The fundamental problem, the cause of all the complications associated with diabetes, is the chronically elevated glucose and insulin levels. Independently of the fact that each individual, each one of us, has a different tolerance to carbohydrates, a different metabolic response to the presence of glucose and insulin in the blood, there are basically only two ways that blood glucose can be elevated: the first is by the consumption of sugar or starch that finds its way into the bloodstream through the intestinal wall; the second is by the stimulation by stress hormones of liver glucose production whereby the glycogen reserves are broken down and the resulting glucose released into the blood. Therefore, in order to most effectively bring down chronically elevated blood sugar levels, it is essential to eliminate insulin-stimulating carbohydrates, but it is also essential to eliminate chronic stress.
The vast majority of the millions of type II diabetics that constitute the body of what is now generally considered to be a diabetes epidemic in many western countries, have developed the condition primarily from the consumption of dietary insulin-stimulating carbohydrates, from eating high-sugar and high-starch diets over the course of decades. The process of growing insulin resistance due to chronic consumption of carbohydrates is described in several other posts (like, for example, We were never meant to eat simple or starchy carbohydrates, A diabetic’s meal on Air France, and Cure diabetes in a matter of weeks). It is for this reason that the same vast majority of type II diabetics responds extremely well to the elimination of these carbohydrates from their diet, whereupon glucose levels drops, insulin levels drop, the cells gradually regain insulin sensitivity, and the tissues and organs gradually recover from years or decades of the toxic environment created by continuously being exposed both to glucose and insulin. Naturally, the recovery process depends intimately on how long and how bad things were before implementing these dietary changes, but it happens in more or less the same way in every person.
The tendency, in many western societies and especially in North America, to create and generate in all sorts of ways, very high levels of stress in most spheres of our activities and our life, and, in fact, thrive on this stress throughout most days, often for years and even decades, in order to be highly “productive” and “successful”, or at least, make ourselves feel or believe that we are, is extremely bad. This, compounded with the fact that most of our standard western diets are very top-heavy in insulin-stimulating carbohydrates, makes one’s evolution towards of type II diabetes faster, more pronounced and much more harmful. As a consequence, there is without a doubt an non-negligible fraction of diabetics that suffer from both a high intake of sugary and starchy foods, as well as high stress levels.
In the extreme, however, it is definitely possible to develop diabetes uniquely or primarily due to chronically high levels of stress. The most important, and indeed, very important difference between elevating blood sugar through diet or as a consequence of stress hormones, is that the former is naturally corrected by the secretion of insulin, which helps put aways the sugar either as glycogen or as fat, whereas the latter, the presence of high levels of stress hormones, simultaneously induces insulin resistance in order to keep the glucose in circulation as long as possible. This makes perfect sense from an evolutionary standpoint because under stress, under a fight or flight situation, we need lots of glucose in the blood and we want it to stay there to allow us to respond physically to whatever needs to be done: to run, jump, climb, fight, survive. The problem is that our high levels of stress are not only chronic, but they are not associated with a situation in which we need to have access to high levels of sugar in the blood in order to respond to the stressor physically with our muscles. And so, glucose remains high and circulates, insulin remains high but is not effective, and from this, all our blood vessels, tissues and organs get damaged: glycated from the glucose, oxidised from the free radicals, and literally corroded by the insulin.
This clearly implies that chronically high levels of stress are far worse than a high carbohydrate diet, and explains in no uncertain terms why high-stress professionals—even low-carb eaters—can not only suffer from chronically elevated blood sugar levels and the full array of damaging consequences, but also develop diabetes, and almost inevitably, heart and artery disease, because they all come from the same place: high stress leads to high levels of cortisol and other stress hormones; high levels of stress hormones lead to high glucose and insulin resistance no matter what is eaten because it comes from the liver; high glucose levels and insulin resistance leads to artery disease which leads to heart disease, and it also leads to type II diabetes. This is why, for those high work volume and high stress high-strung high-achievers, it is essential to eliminate all insulin-stimulating carbohydrates, but it is crucial to significantly reduce, and ideally, eliminate chronic stress. (We have looked at many of the physiological effects of stress in The kidney: evolutionary marvel and in At the heart of heart disease.)
