I have recently this year had a string of pancreatitis
caused by skinny “diabetics” who have been told by their health care providers
that they are fine.
How does this happen? The standard of care labs are a CBC, CMP, lipid panel,
and TSH. The Primary will see elevated triglycerides which they may or may not
prescribe a statin drug for which is the first hint that there is a glucose
problem. A low HDL is a pretty good indication in this scenario that there is a
fatty liver in process. However, the glucose number will still be in normal or
just ever so slightly above normal range.
In standard of care, if you do not have high glucose there is no reason to look
further (I am guessing) because people never have more previous labs than
these. But by checking further to look at the insulin level and the hemoglobin
A1C you will find hyperinsulemia and prediabetes or diabetic A1C ranges even
though the glucose levels are completely normal. Here is a hint…the glucose
level is the last thing to move!
Why is all of this important? Some of the most common things people find their
way into my office for related to glucose issues are lack of or altered brain
function (brain fog, depression, OCD, forgetfulness, ADHD), cardiovascular
issues, thyroid issues, liver/gallbladder issues, and all manner of
inflammatory pain issues including migraines, joint pain, diabetic neuropathy,
and fibromyalgia. At the heart of all of it is an insulin problem that rises
higher in the presence of glucose from direct sugars and carbohydrates.
If we don’t get a handle on how to eat properly while we are young, we will not
age well. Some of us will have family that can take care of us but others end
up in the nursing home because they can’t walk anymore, they have cognitive
decline, they have unmanaged health conditions that leave them repeatedly in an
ambulance for medical care so they end up in a nursing home of some type where
now they have no control over their own meals. I have been in these facilities
and since lobbyist have had the food pyramid completely out of balance my whole
life, here is what I remember seeing.
Breakfast: oatmeal (23 net carbs per ½ cup), a piece of toast (11 net carbs),
strip of bacon or sausage patty (1-2 cargs depending on curing and additives),
and a glass of prune juice (27 net carb, unsweetened) and a glass of water or
coffee (4 net carbs per tsp of sugar). Conservatively there are 60 net carbs
for breakfast.
Lunch: ham (1-6 net carbs depending on curing) and beans (7 net carbs per ¼
cup), a piece of cornbread (11-22 net carbs depending on recipe), and fried
potatoes (3 net carbs per tablespoon), piece of cake, brownie, or cookie (11 –
80 net carbs), and a drink of water, tea, or coffee (4 net carbs per tsp of
sugar. Conservatively there are 40-60 net carbs at best for lunch
Supper: meatloaf (11 net carbs in filler), green beans (6 net carbs per cup),
salad ( 2-6 net carbs depending on mix, salad dressing (2-20 per Tbsp depending
on type), piece of cake, brownie, or cookie (11-80 net carbs), and a drink of
water, tea, or coffee (4 net carbs per tsp of sugar). Conservatively there are
at least 30 net carbs for supper.
Net carbs are the carbs left after subtracting the fiber and sugar alcohols
which do not cause insulin to be secreted to deal with them. So remember my
values are net carb and not total carbs. So in the above day, a senior would
have conservatively taken in 130 net carbs in the least before accounting for
any afternoon or evening snacks or seconds of any foods. With a sedentary
lifestyle, the body can only use 25 net carbs per day without having to
increase insulin levels to deal with the extra carbs. In one day, there was at
least an excess of 105 net carbs minimum then take that times 365 days a year.
It is not a coincidence that our seniors in care of nursing home, or even using
meals-on-wheels are declining before our eyes.
As I work with people who drop their A1C’s and some weight, as time goes on
they stop measuring things thinking they’ve got this. They just start having
that one chip (that turns into more like 7) and the next thing they know they
are back up to 30-50 net carbs a day thinking they are okay, until the next A1C
goes back up some. Unless you are really working out, playing sports, or doing
hard manual labor every day, you do not need more than 25 net carbs per day or
you need insulin to be increased to take care of the extra. How do you know
your true amount needed? You check it with blood work.
Insulin resistance occurs in the presence of too much insulin. Insulin is toxic
to the body in the long run so if you are not clearing it out rapidly, it is
doing destructive damage. So in our crazy mixed up world, pharmacology sold us
the idea of manipulating the glucose number by giving medications that increase
the amount of circulating insulin or by injecting more insulin into the body
thereby perpetuating more insulin resistance…making a diabetic even more
diabetic. This will never reverse diabetes or stop/reverse the damage being
caused to the body. Only removing the offenders (too many carb and too much
insulin) can do that.
Insulin can increase estrogen levels inside the adipose “fat storage” cells.
Estrogen makes things grow. So that sudden need for bigger clothes or that “pot
belly” can be your clue that there is too much estrogen being made under the
influence of insulin. This might not be such a big deal except there are 4
types of cancer that are estrogen driven: breast, prostate, lung, and colon.
What are the majorities of the cancers killing us in this nation? Oh, yeah the
same 4 just listed. By being serious in our diets, what if we significantly
dropped the cancer rates?
I want to help people grow older in number only. The main difference between
active, cruise-taking, dancing, 90 year olds and the 50-70 year old non-mobile
nursing home patients is how they moved and what they ate. There is not one
single nursing home patient that I have ever seen who is not taking medication
(usually a lot of it). However, I have seniors in my practice that take no
prescriptions at all who are getting adjusted so they can continue traveling,
gardening, golfing, or taking yoga classes. So eat wisely, and move.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5405627/