Predictions for the number of Americans who are being diagnosed with Type 2 Diabetes are WAY OFF.
In 2001, the American Diabetes Association published the Projection of Diabetes Burden Through 2050, which estimated that 11 million adults in the U.S. had diabetes at the time. That was predicted to reach 29 million in 2050.
In 2015, the Centers for Disease Control published their findings that nearly 30 million adult Americans had diabetes. We have surpassed the prediction only 15 years into the 50 year mark!
The CDC began collecting prevalence rates for diabetes in 1958, recording only 1.58 million Americans with diabetes that first year. Compare that to the 100 million Americans with prediabetes or diabetes in the US in 2017.
Today, more than HALF ADULT AMERICANS have Type 2 Diabetes or prediabetes. 😲
How Did This Happen?
By and large, most (over 90%) of the new diagnoses of diabetes are Type 2. There are many factors that play a role in the explanation for this, but I like to keep things simple so that the solution becomes clear.
Type 2 Diabetes is a mismatch disease. As explained in detail in The Story of the Human Body, by Daniel E. Lieberman, our bodies have evolved over the last 2 million years to survive and thrive in our earthly habitat. Whether or not you believe in evolution, it’s easy to see that our bodies adapt to our environment. Simply take a look at all the different climates and diets that exist on Earth today.
Natural selection favors genes that allow us to survive and reproduce. This process mostly occurred in an environment that does not at all resemble how most humans live, especially in countries like the United States.
Let’s just take our morning commute to work for example. We emerge from our climate controlled homes and get into our climate controlled cars. If we have a garage, we never even breath the outdoor air or feel the sun on our skin. We can control the temperature to the degree in our vehicle and warm our bums on heated seats if we want. This time of year, we can hit the nearest Starbucks on our way to work and pick up a Venti Pumpkin Spice Latte that has 64 grams of sugar in it. We can cover 10 miles in just 10 minutes without breaking a sweat or wrinkling our slacks.
Did we EVOLVE to SURVIVE in this kind of environment? Not exactly.
I’m a fan of modern comforts as much as anyone, but I can recognize how poorly suited our bodies are for:
- Physical inactivity
- Diets rich in sugar and flour–modern foods that were nonexistent for most of humankind
- Eating patterns that span most of the day and even into the night
Our bodies are not designed to match our modern environment and it is literally KILLING us.
Our brains are directing us to seek pleasure, avoid pain/discomfort, and conserve energy, and this is literally KILLING us.
We have to go AGAINST our evolution to prevent or reverse chronic diseases that result from this mismatch. 🤯
Our Medical System Should Lead The Way, But Are They?
Type 2 Diabetes is a fully reversible disease.
So why is it that most Americans who have Type 2 Diabetes have never heard this from their doctor? The reason is because the medical establishment declares Type 2 Diabetes as a chronic progressive disease that has no cure.
Medical professionals are taught and then go on to teach others that Type 2 Diabetes cannot be reversed or cured. And as a culture, we accept this as the truth. We submit to taking medications and fighting our blood sugars for the rest of our lives, understanding that we are likely to die from the disease.
In 2015, diabetes was the 7th leading cause of death in the United States.
Interestingly, we have observed for many years now that bariatric surgery (e.g., gastric bypass and gastric sleeve) can normalize blood sugars within weeks even before significant weight loss is realized.
The American Diabetes Association now recommends “metabolic surgery” as an option for obese diabetics with uncontrolled blood sugars.
Bariatric surgery is essentially a medically induced dietary change that results in intermittent fasting and severe caloric restriction. Both of these methods without the surgery have been shown in clinical research to yield similar effects, as well as low-carbohydrate diets.
Here are 2 recently published scientific papers on this topic:
Understanding the Mechanisms of Reversal of Type 2 Diabetes. Lancet. 2019.
Reversing Type 2 Diabetes: A Narrative Review of the Evidence. Nutrients. 2019.
Yet, the American Diabetes Association continues to make vague and general recommendations about how a person with Type 2 Diabetes should eat. Every year, the ADA publishes their Standards of Medical Care in Diabetes, and of the nearly 200 pages of this document, only 5 pages specifically address dietary management of Type 2 Diabetes. Considering that this is the ROOT CAUSE of Type 2 Diabetes, I would think more attention would be paid here.
Is the Hemoglobin A1c the End All Be All?
