- THE RESULT IS: no weight loss!
But, of course, weight loss is one of the major aims of the exercise.
And it gets worse:
Consequences of High Insulin Demand
As the pancreas is continulally being called uponn to produce large amounts of insulin, the following sequence of events takes place:
- Body demands for more insulin to reduce excessive blood glucose increase,
- Beta cells in the pancreas up-regulate or increase in size or capacity to meet that demand.
- Continual carb meals and insulin production leads to hypersensitivity.
- This leads to an exaggerated insulin response to even small carbohydrate loads. The flatter curve in the graph on the left demopnstrates that for the same stimulus far more insulin is produced.
- Hyperinsulinaemia (high levels of insulin in the bloodstream) leads to insulin resistance in fat and muscle cells.
- This increases glucose intolerance and insulin resistance.
- The pancreas has to produce even more insulin to be effective
- Until eventually, the pancreas is no longer able to cope and it gives up.
A senior NHS diabetic dietician, who must remain anonymous for obvious reasons, admitted that she had NEVER seen ANYONE with type 2 diabetes able to control blood sugar on the standard high carb diet!
So Bring on the Drugs!
As dietary control fails, drugs are employed to reduce glucose levels.
There are basically four classes of drug used to reduce levels of glucose in the blood:
1. Alpha-glucosidase inhibitors – retard glucose uptake from the intestines (Acarbose)
2. Biguanides – augment muscular uptake of glucose (Metformin)
3. Sulphonylureas – stimulate insulin production by pancreas (Glimepiride)
4. Prandial glucose regulators – stimulate insulin release from pancreas
The first class of drugs slow down the rate at which glucose enters the bloodstream and the second takes it out of the bloodstream for storage in the muscles as glycogen. But the body can only store so much glycogen. So other drugs (3 and 4) are used to increase the amount of insulin in the blood. This increases the removal of glucose but, as it does so by storing the excess glucose as fat, this results in weight gain – the exact opposite of what doctors are trying to achieve.
Polypharmacy May Be Unavoidable
And weight gain is not the only problem. Because of the increased risk that diabetics have of complications, polypharmacy, (the use of many drugs together) is a real concern. A paper published in the British Medical Journal pointed out that: (2)
Given the cardiovascular risk profile of type 2 diabetes, up to 10% of patients could require:
- “A high proportion will also require treatment for coexistent cardiovascular disease and coincidental unrelated chronic disease.”
“It is difficult to see how we can realistically expect patients to comply for long with such a draconian regimen requiring so many separate drugs.”
Polypharmacy is only part of the deterioration in quality of life a diabetic on conventional treatment can expect.
As conventional low-fat diets and drugs fail and glycaemic control deteriorates, eventually insulin is prescribed. Over time, therefore, some non-insulin dependent diabetics end up requiring insulin injections. So they are now insulin dependent, non-insulin dependent, diabetics! This elevates insulin levels in the blood even further – it’s a condition called hyperinsulinaemia. And it is not a healthy progression as it increases the risk of even more serious disease.
And remember that hyperinsulinaemia is also a risk factor for diabetes!!
The complications of Insulin
Firstly, insulin puts on weight. Its purpose is to take energy out of the bloodstream and store it as fat – the very thing that conventional treatment is aimed at stopping. For this reason:
- Diabetics who have to inject insulin find it almost impossible to lose weight.
But weight gain is not the only complication of insulin use, as insulin:
- Fasting and postprandial insulin levels have significant positive associations with systolic and diastolic BP (4)
Hyperinsulinaemia (high blood insulin level) is also known to be involved in:
- and Osteoporosis (5)
Insulin increases heart disease risk
The most important complication of diabetes is the large increase in risk of a heart attack.
A recent study of subjects in Framingham, Massachusetts demonstrated that a blood clot is much more likely to occur if insulin levels are increased. This effect was present in individuals who did not have diabetes, but was more profound in individuals who did have diabetes. (6)
Blood clots (thromboses) are a recognised cause of heart attacks, strokes, blockages in other arteries and deep vein thrombosis.
Insulin increases cancer risk
Breast cancer patients with high levels of insulin in their blood seem to be more likely to die of their disease. Researchers found that insulin may predict whether a woman’s breast cancer recurs after therapy and whether she will die.
In a study of 535 breast cancer patients followed for up to 10 years, those with the highest insulin levels were more than eight times more likely to die and were almost four times as likely to have their cancer recur at a distant site. (7)
Although many of the women in the study were obese, and obesity is known to affect both breast cancer prognosis and insulin levels, obesity alone did not completely explain the link between insulin and poorer cancer survival. Insulin normally helps promote cell growth. Researchers hypothesize that in the breast, insulin can spur the growth of both normal and cancerous cells.
The insulin/cancer risk found confirmation in another study conducted at the Samuel Lunenfeld Research Institute, Mount Sinai Hospital. This study demonstrated that patients with the highest levels of insulin in their blood were twice as likely to have their cancer spread and more than three times as likely to die of the cancer compared to patients with low levels of insulin in their blood. (8)
Recap on Conventional Approach
Major aims are:
- Weight gain is the norm and cardiac risks are increased.
Thus conventional treatment for diabetes, using a diet based on breads, pasta and fruit is likely to do the exact opposite of what is aimed for – and make the condition worse. Why that happens is explained in detail in Part 4: Why carbs are the wrong foods for diabetics
1. Jung RT. Obesity as a disease. Br Med Bull 1997; 53: 307-21.
2. Winocour PH. Effective diabetes care: a need for realistic targets. BMJ 2002;324:1577-1580
3. DeFronzo RA, Eleuterio F. Insulin resistance: a multifaceted syndrome responsible for NIDDM, obesity, hypertension, dyslipidemia, and atherosclerotic cardiovascular disease. Diabetes Care 1991; 14: 173-91. and Meigs JB, Mieeleman MA, Nathan DM, et al. Hyperinsulinemia, hyperglyceima, and impaired hemostasis. The Framingham offspring study. JAMA 2000;283:221-229.
4. DeFronzo RA, Eleuterio F. Insulin resistance: a multifaceted syndrome responsible for NIDDM, obesity, hypertension, dyslipidemia, and atherosclerotic cardiovascular disease. Diabetes Care 1991; 14: 173-91.
5. Bachman JM The low-carbohydrate diet in primary care ob/gyn. Prim Care Update Ob/Gyn. 2001; 8: 12-17
6. Meigs JB, Mieeleman MA, Nathan DM, et al. Hyperinsulinemia, hyperglyceima, and impaired hemostasis. The Framingham offspring study. JAMA 2000; 283: 221-229.
7. Annual meeting of American Society of Clinical Oncology, New Orleans, 23 May 2000
8. Goodwin PJ, Ennis M, Pritchard KI, Trudeau ME, et al. Fasting insulin and outcome in early-stage breast cancer: results of a prospective cohort study. J Clin Oncol 2002; 20: 42-51
Part 1: The scale of the problem
Part 2: What is diabetes — Are you at risk?
Part 3: Conventional treatment for Type-2 diabetes – and why it fails
Part 4: Why carbs are the wrong foods for diabetics
Part 5: The evidence
Part 6: The correct diet for a Type-2 diabetic, (or treatment without drugs)
Part 7: Treatment for Type-1 diabetes
Suitable foods for diabetics