even though it does not influence blood sugar it is useful for determining whether you have type 1 or type 2 diabetes.

C-Peptide is a useful marker of insulin production because it tends to remain in the blood longer than insulin.

• Normal range for is: 0.51 to 2.72 ng/mL (0.17-0.90 nmol/L).
• Low range and high blood glucose levels could be an indicator of type 1 diabetes.
• Low levels of both C-Peptide and blood glucose could indicate liver disease, a severe infection or Addison’s disease.
• High range could indicate insulin resistance, either type 2 diabetes or Cushing’s syndrome.
• High levels of C-Peptide but low blood glucose levels may be a result of insulinoma (cancer of the pancreas) or glucose lowering medication affected the result(1).

Triglycerides TG

Triglycerides are a fat (lipid) found in your blood. During or after eating, your body converts excess calories into triglycerides. The triglycerides are then stored in your fat (adipose) cells.

A cause of high triglycerides is excessive consumption of carbohydrates, specifically refined carbohydrates and sugars. When the liver has sufficient glycogen stored, excess glucose is shunted into the production of fatty acids. Fat cells use these to synthesize triglycerides.

Insulin prevents the breakdown of triglycerides from fat cells, triglycerides will remain high due to insulin resistance.

• Normal — Less than 150 milligrams per deciliter (mg/dL), or less than 1.7 millimoles per liter (mmol/L)
• Borderline high — 150 to 199 mg/dL (1.8 to 2.2 mmol/L)
• High — 200 to 499 mg/dL (2.3 to 5.6 mmol/L)
• Very high — 500 mg/dL or above (5.7 mmol/L or above)(2).

High Density Lipoproteins-Cholesterol HDL-C

HDL cholesterol is an essential fat, the “good cholesterol” and provides stability in every cell of your body. The good cholesterol removes harmful LDL bad cholesterol. HDL-C reduces, reuses, and recycles LDL cholesterol by transporting it to the liver to be reprocessed.

LDL-C receives all of the press and if the readings are normal, no need to worry(3,4). High HDL levels reduce the risk for heart disease — but low levels increase the risk.

Each bit of HDL-C is a microscopic droplet consisting of a bit of lipoprotein around a cholesterol center. The HDL-C particle is dense compared to other types of cholesterol particles, so it’s called high-density.

To travel through the bloodstream, cholesterol has to be transported by helper molecules called lipoproteins. Each lipoprotein has its own preferences for cholesterol, and each acts differently with the cholesterol it carries.

Here are the numbers for the cholesterol test or lipid panel:

• HDL-C greater than 60 mg/dL (1.5 mmol/L) are high. Good.
• HDL-C less than 40 mg/dL (1.0 mmol/L) are low. Not good(5).

HemoglobinA1C HBA1C

This blood test averages blood sugar for the past 2-3 months, providing information on glucose control. It measures the percentage of blood sugar attached to hemoglobin (the protein which carries oxygen in your blood cells). The higher your blood sugar levels, averaged, the more hemoglobin with sugar attached.

The American Diabetes Association recommends 2 checks per year minimum and 7.0% (53 mmol/mol) but work with your doctor. To point out, that at 5.6% you will probably be insulin resistant. The numbers may seem low, but the ADA keeps changing the numbers and you could be insulin resistant for years.

• Lower is better, an HBA1C between 5.6% and 6.4% (38 and 46 mmol/mol) indicates pre-diabetes.
• Greater than 6.4% (>46 mmol/mol) is diabetes.

Homeostatic Model Assessment- Insulin Resistance  HOMA-IR

HOMA was developed in 1985 by Matthews et al. It is a technique to measure insulin resistance and beta-cell function from basal (fasting) glucose and basal insulin. HOMA uses the glucose and insulin variability relationship to predict fasting steady state glucose and insulin concentrations.

HOMA is a model of the relationship of glucose and insulin dynamics that predicts fasting steady-state glucose and insulin concentrations to determine insulin resistance and B-cell function. Insulin is secreted from the pancreatic β-cell in response to glucose levels, while, being regulated by insulin-mediated glucose output from the liver. Therefore, a defective B-cell function will not respond properly to glucose stimulated insulin secretion.

Correspondingly, insulin resistance affects insulin’s lack of glucose uptake. The HOMA uses a set of simple, mathematical equations to describe glucose-insulin relationship. A disadvantage of the HOMA as with all mathematical models, are the limitations and cannot provide a “full” metabolic description.

The model only uses basal values, otherwise it will not yield any usable estimates of function. HOMA is still a homeostatic model, which means it calculates a steady-state solution. The HOMA model is a robust, simple, clinical tool to determine insulin resistance and the latest version is HOMA2.

The HOMA2, free for personal use downloadable calculator

How to Calculate HOMA-IR:
Insulin uIU/mL (mU/L) (multiplied by) X Glucose (mg/dL) (equals) = HOMA-IR

The HOMA-IR calculation requires U.S. standard units.

International S.I. units:

Insulin: pmol/L to uIU/mL, divide by (÷) 6
Glucose: mmol/L to mg/dL, multiply by (x) 18

Healthy Range: 1.0 (0.5–1.4)
Less than 1.0 means you are insulin-sensitive which is optimal.
Above 1.9 indicates early insulin resistance.
Above 2.9 indicates significant insulin resistance(6). Additionally, Dr. Richard Mauer gives a great description of the meaning of HOMA.

TG:HDL-C Ratio

The TG:HDL-C is an excellent, low cost, precision, and easy test to determine insulin resistance. Comparatively, to an insulin test, it is very low cost. People with insulin resistance, TG levels increased while HDL-C levels decreased.

TG:HDL-C ratio is an alternative tool for gauging insulin resistance. The higher the ratio the poorer health status due to a large amount of circulating fats in the blood stream and/or a low amount of healthy cholesterol. A TG:HDL-C ratio of ≥3 indicates significant insulin resistance.

How to Calculate TG:HDL-C:
TG (mg/dL) (divided by) / HDL-C (mg/dL) (equals) = TG:HDL-C

The TG:HDL calculation requires U.S. standard units.

International S.I. units:

HDL: mmol/L to mg/dL: multiply by (x) 39
TG: mmol/L to mg/dL: multiply by (x) 89

Healthy: 1.0
Optimal range: 0.5–1.9
Some insulin resistance: 2.0–3.0
Significant insulin resistance and heart disease risk is found at ratios >3.0(7). See Dr. Richard Mauer’s site.

The Importance Of Insulin Resistance Tests

“Should you be tested, absolutely not, only if you care” – Dr Joseph Kraft(8). Furthermore, for those of you that do care, these tests will save your life. Consequently, hyperinsulinemia left unchecked and progressing on for years is a pathology of the arterial wall.

The wall is an insulin sensitive tissue, chronic exposure to high levels of insulin results in formation of lipid filled lesions similar to early atherosclerosis(9). In addition, long term insulin resistance results in Atherosclerosis found in the vast majority of diabetic cases. Insulin can stimulate the arterial muscle cell proliferation and lipid synthesis in the arterial wall, the phenomena is called endothelial dysfunction.(10).

Surprisingly, many people die from heart attack and stroke and not know they are diabetic. Furthermore, is it any wonder that 80% of type two diabetics suffer and die from cardiovascular issues (11).

Finally, diabetic retinopathy, neuropathy, nephropathy and cardiovascular issues are chronic conditions that damage the body. In fact, the process for each of these chronic conditions takes years even decades to develop. Thus, insulin resistance and high blood sugar will keep on doing damage(12).

So, I hope you understand how to test for insulin resistance. Besides, you will never know until you get the proper and timely tests. Regardless, let me know what you think in the comments.

Thanks for dropping by and reading.

For further reading on diabetes and general health go to my Recommended Books To Read page.

References

1. C-Peptide Test – https://www.diabetes.co.uk/c-peptide-test.html

2. Triglycerides –https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/triglycerides/art-20048186

3. The Great Cholesterol Con: The Truth About What Really Causes Heart Disease and How to Avoid It, Dr. Malcolm Kendrick, John Blake; Updated edition, October 1 2008.

4. A Statin Nation: Damaging Millions in a Brave New Post-health World, Dr. Malcolm Kendrick, John Blake; None edition, June 1, 2019.

5. HDL Cholesterol – https://www.webmd.com/cholesterol-management/guide/hdl-cholesterol-the-good-cholesterol#1

6. the Bloodcode.com HOMA calculator https://www.thebloodcode.com/homa-ir-calculator/

7. the Bloodcode.com Calculator  https://www.thebloodcode.com/calculators/

8. Diabetes Epidemic and You, Dr. Joseph R. Kraft, Trafford Publishing, 2008.

9. Stout, 1979 – https://link.springer.com/content/pdf/10.1007%2FBF01219790.pdf

10. Role of Insulin Resistance in Endothelial Dysfunction – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3594115/

11. Reasner, 2008 – https://www.ncbi.nlm.nih.gov/pubmed/18670366

12. Insulin Resistance: A Clinical Handbook, Andrew Krentz, Wiley-Blackwell, June 9, 2008.

The post How To Test For Insulin Resistance appeared first on Controls For Diabetes.

Diabetes Essentials Masterclass

There’s a common saying in the diabetes community: diabetes won’t kill you, but it’s complications will. Please attend the Diabetes Essentials Masterclass: Encore Weekend – November 17 – 19, 2019.

Why is diabetes so dangerous?

According to the American Diabetes Association, diabetes was the 7th leading cause of death in the United States in 2010, with over 69,000 death certificates listing it as the underlying cause of death.

Add to that the common complications, like cardiovascular disease, kidney disease and infection, and you can multiply that number by 10!

Yet despite these eye-opening statistics, I still see far too many people not taking diabetes seriously. They approach it as something that’s a nuisance rather than something that can and does cause major health complications.  Morbidity and then mortality, if uncontrolled.

—>>That’s why I encourage you to join me at Dr. Brian Mowll’s free Diabetes Essentials Masterclass!

Diabetes is more dangerous than most people assume, and so it becomes easy for many people with diabetes to get lax in their efforts to manage the dysfunction. A 2012 GAPP2 (Global Attitude of Patients and Physicians 2) survey found that 22% of insulin-using diabetic patients missed a basal insulin dose during a 30-day period.

There are very real dangers diabetes poses if left unchecked or mismanaged, and one of my goals today is to motivate you into taking better care of yourself or helping a loved one manage the disease better.

Why is diabetes so dangerous? Because if not managed correctly, it can wreak havoc on just about every system and organ in the body. Let’s take a look at some of the biggest risks diabetic complications pose:

Diabetic Ketoacidosis

Diabetic Ketoacidosis is a very dangerous condition that can occur when patients neglect to take their insulin and have uncontrolled blood sugar. Since insulin is necessary to break down glucose as a source of energy, the body then turns to body fat as a fuel source.

While you may think that burning fat for fuel sounds like a great idea, it’s not in this case. This process of using fat and not glucose for fuel leads to an excessive and dangerous buildup of byproducts called “ketones” making the blood very acidic.

