The Early, Easy Message
Statistics show that about 85% of diabetics are overweight or obese. But that leaves 15% who are not. Why would that be and what should they do?
Everyone’s situation is a little different. Maybe you could use some help identifying your personal differences and how to address them. My own personal story may be helpful.
My Story
I am not diabetic but have been hanging around in the pre-diabetic range for a long time.
Diabetes ran amok in my Dad’s side of the family – dad, his father, and four of his six siblings. All but one were slender. My two sisters are/were diabetic. I call this “amok.”
While I was doing research for my book in 2011, I figured there was no way I could miss diabetes when so many in my family had it. My fasting blood sugar on a normal blood test was good but surely this needed to be look into. So I saw my doctor in January of 2013. She scheduled a glucose tolerance test.
My glucose tolerance test after an overnight fast (drink 75 grams of glucose and then measure blood glucose levels at 30 minute intervals) showed 247 glucose at one hour . Anything above 200 suggests diabetes. It took 3 hours for my glucose to drop to 67. But here is the deal. My A1c (the average amount of glucose stuck to my red blood cells) was only 5.7 (early stages of prediabetes). A quandary.
Insulin was not measured in the test which is pretty normal. We don’t know how much insulin was there but it doesn’t take a rocket scientist to see there was not enough insulin to restore normal blood sugar. I did not know as much about insulin then as I do now but I did know I needed it.
Just for clarity, insulin arrives in phases. Phase 1 is (supposed to be) a big dose. If that dose isn’t enough to restore normal blood sugar, then a series of small phase 2 releases follow.
I bought a glucose meter and test strips, counted carbs, and tested, tested, and tested until I could pretty much say without a shadow of a doubt, anything containing starch and sugar would cause that blood glucose surge. Even though they don’t taste sweet, starches are largely glucose all on their own.
Things tasting sweet were never my particular interest but I was always into starch, particularly bread, pasta, chips of sundry sorts and kinds, breaded meat (fried chicken and fish), fried potatoes, etc.
In 2017 and again in 2019 my doctor agreed to test my fasting insulin. I offered to pay for it since Medicare wouldn’t. In both cases my insulin was on the low side of normal. The perfect test, proving all points, would have been testing insulin in concert with the glucose tolerance test. But that is a expensive 3 hour test that I haven’t been willing to pay for.
The really big deal I usually make about high insulin and insulin resistance doesn’t apply to me. I don’t seem to have enough insulin. This conclusion lead the way into genetics research.
I got a full genome test through 23andMe and loaded it into a program called Promethease in 2017. That program allowed me to see variations in my genes that might be problematic, health wise. I learned about a lot more than diabetes and insulin.
Then I began looking and keep looking for gene research about diabetes and insulin. It was initially a slow slog. Now I find more and more every day. When I find something, I check it against my genome. Low and behold, so far I have at least 4 major gene variations (called polymorphisms or SNPs) that reduce phase 1 and sometimes phase 2 insulin release.
There are other clues that I have an insulin shortfall as opposed to insulin resistance. If I were insulin resistant I would see it in my lipid blood test. My triglycerides (fat in the blood) would be high and my HDL cholesterol would be low. This is exactly the opposite of mine.
If I had ongoing high levels of insulin, a cause of insulin resistance, I would have significant extra body fat. Insulin is in the storing and stopping business. One of its main jobs is to store excess energy in body fat and keep it there until there is an energy shortfall. Based on current obesity levels, energy shortfalls are rare these days. I have never been close to overweight.
By the way, if diabetes starts out with insulin resistance associated with extra body fat, the extreme demand for insulin will eventually cause your pancreatic beta cells to start giving up the ghost. First too much insulin and then not enough.
The Statistics
About 36% of adult Americans are obese. Almost 50% of Americans are prediabetic or diabetic. 85% of the diabetics are overweight/obese; 15% are not.
The 85% of diabetics get an early, easy message. They gain weight steadily over the years, achieving significant overweight/obesity. Eventually they can have fat storage in/around the liver, pancreas, etc. where it does not belong, along with high triglycerides/low HDL.cholesterol, a combination reflecting the insulin resistance that caused the weight gain in the first place.
The 15% won’t have gained significant, visible weight but will still have all the other potential negatives true of the 85%. Problem is, they don’t get the early, easy message so they have to be very attentive to the other danger signals like high triglycerides and low HDL or a family history of diabetes.
The rest of Americans should be recognizing the early, easy message but may not – steady weight gain has the potential to push them into the pre-diabetic/diabetic range.
The Central Issue
So, as always, we come to the central issue. What causes people to gain weight steadily over time? It is food. Which food? Those foods that are high in calories with fast acting glucose.
You, just like me when I tested and tested, will find that certain carbohydrates (starch and sugar) will drive higher blood sugar. You need plenty of insulin to store that sugar into body fat. If you happen to be short of insulin, like me, that storage may not happen but blood sugar can still be high.
What’s Your Situation?
Those who have always eaten in moderation (including starch and sugar) are in a good place, not among the obese or pre-diabetic/diabetic. Steady as you go.
Those who have gotten the early, easy message will want to reduce their body fat and avoid further gaining. I include here those who have steadily gained weight over time, those in the earliest stages of prediabetes/diabetes, and/or those where diabetes runs in their family (regardless of weight).
Weight can only be lost by reducing calories and the foods highest in calories just happen to be the ones driving high blood sugar – starches and sugar. This means minimize processed food containing starch (particularly flour) and sugar, either or both. That level of calorie reduction should be enough to start reducing waist and clothing size. If it’s not, minimize more and then stick to it – forever. This is not a quicky diet, it’s a way of eating for life.
For those who got the early, easy message but ignored it and are now heavily diabetic along with a lot of other chronic conditions, moderation and minimization probably aren’t going to work.
You may well have transitioned from high insulin to low insulin, and are now taking insulin medically. Minimize now becomes avoid processed foods containing starches and sugar. Your metabolism is very messed up and I suggest you start testing foods after eating to see what else you need to avoid. Weird stuff can happen in a heavily diabetic body.
Get the early, easy message and act accordingly.
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Pat Smith is the author of “It’s All about the Food,” a book available on Amazon and Bob’s Food City (Mt. Ida) that guides nutritious food choices as the way to avoid illness and maintain a healthy weight. Profits from her book benefit the Montgomery County Food Pantry. Her website is http://www.allaboutthefood.org/ She can be contacted at patsmith2@live.com, 501-605-3902. Her Facebook page is www.facebook.com/patsmithbooks.