Gabor Szendi:
Diabetes is curable
The number of patients with type 2 diabetes has increased by between seven and eightfold since the 1950s. This is clearly connected to the increasing amount of refined carbohydrates in the diet. For evolutionary reasons, the human body is unable to deal with the amount of refined (high GI) carbohydrates that the current fat-phobic dietary guidelines recommend.
Yes, type 2 diabetes is curable. What is more, is the fact that it is not an illness, but merely an acute metabolic disorder, perpetuated into a chronic, life-long illness by medical treatment itself. Today in Hungary six hundred thousand (in the USA the number is 30 million!) type 2 diabetics are led to believe that there is no hope of recovery. They are misinformed and told that, "From all the medical facts known today," there is no other way than to take pills, administer insulin, and then later to try and control complications and succumb to premature death. The following can be read on the patients' information page of the Hungarian Diabetes Association (MDT):
"It is important to know that presently this illness is not curable but with suitable physical activity, diet and if needed, medication, diabetes is well treatable by keeping blood sugar levels close to normal. "1
For decades it has been an open secret that type 2 diabetes is curable with the right diet, but diabetes is such a sizable business for the pharmaceutical industry, which has no intention of willingly giving up this major area of profit. This profit easily allows the industry to support the Hungarian Diabetes Association (Magyar Diabetes Társaság). I wonder whether all nine corporate pharmaceutical logos would still be displayed on the MDT website if the Association actually told people the truth about diabetes?
When my book, Paleolit táplálkozás (Paleolithic Nutrition) was published in 2009, the total of six hundred thousand diabetes patients in Hungary began to decrease, and many people were cured. Sadly, the great majority did not have access to the information, and many had already become so sceptical and suspicious of any miracle diets that they did not even dare to start a lifestyle change. There were also people whose doctor simply forbad it.
In 2011 Dr Ee Lin Lim et al published research findings in the journal Diabetologia. In the study they state that 11 participants already had normal blood glucose levels after the first week, and after eight weeks they were completely cured.2 If this is so simple (and it is) then why did we have to wait so long for such a study? The answer is disappointingly mundane. Diabetologists believe so strongly that diabetes is incurable that they have never even tried to cure it, and they will not try to do so in the future. It is up to the patient to take their own destiny in hand.
A Short History of Diabetes
There is a lot of documentation on the health parameters of natural people, and we know that there are no diabetics among them. Humankind is genetically uniform, and those genes that are now considered to cause type 2 diabetes are found in natural people as well. Yet they do not cause diabetes. The same genes were at work in people of the 19th century, but diabetes was extremely rare. According to Sir William Osler, the most famous doctor of those times, described as 'the father of modern medicine', they found only ten diabetics out of the 35,000 patients at the John Hopkins Hospital in Maryland, USA. Between 1824 and 1898 in the Massachusetts Hospital a mere 172 were diabetic out of nearly 50,000 patients. That equates to a 0.02-0.3% frequency. At the turn of the 19th -20th centuries it was clear to every expert that diabetes was caused by the increasing amount of sugar and carbohydrates in the diet, and therefore no-one was surprised that during the scarce years of World War I the number of diabetics fell dramatically.3 Statistics tell us that in the USA, even in 1958, only 1% of the population was diabetic. However by 2011 this percentage had grown to 8.3%, or in other words, in sixty years it grew eightfold.4-5 This 8-10% is true for the general population but in older generations it corresponds to a 30% frequency.
If diabetes was extremely rare in the 19th century and it does not exist amongst natural people, then the problem is not with our genes but with our nutrition.
The Death of a Dogma
The dogma that type 2 diabetes is not curable but only treatable, and that it gets progressively worse, has existed for almost sixty years. In spite of the blood sugar lowering and insulin production stimulating medication, 50% of patients become insulin dependent during the first ten years of their illness.6 As the authors wrote in a major summary: "Nearly all the presently applied therapies lead to weight gain, increase the risk of hypoglycemia, and have no effect on the worsening of the actual illness."7 Today's "treatments" are not successful because they treat the symptoms instead of the root cause. The end of the "treatment" can be blindness, leg amputation and early cardiac death.
In 1995 surgeon Walter Pories et al summarised 14 years of experience in stomach ring surgery in an astonishing study. Among the patients there were 165 type 2 diabetics and the same number of pre-diabetics. One week after the surgery all of their blood sugar levels normalised and 91% of the patients were still free of blood sugar problems ten years later.8 The study made it very clear that it was the reduced calorie intake that caused the recovery. The most surprising aspect was that blood sugar levels had already normalised before weight loss even began.
Many people who follow the Paleolithic diet experience that their blood sugar level normalises and their diabetes ceases to exist surprisingly quickly.
So it is a fair question to ask: what is causing this quick recovery?
The Cause of Diabetes
If diabetes can be reversed in one week, then being overweight is obviously not the simple answer. But what is it then?
The answer was provided by the above quoted study led by Dr Ee Lin Lim. In this study 11 diabetic volunteers were put on a 600 calorie/day diet and by the end of the first week two important changes took place:
- The pathological fattiness of the pancreas ceased to exist, and as a result of that the beta cells recovered their normal ability to produce insulin.