This is not the same thing as nutritional ketosis, which is the presence of a small to moderate amount of ketones in the blood that occurs during fasting or with strategic low carbohydrate diets. Nutritional ketosis is safe and used therapeutically for people who suffer from seizures and other health issues.

If left unchecked, however, diabetic ketoacidosis can lead to a diabetic coma and even death. This complication is increasing, with 80,000 hospitalizations reported in 1988 and 140,000 cases in 2009. Symptoms of the condition include difficulty breathing, acute abdominal pain, dehydration, weakness and vomiting.

Diabetic Retinopathy

The retina is the innermost layer of the eye and it performs an incredibly important function. The retina receives light from our surroundings and converts that light into neural signals that are sent to the brain for recognition. Thanks to the retina we know exactly what we are looking at.

Because of the retina’s vital role in vision, any damage to it can cause permanent blindness. Diabetics are at risk of retinal damage because this sensitive eye tissue is affected by poor glucose control, which often causes tiny blood vessels in the retina to become damaged. Diabetics are also particularly at risk of developing cataracts and glaucoma.

Diabetic Nephropathy

Diabetic Nephropathy is a term describing damage to the kidneys caused by diabetes. Your kidneys have tiny blood vessels that filter waste from your blood. High blood sugars, will damage or destroy vessels over time and the kidneys are not able to do their job. In some cases, the kidneys may fail completely. In fact, diabetes is the leading cause of kidney failure in adults.

The number of patients being treated for end stage renal disease (ESRD-DM) has increased. In 1980, the number of persons with diabetes being treated for (ESRD-DM) was “only” 2,600, yet in 2008 that number climbed to 48,374.

Heart Attacks and Stroke

Diabetics, have a greater risk of developing heart disease and strokes. Smoking, high blood pressure, and obesity increase the risk even more. According to The American Heart Association:

+ 74% of people over 65 with diabetes die of heart attack or stoke

+ Adults with diabetes have a 200-400% increased risk for a heart attack or stroke

+ Diabetes is 1 of 7 controlled risk factors for cardiovascular disease

+ It is also the “strongest” risk factor for cardiovascular disease

Complications with Feet

When you have diabetes, even a “simple” callous can lead to a major foot complication. This is because diabetics often have nerve damage (or neuropathy) in their feet. Nerve damage causes poor blood flow as well as loss of feeling. While non-diabetics are able to feel they have a small cut on their foot, a diabetic may not. This loss of sensation combined with poor circulation can lead to a bad infection, which can then lead to amputation.

This nerve damage can also cause changes to the actual shape of your feet and toes. If this happens, it’s important to speak to your doctor about getting special therapeutic shoes instead of forcing your feet and toes into shoes that no longer fit and may cause further damage.

Gastroparesis

Gastroparesis is a condition in which the stomach takes too long to empty its contents. In diabetics, the vagus nerve, which controls the movement of food through the digestive tract, becomes damaged because of regularly-high glucose levels. When this happens the muscles of the stomach and intestines no longer function normally and the movement of food slows or stops completely. This condition can happen with type 1 or type 2 diabetes.

Signs and symptoms of gastroparesis can vary but usually include nausea, heartburn, weight loss, vomiting, abdominal bloating, feeling full suddenly when you’ve just started eating, lack of appetite, erratic glucose levels and spasms of the stomach lining. These symptoms can be mild or severe, depending on the individual.

The real problem with gastroparesis is that it can make managing blood glucose even harder. Because food essentially becomes stuck in the stomach for hours, when it does eventually make its way to the small intestine, blood glucose levels can suddenly spike.

Another complication is that when food stays in the stomach too long it can cause a bacterial overgrowth because of fermentation. Beyond this, the food can also harden into solid masses called “bezoars” that cause nausea and vomiting, and potentially may even cause a very dangerous blockage.

While some medications can help with this condition, a better treatment is to change your eating habits. Diabetics with gastroparesis, should eat less food at each sitting, then after going for a walk.

Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS)

Hyperosmolar Hyperglycemic Nonketotic Syndrome, or HHNS, is a serious condition that is normally seen in older diabetics with either type 1 or type 2 diabetes, but more often in type 2. Note, hospitalizations for HHS in children and adolescents have increased by 52.4% between the years of 1997 and 2009.

HHNS occurs when blood sugar levels rise and, in an effort to rid the body of this excess quickly, the sugar is passed into the urine. At first, frequent urination and many trips to the bathroom. Eventually, the person may not go to the bathroom as often and the urine may become very dark.

Enough reasons to join me at Dr. Mowll’s Diabetes Essentials Masterclass?

—>>Click here to register for the Diabetes Essentials Masterclass Encore Weekend (free & online)!

Type 2 diabetes does not need to be a death sentence, or even cause complications and problems. Above all, diabetes is manageable through a lifestyle change.

If you have diabetes or have a loved one dealing with it, be smart. Get proactive and take action now to stop the progression of the condition and prevent complications.

“The sooner people find out they have pre-diabetes and correct, the better their chances of preventing type 2 diabetes.”

Thanks.

Jimmy.

P.S. When you register today, you’ll also unlock Dr. Mowll’s diabetes cheatsheet to help you maintain control of your blood sugar!

The post Diabetes Essentials Masterclass appeared first on Controls For Diabetes.

High Fasting Blood Sugar On Low Carb

I have been on a Low Carb High Fat (LCHF) diet for over 3 years. Lost 35 pounds and have kept it off during this time frame.
I use a 16/8 fasting regimen and eat 2 meals a day. The amount of carbs I consume on a daily basis is so low it borders on ketogenic. 20 to 30 grams a day, I am almost in ketosis.

I went into the lab on Friday to get my bi-annual blood panel. A couple of hours later, I tested at home on my glucometers, 6.7 mmol/L – 120 mg/dl. WTF. I could not believe it. Have my trusty glucometers let me down?  Is there glucose on my fingers?  Try it again and get the same reading. I have a Contour Next EZ and an ACCU-CHEK Aviva that I mainly use because they are accurate.

Monday, I checked my lab results and was absolutely shocked. My Fasting Blood Sugar (FBS) was 7.0 mmol/L – 126 mg/dl on the Richter scale. Then another shock, my doctor called me to discuss the blood work up. So I made an appointment to see him a few days later.

Why So High?

Why do I have a high fasting blood sugar on a low carb diet? Should I be worried or is there an explanation? Even though, I’m following a low carb diet and starting to understand the irregularities of high blood sugar in a fasted state. For someone that sticks to a low carb diet and has such a high fasting blood sugar, doesn’t mean cheating. There are many reasons for this and other ways to determine metabolic health.

Going back to Sunday, 5 days before the test, my FBS was 5.1 mmol/L – 92 mg/dl. Wednesday 2 days before 5.5 mmol/L – 100 mg/dl and then on Friday, test day 7.0 mmol/L – 126 mg/dl.  So as not to confuse you, blood sugar is the same as blood glucose and glucose.

Dawn Phenomenon and Somogyi Effect

There are  2 common explanations in diabetics for high fasting blood sugar (hyperglycemia) in the morning. The first reason is the Dawn Phenomenon and affects people on a low carb/keto diet. As we sleep hormones become active between 1 and 8 am. Through the process of gluconeogensis the liver breaks down glycogen, (stored glucose) and puts back into the blood system. This is a normal response causing the blood sugar to rise.

The second reason is the Somogyi effect, exogenous diabetic insulin users inject too much insulin before bed. The result is hypoglycemia (blood sugar drops too low) followed by stress and then a blood sugar spike[1].  Diabetic insulin users must be aware of this issue.

Adaptive Glucose Sparing

Physiological insulin resistance otherwise known as adaptive glucose sparing, is not the same as pathologic insulin resistance. Pathologic insulin resistance is higher levels of insulin, also known as hyperinsulinemia. Hyperinsulinemia is associated with obesity, hypertension, metabolic syndrome, type 2, diabetes and many chronic conditions.

People that follow a low carb/keto lifestyle and fasting will have low stable blood sugar. In the morning blood sugar will usually be higher, as the day goes on it will eventually come down. When glucose was available from the abundance of carbohydrates the cells would burn glucose. However on a low carb/keto diet the cells will burn fat for energy instead.

Thus, cells will not need insulin to burn glucose for energy. Excess glucose will be circulating in the blood for organs that need glucose. For example the brain is one of the biggest users of glucose.

Other Blood Measurements

Insulin levels, if your insulin sensitivity is normal and you have a higher fasting blood sugar, means you are good. One measurement is not the deciding factor. Now if your insulin is high and fasting blood sugar is high that is a whole different story. There are of course other measurements that we should consider like HgA1c, triglycerides, hypertension, and HDL. These numbers should all be considered and if they are all low, then something else is going on.

The test we need to investigate is the HOMA-IR.

HOMA-IR stands for Homeostatic Model Assessment of Insulin Resistance. Use the calculator from Dr. Richard Maurer’s site The Blood Code.(2)

On this page there are 2 calculators the first is the HOMA-IR the second is the Heart Disease calculator

https://www.thebloodcode.com/calculators/

On your next blood panel workup have the above tests performed including fasting insulin and fasting blood sugar.  All of the tests are important so get them done. Once you have your fasting insulin and fasting blood sugar plug them into Richard’s formula. Now figure out your insulin resistance, and heart disease risk.

Cortisol

What is cortisol?  Cortisol is a stress hormone secreted from the adrenal glands called glucocorticoids. the adrenal glands sit above the kidneys, and have two areas. The adrenal cortex is one and has several zones that produce cortisol.

Cortisol will be generated from stress and will stimulate insulin and will ultimately affect blood sugar.(3)

Stress

Researchers from the Harvard Business school published a report that found workplace stress causes 120,000 deaths in the US. The costs associated are close to $200 billion in health care expenses.

Stress comes in many forms from physical, (fasting); psychological, (worrying); or environmental (air pollution); and will increase cortisol levels.

Metabolic Effects of Elevated Cortisol and blood sugar
– Reduced transport of glucose into cells
– Decreased insulin sensitivity (increased pathological insulin resistance)
– Increase in appetite and carbohydrate cravings

When stressed, the body prepares itself by ensuring that enough glucose is available. Insulin decreases, glucagon and epinephrine (adrenaline) levels rise and more glucose is released from the liver. Growth hormone and cortisol increase, which in turn causes muscle and fat to be less sensitive to insulin. Now there is enough glucose for the body to use.

These hormonal responses to the low blood sugar may last for 6-8 hours and blood sugar may be difficult to control.  Stress in a in a low carber may make your blood sugar increase as was my case.
You will not need any  medications.

So again do not worry about any of the above if you are on a low carb /keto diet.

Sleep

The CDC reports that up to 70 million Americans suffer from lack of sleep. Worldwide 25 % have this same issue. Lack of sleep will lead to health problems. Most people, about 90 % need between 7 to 9 hours of sleep per day. Surprisingly the other 10 % can do with less.(4)

Problems with our daily lives could be affecting the way we sleep, which leads to stress. You need to get enough sleep. Additionally, one hour of lost sleep can increase cortisol levels by 50 percent and will play havoc with insulin.