The physiological consequences
As every diabetic knows, or at least should know, the consequences or complications associated with the condition of diabetes are horrific. What is very unfortunate is that it appears as though many doctors do not understand the biochemical and physiological connections and chains of reactions and responses that develop and grow more sever over time as a consequence of the underlying chronically elevated blood sugar and insulin levels (as you may remember from your reading of Why do diabetics have high blood pressure?). What happens in the body when levels of blood sugar and insulin resistance stay high? Let’s follow this through:
High blood pressure, atherosclerosis and heart disease
The most immediate consequences are the rise in blood pressure and increased damage to blood vessels from glycation: the elevated levels of glucose that the kidneys have evolved to keep in circulation causes a rise in osmolarity (blood concentration), which the kidneys try to counter by retaining water in order to keep the blood from getting too concentrated. Since blood pressure is mostly a function of the amount of water in the blood, this causes the pressure to rise. Because glucose is meant to remain in minimal circulating concentrations or otherwise be quickly cleared from the bloodstream by pancreatic insulin shuttling it into cells, long-lasting elevated sugar concentration leads to the glycation of tissues, which is the damage of protein or fatty structures of the cells due to the glucose molecules “sticking” in the wrong places and in the wrong way. This, in combination with the higher blood pressure, is the perfect recipe for much increased damage to the blood vessels, especially the large arteries in which the pressure is greatest, the increased production of cholesterol and lipoproteins for cholesterol transport and damage repair, and the consequent plaque buildup termed atherosclerosis, which eventually (sooner than later) leads to artery disease, heart disease, and heart attacks from the occlusion of vessels bringing blood to the heart muscle (the coronary arteries).
Even though it is the kidney that regulates the blood pressure and retains water in order to keep the blood from getting too concentrated with the increasing concentration of glucose, the higher blood pressure puts great strain on all of its micro filtering units, the nephrons, whose function is to filter out acidic metabolic waste from the bloodstream and get rid of it through the urine. The nephron works optimally under optimal conditions, but optimal for it, which means ideal blood pressure: not too low, but especially, not too high. It’s a self-regulating system in that if we are relaxed and at rest, then breathing is slow, heart beat is slow, blood circulation is slow, blood pressure is low and the kidneys are under little strain. As we get moving, through exercise, for example, then breathing is faster, heart beat is faster, blood flow is faster, blood pressure is higher, and the kidneys filter a larger volume of blood per second in order to eliminate as much of the acid that is building up from the activity and that needs to be eliminated in order for the muscles to continue working in ideal conditions.
With chronically high blood pressure, the kidneys are continually under stress and the nephrons get damaged. However, because there are millions of nephrons in each of the two kidneys, and it has been estimated that we can live with only 1/3 of the nephrons in only one of the two kidneys, this problem of the gradual deterioration of kidney function is not really considered as a big issue until the kidneys fail (or little time before), at which point it is far too late, and the situation is irreversible.
In addition, insulin resistance—to any degree—promotes the break down of muscle tissue, because as soon as sugar levels drop after a few hours after a meal or snack, during the night is the most apt example, since the cells cannot use fats for energy, the muscle tissue is broken down and constituents of its proteins made into glucose. This leads to chronically high levels of circulating creatinine that, as a metabolic waste product, must also be filtered out and eliminated by the kidneys. This happens in everyone with insulin resistance, and the amount of muscle breakdown is a function of the degree of insulin resistance. In the case of extreme insulin resistance as is seen in type II diabetics, the process is far more pronounced. The excessive stress on the kidneys inevitably leads to deterioration, nephron dysfunction, and eventually to failure. (You can read more about kidney function in The kidney evolutionary marvel.)
