Medical Experts Once Again Helping People Become Diabetic

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Yet another absurdity in diabetes advice comes from the staff at Harvard Medical School and it illustrates quite nicely why we have become a nation of diabetics.

In an article entitled Sugar’s Role in Diabetes (on a web site with the laughable title Better Medicine), physician author Robert Shmerling argues that elevated blood sugar levels are the result of having diabetes, not the cause.

Improved blood sugar control may reduce the chances that certain complications of the disease will develop. But just because the disease is characterized by an elevated blood sugar level and because lowering the blood sugar level is an important goal of therapy, a high-sugar diet does not cause the illness. An elevated blood sugar level is a result of having diabetes, not the cause.

Dear Dr. Shmerling: I’ve got news for you: Elevated blood sugars are both. They are the result of diabetes and a significant cause.

In his own definition of Type 2 diabetes, Shmerling states:

…the body’s tissues become resistant to insulin, requiring more insulin than the pancreas can produce to keep the blood sugar normal (type 2 diabetes).

What does he claim causes a person’s tissues to become resistant to insulin?

He says that heredity, obesity, and medications are the culprits.

Here’s a CDC graph showing the growth of diabetes in America:

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While I’m sure genetic factors play a role in determining the likelihood and the rate at which one develops Type 2 diabetes, is he really arguing that our population’s genetics have changed so dramatically during this time as to explain this rise in diabetes?

In other words, a rapid and unexplained genetic shift in the modern world’s population, not diet, is causing the incidence of diabetes to skyrocket?

Uh, ok. Sure, doc.

I would have to practice in front of a mirror so that I could say that without bursting into laughter.

And, medications? Please tell me what medications have caused such an alarming increase in diabetes over the past 50 years. The attorney general in every state in America would like the answer to that question, too.

And finally, Shmerling states that obesity causes diabetes. I knew that one would rear its head soon enough. That’s laughable from a man that states:

Assuming an elevated blood sugar level is the cause of diabetes is like assuming that coughing is the cause of pneumonia.

Let me channel Dr. Shmerling:

Assuming that obesity is the cause of diabetes is like assuming that coughing is the cause of pneumonia.

Obesity isn’t the cause of diabetes, it’s simply another result of insulin resistance and elevated glucose levels.

Shmerling seems to have forgotten that elevated insulin levels trap fat in fat cells, preventing weight loss.

In my book, Don’t Die Early, I talk about the effects of insulin on weight retention:

“It may seem unbelievable that having an elevated insulin level could prevent the body from burning fat when we’re hungry, but it’s true. Insulin is amazingly powerful at keeping fat locked into fat cells where it remains inaccessible and cannot be metabolized for energy. How powerful? Obese rats that are given insulin injections to maintain high insulin levels and then put on a starvation diet remained obese while dying of starvation. These starving, yet obese rats digested their own muscles and organs for food until they died from starvation, without losing any of their body fat.

“Yes, even though they were starving, the elevated insulin levels prevented their body from metabolizing fat from their fat cells for energy, forcing their bodies to digest their own organs and muscles for nourishment. Think about this the next time you wonder why people can’t lose their unwanted body fat even though they are not eating much. It’s very likely that the foods that they are eating are causing a large insulin response, which is keeping the fat locked into their fat cells.”

And while we’re on the subject of weight, Shmerling states:

And not all persons with diabetes are overweight — that’s another myth. For these patients, heredity and perhaps other undiscovered factors are more important.

Dr. Shmerling, let me explain the “mystery” of why some diabetics are thin and some are not. (Again, I’m quoting my own book. Sorry to be so self-serving here, but I wrote this book to help enlighten people about the causes of diabetes and other maladies affecting us today. I didn’t think Harvard Medical School staff members were part of my target audience.)

“The most surprising thing about the effect of insulin resistance and trapping fat in fat cells is that despite what I’ve just said about this effect, we cannot determine how insulin-resistant we are by how much extra fat we are carrying.

“While it’s true that an overweight person is almost certainly insulin-resistant, a thin person is no less likely so. Why is this? It’s because fat cells can become insulin resistant at different times in different people. If you’re “lucky” enough to have fat cells that become insulin resistant quickly, before they expand considerably, then you’re a thin, insulin-resistant person, subject to the same damage from elevated glucose and insulin levels as an obese insulin-resistant person.

