Dr. Howe answers several frequently asked questions about Type 2 Diabetes.

What is type 2 diabetes?

Type 2 diabetes, often called non-insulin dependent diabetes, is the most common form of diabetes, affecting 90% - 95% of the 26 million people with diabetes. People with type 2 diabetes produce insulin, but either their pancreas does not produce enough insulin or the body cannot use the insulin adequately.

Typically it is a combination of both factors, which is why most people with diabetes are said to be “insulin resistant.” When there isn’t enough insulin or the insulin is not used as it should be, glucose (sugar) can’t get into the body’s cells. When glucose builds up in the blood instead of going into cells, the body’s cells are not able to function properly.

What should I do to avoid glycation?

Glycation causes the body to age more rapidly – both by consuming foods with high glycation content and or maintaining elevated levels of sugar in the bloodstream. Because glycation levels vary from food to food, it is best to avoid foods prepared in a manner consistent with causing high glycation levels – frying and grilling.

What are the symptoms of diabetes?

If you experience symptoms of severe increased thirst, frequent urination, unexplained weight loss, increased hunger, tingling of your hands or feet – you should request your doctor to test for diabetes. Typically diabetics show disproportional weight distribution, with most of it in the gut, but most type 2 diabetics have no symptoms until their disease is quite advanced.

What if I do nothing?

In the short term, the body will try to reduce blood-sugar levels through more frequent urination (thus the symptoms above). However, when the kidneys lose the glucose through the urine, a large amount of water is also lost, causing dehydration.
When a person with type 2 diabetes becomes severely dehydrated and is not able to drink enough fluids to make up for the fluid losses, they may go into a coma (Hyperosmolar nonketotic diabetic coma), which is life-threatening.
Over time, the high glucose levels in the blood may damage the nerves and small blood vessels of the eyes, kidneys, and heart and predispose a person to atherosclerosis (hardening) of the large arteries that can cause a heart attack, blindness and numerous other ailments.

If my Fasting Glucose level is high, but not diabetic, am I at risk for heart disease?

Yes. The USDA has published research in the 1980’s demonstrating that dietary sugar plays a major role in blood cholesterol levels. A high dietary sugar intake raises blood triglyceride (blood fat) and LDL (“bad”) levels, while lowering HDL (“good”) levels. The study shows that it is the fructose (fruit sugars) component of ordinary white sugar which so powerfully elevates blood cholesterol (white sugars, called sucrose, is a combination of one glucose and one fructose molecule). Fructose (usually appearing as corn syrup) is a regular ingredient of many energy, diet and soft drinks.

What happens when we eat refined carbohydrates?

When we eat, insulin is secreted by the pancreas in response to the presence of carbohydrates in the stomach. The more refined a carbohydrate the more rapidly the glucose enters the blood. If the body does not have to do its job of slowly and steadily breaking down the carbohydrate, glucose rapidly enters the blood stream and quickly the supply of energy is depleted.

So, what are refined carbohydrates?

Refined carbohydrates are created when whole plants, including grains are processed to strip out everything but the quickly digested starch and sugar. This mechanical processing causes the body to break down the foods quickly, generally causing a rapid spike in blood sugar. The over processing of carbohydrates will also remove the fiber and most of the nutritional value of the foods that fuel our bodies.

What are some of the other risks from high sugar and corn syrup consumption?

Most of us are familiar with a process called glycation when we fry or grill food. Typically these foods contain a browning – for example the color of French fries, caramelized onions, meat, donuts and other fried or grilled food. Chemically, glycation is the reaction of sugar with fat and/or protein. This sort of glycation is called Exogenous, meaning outside the body, and is sometimes called dietary or pre-formed glycation.

Exogenous glycations is caused when food is cooked at temperatures over 248°F. The amount of glycation varies from food to food. As much as 30% of glycation can be absorbed by the body. Glycation can also occur within the body as a natural molecular reaction between sugars and fats (lipids) in the blood stream especially when sugars are at an elevated level. These are called Amadori reactions, Schiff base reactions, and Maillard reactions. Such reactions lead to what is called advanced glycation end products (AGEs). Some AGEs are benign, but others are more reactive than the sugars they are derived from, and are implicated in many age-related chronic diseases such as cardiovascular diseases, Alzheimer’s disease, cataracts and cancer – among others. Fructose (corn syrup) is believed to be around ten times more potent in contributing to glycation. Typically the food industry will produce foods with high glycation for purposes of coloring (french fries, donuts are all colored this way as are some soft drinks).

What is the optimal diet?

According to Dr. David DeRose, “The way to describe the optimal diet would be the Cheryl Farley plan. When it comes to the optimal diet, we are talking about turning back the clock as much as we can on insulin resistance. We’re turning back the clock by avoiding saturated fats, avoiding trans-fats, increasing fiber and foods that increase blood fluidity.” Dr. DeRose goes on to say, “Plant foods are loaded with phytochemicals, plant chemicals that have nutritive benefits and decrease inflammation. Inflammation worsens insulin resistance. Plant foods improve blood fluidity and thin the blood.”

What is a fasting plasma glucose test?

Normal fasting blood glucose — or blood sugar — is between 70 and 100 milligrams per deciliter or mg/dL for people who do not have diabetes. The standard diagnosis of diabetes is made when two separate blood tests show that your fasting blood glucose level is greater than or equal to 126 mg/dL.

How can you reverse this process?

The good news is as you change your behavior, eating an optimal diet and living a more active lifestyle, you will start using up the excess of stored fuel bringing the whole system into balance.

How do I recognize refined carbohydrates?

Refined carbohydrates include, but are not limited to foods made with the following:
• Sugars: granulated, brown sugar, high fructose corn syrup
• Grains that have been stripped of the germ or bran, such as white flour, white rice, white pasta, white bread or rolls, sugary cereals
• Starches - corn starch and modified food starch
If it is white, it is probably not good for you.

Is it alright to snack?

We’re designed to have three meals a day so when we do eat we have enough insulin on hand to properly reduce blood/sugar levels. Constant snacking gradually exhausts the pancreas’ ability to produce insulin over time. Diets that encourage snacking, or constantly having our children snack, run the long term risk of exhausting pancreatic functions.