Glucometer Accuracy

There are many factors that can affect the reading on your glucometer. If you are not sure take another reading. I use 2 of the most accurate glucometers on the market and as you can see the readings are identical. The Contour Next EZ; and the ACCU-Chek Aviva are highly recommended and simple to use. Furthermore, other factors that can alter reading on your glucometer are soaps or fruits with high amounts of sugar.

You must wash your hands thoroughly with soap and rinse clean with water before you do a blood test.

In Summary

I started doing my taxes Wednesday night and worked on it until Saturday, which accounted for the high stress levels. I though I was going to owe a lot of money so in the end brought it to my accountant. She worked on it for about an hour and I ended up paying a lot less. Next time I will bring it to her with all the paperwork in a shoebox and let her take care of it.

Should I be worried about my high fasting sugar on low carb? Of course not, because my A1c was 5.4 and my fasting insulin was 43 pmol/L or 6.2 mU/L.  My insulin sensitivity is a little over 1 but I am working on lowering it.  My stress level is back to normal until next year at tax time. So let me ask you a question.  Do you understand the difference between physiological insulin resistance and pathological insulin resistance?  Should you be concerned? Let me know in the comments.

Finally, moral of the story, let your accountant do your taxes and you will not have any stress.

I appreciate question, comments and concerns.

Thanks for dropping by and viewing.

References

1. The dawn phenomenon and the Somogyi effect – two phenomena of morning hyperglycaemia. Rybicka M¹, Krysiak R, Okopień B. https://www.ncbi.nlm.nih.gov/pubmed/21717414
2.  https://www.thebloodcode.com/calculators/
3. The Cortisol Connection Diet: The Breakthrough Program to Control Stress and Lose Weight, Shawn Talbott, Hunter House; 1 edition, September. 20 2004.
4.  Sleep: EXACT BLUEPRINT on How to Sleep Better and Feel Amazing Brain Health, Memory Improvement & Increase Energy,

Recommended Reading (See Recommended Books To Read)

Harper’s Illustrated Biochemistry Thirty First Edition McGraw-Hill Education, Victor W. Rodwell, David Bender,  Kathleen M. Botham,  Peter J Kennelly,  P Anthony Weil, May 18, 2018.

The Blood Code: Unlock the Secrets of Your Metabolism, Dr. Richard Maurer, The Blood Code, March 12, 2014.

The Cortisol Connection Diet: The Breakthrough Program to Control Stress and Lose Weight, Shawn Talbott,  Hunter House; 1 edition, September. 20 2004.

Sleep: EXACT BLUEPRINT on How to Sleep Better and Feel Amazing Brain Health, Memory Improvement & Increase Energy, Brian Adams, CreateSpace Independent Publishing Platform, November 16 2015.

The post High Fasting Blood Sugar On Low Carb appeared first on Controls For Diabetes.

Lose Weight Keep It Off

The U.S. weight loss market, worth a record $66 billion, even though the number of dieters has declined. A good reason is the growth of the size acceptance and body positivity movement. Consumers would rather use Do-it-yourself plans like free diet & fitness apps. Healthy consumers are avoiding processed foods and artificial ingredients, but food companies have adjusted and sales are coming back(1). Can you lose weight keep it off?

Let’s start out by making this perfectly clear. It is not the fat that makes you fat, says Dr. Mark Harman. What is that you say? It is the excessive processed food consumption that makes you fat. Sugar is the main culprit. Candy, soft drinks, fast food, refined processed foods, anything rich in carbohydrates and cooking in vegetable and hydrogenated oil.

Let’s get into the right mind set and be prepared for change. I will show you how you can use brain basics to replace bad habits with good.

What are habits?

Habits are involuntary behaviors controlled by the subconscious mind. Studies have shown that 40 to 95 % of behavior is from habit. Let’s say that you used only 50 % of your subconscious mind, this would mean you are on automatic pilot(2).

Walking up the stairs is an example and once you are at the top you won’t remember you walked to the top of the stairs. Habits whether good or bad are choices that we make and then stop thinking about but continue doing every day. When you think about your habits, it does not matter whether it is good or bad is learned, this means habits can be unlearned.

Change your bad habits you can change your life, it is as simple as that. Going on a diet is a perfect example and if you have done that before this will be easy. Why? You are willing to make a change for the good. It does not matter that the diet failed. Look at that diet failure as a lesson on what not to do.

Overweight and Obesity

According to data from the National Health and Nutrition Examination Survey (NHANES) in the US, 2013–2014

• 1 in 3 adults are overweight.
• More than 2 in 3 adults were considered to be overweight or have obesity.
• More than 1 in 3 adults were considered to have obesity.
• About 1 in 13 adults were considered to have extreme obesity.
• About 1 in 6 children and adolescents ages 2 to 19 were considered to have obesity.

Gary Taubes said “Obesity is caused by carbohydrates, not by gluttony and sloth!”

Obesity and Insulin Resistance

Insulin sensitivity occurs across the human lifecycle, from puberty, to pregnancy and into old age. Increased carbohydrate intake and increased physical activity, are associated with insulin sensitivity fluctuations. Other factors such as stress, and lack of sleep contribute to insulin resistance. Cortisol, is released when you have a lot of stress. Research has shown that cortisol  stimulates insulin, increases appetite and results in fat storage in the abdominal area.

Obesity is the most common pathological condition associated with insulin resistance.

Some obese individuals, despite being insulin resistant, do not develop type 2 diabetes. Pancreatic β-cells of the islet of Langerhans release adequate amounts of insulin that are sufficient to overcome insulin level reductions under normal circumstances, thus maintaining normal glucose tolerance(3).  To be metabolically healthy means your insulin sensitivity is normal or close to 1.

Some people can be obese and be metabolically healthy obese. You are one of the lucky few, but for how long? On the other hand there is a close relationship between obesity and type 2 diabetes. According to the CDC, 87 % of obese people have type 2 diabetes. Moreover, obesity also has important associations with coronary heart disease and stroke.

Normal body fat content is:

• 10-20% for men
• 20-30% for women.

Increased calorie consumption, a decrease in physical activity has contributed significantly to obesity and type 2 diabetes everywhere. Not exercising at all,  may be sufficient to cause obesity.

My Type 2 Diabetes

I have been a long time type 2 diabetic and lucky to not have had a stroke or heart attack from heart disease. Even though I was obese, sluggish, unmotivated, always tired, moody, cramps in my legs at night, feeling helpless and sorry for myself. I thought it would never end and could not tie it to toxic blood glucose.

Type 2 diabetes complications include: neuropathy; nephropathy, retinopathy, non-alcoholic fatty liver disease, and cardiovascular disease(4). End stage 85 % to 90 % kidney failure from high blood glucose means dialysis. Dialysis performs the job of the kidneys and filters your blood.

I decided to do something about it, more than 2 years ago I watched a video by Dr. Iulian Novac. How To Reverse Your Type 2 Diabetes Naturally and Easily. The video is made by Udemy and has a 4.7 out of 5 rating with 3,458 students enrolled.

This video changed my life. I decided to try his recommendations, and I did research to verify his statements. My main objective was to reduce my fasting glucose. I followed his steps and lowered my glucose and everything else seemed to fall into place.

I dropped 35 lbs.,  lowered my HgA1c to the low 5’s, and lost 4 inches off of my waist. You are reading this post on my diabetic website. Furthermore, I have become obsessed with researching everything on type 2 diabetes.

Body Mass Index (BMI)

My BMI is at 25.3, which means it is above normal, but that does not mean anything to me. Everybody is different, some people are big, have a flat stomach and have a BMI above 25. Now if my BMI was at 35 or more, I might be concerned. The definition of average does not fit everybody.

Braun Strowman a professional wrestler, stands 6′ 8″ 385 lbs., a former weightlifter has a BMI of 42.5. The man is massive, with a muscular body. Important to realize 42.5 is not a good description of his body. So let us not use the BMI, instead look at yourself in the mirror. How does it look? Do you need to lose weight? Are you type 2 diabetic?

Another method to determine obesity is to take a tape measure, and check your hip against your stomach. Measure right above the hip bone, that is your stomach, if it is more then you are overweight. As you lose weight or not measure your progress, do this once or twice a week and log. I did not do this but I looked at my belt and noticed it was 4 notches. Also all of my pants are loose and had to buy a smaller waist size pants. I am not complaining. So now start measuring your progress.

Fad, Yo-Yo and Crash Diets

Give all diet plans 2 to 6 months, 1 year tops and then they will fail. Why? Calorie restricted diets are the hardest to follow because sugar is still part of the diet. Restricting your favorite foods is a time bomb ready to go off and as soon you break down, boom, your back to the way it was. Let us be clear, all calories are not created equal. 1000 calories of sugar is not the same as 1000 calories of broccoli.

The sugar causes biochemical chaos and provides empty calories devoid of nutritional value. The broccoli in equivalent terms would provide 21 cups and you could not eat it. Let us say that you could eat it, you would eat all of the fiber and very few of the calories would be absorbed(5).

Even though energy wise they are the same, being processed in the body is a different thing. You must burn more calories than you consume, and you will lose weight, is just plain wrong.

1 diet plan does not fit everybody. Not surprisingly, how can it everybody is different. Motivation is lost, and the old routine of snacking will come back into your life. I know this because this has happened to me many times. I have tried many diet plans, if a plan goes longer than 2 months I am surprised.

My late night snack routine included a 10 ounce pop with a bag of family size chips. Consequently after years of junk food snacking, I became obese and insulin resistant. I hope this does not sound to similar because it is a path to type 2 diabetes. A routine like this is very hard to stop, so hard that you should not start. Ultimately, you will have to restrict your high carb processed food intake.

Steps before Losing Weight

Be open-minded and positive to change. Change your habits for the good. Experiment, test, and measure. Try things out for yourself, if it does not work out the way you want then change something. Get a blood glucometer if you do not have one, diabetic or not. Learn how to test your blood sugar.

Before making any changes in your lifestyle make sure you talk to a health professional like your doctor. Use some common sense, if something does not work for you then obviously you have to try something else. Dizziness or being light-headed means you are hypoglycemic, stop, gather your composure. Think, be prepared have water and an apple close by.

What works for me, may not work for you. Stay focused, research other diabetic websites, there are so many good sites on the net, double check everything I say. Read my posts, check out all of my recommended books, and check out all of my links. I have been there and done that. Everything that I state is backed up by facts.

How To Lose Weight

Start with a low carb diet you don’t have to count calories or worry about being hungry. A good pace is a couple of pounds for the first week and then a pound per week after that. This would total about 56 lbs or 25 Kg per year. Cutting down on sugar, starches, and high processed carbs helps in the weight loss.  Cutting out sugar completely will ensure you lose weight. The weight loss will not be the same for everyone. A low carb diet will not starve you, fill the void with fats. You are going to be eating this way for the rest of your life. You will make a positive habit change.

The weight loss process might seem slow but you will lose weight faster than you put it on. Patience is a virtue. As your body reshapes and slims down so will your insulin sensitivity. You will notice that your pants will fit loosely and your belt will move in a notch or 2. There may be times when nothing happens, don’t worry stay with the plan.