What makes things even worse is that most diabetics/heart disease sufferers have elevated lipoprotein (and cholesterol) levels due to the excessive inflammation and speed at which tissue damage is taking place in the blood vessels and all over the body. This, as you all know, has been wrongly interpreted and widely promoted as a major risk factor for heart attacks. The “treatment” of choice for these patients are a lifelong prescription for statin drugs. Very unfortunately, not only do statin drugs not confer any health or longevity benefits, but they accelerate the speed at which muscle breaks down, causing even greater amounts of creatinine to make its way into the bloodstream, and thus creating a heavy additional load on the kidneys. Is it any wonder that the rise in kidney disease closely reflects the rise in diabetes but also in statin consumption? If you’ve been taking statins, don’t get overly worried: physiological degradation is a slow process, and it is rarely too late to make the intelligent choices and changes that will help stop and reverse the disease process, and in time allow the body to heal itself.
The way in which the kidney regulates blood pressure upwards is by secreting different hormones that prevent water from being eliminated, that thicken the blood, and that contract the blood vessels. In most people, the majority of which is chronically dehydrated, there is already a shortage of water and therefore a dehydration response by the kidneys; the elevated sugar concentration makes this far worse, of course. And under dehydration conditions, the means by which the kidney can retain even more water, as much water as it can, is by increasing the concentration gradient in the interstitial medium through which the nephron passes in order to pull as much water out of the filtrate as possible.
Increasing the concentration gradient is done by keeping and concentrating sodium and uric acid. It is more important to retain water than to eliminate uric acid, because water is primordially important for all body functions. Consequently, urea and uric acid levels rise, gradually but consistently over time. Because acid cannot accumulate in the blood, whose pH must absolutely be kept pretty much exactly at 7.4 (7.35-7.45), but because, at the same time, it cannot be eliminated by the kidneys under the given circumstances, it is stored away in the tissues all over the body: joints, ligaments, tendons, muscles and organs. Chronically high levels of uric acid in the blood lead to the condition known as gout. The buildup of acid in the tissues leads to pain, inflammation, arthritis, cartilage breakdown, bone demineralisation and osteoporosis, and a slew of other undesirable consequences, including increased susceptibility to all forms of infections: yeast, viral and bacterial, and severely depressed immunity. (You can read more about acidosis and alkalisation in A green healing protocol, Detoxification, and Such a simple and yet powerful natural anti-inflammatory.)
Maybe the most critical point about acidosis in how it relates to diabetes is that the pancreas and its precious beta cells, those that produce the insulin, are extremely sensitive to pH, and simply cannot function when the blood and cellular environment is acidic. The cells simply stop functioning because of the overload of acid that is not excreted and not neutralised. This makes the pancreas more and more dysfunctional over time, and eventually leads to exhaustion and the complete inability to secrete insulin or do any of the other functions that it is intended to perform. Something very similar happens in the liver, and, in fact, everywhere else, when chronic acidosis defines the internal environment of the body.
The distinction between type I and type II diabetes is usually highlighted by calling the first insulin-dependent diabetes, and the second insulin-resistant diabetes. Type I diabetics are usually identified and diagnosed as children or young adults because their pancreas does not produce insulin, and are then “treated” by having to inject themselves insulin after they eat for the rest of their lives. Naturally, over time, from the continual and usually excessive exposure to insulin, their cells become insulin-resistant, and they subsequently develop all the same problems as type II diabetics, whose condition is, in a way, exactly the opposite, in the sense that they suffer from chronic hyper-insulinemia, because their pancreas that senses the elevated glucose concentration in circulation, produces more insulin in order to clear it out and store it away. The problem is that the cells are not sensitive to the presence of insulin, and therefore do not take in the sugar. The pancreas is then forced to produce and secrete more insulin, and on it goes. Amazingly, type II diabetics are also “treated” by insulin injections, which increase insulin levels even more, and increase insulin resistance even more, obviously making the situation far worse. Eventually, the pancreas of the type II diabetic gets completely exhausted, and loses the ability to manufacture and secrete insulin. At this point, the type II becomes a kind of type I. Interesting how this goes, isn’t it.
