By Dr. Mercola
Diabetes has reached epidemic proportions around the world,1 with China emerging as the “epicenter” of rising prevalence.
Last year, data2 from the US Centers for Disease Control and Prevention (CDC) showed that more than one-third of all Americans3 are prediabetic, yet nine out of 10 of them don’t know they have it.
At that time, more than 29 million Americans were diagnosed with full-blown type 2 diabetes4 — a statistic researchers predicted in 2001 wouldn’t be reached until 2050!5 All told, one-third of Americans (115 million) were either prediabetic or diabetic.
Now, research6,7,8,9,10 published in the Journal of the American Medical Association on September 8, 2015, suggests nearly HALF of all American adults had either diabetes or prediabetes in 2011 to 2012.
The situation is similarly dire in the UK, where diabetes rates have soared 60 percent in the last decade, rising from 2.1 million in 2005 to 3.3 million in 2015 — a rise that threatens to bankrupt the British National Health Service (NHS).11
Reported Diabetes Prevalence and the Fight to Expand Medicaid
According to the latest statistics, about 38 percent of US adults have prediabetes which, if left unaddressed, sets you squarely on the path of not just type 2 diabetes but many other chronic diseases as well, including heart disease.
Another 12 to 14 percent have type 2 diabetes, which is associated with a number of health complications, including nerve damage (neuropathy), soft tissue infections, poor wound healing, and limb amputations.
In the UK, diabetes is responsible for 135 foot amputations each week.12 Diabetic women under the age of 45 also have a six-fold greater risk for heart attack, recent research shows.13
Meanwhile, high blood pressure carried a four-fold increased risk for heart attack, and smoking raised it by 1.6 times. Consider that for a moment... diabetes turns out to be a FAR more potent risk factor for heart attack than smoking!
However, it’s interesting to note that the sudden jump from one-third to one-half of Americans being either prediabetic or diabetic appears to be due to a manipulation of the numbers to show more people having diabetes...
The authors even admit they "may" have counted people as having diabetes who really don't, and they don't how many of those numbers they've miscounted. Why would they do that, you ask?
It could be related to hitting 2020 “Healthy People” goals by forcing states to expand Medicaid eligibility under the Affordable Care Act.
At present, about half of all US states have refused to do so, citing costs, and this study could be used as fodder to either impel them to expand coverage, or convince Congress to rewrite the law in such a way that the states will be forced to fall in line.
Estimates and Misclassification May Account for Some of the Reported Increases
The new study citing half of people in the US having either prediabetes or diabetes includes minority groups for which prevalence is being "estimated" for the first time ever.14 They also explain that in this study, "some participants without diabetes may have been misclassified as having diabetes."
The reason for this misclassification, they admit, is due to not following the American Diabetes Association’s protocol for diagnosing diabetes for the purposes of this study.
William Herman, who wrote an editorial15 to the featured study, also authored a March 2015 article16 criticizing states that haven't opened the doors to increased Medicaid.
In that article, he notes that “in states that expanded Medicaid, more people were diagnosed with diabetes at an earlier stage of the disease,” and clearly, early diagnosis is important. Insulin resistance and prediabetes are easily reversible with the appropriate lifestyle changes.
Even type 2 diabetes is typically 100 percent reversible through diet, intermittent fasting, and exercise, but may require you to be far stricter than had you started at the first signs of insulin resistance.
Medicaid Expansion Led to Significant Increase in Diabetes Diagnosis, but Not Improved Health...
However, while expanded Medicaid coverage may lead to more people getting tested for diabetes, the jury is out on whether having insurance will actually improve health. This isn’t surprising, considering that conventional medicine doesn’t address the root causes of diabetes.
The Oregon Study, 17 published in 2013, looked at the effect of Medicaid on clinical outcomes versus having no insurance. The study found there was "a statistically significant increase in the diagnosis of diabetes and the use of diabetes medications” with the expansion of Medicaid.
The New York Times18 did a story on this in March, explaining that with Medicaid expansion, "the number of Medicaid enrollees with newly identified diabetes rose by 23 percent ... [compared to] 0.4 percent in states that did not expand Medicaid."
However, despite the increased diagnosis of diabetes and use of drugs, the health of these patients did NOT improve, and no change in mortality was observed, which effectively put the brakes on Obamacare’s expansion of Medicaid.19,20
So, the latest study suggesting diabetes and prediabetes is now at 50 percent among Americans may simply be a way to strong-arm states that haven’t expanded Medicaid to do so, immediately, through public pressure and dedicated advocacy.
In my view, the fact that patients’ health did not improve despite diagnosis and treatment simply proves that conventional approaches to diabetes are seriously misguided.