- The triglyceride content of the liver decreased, and consequently the insulin sensitivity of the liver was restored.
But what does the liver have to do with diabetes?
Under normal circumstances, during "fasting" periods in between meals, the liver synthetises sugar from glycogen stores. Fasting glucose level actually reflects the sugar producing activity of the liver.6 When we continuously eat more carbohydrate than necessary, the glycogen stores of the liver and the muscles get full, and from then on the liver produces and stores triglycerides. This is the process of how fatty liver is formulated. The liver becomes insulin resistant at the same rate as it becomes more and more fatty. If the liver is insulin resistant then it does not register the elevated blood sugar and insulin levels following eating, and continues to raise blood sugar.6 However, the sugar from food and the sugar produced by the liver together is too much, because if the muscles are insulin resistant they cannot take up sugar, and so the blood sugar and insulin levels become permanently high. This state is diabetes itself.9 High insulin levels that we call hyperinsulinism, constantly stimulate the liver to store fat, and this is the reason why diabetes becomes constantly worse. If insulin supplementation is introduced as well, or insulin production is encouraged by oral medication, understandably the situation only gets more severe, because the fattiness of the liver is enhanced. The decreased insulin production is due to the fact that the fatty liver creates high blood fat, which blocks the insulin production capacity of beta cells in the pancreas.6
Because in calorie restriction the fat reserves first start to dissolve from the liver and the pancreas, the blood sugar level normalises without major weight loss.
It is also clear from the studies that the insulin resistance of the muscles does not cause diabetes on its own, but in the case of large carbohydrate intake it contributes towards the fatty liver. In the case of low carb eating (low-carb, Paleo) the muscles also become insulin resistant but this has nothing to do with diabetes. With diabetics the amount of insulin needed is in proportion with the extent of the fattiness of the liver and, even in a person appearing healthy, fatty liver indicates a five to six fold diabetes risk for the years ahead.6
But what is the situation with type 2 diabetics who are not overweight? "Show me a type 2 diabetic with normal weight and I will prove that he has fatty liver," writes Roy Taylor, a doctor who is the brains behind the study led by Dr Lim.6
One of the roots of Doctors' pessimism is that the insulin producing beta cells of the pancreas seem to die off with the progression of diabetes, and their numbers constantly diminish. But when years-long existing diabetes was terminated by stomach ring surgery or calorie restriction, beta cells "woke up." So in actual fact the majority of them did not die but were only inhibited. It seems therefore that there is no irreversible damage in type 2 diabetes, or it is not to such a degree that it would hinder complete recovery.
So What Then?
The fact that diabetes can be cured was brought to light in the last few decades not by diabetologists, but by surgeons, and researchers of metabolism. In my opinion this is quite astonishing but it clearly shows that dogmas and financial interest have the ability to blind one to the facts. However, from the recovery stories on my website it is clear that the theory works in practice.
After the publication of their study, Dr Ee Lin Lim and her team began to receive numerous e-mails and phone calls. During a period of six months they were contacted by about 1,000 diabetics. The leaders and colleagues of the Newcastle Magnetic Resonance Centre in the UK did not turn away these people, but answered their letters, telephone calls, and quickly established advisory pages.10 According to the feedback, calorie restriction resulted in complete recovery in half of the patients, in one case after 28 years! Seventy seven people informed the Centre that they acted and were cured by completely flouting their doctors' firm opposition.6 Those who did not recover were mainly less motivated. A lonely warrior, Dr Gilles Plourde, convinced a man who had been diabetic for 20 years to try a low energy density diet, and cured him of diabetes in 16 weeks.11
The working team declared that in their opinion the main problem was that only the very determined few are willing to fast. The Paleolithic diet addresses and resolves exactly this problem.
Why Paleo?
Until modern diabetology carved it in stone that diabetes is incurable, enlightened doctors always treated diabetes with carbohydrate restriction. In their summary Caroline Day and Clifford J. Bailey listed those doctors from the 1600s who realised that with a diet called 'low carb' today, in other words: lots of fat and protein and few carbs, diabetes can be successfully treated.12 The authors conclude their study with the observation that if this method was effective in the 18th century, then it should be effective today.
Actually, it would take too long to list all the studies that confirm that dramatically lowered carbohydrate intake normalises glucose metabolism.13-19 So if someone states today that type 2 diabetes is not curable, they are only admitting their own ignorance and the fact that they haven't read the medical literature. Or, even worse, theoretically they accept the facts but believe that in practice the feasibility of recovery is impossible to implement, so they keep the information to themselves.
"Feasibility" in medical literature means that for the sake of their health and long life, ill people must be willing to bear quantity limitations in their diet.
In the case of type 2 diabetes the healing factor is one of the fundamental characteristics of Paleo: low energy density. I didn't write calories on purpose. From vegetables, fruit, meat and fat - Paleo in a nutshell - we can eat as much as we need to feel completely satisfied, and we will consume few carbohydrates, and those of the slow absorption kind. Fats and proteins are filling, so we will not feel hunger for a long time. This diet does not lead to obesity and fatty liver. It is the diet of natural people and this is the reason why diabetes is unknown in their circles.