“Everything I’ve said in this section about fat being trapped in fat cells and about a person becoming hungry every couple of hours and spending the majority of the time with elevated glucose and insulin levels can be just as true for a thin person as for an overweight person. In fact, it’s probably the thin person who is less fortunate when it comes to insulin resistance because the thin, insulin-resistant person’s diabetes will go undetected far longer, due to the false sense of security that being thin brings.”

So back to the original question, what does cause insulin resistance, the definition of Type 2 diabetes?

Why, it’s exposure to increased levels of glucose, of course!

I’ll once again quote from my own book:

“Let’s think about the amount of glucose in a healthy, non-diabetic person. In such a person, the total amount of glucose in the blood-stream during the fasting state is less than a teaspoon (which is less than 4 grams of glucose). An 80-pound, fasting, non-diabetic child has less than one-half teaspoon of glucose.

“What do you think happens when a person eats a meal that dumps ten or a hundred times the fasting amount of sugar into the bloodstream? The body simply cannot allow the blood glucose level to suddenly become 100 times the normal fasting amount. That much glucose in the bloodstream would be acutely harmful, perhaps even fatal, if not metabolized quickly. The body reacts to elevated glucose levels by doing whatever it must do to quickly metabolize the glucose. This means secreting insulin. Lots of insulin! Way more insulin than was ever necessary for a person before the advent of refined white flour, 64-ounce sodas, tortilla chips, and candy bars. 

“Over time and with frequent exposure to high levels of insulin, the cells in the body become increasingly resistant to insulin, requiring more and more insulin to accomplish the same glucose transport functions as before.”

In other words, repeated and significantly elevated glucose levels, the levels caused by our daily diet of grains, 64-oz sodas, chips, and other crap, cause insulin resistance.

What other problems do elevated glucose levels cause?

In a sad, cruel irony, elevated glucose levels damage the very components that are responsible for producing insulin: the beta cells of the pancreas.[1]

That is, elevating one’s glucose levels causes beta cell death, which causes glucose levels to rise, thus hastening beta cell death.

It’s what I call a “shit spiral.”

But in his thoughtful assessment of diabetes, Dr. Schmerling completely ignores the role that elevated glucose levels play in damaging the beta cells of the pancreas.

Oh, I forgot. Sugar doesn’t cause diabetes.

In conclusion, Shmerling states:

…the notion that a high-sugar diet causes diabetes is a medical myth that demonstrates how the effect of an illness may be mistaken for its cause.

And I submit to you, Dr. Shmerling, that by ignoring the role of excessive carbohydrate intake in the development of Type 2 diabetes, you are propagating a horribly damaging falsehood.

The advice from physicians of your ilk are a significant factor in the rise of diabetes and the decline of this nation’s health.


[1] Gleason, CE, et al. Determinants of glucose toxicity and its reversibility in pancreatic islet Beta-cell line, HIT-T15. American Journal of Physiology, Endocrinology, and Metabolism 2000;279: E997–E1002.

This is only one of many studies showing how elevated glucose levels kill pancreatic beta cells, thus hastening the onset of Type 2 diabetes.

Lipids: How Big Their Role?

If you’ve read Don’t Die Early, you know the book explains in great detail the failings of the Lipid Hypothesis, the dangerously inaccurate model that proclaims that having “too much cholesterol” causes heart disease. Don’t Die Early explains that the real factors that combine to form heart disease are glycation (elevated blood sugar), inflammation, oxidation, and damagingly small LDL particles. These four factors are overwhelmingly more relevant to one’s risk of heart disease than simply measuring total cholesterol, or even measuring the quantity of LDL (the wrongly labeled “bad cholesterol”).

Examining these four factors, however, begs the question do they all contribute equally to heart disease? In other words, can one or more of these factors be less of a worry if others are in check?

I’ve posed this question to a number of forward-thinking[1] cardiologists and studied the work of various researchers and the answer is a definite “maybe.” And the “maybe” points at lipids.