Part of the low carb diet is eating healthy high fats, eat lots of fat until you are full.  Make up the difference in fats, other wise you will be hungry and revert back to your old diet. Liberally use butter to fry food, add lots of cream to sauces and lots of olive oil in salads. Natural high healthy fats and lots of it will keep you feeling full.

Carbohydrate Restriction

Carbohydrate restriction is the key to losing weight along with cutting down on proteins. A free without the use of an app method of losing weight. Carb restriction is different for everyone. Some people can ingest 200 grams of carbs per day and not get fat. 200 grams per day is a very high amount. This will not be easy, you will need to work and experiment with your carb intake.

Dr. Bernstein recommends that diabetics restrict themselves to 45 grams of carbs per day. For those of you that are not diabetic, start with a limit of 100 grams per day. As a result each one of your meals is 33.3 grams, times 3. Or if you eat 2 meals it will be 50 grams per meal.

Counting carbs and protein is a must, if 100 grams does not work, lower it to 75 grams.  If that does not work, try 50, 25, and 20, whatever works. Once you find that amount, give it a try. Do not think that the amount is too little because you can make it up with fats. The plan should take 2 to 4 weeks or 6 weeks it depends on how you adjust. Change the plan accordingly, if it is not working for you, it will be a work in process. Fruits are high in carbs, goes easy or avoid, if your diabetic avoid. Carbs equal sugar.

Dairy, milk, and yogurt contain a high amount of lactose. Lactose is not sweet and is broken down into glucose and galactose. Milk also contains protein which will also affect insulin secretion. You can test each one of these foods to see if you can tolerate or if it obstructs your weight loss. Lactose intolerance means no dairy.

Carbohydrate Tolerance (Insulin Sensitivity)

Some people have a high tolerance they can eat food (carbohydrates) and need a small amount of insulin to metabolize the food. On the other hand some one that is carbohydrate intolerant can eat the same food but their insulin will go up. This means a person will need more insulin for the low carbohydrate tolerance which is driven by insulin resistance a fat storage hormone.

The Inuit

Ketogenic, may be the only solution if you are severely diabetic, this means low to no carbs, protein and a high fat diet. The Inuit in the Canadian Arctic consumes a protein and fat diet of whale, seal and fish. Surprisingly, they have the lowest rate of heart disease, cancer and no type 2 diabetes(6). How can they have type 2 diabetes?  Well of course, they cannot, there is no sugar in their diet.

The key is to eat low carb healthy whole natural unprocessed foods. Most of the foods have labels from manufacturers, and list carb content, if you are not sure google it.

How Often Should You Eat?

Diet is the most important factor and you must work on perfecting this.  Experiment and eat 3 meals a day and make adjustments, cut out the snacking and quit sugar. Why do we eat 6 times a day? Breakfast, snack, lunch, snack, dinner, snack and snack to no end. Consequently, obesity is epidemic and therefore, eating habits must be changed.

When you are not eating, you are not secreting insulin. Insulin is secreted in the presence of blood glucose, and causes fat storage. The goal is to keep insulin secretion to a minimum.

Here is a typical meal plan that you can try:

Meal 1 – 4 eggs, scrambled, with a small green pepper, 1 ounce of cheddar cheese, 3 crimini mushrooms, cooked in 3 tablespoons of butter. Over the course of the day 3 or 4 cups of coffee with 2 tablespoons of 34 % whipping cream, and 1 bottle of water. Equally important, seasonal vegetables can be substituted. On the other hand, limit your fruit consumption because fruits contain fructose.

Meal 2 – Coleslaw or lettuce salad with an avocado, cherry tomatoes, cheddar cheese with high fat yogurt, 1 tablespoon of natural peanut butter (no sugar or hydrogenated oil) and 3 boiled chicken legs. The chicken can be substituted with any protein to your liking. Beef, fish or pork. Have another bottle of water. After dinner, at the end of the day, a cup of black or green tea. Stop no snacking.

Trial and Error

Make adjustments to the carb content, work on it until you get it right. Keep lowering your carb content and eventually you can quit sugar. Cutting out sugar additives is a good idea too.

Teach yourself nutrition, learn how to cook, additionally, you must be self sufficient. Why? So that you do not have to depend on anyone else. Thus, the problem with take out and eating out is you do not know what people add to the food.

Grocery shop for healthy food, take your time, and buy the freshest food that you can.  Finally, be a savvy consumer and stay away from processed food.

Intermittent Fasting

Is an excellent way to keep your insulin sensitivity low. Another way to reduce and burn fat without using an app. Adjust your meals by fasting and eating 2 or 3 meals a day and fast when you are not eating. The goal is to keep insulin sensitivity in the normal range. As a result, you may want to log/record how much time you actually spend fasting.

My schedule for eating is Monday, Wednesday, Friday, Saturday and Sunday fast for 16 to 18 hours with 2 meals. Tuesday and Thursday will be a 24-hour fast with one meal. I will adjust this schedule according to my next day fasting glucose, if it is higher than 5.5 mmol/L or 99 mg/dl. I will add a third day of 24 hour intermittent fast.

Experiment and test, as well as, test and measure your blood glucose. Finally, after doing this for a few months you should be good enough to make adjustment as needed. The good habits will start to burn in.

Exercise, Do You Need It?

In reality, you do not have to exercise, but why would you not exercise? Moreover, everyone knows that the benefits far outweigh anything else. Of course, you do it for your well-being, but only if you can and are not injured. Use some common sense, start slow and build up. For those of you that can exercise, why would you not?

Start by walking for 5 minutes and build up to an hour a day, every day. Additional exercises like push-ups or planks, benefit your cardiovascular system,  but only if you can. Do not over do it, if you are sore then stop. Unfortunately, I cannot hold your hand, or motivate or watch you.  So start slow, go easy, be safe and take care.

Diabetic neuropathy (nerve damage) means you have to use the utmost care. Check your feet for any kind of ulcers or cuts. Diabetic foot ulcers with high fasting blood sugars are dangerous and you should not exercise. Wait until your weight goes down so that you can comfortably start walking. In the end you will want to start walking.

People can lose weight when they exercise. There are numerous studies to show that you can lose weight when you exercise. Equally important to start an exercise program and work at it regularly. Additionally you should gain muscle you may even gain weight, but it is all good.

Spot Train

You cannot “spot train” body fat off of a certain area of your body. For example – bicep curls and tricep curls in an effort to burn the fat off of your triceps and biceps. Of course, it doesn’t work that way. The muscle will build and improve the appearance of the arm, but fat will not burn from that specific area.

Uniquely, body fat is lost systemically, from within and all over the body. You can’t burn fat off of just your arms with isolated exercises. Furthermore, you cannot control where the body fat comes off first.

Benefits Of Weight Loss

• losing 5 lbs will drop your fasting blood glucose
• your body will slim down
• your skin will look better, and acne will slowly go away
• you will feel better with a sense of well-being
• you will feel like you accomplished something
• your insulin sensitivity will start to normalize, insulin resistance will decrease(7)
• your risk for all diseases and cancer will go down.

How To Keep It Off

Experiment and change your diet as necessary, go week by week and make adjustments to your carb intake.  Stay focused and count the carbs to determine daily requirements. The long term goal is to be regular. Special events like birthdays and holidays will introduce high carb processed foods.  Avoid and explain to people that you are on a diet.

Resist the urge to eat fast foods and high carb snacks. Alcohol, smoking and drug use increases your risk of insulin resistance, avoid if possible.

The low carb restriction will require dedicated work  and it will not be easy. A healthy lifestyle will enable you to meet short and long term health goals.

Some studies have shown that overweight people often eat more quickly than thin people. This is an observational study and does not prove causation, so approach this finding with caution. Eat slower, and make sure you notice when you are full. Take your time to fully enjoy your food.

A final note, if you think that you are not maintaining your weight loss, then cut down on your fat intake. Go slow and monitor your food.

In Conclusion

Lose weight keep it off by lowering your carb intake to fit your weight loss needs.  Stick to a regular schedule of eating, intermittent fasting and daily exercise.  Try to keep the stress level low and try to get 7 to 8 hours of sleep every night.

Use common sense, if you do not feel good stop. Consult your doctor if you do not feel well . Losing weight drops insulin resistance.

Get motivated and help yourself, start your carb restricted diet immediately.

Prioritize your health, your health is everything, you are number 1.  See your doctor and get a blood work up for insulin resistance and diabetes.

I thank you for dropping by and reading this post.

I welcome and appreciate questions, comments and concerns. Please send me an email.

Recommended Reading (See also Recommended books To Read)

Food is your Best Medicine: The Pioneering Nutrition Classic, Henry G. Bieler, July 1987, Ballantine Books

The Art and Science of Low Carbohydrate Performance, Jeff S. Volek, June 2012, Beyond Obesity LLC

The Obesity Code: Unlocking the Secrets of Weight Loss, Jason Fung, March 2016, Greystone Books

The Complete Guide to Fasting: Heal Your Body Through Intermittent, Alternate-Day, and Extended Fasting, Jason Fung, October 2016, Victory Belt Publishing

Good Calories, Bad Calories: Fats, Carbs, and the Controversial Science of Diet and Health, Gary Taubes, September 2007, Alfred A. Knopf

References

1. https://www.marketresearch.com/Marketdata-Enterprises-Inc-v416/Weight-Loss-Diet-Control-10825677/

2. http://www.helpingyouengineeryourfuture.com/habits-work-smarter.htm

3. https://www.ncbi.nlm.nih.gov/pubmed/9467581/

4. https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/symptoms-causes/syc-203511933.

5. https://drhyman.com/blog/2014/04/10/calories-dont-matter/

6.  http://www.theiflife.com/the-inuit-paradox-high-fat-lower-heart-disease-and-cancer/

7. https://www.ncbi.nlm.nih.gov/pubmed/11225637

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Take the Diabetes Quiz

How well do you know type 2 diabetes?

A bit, a lot or not at all.

1. How do you know you have diabetes?  Type 1 Diabetes. Type 2 Diabetes. or Gestational Diabetes.

Type 1 diabetics have a pancreas abnormality and cannot produce insulin after carb and protein consumption, therefore a person will need insulin to metabolize glucose into the cell for energy.

Type 2 diabetics are the opposite, have insulin resistance,  high blood sugars and other metabolic syndrome type disorders..

Gestational diabetes mellitus is a type of diabetes that occurs during pregnancy. The body cannot produce enough insulin to handle the effects of a growing baby and changing hormone levels. Additional insulin helps to control the level of glucose.

2. What is the normal A1c range for a non diabetic? For a diabetic?

Hemoglobin is a protein found inside red blood cells that carry oxygen to every cell in every part of the body. Blood glucose will attach proportionally relative to the level in the blood to the red blood cells. The amount of glucose attached to the Hemoglobin is measured by a Hemoglobin A1C test.

