In treating diabetes, we certainly put way too much weight on short term results, at the expense of the long term view, and in fact we not only neglect the long term view, we give up on it entirely, as in you're going to get worse over time but that's diabetes.
If this were really the case, if we are so doomed, then we have to wonder what the point of even bothering to treat diabetes is. Well one possibility might be that we can improve our long term outlook, but that's not even looked at, no one even cares to look, and it's probably that those who are using conventional approaches don't want us to see what's behind the black curtain, because it is so ugly.
So we're armed with our blood sugar meters and our A1C tests although even an A1C doesn't give us much of an idea of where we're headed, and we can't just assume that if we have good control, then good control begets further good control down the road, because we know that this is definitely not always the case, and most often isn't.
The truth is, we get worse over time because we aren't even treating the disease that we have, and it's not that we aren't treating the disease well enough, it's that we aren't treating it at all. Even worse, by the way we treat diabetes conventionally, we for the most part not just don't make the disease better, we make it worse.
What we suffer from, what our disease is, is a metabolic disorder that, among other things, causes our blood sugar to go too high. I love Dr. Fung's analogy here of someone having a fever from an infection, and our focusing on reducing the fever but ignoring the cause if it, the infection. This would be pretty stupid, but that's exactly how we approach diabetes, look to reduce one of the symptoms, high blood sugar, while ignoring the causes.
So if you try that with an infection, and don't treat it in other words, then the infection is likely to get worse, and if you ignore the cause of diabetes and worse, if you intentionally make the causes worse, as we tend to do a lot, then do you think that the disease is going to get better, or will it just get worse? Well it does just get worse, not surprisingly, but we don't care, because this is a very profitable way to treat diabetes.
So we have an underlying metabolic disorder, and another symptom that we often see is excess weight, as well as things like dyslipidemia, hypertension, chronic inflammation, insulin resistance, fatigue, cognitive impairment, fatty liver, and so on. So there is a common thing that causes all of this stuff directly or indirectly, and that's insulin resistance and the high insulin levels that are behind it.
While high insulin isn't as widely accepted as it should be in the medical community, because if they admit that this is the central problem in diabetes they would have to admit that they are making us worse by seeking to keep it at toxic levels, everyone pretty much accepts that insulin resistance is the primary mechanism involved in type 2 diabetes.
So you would think, maybe they would monitor us for this, the way they monitor us for blood sugar, blood pressure, lipids, liver and kidney function, and so on. This is a simple blood test, you just measure glucose and insulin and use a HOMA calculation to determine the degree of insulin resistance, and use that to guide your therapy.
The truth is, they don't want us knowing this because this will expose the fact that this is getting worse, and they would have to say well your insulin levels are too high relative to your blood sugar, but don't worry about that, let's increase them further, let me write you another prescription.
It's like pulling teeth with many doctors to even get a serum insulin test, but there's another tool we can use to monitor our progress of our insulin levels, and that's a scale.
We know that excess weight is strongly correlated with poor blood sugar, but that's not even what this is about. Excess weight is primarily an indication of excess insulin, and we can even just use weight monitoring to get a pretty good idea of where we are at here, and also trends that may alert us to things going awry.
The first thing you need to do is to get down to a healthy weight if you are not there already. This to me is even more important than blood sugar because it affects long term blood sugar and diabetic outcomes, as it exposes the degree of metabolic disorder that underlies our disease.
Losing weight in itself can improve blood sugar, but once again, this isn't what this is about, and we need to stop focusing so much on blood sugar here and instead focusing on getting well, and as you do so, your blood sugar will tend to get better as well, although just as a side effect, but high blood sugar is just a side effect anyway,. a side effect of the metabolic dysfunction that we need to look to improve.
Being overweight does affect things like inflammation and leptin resistance, but more than anything, it is a symptom of something that is paramount in addressing with diabetes, and that's hyperinsulinemia. It's not that we are overweight that matters the most here, it's why we are overweight and all the other bad things that the primary cause of this is doing to us, most notably, increasing our insulin resistance over time and worsening our diabetes.
There are some people who do low carb and use insulin and who can maintain a healthy weight doing that, and that tells us that they aren't hyperinsulinemic on this protocol, because if they were, well the pounds come on. If they are overweight and doing this, well they would be well served to pay attention to their weight more.
I don't think that there is a single marker that we need to pay attention to more than weight. This may be an even better marker than insulin levels themselves, because it measures the effects, the consequences, and the desirability or lack thereof of given levels of insulin.
So pay attention to your weight more if you don't do so already and you'll be really helping manage your diabetes in the long run, rather than what happens to the typical diabetic, who both gains weight and sees their blood sugar rise over time.