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Defining a New Disease Condition: Dr. Bill Wilson and the Carbohydrate Associated Reversible Brain Syndrome (CARB Syndrome)

It should come as no surprise to anyone who has spent time on this blog, or to anyone who had read Don’t Die Early, that I believe most of today’s modern diseases are the product of our unfavorable lifestyle decisions and, in fact, result from the small set of root causes, like poorly controlled glucose levels and rampant inflammation.

It’s also no secret, either, that I think most mainstream clinicians are too inclined to wait for diseases to manifest instead of focusing on prevention. (See my rant on preventive cardiac care for an example of how misguided standard clinical guidelines can be.)

Fortunately for all of us, there are some great physicians out there who see the bigger picture. They think like scientists and look beyond the symptoms to identify root cause instead of just writing a prescription and moving on.

One such physician is Dr. Bill Wilson, founder of the CARB Syndrome Project. The CARB Syndrome is Dr. Wilson’s name for an array of neurological maladies induced by overconsumption of high glycemic foods. As Dr. Wilson points out, the average person’s sugar intake 100 years ago was one pound per year. Today it’s 150 pounds per year. The human body, especially the brain, cannot withstand that glucose assault without being harmed. This harm manifests itself as “depression, ADHD, autism, eating disorders, fibromyalgia, irritable bowel syndrome, PTSD, bipolar II, anxiety disorders and others.” In other words, many of the disease that have become household words today.

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“Obesity Across the Globe” Experts Still Not Getting It Right

Today’s issue of the Dallas Morning News features the headline “Wide world: Obesity is spreading.” According to the article, hunger no longer holds much of the world in its grip, as the obese now outnumber the malnourished worldwide 2 to 1.

While I don’t doubt for a moment that this is true, what I find more alarming is that the so-called “experts” are still singing the same, fatally flawed tune about the cause of the world’s obesity being lack of exercise and the consumption of too much fat.

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A Cry For Help

I received the following email recently, from a woman I’ll call “Sandy”:

“Both my parents died from heart attacks at a young age. I also have high cholesterol. I’m 44. Any advice for me? I would like to see grandchildren some day.”

My first thought upon reading this was, “Wow, Sandy, I certainly feel for you.” There’s hardly a person alive today whose life hasn’t been affected by heart disease. Either facing it directly, or having lost, or is at dire risk of losing, someone dear. Even those fortunate enough not to have lost a loved one to heart disease will hear stories about the friend of a friend who seemed healthy and passed all his checkups, only to suffer a heart attack. No matter who we are, just hearing that heart disease is the #1 killer today can cause us to wonder, “will that be me someday?”

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Is Your Physician Really Practicing Preventive Cardiac Care?

I wrote Don’t Die Early as a guide that anyone, of any age or gender, can use to better sort through the maze of soundbites and misinformation that permeate the airwaves today. By understanding the critical health issues that plague us, we can better chart a course towards optimum health, focusing on what’s timeless and important, not on what happens to be on the news today.

That said, this blog post is geared towards those you who are specifically concerned about preventing, or addressing heart disease. Perhaps you have a strong family history of heart disease and have vowed not to suffer the fate that took Granddad or Uncle Fred. Perhaps a close friend has suffered a heart attack at the gym, mere weeks after passing a stress test with flying colors. Maybe, like so many of us, you’ve simply turned the corner into the second half of your life and want to pay more attention to preventing heart disease. And don’t think that because you’re female that you can tune out the discussion at this point: heart disease kills more women than men in this country. [1]

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Chasing Symptoms Again

This recent news article on reversing diabetes caught my eye and upon seeing the headline I was initially excited to find someone talking about reversing diabetes instead of just treating it (usually with misguided, low-fat diets that are primarily grains, if they’re following common mainstream advice).

According to the article, a 37-year old woman recently diagnosed as a Type 2 diabetic found “an intensive weight-loss program designed for people with weight-related health problems, such as diabetes” and after losing a total of over 100 pounds “she no longer needed meds to stabilize her blood sugar…”

The article quotes the woman as saying “At my last checkup, my doctor told me I basically wasn’t diabetic anymore. I didn’t know that was possible.”
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