The pancreas’ main function is not to secrete insulin, even though in our diabetic-centric worldview it is certainly considered as such. This is one of its functions, but not the most important. By far the most essential is the production and secretion of enzymes, the specialised proteins that break down foods but also do everything else that needs to be done, especially tissue building and repair throughout the body. The third essential function of the pancreas is the concentration and secretion of sodium bicarbonate in the small intestine following the movement of the pre-digested chyme from the stomach into the small intestine. This is also extremely important because all absorption and digestion in the intestine must take place in an alkaline environment, compared to the acidic environment required in the stomach when protein is present. Pancreatic exhaustion from the over-production of insulin for years on end, therefore spells disaster on many more fronts than just insulin and glucose metabolism. It spells disaster for all digestion and absorption processes, and all enzyme regulated activities, which basically means everything, really. This is very serious.
The liver does an amazing amount of vital work, most of it incredibly complex. This includes filtering the blood from all sorts of toxins, both biological and chemical in nature, and breaking those down for elimination; it includes the manufacture of cholesterol and lipoproteins, vital for survival, but the details of which are so intricate that they are still not completely understood after a century of study; it includes the transformation of excess glucose into glycogen and into fat for storage; and in includes the manufacture of glucose from liver-stored glycogen to continually adjust the levels of glucose in the circulation depending on the body’s needs, or more specifically, on the hormonal and biochemical environment. The distinction may appear subtle, but it is quite important in the sense that it is really the hormones and biochemistry of the blood that regulates the function of most tissues and organs, especially those of the vital glands like the liver, pancreas and adrenals, and there is hardly anything more disruptive and unbalancing to the hormonal and biochemical makeup than chronically elevated glucose, stress hormones and acid levels.
Under such conditions, the liver must manufacture an inordinate amount of glucose from the glycogen stores that it itself must also replenish, but also from the broken down muscle tissue. At the same time it converts as much as it can of the glucose into fat for storage, but unfortunately, insulin resistance makes it impossible for the triglycerides to be used, and they are therefore left in circulation for longer than they should before eventually being stored in our fat cells. To top up the list, the free-radical and glycation damage to the vessels and tissues require the liver to also manufacture an inordinate amount of cholesterol and lipoproteins in an attempt to repair these damaged cells, which is no small feat, (you can read more about cholesterol and lipoproteins in But what about cholesterol? and in Six eggs per day for six days: cholesterol?). All of these processes are perfectly natural. However, they are not meant to be running in overdrive for years on end. It is no surprise then that imposing upon the liver to cope with this, eventually leads to dysfunction, deterioration, exhaustion and failure.
Towards a working solution
This is definitely not the end of the list of the complications and physiological consequences that develop from chronically high circulating glucose and insulin levels, but they are some of the most important. Also, it is essential to understand the process by which these consequences first arise and then grow in severity and into the disease process over time. It is, however, infinitely more useful to know what to do in order to maintain a biochemical and hormonal environment in which none of these various dysfunctions and complications can arise if they haven’t yet, or how they can be stopped and reversed if they have.
It shouldn’t be surprising that these are the same, and that they are keys to any optimal health plan, simply because the cells, tissues and organs that make up the human body function, or rather, should function in the pretty much the same way in everyone, allowing for small differences in some of the details. For example, the fact that different people have different tolerances to carbohydrates does not change anything to the consequences of chronically elevated glucose levels on physiological function. It only changes the details relating to the thresholds and time scales involved in developing the same problems. The same goes for vitamin D: the fact that different people require different amounts of vitamin D in order to remain healthy does not in the least alter the basic fact that virtually all complex living creatures depend on it for life. So, yes, everyone is different, but, at the same time, everyone is the same.
