Sometimes, working, I forget to eat. My friends don’t believe that you can forget to eat. They think if you don’t eat you get jittery and weak and blank in your brain – how can one work through that?
Then I remember that I used to be like that, too. To this day my family makes fun about the time I wanted to fast for a day, and broke the fast after three hours because I couldn’t go on – it felt as if I was falling apart.
The difference between being hungry and being in the grip of hypoglycemia lies in how healthy your metabolism is. When you are diabetic or prediabetic (and most Americans fall in either category), you are always looking for food. You cannot go without for any prolonged time. Most Americans, for that reason, do not only eat, but they snack in between. And, listen – I don’t blame them. Because if your metabolism is lousy (because of the Standard American Diet – or SAD) you NEED to eat frequent meals. Otherwise you fall apart. You feel you are hungry. In reality you are voracious because your cells are on a sugar rollercoaster.
This is how your metabolism – the sum of all the chemical and biochemical events in your body at any given time – functions if you eat SAD: You eat a load of sugar (white starches are chains of sugar molecules that are being digested within seconds of entering your mouth, filling you up with sugars, and more sugars). Your brain gets a nice sugar high. Insulin kicks in because high sugars are dangerous for your body (leading to blindness, impotence, heart disease, stroke, dementia, amputations, polyneuropathy, and so on). Since high sugars are so dangerous, your body shoots out much to much insulin. Next thing you know, your blood sugar is really low, and you feel lousy: weak, confused, shaky. What do you do? Well, you reach for another meal or a snack that starts the high-sugar/low-sugar cycle again. On the way, you gain weight because weight gain is the number one side-effect of insulin. And you go see-sawing through high and low blood sugars, never feeling top-fit and at your best potential.
What is the difference when your metabolism is healthy? You eat your three meals, and then you forget about it. You have energy to pursue what you love to do in life. And yes, sometimes you forget to eat because making music, or cleaning the yard, or making a scrapbook is so much fun.
What to eat to reach your perfect metabolism I have described in my diabetes book. But the main points are: Stop sugars and white starches (and don’t replace them with artificial sweeteners). Eat proteins and good fats in every single meal. Within a day or two, your body will experience the difference between hunger and hypoglycemia. When somebody around you says: “I am hungry,” I bet that in ninety percent they are talking the low-sugar jitters. Real hunger is different. Our ancient bodies are made to survive the normal periods of hunger and plenty of food. Our ancient bodies are not made to survive the overfeeding with sugars.
By the way, I didn’t say that you can just suppress that feeling of being “hungry” and ignore it. That is exactly the point: Hypoglycemia is a real condition, and really dangerous. Don’t try to starve when you come off a sugar high. Eat reasonably first. Then you can even put in a fasting day – as I can do now without difficulty. Or you can, once in a while, forget to eat altogether because you are so happily ensconced in a project that warms your heart. Read More
Blog: On Health. On Writing. On Life. On Everything.
How to Measure Diabetes
July 21, 2010
In ancient times, diabetes was diagnosed by licking the urine of the patient. If it tasted sweet, a diagnosis of diabetes mellitus (“honeysweet flow”) was made. As a physician, I am glad we have advanced to better tests...
There are basically four different tests to diagnose diabetes (I am talking here mostly of type II):
• Spot blood sugar. Since sugars rise and fall depending what and when you ate, this is a very unreliable test.
• Fasting blood sugar. Does only take a bit of blood, is cheap and fast – but still can vary with what one ate the day before. However, if your fasting numbers are up consistently, you should pay attention!
• Oral Glucose Tolerance Test: a complicated procedure where one drinks an awfully sweet fluid before blood will be drawn in half-hour intervals to ascertain how fast the sugar load is cleared out. It’s complicated, and very time-consuming for the patient. I object of giving a patient a drink 75 to 100 gm of unpalatably sweet glucose solution – which can’t be healthy if there is a disease caused by sugar. My suspicion is that this test is still be used because doctors can bill the most for this.
• Glycosylated hemoglobin, also called A1c: An easy blood test that gives a rough average of your sugars through the last month. I like this one the best because the usual ups and downs of sugar are not interfering with the test, but going into the overall measuring. With frequent episodes of hypoglycemia (too low blood sugars), the test might come back falsely low or normal. In iron-deficiency, A1c are higher than they really are, suggesting diabetes where there might be none. Every time one eats sugar, it “glycosylates” (adding a sugar to the molecule) a protein on the surface of an erythrocytes (red blood cells), and the chemical process is never reversed as long as the blood cell lives. Red blood cells live about three months; blood we draw is always a mixture of very young cells, newly released into the bloodstream from the bone marrow, and older cells, soon to be discarded. Measuring blood glycosylation therefore represents a fair mirroring of recent sugar intake and over time, those numbers can be compared: A lower A1c means you have done something right lately.
In conventional medicine, A1c is called normal if it is below 6.0. A1c is measured in percent of how much of the blood is “sugared”. Starting at 6.1, you have diabetes. That in it itself is rather absurd: A little step upward from 5.9 to 6.0 does not give you diabetes – you had it coming all along. In Natural Medicine, we think that between 5.0 and 6.0, one has “latent” (developing) diabetes. Why that number of 6.0? Because if one would chose 5.0 as the cut-off point, most Americans would have to be diagnosed with the disease.
The Oral Glucose Tolerance Test is more sensitive to detect cases of diabetes – but only if the cut-off point for diabetes is set at 6.0 A1c.
Arbitrarily putting the number to 6.0 does not make a person healthier. In fact, at the date of diabetes diagnosis, I good proportion of patients have already end-organ failure, namely eye problems, kidney failure, neuropathy – to name a few.
Just looking around tells us that many people are overweight and have some of the telltale signs of diabetes: belly fat, scant hairs on arms and legs, rosy cheeks. One sign alone does not make the diagnosis – but several together gives me an idea. But one can be very overweight and never develop diabetes, because in order to get the disease, you have to have the genes AND an unfortunate lifestyle.
Don’t think that genes are an excuse. Because diabetes type II does not strike, if one lives frugally. For instance, after World War II in Europe, basically nobody had it (but people died in droves of tuberculosis then…). Ten years later, with ballooning economies and waistlines, diabetes was back.
But you don’t have to starve yourself, to heal diabetes. You need a mixture of moderate movement (walking, swimming, biking – or dancing; whatever you like) and a diet without sugars, white starches and bad fats.
In diabetes drug studies, diabetes often is called “controlled” if the blood sugar stays within the limits if 7.0 to 10.0 A1c. We can be sure that at those numbers the damage done by high sugars is continuing in the body. I personally favor an approach that does not “manage” the patient’s diabetes, but gets rid of it. And in many cases it can be done, with exercise, better nutrition – and determination on the patient’s side. Read More