Evidence-based learnings for understanding and strategies for managing insulin resistance and Type 2 Diabetes.
Before I met my husband who is Type 1 Diabetic, I did not know much about any type of diabetes. Very quickly, I learned that as a diabetic he has to pay special attention to carbs and sugars in his food all day (and even at night). He has to check his blood glucose often and take insulin before every meal and at night. And, he has to watch what he eats in order to maintain good A1C levels (average blood sugar levels over the past 3 months) in order to keep his health.
463 million people in the world are living with diabetes. It continues to rise at an alarming rate of 33% in North America. According to CDC, More than 34 million Americans have diabetes (about 1 in 10), and approximately 90-95% of them have type 2 diabetes. These are some alarming numbers especially for a disease that can be managed by improvements to the lifestyle.
In the past year, my brother got diagnosed with borderline Type 2 Diabetes which starts with insulin resistance. It runs in both sides of our family. At first, I assumed that Type 2 Diabetes is much like Type 1 Diabetes, where you can manage it with insulin and don’t have much of a recourse.
Boy, was I wrong.
I began my search with a mission to understand the root cause of Type 2 Diabetes.
Why some people get insulin resistant as they age?
And, others don’t?
Is there a role that genetics and lifestyle play?
Is there a way to prevent it?
And, most importantly, is there a way to reverse it?
It’s one thing to understand what causes diabetes and why it’s so deadly, but having to manage diabetes gets even more complex. Once I began to dig into the latest scientific papers and listen to the experts in this area, I learned so much.
So today, I’m sharing a summary of what I’ve learned. I will caveat by saying that this is not medical advice and I’m only sharing what I have learned as a health coach through extensive research for the health of my family. Also, new research comes out all the time and this is only a snapshot of the strategies that I’ve come across and compiled.
Surprising Things I learned About Type 2 Diabetes
A little knowledge goes a long way, and can help you treat or even reverse Type 2 Diabetes. Here are the basic things you should know about Type 2 Diabetes:
1. In diabetes, blood sugar increases after a meal and remains high due to a lack of insulin, or a problem with insulin signaling. The three classic diagnoses of this disease are Type 1, Type 2 and Gestational Diabetes.
2. Type 2 diabetes can lead to Alzheimers which is also known as Type 3 diabetes (in research). Scientists have known for a long time that people with Type 2 Diabetes are at a high risk for developing Alzheimers. Type 3 diabetes occurs when neurons in the brain become unable to respond to insulin, which is essential for basic tasks, including memory and learning.
Watch the video below from one of the leading research scientists Dr. Guojun Bu of Mayo Clinic on the link between Diabetes and Alzheimer’s disease.
3. Type 2 diabetes is not the same as Type 1 Diabetes. In Type 1 Diabetes, people do not produce enough insulin to regulate blood sugars.
In Type 2 Diabetes, the body has insulin but this insulin doesn’t work. Insulin resistance is the real cause of Type 2 Diabetes. In this condition, our muscle cells become resistant to the effect of insulin. To compensate for insulin resistance, the pancreas produces more and more insulin, but over time the pancreas may lose the ability to produce it altogether. If this happens, Type 2 Diabetics must take insulin daily. What’s gumming up the locks on our muscle cells? What’s preventing insulin from letting the glucose in? The answer is Saturated fats.
Latest research shows that Type 2 Diabetes is not just about insulin. It is also due to production of glucose by the liver. In healthy people, the liver does not produce excess glucose if there are already enough sugars in the blood from food. In patients with excess liver and pancreas fat, this overproduction of glucose sets off a vicious cycle. This could lead to Type 2 Diabetes regardless of insulin. In short, fatty liver disease or fat in the pancreas can lead to the development of Type 2 Diabetes.
4. Saturated fats play a role in Type 2 Diabetes. Fat build-up inside the muscle cells creates toxic fatty breakdown products and free radicals that ‘block’ the insulin-signaling process. This mechanism closes the ‘glucose gate,’ and make blood sugar levels rise making the cells insulin resistant.
And, this can happen really fast.
In fact, insulin resistance can occur in 180 short minutes (or just 3 hours!) after eating a diet high in saturated fats.