A1c                                                                            Status

< 5.7 %                                                                     Normal

5.7 % – 6.4 %                                                         Prediabetes

> 6.5 %                                                                     Type 2 Diabetes

3. What are the symptoms of Type 2 Diabetes?

Symptoms of diabetes include:

• Increased thirst and you can easily monitor this throughout the day, it is a good idea to cut down on the juices and sodas.
• To go along with the increased thirst will be frequent urination.
• Unusual fatigue during the day, this could be due to the unbalance of the blood sugars going high and low.
• Increase in waist circumference  and weight, this could be due to insulin resistance and visceral obesity. Eat healthy natural foods and exercise to keep your insulin sensitivity in the normal range and blood sugar low.
• Cloudy or blurry vision, high blood glucose causes problems in the eyes known as retinopathy.
• Wounds heal slowly, if it is not infected then, due to high blood glucose and insulin resistance will prevent healing in a normal fashion, known as neuropathy.
• Cramping of the legs, this usually happens at night when sleeping and you wake up with a debilitating knife stabbing pain.
• Numbness in any part of the body due to high blood glucose.
• Sharp tingling pain in any part of the body due to high blood glucose.

4. What is a carbohydrate?

Carbohydrates are found in a wide variety of foods, for example vegetables, fruits,  processed foods and sugar. Carbohydrates break down after digestion into glucose.

Glycogen is a carbohydrate found in the liver and muscles used for energy source.

5. How many people in the world are diabetic?

It is epidemic and beyond control. According to the IDF in 2017 there were 425 million diabetics in the world. This does not include prediabetic and the people that are undiagnosed. This number could easily be well above 1 billion people. This is about 1 in 7 people with diabetes. Holy high blood glucose batman.

6. What is a Low Carb High Fat (LCHF) diet?

Otherwise known as Low Carb Healthy Fat diet. Eat whole natural food. Key word being natural. Whether you eat ketogenic, paleo, or what have you. Stay away from high carb processed foods and eliminate sugar and all of the 56 + other known sugars and additives. 

7. Who is Dr. John Yudkin?

Dr.  John Yudkin was one of the first people to note the dangers of sugar in a book that he wrote in 1972. In his book he reveals the dangers that sugar presents and its links to insulin resistance, type 2 diabetes, heart and liver disease and dental issues.

8. How many grams of sugar are in a teaspoon?

There are approximately 4.2 grams of sugar in a level teaspoon rounded to 4 grams. Total calories is 16. Total carb content is 4 grams and provides no nutritional value.

9. If you drink one 12 ounce soda every day for a year, how much weight will you gain?

If you drink one 12 ounce can of soda each day for a year you will gain 15 lbs.  Here is the math – One can  is 140 calories x 365 days = 51, 100 calories,  1 pound is 3500 calories

51,100 / 3500 = 15 lbs.

10. Is type 2 diabetes inherited?

Type 2 diabetes is not inherited. The only thing that is inherited would be family members consuming the same high carb processed food diet, leading to insulin resistance and type 2 diabetes.

11. Why do wounds heal slow when you have type 2 diabetes?

Wounds heal slowly because of insulin resistance and high blood glucose. High blood glucose is toxic and every part of the body will be affected.

12. What is blood glucose, blood sugar, and glucose?

Blood glucose, blood sugar, and glucose mean the same thing.

13. What is fructose?

Fructose is used in High Fructose Corn Syrup (HFCS) and is the other half of the monosaccharide in sucrose, otherwise known as table sugar. Sucrose is composed of glucose and fructose bonded together. Fructose is the sweeter of the pair of monosaccharides in sugar. There is no nutritional value of fructose and after digestion goes straight to the liver to be metabolized. Is a main contributor to Non alcoholic fatty liver disease.

14. Does obesity contribute to diabetes?

Partially yes and no, there are people who are obese and do not have diabetes. They are the lucky ones, once the subcutaneous fat and the visceral fat fills up diabetes is right around the corner.

15. What is carb counting?

Carb counting is used to monitor your intake of carbs so that you can lower your glucose, insulin and  HbA1c.

16. Why should you carb count?

You should carb count if you want to lower your insulin resistance and HbA1c. The idea is to normalize your insulin resistance and bring your HbA1c to a normal range. The end result is to reverse your type 2 diabetes.

17. What does intermittent fasting do?

Intermittent fasting helps burn off fats while you are not eating. This is the best way to burn unwanted fat. It will take a bit of time to get used to, but is well worth it.

18. What is insulin resistance?

Insulin resistance is a resistance to insulin. Prolonged and excessive exposure to insulin or hyperinsulinemia causes insulin resistance.

19. Were you able to answer all of the questions?

Hint, the answers to these questions are on this website.

I appreciate and welcome any questions and or concerns.  Please leave a comment and or send me an email.

Many thanks for dropping by and viewing.

The post Take the Diabetes Quiz appeared first on Controls For Diabetes.

Eight Myths of Type 2 Diabetes

Before my research and advocacy on type 2 diabetes I though diabetes was a crippling and killer disease. Type 2 diabetes can be a crippling and killer disease only if you let it. Here are eight myths of type 2 diabetes.

Myth 1

Type 2 diabetes is a chronic hereditary disease.  Myth.

Type 2 diabetes (T2D) is a dietary disease, not chronic nor hereditary. The only way that it is in any way hereditary is if you eat the same high carb and high sugar diet as your parents. If you were brought up eating a high carbohydrate and a low fat diet then, of course, you have a greater chance of developing type 2 diabetes.

For years the way to eat was high carb low fat diet. The diet included high carb foods like grains, pasta, potatoes, bread, pastries, desserts, sodas, and sugar. All of the foods are very high on the glycemic index rating. The trend also was to eat lots of trans fat, sugar additives and margarine which is very bad for your body. Eat a Low Carb High Fat (LCHF) diet this consists of natural, unprocessed foods and is better for your diabetes. LCHF diet will reduce your intake of carbs, and you will eat natural foods until you are satisfied.

Myth 2

Herbal Supplements will help to lower and cure type 2 diabetes (T2D). Myth.

Companies are producing the so called wonder herbal supplements that claim to cure type 2 diabetes. These supplements in combination with your normal routine diet will have very little effect if any at all. The program will tell you to modify your eating habits and take the supplements in conjunction with a revised diet. If it suggests an LCHF diet then, of course, it will work.

You will gain better results by going to a Low Carb High Fat diet, and you will not need any supplements of any kind. It will lower the risk of cardiovascular events (stroke and heart attack) by up to 2 times. If you have diabetes and are using any medication or supplements, you are looking for a quick fix.

Taking supplements of any kind is costly and time consuming. The supplements have a disclaimer if you have liver and kidney issues, do not take. It could cause allergic reactions, so what is the point in taking the supplement? Who is kidding who? Get off of medication and supplements and eat natural foods.

Myth 3

Diabetes and obesity do not go hand in hand. Myth.

There are currently 1 billion people that are prediabetic or diabetic in this world. The numbers are staggering and beyond epidemic proportions. In most cases the people are obese or close to it, the numbers are in the 80 % range. Of course, you can be slim and still be type 2 diabetic. Diabetes does not pick and choose but favors obesity.

Another word for diabetes and obesity is diabesity, the word speaks for itself. Eating an LCHF diet, exercise and intermittent fasting will help to get your A1c and insulin down to a normal range. Once you lower your insulin and A1c, you will quickly lose weight and lose inches off of your waist.

Myth 4

If you are diabetic, you will end up taking insulin. Myth.

The main point for this myth is you must take care of your diabetes. If you take diabetes lightly, then yes you will end up on insulin. Insulin resistance and high blood glucose are toxic to the body. Make a change in your lifestyle by changing your diet over to LCHF and stop eating sugar. Only you can make this change. Start as soon as you get word from your doctor or health practitioner. If you do not know you are diabetic and think you are, then see your doctor and ask for a Hemoglobin A1c test. You do not have to do any fasting, but I would suggest you get other tests done, so you will have to fast for 10 hours and then get your blood work up done.

Diabetes left unchecked can lead to insulin, but only if you let it. Do not let diabetes control you. It is a slow and painful way to suffer and then die.

Myth 5

If you get diabetes, you will go blind or have a limb amputated. Myth.

The only way that you will go blind or have a limb amputated is if you let diabetes defeat you. Diabetes and high blood sugar are very toxic, and in the long term yes it can lead to blindness, stroke, cramps, slow healing wounds, and amputation. If you take control and the sooner you do it, the sooner, you will be on your way to normal blood sugar and better health.

Start by getting rid of all the junk food high carb foods in your cabinets, pantries, fridge, and freezer. Next trip to the grocery store buy LCHF food and start eating naturally. You have to get off of medication and eat naturally.  Start today.

Myth 6

Type 2 diabetes cannot be reversed. Myth.

Will your type 2 diabetes get progressively worse? My answer to that is yes, if you listen to your doctor and do not change your lifestyle. Many people have lowered and in fact defeated type 2 diabetes by making a lifestyle change. I am proof that type 2 diabetes can be reversed, along with thousands of others.

How do you reverse type 2 diabetes? Make a change in your lifestyle. This means changing your diet, increase exercise and start fasting. Eliminate sugar from your diet this means no high carb junk foods and processed foods. Stop drinking juice, pop, and sodas. Stop eating snacks, cookies, pastries and so on. Carbs are equal to sugar. Start walking, and increase the time you walk for as long as you can comfortably do.

Myth 7

You must eat at least three meals a day with snacks.  Myth.

Eating three meals a day with snacks has been burned into everyone’s mind and is wrong. It is an old mother’s tale handed down from generation to generation. Type 2 diabetes is a dietary disease, let me repeat that, type 2 diabetes is a dietary disease. The more junk food carbs you eat, the more sugar you intake and the higher your blood sugar goes. Eat an LCHF diet and fast every day for at least 12 hours, and if you can 2 times a week for 16 to 20 hours. I eat 2 meals and fast everyday for 16 to 18 hours.

You will find that once you start fasting, you will lower your insulin and A1c and lose weight naturally, almost at will if you want to. Get into the mind habit of no snacking on junk food. You can eat LCHF until you are satisfied.  I stress that you only eat until you are satisfied. Continue to eat LCHF and fast until you have dropped your insulin and A1c to a normal level.

Myth 8

Diabetes is a Crippling and Killer Disease. Myth.

Diabetes is a crippling and killer disease only if you let it control you. Continue to eat junk food carbs and sugar type snacks and of course you are in for a slow crippling death sentence.  Not only do you have a chance of being killed by diabetes but the other diseases associated with metabolic syndrome and cardiovascular issues. Although carbs are highly addictive you have to change your eating habits and eat healthy. LCHF is the only way to go.

You must want to do this, and I cannot help you. Only advise you. You have to want to defeat diabetes. Put time into educating yourself and stop any excuses that may pop up. I do not want to hear that you are too busy, have no time, will start tomorrow, and any other BS. I put time into researching, testing and living the lifestyle and am still maintaining my health. The healthy lifestyle is something that you will continue to do for the rest of your life. I will inspire you to keep on going. I am on your side, so start today and have a great journey into health and wellness.

If I can do it so can you.

In conclusion

These are the eight myths of type 2 diabetes. Before making any changes to your diet or lifestyle consult with your doctor and or health practitioner.

Start reversing diabetes right now.

Recommended Reading (See also Recommended Books To Read)

The Diabetes Code: Prevent and Reverse Type 2 Diabetes Naturally, Jason Fung, Greystone Books, 2018.