For those who live on the western diet, keeping low carb is only possible with great self discipline since the larger part of nearly all foods contain refined carbohydrates (bread, cakes, potatoes, rice, sugar, etc.). People who live on calorie restricted diets are always hungry and frustrated. Paleo takes care of this problem.
The words of Einstein are very well suited to end this article: "Everyone knows that certain things are impossible to realise, until someone comes along who is not aware of this and realises it." The solution is already known, and it is not necessary to wait for the encouragement of diabetology.
References
1. MDT: Hungarian Diabetes Society, 2013
2. Lim EL, Hollingsworth KG, Aribisala BS, Chen MJ, Mathers JC, Taylor R. Reversal of type 2 diabetes: normalisation of beta cell function in association with decreased pancreas and liver triacylglycerol. Diabetologia. 2011 Oct;54(10):2506-14.
3. Taubes, G: Good Calories, bad calories. Alfred A. Knopf, New York, 2007.
4. Engelgau MM, Geiss LS, Saaddine JB, Boyle JP, Benjamin SM, Gregg EW, Tierney EF, Rios-Burrows N, Mokdad AH, Ford ES, Imperatore G, Narayan KM. The evolving diabetes burden in the United States. Ann Intern Med. 2004 Jun 1;140(11):945-50.
5. ADA: American Diabetes Association. http://www.diabetes.org/diabetes-basics/diabetes-statistics/ letöltve 2013 okt.23.
6. Taylor R. Banting Memorial lecture 2012: reversing the twin cycles of type 2 diabetes. Diabet Med. 2013 Mar;30(3):267-75.
7. Ashcroft, FM; Rorsman, P; Diabetes Mellitus and the ? Cell: The Last Ten Years, Cell, Volume 148, Issue 6, 16 March 2012, Pages 1160-1171
8. Pories WJ, Swanson MS, MacDonald KG, Long SB, Morris PG, Brown BM, Barakat HA, deRamon RA, Israel G, Dolezal JM, et al. Who would have thought it? An operation proves to be the most effective therapy for adult-onset diabetes mellitus. Ann Surg. 1995 Sep;222(3):339-50;
9. Radziuk, J; Pye, S: The Role of the Liver in Insulin Action and Resistance. in:Reaven, GM; Laws, A: Insulin Resistance Humana Press, Totowa, New Jersey 1999. pp:197-232.
10. Steven S, Lim EL, Taylor R. Population response to information on reversibility of Type 2 diabetes. Diabet Med. 2013 Apr;30(4):e135-8.
11. Plourde, G: Reversal of type 2 diabetes mellitus in an obese man: Role of dietary modification and physical activity Clinical Nursing Studies, 2013, 1(2): 38-42.
12. Day, C.; Bailey, C.J: The hypocaloric diet in type 2 diabetes - déjá vu. Br J Diabetes Vasc Dis 2011;12:48-51.
13. Williams KV, Mullen ML, Kelley DE, Wing RR. The effect of short periods of caloric restriction on weight loss and glycemic control in type 2 diabetes. Diabetes Care. 1998 Jan;21(1):2-8.
14. O' Neill DF, Westman EC, Bernstein RK. The effects of a low-carbohydrate regimen on glycemic control and serum lipids in diabetes mellitus. Metab Syndr Relat Disord. 2003 Dec;1(4):291-8.
15. Willi SM, Martin K, Datko FM, Brant BP. Treatment of type 2 diabetes in childhood using a very-low-calorie diet. Diabetes Care. 2004 Feb;27(2):348-53.
16. Westman EC, Yancy WS Jr, Mavropoulos JC, Marquart M, McDuffie JR. The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus. Nutr Metab (Lond). 2008 Dec 19;5:36.
17. Lazo M, Solga SF, Horska A, Bonekamp S, Diehl AM, Brancati FL, Wagenknecht LE, Pi-Sunyer FX, Kahn SE, Clark JM; Fatty Liver Subgroup of the Look AHEAD Research Group. Effect of a 12-month intensive lifestyle intervention on hepatic steatosis in adults with type 2 diabetes. Diabetes Care. 2010 Oct;33(10):2156-63.
18. Malandrucco I, Pasqualetti P, Giordani I, Manfellotto D, De Marco F, Alegiani F, Sidoti AM, Picconi F, Di Flaviani A, Frajese G, Bonadonna RC, Frontoni S. Very-low-calorie diet: a quick therapeutic tool to improve ß cell function in morbidly obese patients with type 2 diabetes. Am J Clin Nutr. 2012 Mar;95(3):609-13.
19. Svendsen PF, Jensen FK, Holst JJ, Haugaard SB, Nilas L, Madsbad S. The effect of a very low calorie diet on insulin sensitivity, beta cell function, insulin clearance, incretin hormone secretion, androgen levels and body composition in obese young women. Scand J Clin Lab Invest. 2012 Sep;72(5):410-9.