No sugars, no starches, no dairy
The first step to take is to eliminate from the diet foods that cause glucose and insulin levels to rise. For this, we must
- Eliminate all simple sugars: that’s basically anything that tastes sweet, including sweet fruit, because all simple sugars will elevate blood glucose levels almost immediately after consumption;
- Eliminate all starchy carbohydrates: that’s all grains and grain products (at least 90% carb), beans (typically more than 70% carb), potatoes (virtually 100% carb), and other starchy veggies like sweet potatoes, yams, taro, etc, because the starches they contain are broken down to glucose by enzymes in the digestion process; but also sweet root vegetables like carrots and beets, which are just full of simple sugars (you’ll know this if you’ve ever had carrot or beet juice?)
- Eliminate dairy: that’s all milk products, which, even those low in sugars like hard cheeses, cause a rise in insulin levels. Besides, most people are allergic or intolerant to dairy products, whether they are aware of it or not.
And aside from just glucose and insulin levels, as we discussed in At the heart of heart disease, insulin-stimulating carbohydrates are highly inflammatory, triggering more than 300 inflammatory pathways. So, excluding them from our diet not only brings about plenty of positive metabolic and physiological changes, but it is, as far as I am concerned, a requirement to make those positive changes happen.
Drop the stress
For those people to whom we referred to earlier that suffer mostly from the chronically elevated stress hormone levels, it is crucial to eliminate the causes of stress, ensure long hours of high quality sleep, and incorporate exercise and activities that effectively reduce stress levels, as well as supplements that can help with that. Obviously, the most important sources of stress for most professionals are psychological ones. But what is also well established is that the level of stress that is experienced (i.e., the amount of stress hormones secreted and in circulation) depends entirely on each person’s outlook and attitude. Therefore, it is this—the attitude and outlook—that are the most influential factors in generating or relieving stress on a daily basis.
Having said this, it is also obvious that going to a remote holiday house on sandy beach without access to phone or internet communications, and making a point of simply relaxing, going for walks, swimming in the sea, reading good books, watching good films, taking naps, eating healthfully and sleeping long and soundly every night, is inherently far more conducive to eliminating stress than the usual school year and work day conditions. What we must find a way to do is to function well in all circumstances with minimal stress, and most importantly, without chronic stress. It is chronic stress that is the problem; not relatively short periods of high stress. And stress, it shouldn’t be surprising, is also happens to be extremely acidifying (haven’t you ever noticed the strong, acidic smell of underarm stress sweat?).
Very helpful in this is taking Tulsi in the morning and at lunchtime (only during the day), and valerian root before bed. But exercise, conscious relaxation, and modifying outlook and attitude towards a more open and relaxed position are definitely most important.
Lower blood pressure
Lowering glucose levels will automatically lower blood pressure. Lowering stress will also automatically lower blood pressure. Biochemically though, the most important muscle relaxant—and this most definitely applies to the smooth muscle cells that line the blood vessels—is magnesium. Therefore, magnesium baths, oil and oral supplementation is essential. On the other hand, calcium is contractile and unfortunately, much more present in the foods we eat. Therefore, most of us are magnesium deficient but also over-calcified. Hence, minimising calcium intake is also very important. (You can read more about these topics in Minerals and bones, calcium and heart attacks, and in Why you should start taking magnesium today.)
Proper mineral balance, especially sodium and chloride, are essential for blood pressure regulation. Eating plenty of unrefined sea salt with meals (and with drinks) is also crucial. Naturally, we seek balance, and salt intake has to be balanced with water intake, and this leads to optimal kidney function. (You can read more about water, salt and physiological function in How much salt, how much water and our amazing kidneys, Why we should drink water before meals, and in Water, ageing and disease)
Support the kidneys
The kidneys want to maintain optimal blood pressure; regulate water, sodium and mineral content of the blood; and clear out metabolic wastes, mostly uric acid. To have them do what they are trying to do as best they can, we must very simply provide plenty of water, plenty of unrefined salt rich in sodium and all the other essential minerals, plenty of alkalising sources in drink and food, minimise glucose levels and minimise creatinine levels. The importance of alkalising the body intensely at first and continuously thereafter cannot be overstated with regards to the proper function of all the vital organs discussed here, and everything else really: every cellular process and every enzymatic action; everything depends on this.