I welcome and appreciate all comments, questions and or concerns. Good, bad, or indifferent, please let me know what you think.

Many thanks for dropping by and reading.

The post Eight Myths of Type 2 Diabetes appeared first on Controls For Diabetes.

Can Too Much Sugar Cause Diabetes?

Sugar is sweet. Sugar and spice and all things nice. Just a spoonful of sugar helps the medicine go down. Eat less sugar. You are sweet enough. Sugar is eight times as addictive as cocaine. Pretty please with sugar on top.  Everybody has got their poison and mine is sugar. Of course, we have all heard these famous sugar quotes from various famous people.

We feast on sugar whether it is a holiday, birthday, special occasion, and almost, anytime. Sugar consumption has been the highest it has been in years; it is part our culture. In contrast, glucose provides energy to every living cell in our body! Above all, without glucose, you could not survive. Can too much sugar cause diabetes?

So, there is no simple answer. As an illustration, everyone says it is OK in moderation. Is it like smoking?  Is smoking OK in moderation? Although, true or not, let us define moderation.

What is moderation?

How do you define moderation for a toxic substance known as sweet poison. Can we compare sugar to moderation in smoking? Is 1 cigarette smoked moderation? Can we safely say? No, because each and every person will have a different limit before a health issue occurs. Do you want to take your chance with moderation? Gary Taubes wrote a piece on moderation in his book “A Case Against Sugar”.

According to the American Heart Association (AHA), February 2017 – The maximum amount of added sugars you should eat in a day are Men: 150 calories per day (37.5 grams or 9 teaspoons). Women: 100 calories per day (25 grams or 6 teaspoons).  This is true for all added sugars[1]. See this detailed study[2]. One teaspoon is equivalent to just over 4 grams of sugar.

There are four calories in one gram. Definition of a teaspoon – perfectly level and not a rounded heaping teaspoon, anything above will raise the grams and calorie count.

According to the World Health Organization (WHO)  MARCH 2015  GENEVA – The WHO guideline recommends adults and children reduce their daily intake of free sugars to less than 10% of their total energy intake. A further reduction to below 5% or roughly 25 grams (6 teaspoons) per day would provide additional health benefits[3].

See detailed study for sugar intake for adults and children[4].

According to the FDA

According to the Food and Drug Administration (FDA) May 2016 – It is difficult to meet nutrient needs while staying within calorie requirements. If you consume more than 10 percent of your total daily calories from added sugars. Americans intake 13 percent of their total calories from added sugars.

With the major sources being sugar-sweetened beverages (including soft drinks, fruit drinks, coffee and tea, sport and energy drinks, and alcoholic beverages) snacks and sweets (including grain-based desserts, dairy desserts, candies, sugars, jams, syrups, and sweet toppings)[5].

The definition of added sugars includes sugars that are either added during the processing of foods, or are packaged as such, and include sugars (free, mono- and disaccharides), sugars from syrups and honey. Sugars from concentrated fruit or vegetable juices that are in excess of what would be expected from the same volume of 100 percent fruit or vegetable juice of the same type.

The definition excludes fruit or vegetable juice concentrated from 100 percent fruit juice that is sold to consumers (e.g. frozen 100 percent fruit juice concentrate). As well as some sugars found in fruit and vegetable juices, jellies, jams, preserves, and fruit spreads[5].

Further more, any added sugars contain zero nutrients, definition from the FDA on added sugar. As a result, this means sugar provides no benefits.

To summarize, moderation of sugar consumption is clearly undefined. My understanding is less is better.

Pop or Soda drinks

One 12-ounce (355 ml) can of regular soda contains 40 grams (g), ten teaspoons of sugar, or 140 calories. Some quick math. If you drink a can every day for one year,  35 pounds (lbs) or 15.9 kilograms (kg) of sugar. As a result, you could gain 15 lbs or 7 kg of fat if you do not work it off and most people do not.

A 20-ounce soda is labeled as two and a half servings, 68 g, 17 teaspoons of sugar, or 250 calories, 91,250 calories a year. Consequently, you could gain 26 lbs or 12 kg. In addition, this size is now the standard. For .99 cents, how could you lose?

In fact,  200 or 300 years ago the average sugar consumption was 4 lbs per year. In the United Kingdom people consumed over 100 lbs of sugar in 1972[6]. The US consumption was 123 lbs.

According to the United States Department of Agriculture (USDA) in 2014 reported the average American consumes 150 to 170 lbs per year. Thus, 120 teaspoons equal 1 lb. Even to this day sugar consumption is still on the rise.

Abundance of Sugar

The problem consequently, with sugar is that it is in almost everything. Pop, juice, energy drinks, milk, bread, pasta, pastries, snacks, chips, chocolate, and candy. Processed foods, packaged foods, yogurt, fruits, and yes in addition, vegetables. As we consume sugar, it is slowly unknowingly destroying our bodies and further more, killing us.

Sugar is also a factor in type 1 diabetes. The temporary cure for type 1 diabetes is insulin. People that are diabetic should consume as little added sugar as possible. Therefore, quitting sugar is the best plan and many people have done it, including myself.

The numbers for moderation from the mentioned organizations are maximums for daily consumptions. If we listen to the WHO and use 5 % that to me is very high. Is OK to drink a soda or juice or energy drink every day for the rest of your life?  In the long term, not a chance, short term tastes good.

Studies have shown sugar is not good

People that are used in these studies have diabetes due to the fact that starting a study for diabetes or anything long term is hard to accomplish. It is easier to find diabetics, work backward ask questions concerning diets and base studies on that. Short-term studies have used rats due to the similarities in organ function to humans.

John Yudkin used rats and fed them with sugar and they developed a decreased glucose tolerance resembling the condition in diabetes. When glucose is given by mouth to a fasted animal, the already high level of glucose increases to a still more abnormal level and does not return to the fasting level within 2 hours[7].

Glucose tolerance was back to normal following the diet change. The cycle repeated when it was switched to the sugar diet[7].

A High Sugar Diet

In human subjects, a high-sugar diet maintained for several weeks showed reduced sugar tolerance. A low sugar diet for several weeks showed improvement. The first effect of the sugar would be to improve the body’s use of the glucose by the process of adaptation[8].

It would do this by producing insulin from the pancreas or by improving the sensitivity of the body tissues to the action of the insulin. Continuing to give a high-sugar diet adaptation would diminish and exhaustion takes place, and the use of glucose would now be less than normal. This experiment was performed twice with the same results[8].

Decreased glucose tolerance found in diabetes is a characteristic along with some other long-standing issues[8]. Another issue includes ‘diabetic retinopathy’ or ‘retinitis’ an abnormality in the retina.  Professor Aharon Cohen showed that sugar produced abnormalities of the eye in the rat[9].

A detailed study by a London Group concluded that the abnormalities from careful biochemical and microscopic examination were identical with those found in diabetic rats. Sugar produces enlargement of the liver and kidneys[9]. As a result, sugar is the main cause of cavities if proper brushing and flossing is not done.

Further more, John Yudkin, god bless this man, was a pioneer and saw the bad in sugar. Regular consumption on a day to day basis for 2 to 3 weeks will show decreased glucose tolerance. In susceptible people increased insulin concentration in the fasting glucose[10]. This means insulin resistance.

Quick Sugar basics

Sucrose is the chemical name for white table sugar and is a common disaccharide. A disaccharide is made up of 2 simple monosaccharides in the form of glucose and fructose bonded together. A fifty-fifty mix of glucose and fructose,  produced after digestion called ‘invert sugar’.

Glucose or blood sugar provides energy for every cell in the body. In addition, we cannot live without it. Fructose after digestion goes straight to the liver and is stored as fat.  Furthermore, fructose does not get converted into glucose through the liver. For this reason, it only takes 2 weeks for the fat to become fatty liver. It is like consuming alcohol.

In other words, fructose is the worst part of sugar. It is also part of table sugar and High Fructose Corn Syrup (HFCS). HFCS is the key sweetener in soda. For a detailed analysis see this study by Sharon S. Elliott et al that describes the effects of fructose[11]. Hence, see The Deadly Effects of Fructose by Jason Fung[12].

Non-Acoholic Fatty Liver Disease​ (NAFLD)

In the last decade, non-alcoholic fatty liver disease (NAFLD), is the leading cause of liver disease in the US. It is closely associated to obesity, diabetes, high blood pressure and cholesterol​. Liver disease has been linked to alcohol and drug abuse. People do not go to a hepatologist (liver doctor) because they are afraid of being labelled “drug abuser”. This is not the case nowadays.

The reason people develop NAFLD is by an unhealthy lifestyle habit and not enough physical exercise. Having NAFLD may not show any symptoms and you may carry on life as normal. The liver will be the last thing on your mind. In reality, a neglected or diseased liver will bring consequences beyond your control.
You may exist for a day or 2 if your liver stopped functioning. Don’t count on it.

A fatty liver contains deposits (bubbles) of fat that can cause inflammation. Next, if the condition is allowed to progress fibrosis, scar tissues form. If the injury persists, further damage to the liver cells and then on to cirrhosis​. Cirrhosis is scarring and hardening of the liver making it unable to function.
Once cirrhosis sets in, there is a “Point of no Return” and you will need a liver transplant[18].

Satiety and Leptin resistance

Two hormones that affect our regulation of appetite are ghrelin and leptin.

Ghrelin is a hunger hormone that stimulates the appetite. It is high before you eat and low after you eat[13][14] [15].

Leptin is a hormone that suppresses (decreases) the hunger after eating. Eating too much sugar causes leptin resistance. Once you develop leptin resistance there will be no signal to tell you that you are full[16].

Ghrelin and leptin are ineffective as the intake of sugar increases and obesity slowly occurs. As you become obese leptin resistance sets in similar to insulin resistance.  Both have similar pathways which the brain is ignoring. Leptin resistance leads to obesity and type 2 diabetes.

Is there a moderation for sugar intake?

According to the Harvard School of Public Health (HSPH) researchers, the study provides empirical evidence that intake of sugary beverages should be limited to reduce the risk of these conditions. A high sugar diet will increase the risk of type 2 diabetes. This finding showed that drinking one to two sugary drinks per day increased the risk of type 2 diabetes by 26%.

Metabolic syndrome up 20% compared with those who consumed less than one sugary drink per month. In fact, drinking one 12-ounce serving per day increased the risk of type 2 diabetes by about 15%[17].

“The association that we observed between soda consumption and risk of diabetes is likely a cause-and-effect relationship because other studies have documented that sugary beverages cause weight gain, and weight gain is closely linked to the development of type 2 diabetes,” said Frank Hu.[17]

Are soft drinks the cause of obesity?

Surprisingly, it depends on who you ask.

“There is no association between sugar consumption and obesity”

Richard Adamson Scientist for National Soft Drink Association BMJ 326, March 2003

“Each additional sugar-sweetened drink increase over a 19-month follow-up increases – Body Mass index (BMI) and obesity odds risk at 60 %.”

Ludwig et al. Lancet  2001  Boston’s children hospital

Can too much sugar cause diabetes?