As a colleague of mine, Dr. Ron Rosedale, used to say: doctors cause diabetics to D.I.E. from their flawed prescriptions, which stem from a basic lack of insight into the root cause of this disease. D.I.E., here, is a clever acronym for "Doctor Induced Exacerbation," which does indeed include early death.
Have You Checked Yourself for Diabetes?
Be that as it may, it’s quite clear that diabetes and insulin resistance is on the rise, and there’s no doubt that it takes an enormous toll on people’s health (the Oregon study actually confirms both of these statements), sending health care costs skyward over the long term. In 2012, diabetes in the US came with a price tag of $245 billion21 after health care costs and lost productivity were calculated.
Part of the answer is diagnosis. If you have no idea that you’re in the danger zone, you’re far less likely to consider doing what it takes to correct it, and you’re more likely to suffer complications as the disease progresses.
Unfortunately, while diagnosis rates have improved, it’s estimated that more than one-third of American type 2 diabetics are still undiagnosed.22 Among Hispanics and Asians that rate may be even higher, with perhaps more than half of cases going undetected.23,24 Anyone can get type 2 diabetes and, except for gestational diabetes, it’s a gradual process that evolves over a long period of time as it moves from a state of “impaired glucose tolerance” to full-blown diabetes.
If you are insulin-resistant, it means that glucose (sugar) is building up in your blood and causing damage, because your body is not using its insulin effectively. This in turn starves your fat, muscle, and liver cells, which causes your body to signal the pancreas to make more insulin in an attempt to make up for what those cells aren’t getting. It quickly becomes a vicious cycle that can lead to prediabetes and, ultimately, diabetes.
Prediabetes is a term used to describe a state of progressing insulin resistance, in which your blood glucose levels are higher than normal but not quite high enough to actually be called diabetes. You may be diagnosed with prediabetes if your fasting glucose numbers are between 100 and 125. Having prediabetes is a strong risk factor that you will get type 2 diabetes in the future. Risk factors25 that can trigger prediabetes and eventually contribute to your becoming diabetic include the following:
|Age 45 or older
||Overweight or obese |
|Family history of diabetes
|History of gestational diabetes
||Atherosclerotic cardiovascular disease|
|HDL-C levels under 35mg/dL
||Fasting triglycerides over 250 mg/dL|
|Treatment with atypical antipsychotics, glucocorticoids
||Obstructive sleep apnea and chronic sleep deprivation|
|Certain health conditions associated with insulin resistance
||Member of high-risk population (African American, Hispanic/Latino, Native, or Asian American)|
Various Methods of Diabetes Testing
While a fasting glucose tolerance test used to be the standard test to determine whether you had diabetes in years past, today there are a number of newer tests26 available, including the following:
- A1C – Sometimes called the hemoglobin A1 c. For this test, there’s no need to fast. An international team on diabetes recommended the A1C in 2009 for diagnosing type 2 diabetes as well as prediabetes. The test measures protein in red blood cells and is reported as a percentage. The higher the percentage, the higher your blood glucose levels have been. A normal A1C level is below 5.7 percent. If you have A1C numbers of 6.5 or higher, you have diabetes. Prediabetes is the diagnosis if your A1C is between 5.7 and 6.4.
- Fasting Plasma Glucose (FPG) – You must be fasting to take this test, meaning that other than water, you haven’t had anything to eat or drink for at least eight hours. Glucose levels are measured from blood samples and diabetes is diagnosed when your level is greater than or equal to 126 mg/dL. You have prediabetes if the levels are 101 to 125. Normal is 70 to 100.
- Oral Glucose Tolerance Test or OGTT – With this test you’re given a special sweet drink. Your blood glucose levels are measured just before you drink it, and two hours after. You’re diagnosed with diabetes if your blood glucose is equal to or greater than 200 after two hours. You have prediabetes if your numbers are 140 to 199.
- Random or Casual Plasma Glucose Test – This is a blood check that your doctor may do if you have immediate, severe diabetes symptoms. Diabetes is diagnosed if your blood glucose is equal to or greater than 200 mg/dL.
Fructose Is #1 Driver of Diabetes, Analysis Confirms
The dogmatic belief that "a calorie is a calorie" has significantly contributed to the ever-worsening health of the Western world. It's one of the first topics dieticians learn in school, and it's seriously flawed. In reality, the source of the calories makes all the difference when it comes to health.