Rejuvenate the pancreas
The pancreas senses and responds to glucose in the blood by manufacturing and secreting insulin. It responds to the movement of food from the stomach to the intestines by manufacturing and secreting sodium bicarbonate and digestive enzymes. To rejuvenate the pancreas, we need to not only give it a break, but help it recover. For this, we need to minimise glucose levels in the blood, and thereby minimise the need for it to manufacture insulin; maximise intake of enzymes to minimise the need for it to produce them; and, especially in light of what we discussed under acidosis, we need to maximise alkalisation, including through oral and transdermal absorption of sodium bicarbonate and magnesium chloride, with a focus on chlorophyl and chlorophyl-rich foods and drinks.
Cleanse the liver
The liver’s most taxing function is the breakdown of toxins (all substances foreign and dangerous to the body). Another taxing function of the liver is the manufacture and recycling of cholesterol and lipoproteins that, as we said earlier, are in production overdrive because of the excessively fast free-radical and glycation damage to the lining of the blood vessels, as well as the damage these cause everywhere else in the tissues of the body, accompanied by the chronic systemic inflammation this leads to (you can read more about systemic inflammation in Treating Arthritis and At the heart of heart disease.)
To help the liver, we must therefore first stop ingesting chemically manufactured medications, and we must eliminate sources of toxins and chemicals from the things we eat and drink; from the air we breathe, especially from those toxic cleaning products we use; and from all the chemicals we absorb through the skin in soaps, shampoos, lotions and creams. Second, we eat and drink to minimise inflammation and internal tissue damage, therefore minimising the strain of excessive manufacture of cholesterol and lipoproteins. And third, we must take regular toxin cleansing and alkalising baths with sodium bicarbonate and magnesium chloride. This simple therapy is the most effective means of detoxifying the body from chemicals and toxins or all kinds, including the most notorious radioactive isotopes that can make their way into our bodies from nuclear weapons, spills and power plant accidents through the air, water and food. Here again, chlorophyl and chlorophyl-rich foods and drinks are essential.
The basic conclusion is the same as what we have come to whenever we discussed type II diabetes: while it is a devastatingly damaging condition that affects every metabolic and physiological function of the body, it is incredibly easy to prevent, and even after many years of deterioration for the diabetic sufferer, it is relatively easy to reverse the condition and cure the disease, including the beta cells of the pancreas, by understanding the disease process thoroughly, and by adopting an appropriate healing protocol. Here, we have detailed several of the key problems or complications that stem from chronically elevated glucose and insulin levels, with specific discussion of the ensuing dysfunction in some vital organs, and highlighting the crucial importance of considering the effect of stress in addition to the effects of dietary insulin-stimulating carbohydrates.
You might have noticed that a discussion revolving around overweight, obesity and fat metabolism is missing, maybe conspicuously so. This is not an oversight, but a conscious move towards a focus on the underlying causes of the metabolic, hormonal and physiological natures of the disorder instead of the superficial and rather inconsequential repercussions of it that take expression in the form of excess body fat. The only point I want to mention about this is that by correcting the causes of the disorder, excess body fat stores will melt away on their own. Some help from supplements and hormonal manipulation through diet and timing here and there will be useful. But, the point remains that if the body is in optimal biochemical balance, then physiological and metabolic functions will also be optimal, and no excess body fat will remain, no matter how young or old we are, and no matter what our genetic makeup happens to be.
The overview of the basic strategy for preventing and overcoming diabetes should make it clear that what it implies, although in some aspects quite specific and targeted, is very simple in that it relies mostly on drinking clean water, eating unrefined salt and clean foods, especially those that are chlorophyl-rich, eliminating damaging foods, chemicals and toxins, alkalising and detoxifying with sodium bicarbonate and magnesium chloride, and finally, using a number of important supplements to correct deficiencies and restore optimal biochemical balance. In a subsequent post we will formulate a detailed programme that incorporates all of the elements and strategies discussed here in general terms, together with some additional considerations about details like the timing and amount of food, drink, exercise and supplements.
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