The answer is yes it can cause type 2 diabetes long term.  Affect type 1 diabetics as sugar intake is increased. As a result, sugar affects the liver and kidneys after 2 to 3 weeks of regular consumption. The proof is in the pudding, no pun intended. Cut down or eliminate sugar from your diet. In the event that type 2 diabetes does not affect you.  There are other medical problems  like Metabolic syndrome, hypertension, heart disease, gout, neuropathy, retinopathy and or an amputation that will.

As a result, you will have high blood sugar which is a slow, painful, uncomfortable, lifelong, journey into old age. In addition, you will become an economic burden to the healthcare system and your family. Consequently, one billion people have diabetes knowingly or not. Therefore, I would not wish diabetes on anyone.

I congratulate you on reading this far, something must have caught your attention.

Conclusion

Note the harmful effects of sugar, stay clear and it will change your life for the better.

Absolute recommended viewing –  Sugar: The Bitter Truth – by Dr. Robert Lustig. Dr. Lustig is a medical doctor, advocate, and scientist in the crusade against sugar as well as myself. The video is very informative and as a result has over seven million views.

Take action by educating yourself because no one is going to help you but you yourself. Further more, double check my research and form your own opinion. I am hoping to push you in the right direction.

I appreciate all feedback, comments, questions and or concerns. Please send me an email.

Many thanks for dropping by and viewing.

References

1. 1. http://www.heart.org/HEARTORG/HealthyLiving/HealthyEating/Nutrition/Added-Sugars_UCM_305858_Article.jsp
   2. http://circ.ahajournals.org/content/circulationaha/120/11/1011.full.pdf
   3. http://www.who.int/mediacentre/news/releases/2015/sugar-guideline/en/
   4. http://www.who.int/nutrition/publications/guidelines/sugars_intake/en/
   5. https://www.fda.gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/LabelingNutrition/ucm385663.htm
   6. John Yudkin, Pure, White and Deadly, Penguin Books, London England, 1986 p 38.
   7. John Yudkin, Pure, White and Deadly, Penguin Books, London England, 1986 p 108.
   8. John Yudkin, Pure, White and Deadly, Penguin Books, London England, 1986 p 109.
   9. John Yudkin, Pure, White and Deadly, Penguin Books, London England, 1986 p 110.
   10. John Yudkin, Pure, White and Deadly, Penguin Books, London England, 1986 p 112.
   11. http://ajcn.nutrition.org/content/76/5/911.full
   12. http://us7.campaign-archive1.com/?u=4f49b1bc5c73173b727fe0ca2&id=d9ca8600a4&e=211670c155
   13. https://www.ncbi.nlm.nih.gov/pubmed/16923214
   14. https://www.ncbi.nlm.nih.gov/pubmed/15850537
   15. https://www.ncbi.nlm.nih.gov/pubmed/14993401
   16. http://advances.nutrition.org/content/3/5/736.full
   17. https://www.hsph.harvard.edu/news/press-releases/sugar-sweetened-beverages-sodas-diabetes-metabolic-syndrome/
   18. Kristin Kirkpatrick: Skinny Liver – A Proven Program to Prevent and Reverse the new Silent Epidemic – Fatty Liver Disease, Da Capo Press, 2017 p 27.

Recommended Reading (See also Recommended Books To Read)

Robert H. Lustig: Fat Chance: Beating the Odds against Sugar, Processed Food, Obesity, and Disease, Hudson Street Press, December 27, 2012.

Gary Taubes: The Case Against Sugar,  Knopf Publishing Group, December 27, 2016.

John Yudkin: Pure, White and Deadly: The new facts about the sugar you eat as a cause of heart disease, diabetes and other killers, Penguin Books, November 24, 1986.

Kristin Kirkpatrick: Skinny Liver – A Proven Program to Prevent and Reverse the new Silent Epidemic – Fatty Liver Disease, Da Capo Press , 2017.

Robert H. Lustig: Sugar Has 56 Names: A Shopper’s Guide, A Penguin Special from Hudson Street Press, 2013.

The post Can Too Much Sugar Cause Diabetes? appeared first on Controls For Diabetes.

What Does Insulin Resistance Mean?

Fewer people smoke, people are living longer, and we have the latest state of the art medical treatment for heart disease, stroke, and cancer. Can you believe people are still unhealthy, and overweight? 80 percent of type 2 diabetics are overweight, and type 2 diabetes is past epidemic proportions. Obesity, insulin resistance and type 2 diabetes are they related?  What does insulin resistance mean?

In 1971

Insulin receptors are discovered on cell membranes. This discovery raises the possibility that missing or defective insulin receptors may prevent glucose from entering the cells. Thus contributing to the insulin resistance of type 2 diabetes. From the history of the American Diabetes Association.

Fast forward to 2017

Even though medicine is so advanced, people do not look like they did before. Do not feel as good, and are suffering from serious medical problems. People have different shapes than before, bigger bellies, and bigger abdomens. They are obese. (Obesity means being at least 20 percent over the ideal body weight for one’s height, build, and sex.). Thin people have potbellies. Obesity is out of control!   The cause is the hormone insulin.

Discovery of insulin

Fredrick Banting, Charles Best, and John Macleod discovered insulin at the University of Toronto in 1921. They first tested on dogs, successfully. Needing more insulin, they used cows. In late 1921 a biochemist Bertram Collip, joined the team, who purified the cows insulin for human use. In January of 1922 they injected Leonard Thompson a young 14 year old, with type 1 diabetes.

The test was a success, otherwise he was near death and would surely have died. Type 1 diabetes before 1922 was a death sentence. He regained his strength and appetite, then went on to live another 13 years.

Later on they tested the insulin on other diabetics with the same success. In 1923 the Nobel Committee awarded Banting and Macleod the Nobel Prize in Physiology or Medicine[1]. Type 1 diabetes was a fatal disease due to diabetic ketoacidosis (DKA), a buildup of acids in the blood. Blood sugar is very high and the cells cannot convert into energy due to a severe lack of  insulin.

Instead fats in the body will be burned for fuel. Burning the fats produces acid called ketones, if there is no insulin this process will go on and build up in the blood. High amounts of ketones will be excreted with glucose in the urine.  Weight loss and the chemical balance of your entire system will collapse. You will become very ill, very quick.

Symptoms include confusion, rapid breathing, abdominal pain, a fruity smell to one’s breath, and or go into a coma. Insulin must be is administered, or death is imminent. Type 1 diabetes is now a chronic disease treated with insulin.

What is Insulin?

Let’s start at the pancreas, a large gland about the size of your hand, located below the stomach behind the abdominal cavity. It is responsible for manufacturing, storing, and releasing the hormone insulin. The pancreas also makes several other hormones, as well as digestive enzymes naturally. We all have to have insulin to survive.

Insulin is a hormone produced by the beta cells of the pancreas. The main function is to regulate the level of glucose in the blood stream. By facilitating the transport of blood glucose into all of the billions of cells in the body.

Insulin stimulates glucose transporters to move to the surface of cells to allow glucose entry into the cells. Like a key unlocking a lock.  Insulin also stimulates centers in the hypothalamus of the brain responsible for hunger and satiety. As we begin to eat insulin secretes before glucose hits the bloodstream.

Insulin also instructs fat cells to convert glucose and fatty acids from the blood into fat. The fat cells then store until needed. Insulin is an anabolic hormone. It is essential for the growth of many tissues and organs. In excess, it can cause excessive growth, for example, of body fat and of cells that line blood vessels.

Finally, insulin helps to regulate, or counter-regulates, the balance of certain other hormones in the body.

Insulin As A Storage

When you eat, processed foods/carbohydrates/proteins the pancreas secretes the hormone insulin. To help move the sugar (glucose) into your cells, where it’s used for energy. Glucose and sugar will be used interchangeably. Excess glucose is either stored in the liver as glycogen where it will be used later as the body needs it, or turns it into fat.

The liver has limited space and has room for a limited amount of glycogen. Any excess glucose is turned into fat by a process called De Novo Lipogenesis (DNL). Which means “to make new fat.”

Insulin tells the excess glucose to be stored as new fat, called triglyceride molecules. The fat is exported out of the liver to be stored in fat cells later supplying the body when needed. Insulin provides the signal to stop burning glucose and fat, resulting in storage.

Glycogenolysis, takes the glucose from glycogen and will send the glucose to parts of the body where energy is needed. So when feeding and insulin is high there is a balance, when fasting and insulin is low, the result is no weight gain. The result is a metabolically healthy system and provides glucose for short term fasting, up to 36 hours.

Gluconeogenesis is the opposite of the glycogen process and will take the stored fat in the liver in times of prolonged fasting and not eating.

Another factor of insulin, when the liver has a full limited supply of glycogen, there will not be room for DNL. These triglyceride molecules are packaged together with specialized proteins, called lipoproteins, which are made in the liver and exported into the bloodstream as Very Low-Density Lipoprotein (VLDL).

Insulin activates the hormone LipoProtein Lipase (LPL), which signals fat cells, called adipocytes. The adipocytes remove the triglycerides from the blood for storage as body fat.

Excess Glucose

On the other hand, if the body cannot burn off the excess glucose, the pancreas secretes even more insulin to overcome this resistance. This forces more glucose into the overflowing cells to keep blood levels normal. The effect is temporary as there is still excess glucose.  As a result, it has moved the excess from the blood to the cells, making more insulin.

Insulin Resistance

Even though insulin is still secreting, the insulin cannot force anymore glucose into the cells. We then say that the body has become insulin resistant, insulin does not know any better. It is a hormone reacting the way it should. The primary problem is that the cells are overflowing with glucose. The insulin resistance cycle continues until it reaches a stage of too much glucose. There are many metabolic problems that may develop along the way.

If you don’t burn off that glucose, then over a long period, it could be years or decades. Cells become filled and cannot handle anymore. The next time you eat sugar, insulin cannot force anymore glucose into the filled cells. It has nowhere to go, so the excess stays in the blood. When there’s too much glucose in the blood, insulin does not appear to be doing its job of moving the sugar into the cells.

The high blood glucose is only part of the issue. Not only is there too much glucose in the blood, there’s too much glucose in all of the cells. Too much glucose leads to prediabetes and then type 2 diabetes. Kids as young as 3 years old are developing type 2 diabetes, so the insulin resistance cycle is now elevated at months rather than years.

Jason Fung says that he can make you fat by prescribing insulin. Excessive insulin causes weight gain and obesity[2].

Excessive Insulin Drives Obesity

Constantly eating and snacking will result in your insulin secretion predominating over your recover period. The myth of eating 6 times a day will not allow you to fast. This means that the insulin dominance leads to fat accumulation. Too much insulin means more new fat via DNL.

Normally, if the feeding periods of high insulin balance the periods of low insulin (fasting), there should be harmony, weight remains stable. High insulin tells the body to store food energy as body fat. Eating and not allowing the body to recover from insulin will never allow you to be thin.

Our hormones, mostly insulin, ultimately set our body weight and level of body fat. Remember, obesity is a hormonal imbalance, not a caloric one. Says Jason Fung taken from his book The Diabetes Code.

It is a known fact that if people are given insulin and or cortisol they will gain weight.  When stopped they lose weight.

