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The Path to Diabetes

November 4, 2010

This insidious disease usually takes a fairly predictable journey. Here is a road map to help you take a detour before you get too far along the route to diabetes.

The modern American diet is grossly tipped toward refined carbohydrates such as sugar and white flour, both of which rank high on the glycemic index. When you eat such junk foods, your body overreacts: So much glucose pours into your bloodstream that your pancreas goes into emergency mode and pumps out excessive insulin.

In your youth, your body was functioning efficiently and you may not noticed any symptoms resulting from this flood of blood sugar and the resultant insulin overload. Later in life the symptoms pile on, often along with pounds. The vast majority of overweight people on a high-carbohydrate diet display an extensive range of symptoms, the by-products of unstable blood-sugar levels.

A significant number of people who are overweight are also insulin resistant. It may be that in most people, insulin resistance precedes hyperinsulinism. Either way, because insulin in not effective in doing its work, the pancreas reacts by pouring forth ever-increasing quantities of insulin. People who are both obese and pre-diabetic often have insulin levels some 20 times higher than the norm. The massive amounts of insulin cause blood sugar to drop to an inappropriately low level. The adrenaline the body releases to correct the blood-sugar level when it has fallen too low also produces many of those symptoms.

Ralph deFronzo, M.D., one of the nation’s leading diabetic specialists, has clarified the confusion that leads to a delayed diagnosis by pointing out that there are five stages of diabetes1. The first three stages precede the actual diagnosis of the illness. That's because conventional medicine does not routinely recommend the GTT with insulin levels, so people at risk are rarely found in the early stages of the disease.

The Five Stages of Diabetes

Stage 1 - insulin resistance (IR) only

Stage 2 - IR, plus hyperinsulinism (HI)

Stage 3 - IR, HI, plus abnormalities in a GTT

Stage 4 - Type II diabetes, with high insulin levels

Stage 5 - Type II diabetes, with low insulin levels

The road to diabetes is a clear. If you take the high-carbohydrate trail you may—after many years of unstable blood sugar and excessive insulin release that you may not even be aware of—finally arrive at that unpleasant destination. Since insulin is the body’s premier fat creator, most of us will have picked up significant extra pounds along the journey.

Then, after you actually become diabetic, your blood-sugar level ceases to oscillate; it is now consistently high. Massive insulin resistance has been preventing insulin from effectively doing its job (stage 4) or your pancreas will have exhausted itself after years of overproduction, and will not be able to make enough insulin (stage 5). Either way, you’ve waited a little too long to make the diabetes go away, but not too long to achieve a useful level of control.

This means that if you have not dealt with pre-diabetes, you now have full-blown diabetes. You’re in trouble. Blood sugar that cannot be transported by insulin into your cells and liver now spills over into your urine, wasting vital energy (stage 4). Once your insulin has been reduced to very low levels (stage 5) you start losing weight inexplicably. Heavy urination leads to constant thirst. Your body burns anything it can find to fuel its daily operations. You now know that something is very wrong.

But if you attend to the early warnings long before you hit this juncture, you can head off diabetes at the pass.

Selected References

1.DeFronzo, R.A., Bonadonna, R.C., Ferrannini, E., et al.,"Pathogenesis of NIDDM: A Balanced Overview," Diabetes Care, 15(3), 1992, pages 318-368.

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