Sugar & Diabetes: What Even Young, Fit People Need To Know

Illustrated by Mary Galloway.t
November is Diabetes Awareness month, and although most people are aware of the disease, for many it’s still a somewhat abstract concern. Diabetes is often chalked up to genetics, deemed inevitable, or dismissed as something only old or extremely overweight people have to worry about — but this is far from the truth. Type 2 Diabetes can affect anyone, at any age, and usually it’s not the result of cruel fate, but our own choices. What you’re eating now plays a direct role in whether you could develop Type 2 Diabetes; we talked to the experts to understand just how this disease takes over and what we can do.

Which type is which?
The two main types of Diabetes are Type 1 and 2. "In a nutshell, Type 1 is an autoimmune condition, while Type 2 is a lifestyle disease," says Francesca Orlando-Baldwin, CGP and Nutritional Therapy Practitioner. The difference is all about insulin, a hormone produced by the pancreas that takes sugar out of the blood and stores it as glucose in the liver, muscles, and fat cells. "Type 1 Diabetes typically affects young people and only represents about 5 to 10% of the population," says Ron Rosedale, MD, author of The Rosedale Diet, and co-founder of the Colorado and Carolina Centers for Metabolic Medicine. With Type 1, the pancreas is unable to produce insulin, whereas "Type 2 is a disease of insulin excess," he says. "There is too much insulin in the body, brought on by too much sugar in the blood."

Eating for illness
When people eat diets high in refined carbohydrates — Butterfingers, bagels, and pretty much anything on the Buddy The Elf Diet — they are essentially filling their blood with sugar, as these foods quickly break down to sugar once inside the body. The body responds by pumping out insulin to get the sugar out of the blood. "When our cells are bombarded with insulin day in and day out, they eventually become desensitized to its presence, or insulin-resistant," says Orlando-Baldwin. Our cells start ignoring the insulin. When this happens, insulin can’t get the sugar into the cells, and our blood sugar remains high. As a result, our body pumps out even more insulin, according to Jamie Busch, MD. A vicious cycle. Eventually the pancreas can wear out, unable to produce enough insulin to overcome the resistance, and blood sugar remains perpetually high.

Illustrated by Mary Galloway.t

What’s so bad about blood sugar?
According to Dr. Busch and Orlando-Baldwin, chronically high blood sugar can cause irreversible and devastating damage to the kidneys, heart, nerves, and eyes, while Dr. Rosedale credits high blood sugar, in part, for nearly all of the "chronic diseases of aging" — cardiovascular disease, obesity, osteoporosis, autoimmune diseases, cancer, and even accelerated aging itself.

Can this happen to anyone?
According to all three experts: Yes. Anyone consuming a diet high in sugar and/or refined carbohydrates is at risk for developing this condition. Additionally, obesity, a sedentary lifestyle, insufficient sleep, and chronic stress can all cause pre-diabetes and subsequent Type 2 diabetes, says Dr. Busch.

What about genetics?
Family history, especially first-degree relatives with diabetes, increases risk, says Dr. Busch, while research shows babies can begin developing insulin resistance before they’re even born, depending on their mother’s pregnancy diet. As Dr. Rosedale puts it, "You are what your grandmother ate." But, Orlando-Baldwin as well as Drs. Busch and Rosedale all agree: Predisposed does not mean doomed. "We now know that we have the power to turn on and off genes," says Dr. Rosedale. Although there are several genes that are linked to a higher diabetes risk, "None of these genes cause Type 2 diabetes on their own," says Dr. Busch. "This is one area where the patient can have tremendous influence on the course and progression of the disease."

How much is too much?
Unfortunately, the amount of sugar your body can handle — and for how long — is different for everyone. There is no magic number, but there are several signs that could mean you’re overdoing it. The primary symptom of Type 2 Diabetes is weight gain, says Dr. Rosedale. This is because the body desperately tries to get sugar out of the blood by storing it in your fat cells. But this is by no means the only indication something could be wrong — there are plenty of people out there who can shovel down the danishes without gaining an ounce. Other symptoms to look out for are increased hunger and thirst, changes in vision, frequent urination, and numbness or tingling in the hands or feet, says Dr. Busch. Fatigue is another common one — since even though you’re eating, insulin can’t get that sugar (or energy) into your cells. Still, the most frightening symptom is the absence of symptoms. Most people with pre-diabetes have no signs at all, say both Dr. Busch and Orlando-Baldwin. But, no symptoms does not mean mean no damage.

Illustrated by Mary Galloway.t

How do I know?
The CDC estimates that a whopping 37% of U.S. adults aged 20 years or older have pre-diabetes — the condition where your blood glucose is higher than normal but not high enough to be diagnosed as diabetes. This is why Dr. Busch advises everyone to get an annual screening. But, rather than looking at glucose, Dr. Rosedale recommends asking your doctor to check for an elevated fasting insulin level. Ideally, he says, it should be under 7 IU/mL — or even better, under 5. "Glucose rises only after the body has exhausted its other ways of keeping it low, like storing it as fat," he explains. "Glucose won't really become appreciably elevated until the disease has been occurring for many years." You could also check your triglyceride level. According to Dr. Rosedale, the lower your triglycerides, the better — but aim for under 100 mg/dL, as triglycerides increase when the liver converts carbohydrates into fat and the body is unable to burn them for energy.

What can I do about it?
All three experts agree the key to preventing this deadly disease is keeping your sugar in check. "If we follow a real food diet, we cannot overdo it in sugar," says Orlando-Baldwin. Dr. Busch agrees, encouraging patients to eat 100% natural, unprocessed foods, focusing on adding more fresh produce, high-quality protein, and healthy fats, while avoiding or reducing pasta, rice, and breads. And, while fruit does come from nature and has fiber, vitamins, and minerals that are lacking in processed carbohydrates, a whole foods diet isn’t a license to go downing bags of dried mangos. Orlando-Baldwin cautions against gorging on foods that contain too much natural sugar — sugar is still sugar, no matter where it’s coming from.

What if I already have it?
According to Dr. Rosedale, unless your pancreas has almost completely failed, it is possible to manage Type 2 Diabetes without medication. Many commonly prescribed medications work by forcing an already overworked pancreas to produce more insulin. "This is like whipping a tired horse to try and make it run faster and longer," he says. "That will just end up killing it." Furthermore, "The problem isn’t really too little insulin, it’s the inability of your cells to respond to the insulin that you have." According to all three experts, the cure lies in addressing the cause: sugar. The sugar intake for people with Type 2 Diabetes should be relative to your pancreas’ ability to produce insulin. "If you can only produce a very small amount of insulin, then you can only eat a very small amount of sugar," says Dr. Rosedale, who recommends a diet very low in carbohydrates, with moderate amounts of protein and the majority of daily calories coming from fat.

Unfortunately, the road to Type 2 Diabetes is paved with delicious treats. But, even though prevention might not taste as sweet, what is pretty sweet is that this potentially deadly disease is neither inevitable nor irreversible. If you treat your body right now, it will pay you back — and not 50 years down the road either. You could actually start feeling better today. How’s that for instant gratification?

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