A Simple Anti-Insulin Resistance Plan
Given my family history for Type 2 Diabetes and the increased risk, I’m determined to keep this disease at bay. Here is my plan for a healthy anti-diabetic life especially as I age. Some of these strategies have been borrowed from my brother who has been able to reverse his type 2 diabetes:
- Eat a 90-95% plant-based diet. A plant-based diet primarily consists of legumes, vegetables, fruits, nuts, seeds, and some whole grains. (Some of my favorite recipes are here). There is strong evidence that a plant-based diet supports prevention and reversal of Type 2 Diabetes. I still eat some dairy and meat occasionally. I personally find this way of eating to be less restrictive and more sustainable than many other diets such as Paleo or Keto.
- Reduce saturated fats in diet. While I love butter and cheese (I really do), in recent months I’ve significantly reduced my intake of saturated fat. My primary sources of fat include olives, nuts, seeds, nut butters, avocado and unfiltered extra virgin olive oil. This seems to help reduce my cholesterol levels and body fat. It has also helped with my postprandial (a period of 2 hours after eating) blood glucose levels.
- Reduce processed carbohydrates. This includes processed flours, commercial breads and pasta. I’m also cautious about the amount of carb intake in a day as it can play havoc on your blood sugars. Whole grains such as sprouted spelt, Khorasan wheat (Kamut), freekeh, bulgur, farro, einkorn, emmer, barley, teff, oats, and sorghum don’t raise my postprandial sugar levels as much. Pseudocereals such as quinoa, chia, buckwheat, amaranth and millet are also a good addition to a plant based diet. You might need to experiment with the type and amounts of grains that work best for you. It is recommended to include some grains in a healthy diet (if you’re not allergic to them), as they help with building a strong immune system and optimum gut microbiome. I will write more on the importance of grains in another blog post.
- Exercise to reduce body fat. Studies show that even losing 1 gram of fat from the pancreas (I’m sure this sounds easier than it is) can reverse the disease in patients who already have Type 2 Diabetes. Our body fat percentage increases as we age and lose muscle. The best way to combat this is through strength training as increased muscles helps burn fat. Another added benefit of exercise is the production of hormone ‘irisin’. Recent studies show that irisin counteracts insulin resistance besides its many other benefits including weight loss, anti-cancer properties and bone formation. My go to exercises for this are HIIT and strength training 3-4 times a week.
- No snacking unless hungry. Recent science as well as ancient wisdom of Ayurveda advises us against the dangers of snacking. Snacking keeps your blood glucoses levels high which further exacerbates the insulin resistance, in addition to piling on the calories. If you are hungry, make sure to snack on real foods that nourish your body and don’t raise your blood sugars too much e.g. avocados, sweet potato with lime, celery with nut or seed butter, quinoa salad, beet hummus, edamame, bean salad, boiled egg or olives.
- Incorporate circadian rhythm intermittent fasts. Simple fasting improves metabolism, lowers blood sugar, lessens inflammation, which improves a range of health issues. It helps clear out toxins and damaged cells, which lowers risk for cancer and enhances brain function. The key is to incorporate circadian rhythm intermittent fasting which is a time-restricted eating plan where you eat in sync with your internal body clock. This means that you eat during the daylight hours, within a window of 12 hours or less and fast for the remaining 12 or more hours each day. This has been shown to improve insulin sensitivity in your body among all the benefits listed above. Here is a link to a paper that discusses the in-depth findings behind eating early in the day to be in alignment with circadian rhythms in metabolism.
- Reduce stress through deep breath work and restorative exercises. There are new studies underway e.g. this one at the University of Birmingham to show the link between stress and Type 2 Diabetes. Stress can cause inflammation and it may interfere with insulin producing beta cells in the pancreas. We also know that stress can impact cortisol levels which can lead to our bodies to hold on to fat which can then lead to Type 2 Diabetes. Deep belly breathing such as the 4-7-8 breathing (where you breathe in for a count of 4, hold for 7 and exhale for a count of 8), yoga and long nature walks are shown to lower our stress levels considerably. I personally love all of these activities and incorporate them in my daily routine.
I’m happy to report that my brother has been using these strategies for a while and has been able get off his medication for blood sugar control. The plan is to stay that way.
As you can see, this is not a diet in any way. This is a lifestyle aimed to keep insulin resistance away and improve your overall health. It is completely ok if you end up eating in an un-resourceful way. Be kind to yourself. Use this opportunity to understand the triggers so you can mitigate them in future.
Do you or anyone you know have insulin resistance or are at a risk of Type 2 diabetes? How are you managing it? Let me know in the comments below.