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Conquering Diabetes

with Michael Dansinger, MD

This blog has been retired. We appreciate all the wisdom and support Dr. Dansinger has brought to the WebMD community.


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Friday, June 26, 2009

What Is Diabetes Reversal? (Part I)

When I discuss “diabetes reversal” this is what I’m talking about:

First, I’m talking about Type 2 Diabetes, the kind that is associated with being overweight or obese. Type 1 diabetes, also known as autoimmune diabetes, which usually develops in childhood or early adulthood, is not what I’m talking about. Around 80-90% of diabetes is type 2.

Second, when I talk about “Diabetes Reversal” I’m talking about trying to put the diabetes into REMISSION, meaning that the blood sugar levels are normal without diabetes medication. In other words, the disease is undetectable.

Third, if the diabetes is too far advanced or if you have been on diabetes medication for too long, the diabetes might not be fully reversible, or may quickly relapse.

Fourth, it takes hard work and sacrifice to master the eating and exercise strategies that reverse the diabetes. I can show you the way, but I can’t make you do it. You have to want it badly enough to make it happen.

I suspect that 75-80% of people with type 2 diabetes can potentially reverse their disease to the point of full remission. These remissions can last for years. Perhaps lifelong remissions are possible!

In the coming weeks and months I’ll discuss more about how diabetes reversal works and how to do it. Remember, you know you’ll succeed once you decide you’ll never give up trying.

How Type 2 Diabetes Develops

To really understand diabetes reversal, it is important to first understand how type 2 diabetes develops.

Type 2 diabetes is traditionally considered to be a progressive disease. It works like this. As we all know, we must eat food for energy. Unfortunately, people with diabetes have a problem getting the energy from food into the muscles and organs that depend on that energy to work properly. In all people, with or without diabetes, the food we eat is digested and absorbed into the blood stream, causing the blood sugar level to rise. The cells of our body tissues, especially cells in muscles and organs, are designed to use that sugar for energy, and our cells have a specific way to let that sugar in. The cells of our bodies require INSULIN, a hormone made by the pancreas organ and secreted into the blood stream, to get the sugar from the blood stream through the cell surface membrane, to the inside of the cells where the sugar can be used for energy. In normal healthy people, the insulin hormone attaches to the surface of cells in a manner that is analogous to a key unlocking a door to let the sugar into the cell. In contrast, in people with type 2 diabetes, the cells do not recognize the insulin properly, and the sugar doesn’t get into the cells very efficiently, like a door with a blocked up keyhole. The sugar can’t get into the cells very efficiently, resulting in high blood sugar levels.

Why is the keyhole blocked up? In other words, why don’t the cells recognize the insulin? This is what we call INSULIN RESISTANCE, which results from a combination of unhealthy eating, excess body fat, lack of exercise, and genetic predisposition. For example, being overweight or obese leads to excess fat levels in the blood and in the muscles and organs, that “jams the keyholes” or causes the cell surfaces to recognize insulin less efficiently.

In the face of insulin resistance, the body makes MORE insulin hormone. The pancreas organ makes twice as much insulin as normal, in order to get the sugar from the blood into the cells. Many overweight people live their full lives with high insulin levels and do not develop type 2 diabetes. Others may seem healthy for 10 or 20 or even 50 years with increased insulin levels before developing diabetes. In fact, a person does not develop type 2 diabetes unless the pancreas becomes so overworked, that it cannot continue to do “double duty”, and can no longer make so much extra insulin. Only then does the blood sugar level start to rise abnormally, in which case we recognize this as PREDIABETES. Over time, as the insulin-producing cells of the pancreas continue to wear out, the blood sugar levels rise further and we recognize this as type 2 diabetes. Therefore it is the COMBINATION of insulin resistance PLUS the weakened ability to make excess insulin that leads to type 2 diabetes.

Why does the pancreas, or the insulin-producing cells of the pancreas, weaken in some people faster than in others? Scientists are working hard to learn more about this, but in fact we don’t have a good enough understanding for me to propose a satisfactory answer. The simplistic answer is that some people just have better luck than others. It is common to see individual differences in the way an organ or body part responds to overuse. For example, some people exposed to lots of noise eventually need hearing aids, others never do. Some joggers eventually get bad knees, others do not. Excess alcohol over many years sometimes causes severe liver disease, sometimes it doesn’t. These differences are often genetic, but may also depend on the presence or absence of other environmental factors that we often just don’t recognize.

DIABETES REVERSAL is about reversing the underlying insulin resistance and strengthening the insulin-producing cells of the pancreas, aiming to normalize the blood sugar levels without diabetes medication. In future postings I’ll explain more about this.

— Michael Dansinger, MD

Posted by: Michael Dansinger, MD at 12:22 pm

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