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There are two kinds of diabetes: Type 1 and Type 2.  Type I Diabetes (aka Diabetes Mellitus Type 1) is an autoimmune disease but Type II Diabetes (aka Diabetes Mellitus Type 2) is more of a lifestyle disease that can be controlled with diet and exercise. Insulin Resistance is the body's inability to properly utilize insulin and the main cause of Type 2 Diabetes.  Pre-Diabetes is a condition where your blood sugar is higher than the normal range but below the diabetic range and requires increasingly greater amounts of insulin for control. Obesity can be a side effect of insulin resistance and, to add insult to injury, obesity adversely affects Type 2 Diabetes because it increases insulin resistance. Not sure if you're insulin resistant?  Your body has a couple of signs of this condition: skin tags and dark skin creases (Acanthosis Nigricans).

People are often considered to be genetically predisposed to Type 2 Diabetes and health professionals want to know if Diabetes runs in your family.  Since a majority of the North American population has Diabetes or Pre-Diabetes, I would argue that Diabetes is normal response to an unhealthy, carbohydrate-rich diet prevalent in developed countries.  I think that people who can tolerate a high carbohydrate diet without developing insulin-resistance are the exception rather than the rule.  Dr Robert Lustig of UCSF suggests that Type 2 Diabetes should be more accurately labeled as Processed Food Disease.

In contrast to conventional medical advice, Both Dr Sarah Hallberg and Dr Jason Fung believe that Type 2 Diabetes is a reversible condition that CAN be cured with a low carb diet and Dr Fung is a proponent of therapeutic fasting.  Unlike caloric reduction, intermittent fasting doesn't reduce the basal metabolic rate.  A ketogenic diet is compatible with low carbohydrate consumption and works well with fasting. Dr Fung says that it isn't easy to regularly fast, presumably because extended periods of hunger can be somewhat uncomfortable, although he says that it is easier to fast while on a ketogenic diet.  Hunger typically comes in waves due to the hormone Ghrelin and peaks during accustomed eating times and will dissipate until the next meal time.

Being Type II diabetic now, I've been reading up on leading a healthy lifestyle and I've learned a few things.  In no particular order:

  • Understanding the role of pancreatic hormones (insulin and glucagon) is crucial in achieving overall health.
  • Exercise has great health benefits but isn't very effective in rapid weight-loss.  It doesn't burn-off nearly enough calories although you're probably not snacking while you're exercising.  It's a lot more effective to avoid ingesting unnecessary calories than it is to metabolize them.  For example, a 300 calorie donut will require about 60 minutes of walking (3.5 mph / 17 minutes/mile) or 30 minutes of running (5 mph / 12 minutes/mile) for a 155 lb person. See Calories burned in 30 minutes for people of three different weights.
  • A healthy diet and lifestyle result in longevity, of which a healthy weight is a characteristic.
  • No-one becomes overweight overnight and the weight you've gained over the years should be shed slowly.
  • Your body is extremely good at energy conservation.  If you lose weight too quickly, your body will reduce its metabolic rate and make weight loss even more difficult.
  • The body's mechanism for reducing the basal metabolic rate in order to conserve energy is the Famine Response.
  • Snacking between meals keeps insulin at a continuously high level and inhibits the body's ability to burn fat.
  • Gut health is extremely important and you need to keep your microbiome healthy and well nourished.
  • A good attitude is important.  It is better to have positive thoughts that you are becoming healthier or more attractive than to to have negative thoughts about having a deadline for losing weight.
  • Muscle is a denser tissue than fat so it is possible to become heavier even though you're becoming leaner, especially if you also engage in weight-training.

References