One recent meta-review published in the Mayo Clinic Proceedings,27,28 confirms that all calories are not equal, and that calories from fructose (think high-fructose corn syrup) and other added sugars are the worst of the bunch when it comes to promoting diabetes. The researchers looked at how calories from the following types of carbohydrates — which include both naturally-occurring and added sugars — affected health:
As reported by Time Magazine:29
“What they found was that the added sugars were significantly more harmful. Fructose was linked to worsening insulin levels and worsening glucose tolerance, which is a driver for prediabetes. It caused harmful fat storage — visceral fat on the abdomen — and promoted several markers for poor health like inflammation and high blood pressure. ‘We clearly showed that sugar is the principal driver of diabetes,’ says lead study author James J. DiNicolantonio...” [Emphasis mine]
As a standard recommendation, I strongly advise keeping your total fructose consumption below 25 grams per day, which is about six teaspoons. If you have no signs of insulin resistance you should be able to consume fruit liberally even though it has fructose. If you have signs of insulin resistance, such as hypertension, obesity, or heart disease, you’d be wise to limit your total fructose consumption to 15 grams or less until your weight and other health conditions have normalized.
According to the featured review, the research clearly shows that once you reach 18 percent of your daily calories from sugar, there’s a two-fold increase in metabolic harm that promote prediabetes and diabetes.
Antibiotics Also Raise Your Diabetes Risk
According to a recent study,30 type 2 diabetics tend to have been more overexposed to antibiotics in the years prior to their diagnosis, compared to non-diabetics. Antibiotic exposure is one reason why I don’t recommend eating foods from factory farmed animals, as they tend to be raised on antibiotic growth promoters. Hence every time you eat meat from such animals, you’re getting a small dose of antibiotics, which over time with regular consumption can upset your gut flora and have a notable impact on your weight and metabolism.31
Food and Beverage Industries Are Primary Culprits
Research shows that the primary drivers of diabetes are processed foods and added sugars. Fructose (such as high-fructose corn syrup) is particularly pernicious, as well as antibiotics, which are commonly used on confined animal feeding operations (CAFOs) where most of the meat and animal products (dairy, cheese, and eggs) sold in the US are raised. It’s quite clear that the food and beverage industries play a significant role in the diabetes epidemic, and we are bound to fail to reduce prevalence unless we change our dietary habits.
However, that’s the last thing the food- and beverage industries want you to do, and industry-funded research has done a lot to confuse consumers about these dietary influences. For example, Coca-Cola Company funds the Global Energy Balance Network, a front group aimed at confusing you about soda science and diverting attention away from evidence showing soda is a major contributor to obesity and diabetes.
Scientific American32 also recently wrote about how the soda industry is giving money to US mayors to “fight obesity,” not by focusing on reducing soda and junk food consumption, but by promoting access to fruits and vegetables and exercising more. While both are admirable strategies, they will still fail to make a significant dent in the diabetes epidemic unless or until our children are also taught about the importance of avoiding the primary culprits — processed foods, junk foods, and sugary drinks.
Diabetes Is Preventable and Easily Treatable with Diet Alone
To recap, if you’re insulin/leptin resistant, have diabetes, high blood pressure, heart disease, or are overweight, you’d be wise to limit your total sugar/fructose intake to 15 grams per day until your insulin/leptin resistance has resolved. The easiest way to accomplish this is by swapping processed foods for REAL FOOD, i.e. whole, ideally organic foods. This means cooking from scratch with fresh ingredients.
My free nutrition plan offers a step-by-step guide to feed your family right. Cutting out processed foods means you’ll be eliminating a lot of energy (carbs like sugar, fructose, and grains) from your diet, which need to be replaced with energy from other sources. The ideal replacement is a combination of:
- High quality healthy fat (including saturated33 and monosaturated). Those with insulin resistance may benefit from upwards of 50 to 85 percent of their daily calories in the form of healthy fats. Good sources include coconut and coconut oil, avocados, butter, nuts, and animal fats. (Remember, fat is high in calories while being small in terms of volume. So when you look at your plate, the largest portion would be vegetables.)
- As many non-starchy vegetables as you want
- Low-to-moderate amount of high quality protein. Substantial amounts of protein can be found in meat, fish, eggs, dairy products, legumes, and nuts. When selecting animal-based protein, be sure to opt for organically raised, grass-fed, or pastured meats, eggs, and dairy, to avoid antibiotics, GMOs, and pesticides.
The timing of your meals is another really important consideration. If you’re diabetic, I strongly suggest you start intermittent fasting as soon as possible. To learn more, please review my previous article “How Intermittent Fasting Can Help You Live Healthier,” and for even more guidance on resolving type 2 diabetes, see my special report on “How to Reverse Type 2 Diabetes” or my free ebook on diabetes.