Carbohydrate-Insulin Model of Obesity (CIM)

According to Dr. David Ludwig the Carbohydrate-Insulin Model of Obesity (CIM), the following are true and drive weight gain.

1. Processed carbohydrates — think white bread, white rice, potato products, low -fat snacks — raise insulin more than any other food, calorie for calorie. This is just Nutrition, 101.

2. Insulin is the Miracle-Gro for your fat cells. A child with new onset type 1 diabetes — unable to make enough insulin — will invariably lose weight until receiving treatment, no matter how many calories consumed. Give that child the right amount of insulin, and weight trajectory returns to normal. Give that child (or an adult with type 2 diabetes) too much insulin and excessive weight gain will predictably result. This is just Endocrinology 101.

3. When too many of the calories we eat get locked away in fat cells, there aren’t enough calories to supply the needs of the brain and other organs. So we get hungry and “overeat.” And to make matters worse, metabolism slows down, further fueling weight gain. This is just Obesity 101[3].

There is a bit more information that needs to be studied and incomplete according this study[4]. The 3 points are the basis for the CIM but there are other factors that contribute to the model. These factors include medication, drugs, stress, smoking, lack of sleep and much more.

Drug Resistance (Tolerance)

Insulin resistance has the exact same analogy as any other resistance or tolerance.

When cocaine is taken for the first time, there is an overwhelming reaction of the “high.” With each use of the cocaine, this high decreases progressively. The users may increase the dose to achieve the same high. Repeated use and prolonged exposure, will develop resistance to the drug’s effects,  this is a condition called tolerance (resistance). People build up resistance to many types of drugs, including heroin, marijuana, nicotine, caffeine, and alcohol.  Constant use builds resistance.

Removing the drug removes the resistance. Stop drinking alcohol for a long period, say for a year, the first drink afterwards will have its full effect again.

The term insulin resistance has been around since the seventies. Doctors should be able to diagnosis and treat it if they know what to do. The world is experiencing an epidemic of insulin resistance. A third or more of the American population develops it by the time they turn forty.

Kids, teens and young adults have insulin resistance.  The reason is due to the sodas and energy drinks available everywhere. Insulin resistance is now a precursor to type 2 diabetes.

Our Ancestors

People of yesterday had no problems with insulin resistance because they did not eat the processed, refined carbs that we consume today. Diets, workout at the gym and medication are not needed. You need to reduce the amount of insulin your body produces.  If you understand this, it should be a piece of cake, pardon the pun.

Now is a good time to get a bloodwork done and the only person who is in control of that is you. Get it done and out of the way. If you have had it done, you know what your A1c is, and then you can monitor your fasting glucose on a daily basis.

People nowadays eat too much starch, sugar and processed refined carbs; hundreds of times more glucose than our prehistoric ancestors did. Our ancestors did not have diabetes because they did not eat process refined carbs.

Some people are the few lucky ones, the others do not handle high glucose so well. The result is obesity, insulin resistance, and many other metabolic complications.

High levels of insulin in the blood down-regulate the affinity for insulin that insulin receptors all over the body have naturally. This “tolerance” to insulin causes even greater insulin resistance.

Banting Lecture

In his American Diabetes Association Banting lecture in 1988, Gerald Reaven used the term “Syndrome X” to describe the relationship of insulin resistance, hypertension, type 2 diabetes and cardiovascular diseases. Insulin resistance is such a high predictor of age related diseases[5].

Known as Reaven’s Syndrome, Syndrome X, Dysmetabolic Syndrome, Multiple Metabolic Syndrome, Diabesity, Metabolic Syndrome X, Metabolic Mayhem, Cardiometabolic Syndrome, Visceral Obesity Syndrome, Prediabetes, and Insulin Resistance Syndrome. Call it whatever you want they all mean the same thing.

Metabolic Syndrome

Untreated Metabolic Syndrome can increase the risk factors to many chronic illnesses. We now know that eating processed foods (for example sodas, sweets, pastas, and breads) can raise glucose, triglyceride and insulin levels. Also, elevated insulin can promote obesity and high blood pressure. The problems are related and occur in clusters, as a result form a syndrome.

Metabolic Syndrome is a disorder that can affect anyone, young, old, and can remain hidden for years, even decades. The symptoms include fatigue, poor mental concentration, abdominal
(apple-shaped) obesity, inflammation, nerve damage and a craving for sugary carbs.

Metabolic Syndrome is defined as the presence of any three of the following:

1. Low HDL Good Cholestrol HDL-C < 40 mg/dl – 1.03 mmol/L in men, < 50 mg/dl – 1.29 mmol/L in women.
2. High Blood Triglycerides TG > 150 mg/dl – 169 mmol/L
3. Abdominal obesity visceral (Large waist size) BMI > 30 kg/m2
4. Hypertension systolic blood pressure > 130 and or diastolic > 85 mm HG
5. Impaired fasting glucose > 110 mg/dl – 6.11 mmol/L

Measure Insulin Resistance

Insulin resistance can be measured only after a blood workup. The best way to measure insulin resistance is through the HOMA-IR test.

The National Cholestrol Educational Program defines Insulin Resistance as the following:

TG > 150 mg/dl HDL-C < 40 mg/dl
BMI > 25 Glucose > 110 mg/dl

Visceral Obesity

The culprit is a particular kind of body fat. Visceral obesity is a type of obesity in which a special kind of fat is concentrated around the middle of the body. Particularly surrounding the organs for example the liver. Males who are viscerally obese have a waist of greater circumference than the hips.

Females who are viscerally obese will have a waist at least 80 percent as big around as her hips. All obese individuals and especially those with visceral obesity are insulin resistant. The ones who eventually become diabetic are those who cannot make enough extra insulin to keep their blood sugars normal.

Body Mass Index – BMI

Is a measure of a persons weight in relation to his or her height.
Calculate using either of these formulas
BMI = weight in kilograms/height in meters squared or BMI = (weight in pounds x 703)/height in inches squared.

Another method of checking obesity is to measure fat at the belly button. How does it look?
How much can you pinch? Can you pinch an inch?

Type 2 diabetes risk may be incrementally higher in those with a higher BMI.

The US department of health considers a person with an index of :

• 19 to 24.9 Normal
• 25 to 29  Overweight
• 30 to 39 Obese
• 40 + Morbidly Obese

Joseph R Kraft

I stumbled across this fantastic book “The Diabetes Epidemic and You” by Dr. Joseph R Kraft[6].  He was the pioneer of the insulin assay and decoded hyperinsulinemia.  Dr. Kraft measured people for Insulin/Diabetic issues. 14,384 people ranging  from 3 to 91, for 20 years.

Testing was based on an oral glucose tolerance testing (OGTT), glucose is measured in response to drinking glucose. This response identifies how much the body metabolizes and removes glucose from the blood. Important information for diabetes and other metabolic issues.

Dr. Kraft’s tests were different and thorough. First, rather than monitoring glucose for 2 hours, he would monitor for at least 4 and 5 hours. Second, he measured insulin, as well as glucose, over the entire test. Hyperinsulinemia means the same as insulin resistance.

He accurately quantified Type 2 Diabetes in each person.  Surprisingly, the prevalence was far higher than perceived from standard tests.  He measured their Insulin response to a glucose load,  and noticed that there were 5 different patterns of response.

 Kraft Patterns

The first group ‘Pattern 1’ is healthy or ‘Euinsulin’  a small percentage were in this group.  Within the first hour the insulin will peak and it is back to the baseline, normal pattern. The next Pattern 2, shows insulin resistance and would be overlooked if you just looked at glucose dropping off.

Patterns 3 and 4 show different levels of insulin resistance.   Patterns 2 – 4 mean that you are diabetic, his term called ‘Diabetes In-Situ’. Diabetes In-Situ means normal glucose response to abnormal insulin response. My thanks to Ivor Cummins for the diagram.

Pattern V  could be type 1 diabetes, is a beta cell failure in the pancreas and cannot generate insulin. Another possibility is a healthy person on a low carb diet. The diagnosis in this case is left to the experts.

Dr. Kraft through his pathology and observations, summarized that:

1. Diabetes can be detected earlier.
2. Abnormally high insulin levels damage the vascular system, and affect every organ in the body.
3. Hyperinsulinemia is a condition and the causal mechanism behind metabolic and chronic diseases.

Once the medical establishment standardizes the test, it would benefit everyone.

I highly recommend you read his book.

How to Reduce Insulin Resistance

1. Reduce added sugar, eliminate desert, if you have to have desert eat nuts, apples, dark natural chocolate (not milk chocolate).
Do not replace sugar with artificial sweeteners, sugar additives, agave or anything similar. No snacking, surprisingly you will save money.

2. Reduce consumption of refined grains, white flour, refined carbs, pasta, and concentrated grain. Eat carbs in the whole natural state. Processed foods increase blood glucose very quickly along with insulin. Follow the Low Carb High Fat diet this is a natural and healthy way of eating

3. Moderate protein in your diet to 20 to 30 % of total calorie intake. No protein shakes, protein bars, protein supplements and processed anything.

4. Increase consumption of natural fats, for example butter, olive oil, coconut oil, nuts, full fat dairy whipping cream, and avocados.

5. Increase consumption of fiber – nuts, natural whole foods, beans, chia seeds, avocadoes, egg plant, and apples.

6. Timing is everything.  Eat and fast, try to fast for 20 – 24 hours 2 days a week and 14 to 18 hours for 5 days. You will find that fasting burns fats, lowers blood glucose and normalizes insulin.

7. Try to get 7 to 8 hours of sleep everyday, doing so will keep the cortisol levels in check to reduce blood glucose and insulin.

8. Stop consuming alcohol, drugs and smoking in order to reduce insulin secretion.

Finally

Following these points will give you a better chance with insulin resistance. Consult your doctor or health practitioner before making any change(s) to your lifestyle.

Have a look at these videos and then you can answer my questions.

Video by The Fat Emperor  Ivor Cummins – ‘The Pathways of Insulin Resistance: Exposure and Implications‘ .

Video by Dr. Hallberg –  Carbohydrate Intolerance, Insulin Resistance and Reversing Diabetes .

Do you understand the meaning of insulin resistance? What does insulin resistance mean? Should you be checked?

I welcome and appreciate any comments, questions or concerns. Please send me an email.

Many thanks for dropping by and reading this post.

References

1. august-krogh-and-the-nobel-prize-to-banting-and-macleod

2. The Diabetes Code: Prevent and Reverse Type 2 Diabetes Naturally, Jason Fung, Greystone Books, 2018. p47.

3. https://medium.com/@davidludwigmd/genetic-study-supports-carbohydrate-insulin-model-of-obesity-327d84be6d2b

4. https://www.ncbi.nlm.nih.gov/pubmed/28074888

5. https://www.ncbi.nlm.nih.gov/pubmed/11502781

6. Diabetes Epidemic and You, Joseph R Kraft, Trafford Publishing, 2008.

Recommended Reading (See also Recommended Books To Read)

The Diabetes Code: Prevent and Reverse Type 2 Diabetes Naturally, Jason Fung, Greystone Books, 2018.

Diabetes Epidemic and You, Joseph R Kraft, Trafford Publishing, 2008.

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