When you go to the doctor’s office for your diabetic checkup, everyone holds their breath for the results of your HbA1c test. In the United States, we generally shoot for <7%. This measurement has become so paramount to the management of diabetes, that insurers are requiring medical providers to report how successful they are in controlling the HbA1c as a contingency of reimbursement.
We are obsessed with the A1c.
It is rooted in the landmark Diabetes Control and Complications Trial (DCCT). Published in 1993, this large randomized controlled trial unequivocally showed that controlling blood sugars in Type 1 Diabetes had enormous benefits. Type 1 Diabetes is the type where people do not make their own insulin and are dependent on insulin injections.
The DCCT found a 76% decrease in eye disease, a 50% decrease in kidney disease, and a 60% decrease in nerve damage. Seventeen years later, the EDIC study was published. Over 90% of the original DCCT patients were found to have an impressive 42% decrease in cardiovascular disease with intensive insulin treatment.
Because controlling blood sugars had such dramatic benefits in Type 1 Diabetes, we have been chasing the idea that this same strategy works for Type 2 Diabetes. But over the last several decades of research in people with Type 2, we haven’t seen the same results.
There are actually 2 very large studies called the United Kingdom Prospective Diabetes Study and the ACCORD study that looked at this question. The UKPDS showed only a mild improvement for any diabetes-related complication(4.1% absolute risk reduction) over 10 years of well-controlled blood sugars using insulin or insulin-enhancing therapies.
Results from the ACCORD study were completely the opposite of what was expected. This study showed that when you shoot for even tighter blood sugar control (A1c <6.0% compared with 7-7.9%), people died a lot faster. Over a mean follow up period of 3.5 years, the risk of death for this group increased by 22%! You would think that tighter control would be better, but clearly it was worse.
So the bottom line here is that we can’t say that controlling your blood sugars to recommended levels will eliminate or even significantly reduce the possibility of complications from Type 2 Diabetes.
So, the next question that begs to be asked is: Why don’t we address the CAUSE of Type 2 Diabetes instead of just focusing on controlling blood sugars? If you interrupt or reverse the disease process, it is only logical that the long term consequences might be avoided, right?
A Different Approach
Imagine we are in the hull of a sinking boat. Water is leaking into the boat and filling the bottom of the boat. It’s only a matter of time before we are underwater and nothing can save us. Maybe someone has found a way to bail water out of an opening to buy us some time, but we aren’t keeping up with the rate water is flooding the boat.
Now imagine there is actually a door that we can escape through, but no one is aware of it. Wouldn’t it be ideal to just climb out of the hold through that door? What I want to point to is the DOOR OUT. The door is the escape, the solution to the problem.
What medicine is doing is focusing on bailing water. Medications are much like bandaids. I have written a whole blog post on this topic because it is important for people who prescribe and who take diabetes medications to see their limitations.
In order for us to change the culture around treating Type 2 Diabetes, we are going to have to:
- Educate both medical providers and patients about what has gone wrong in the body that leads to Type 2 Diabetes. As a medical professional, I see how poorly informed I was about this disease until I searched for and found the information myself. Once we see clearly exactly how this disease develops, the solution is obvious.
- We need to recognize and identify Type 2 Diabetes as a reversible condition. We need to stop talking about it as a lifelong disease that inevitably gets worse over time.
- We need to offer reversal through dietary strategies as a treatment option to people who receive the diagnosis of Type 2 Diabetes.
- We need to support diabetics through behavioral change, which can be the most challenging part.
This is exactly what I do in my program, Reverse Type 2 Diabetes. I show people that their bodies and their brains are functioning exactly like they were designed to. Then, I teach them how to overcome their evolution to free themselves of disease.
I teach them powerful methods and tools that produce rapid weight loss and normalization of blood sugars. Together, we design an eating plan (or protocol) that they want to implement.
As they use their protocol, we uncover the thinking that causes them to go off their plan. This is where my skills as a life coach come in. I show them when their thoughts are in the way of them taking the action they really want to take. Because our thoughts drive all our actions and create our results in our lives, awareness of our thinking is critical to behavior change.
Finally, as blood sugars normalize, there is usually less need for medication. As a skilled pharmacist managing medications in a primary care clinic, I have the knowledge and experience to identify when medication adjustments are needed. I then alert my clients, allowing them to contact their doctor before they become overmedicated.
This is an empowering option that all people with Type 2 Diabetes should have.
If this is something you want to explore, it’s easy to get in touch. Just fill out this form below, and I will get back to you to set up a time where we can chat.