Type One Diabetes Quotes

According to the surgeon general, obesity today is officially an epidemic; it is arguably the most pressing public health problem we face, costing the health care system an estimated $90 billion a year. Three of every five Americans are overweight; one of every five is obese. The disease formerly known as adult-onset diabetes has had to be renamed Type II diabetes since it now occurs so frequently in children. A recent study in the Journal of the American Medical Association predicts that a child born in 2000 has a one-in-three chance of developing diabetes. (An African American child's chances are two in five.) Because of diabetes and all the other health problems that accompany obesity, today's children may turn out to be the first generation of Americans whose life expectancy will actually be shorter than that of their parents. The problem is not limited to America: The United Nations reported that in 2000 the number of people suffering from overnutrition--a billion--had officially surpassed the number suffering from malnutrition--800 million.

She thought about how no one had taught us to grow old, how we didn’t know what it would be like. When we were young we thought of old age as an ailment that affected only other people. While we, for reasons never entirely clear, would remain young. We treated the old as though they were responsible for their condition somehow, as though they’d done something to earn it, like some types of diabetes or arteriosclerosis. And yet this was an ailment that affected the absolute most innocent.

If you don’t drink coffee, you should think about two to four cups a day. It can make you more alert, happier, and more productive. It might even make you live longer. Coffee can also make you more likely to exercise, and it contains beneficial antioxidants and other substances associated with decreased risk of stroke (especially in women), Parkinson’s disease, and dementia. Coffee is also associated with decreased risk of abnormal heart rhythms, type 2 diabetes, and certain cancers.12, 13 Any one of those benefits of coffee would be persuasive, but cumulatively they’re a no-brainer. An hour ago I considered doing some writing for this book, but I didn’t have the necessary energy or focus to sit down and start working. I did, however, have enough energy to fix myself a cup of coffee. A few sips into it, I was happier to be working than I would have been doing whatever lazy thing was my alternative. Coffee literally makes me enjoy work. No willpower needed. Coffee also allows you to manage your energy levels so you have the most when you need it. My experience is that coffee drinkers have higher highs and lower lows, energywise, than non–coffee drinkers, but that trade-off works. I can guarantee that my best thinking goes into my job, while saving my dull-brain hours for household chores and other simple tasks. The biggest downside of coffee is that once you get addicted to caffeine, you can get a “coffee headache” if you go too long without a cup. Luckily, coffee is one of the most abundant beverages on earth, so you rarely have to worry about being without it. Coffee costs money, takes time, gives you coffee breath, and makes you pee too often. It can also make you jittery and nervous if you have too much. But if success is your dream and operating at peak mental performance is something you want, coffee is a good bet. I highly recommend it. In fact, I recommend it so strongly that I literally feel sorry for anyone who hasn’t developed the habit.

No one gets an easy pass in life. We all meet struggles while pursuing our dreams. Sometimes our knees shake when facing giants, and sometimes our feet get knocked out from under us. Those are defining moments.

After the mountains, I found that when my blood sugar levels were between 140 and 180, I was strong during my pulls--and felt refreshed and ready to go for the next ones. Same with Joe. This was a vital piece of information for all eight of us and we immediately spread the word among our teammates. Working out the diabetes strategy was as important as our race strategy. Bike-racing teams ahve to worry about a lot of things; Team Type 1 has to worry about all those same things plus a potentially life-threatening disease.

Scientists generally agree that the more HDL you have, the lower your risk for heart disease. As you might have imagined, people with Metabolic Syndrome and type 2 diabetes also typically have low levels of beneficial HDL. Exercise is one of the cheapest, easiest, and most effective ways to raise HDL. Consuming saturated fat is another!

the odds are overwhelming that you will die as a result of one of the chronic diseases of aging that I call the Four Horsemen: heart disease, cancer, neurodegenerative disease, or type 2 diabetes and related metabolic dysfunction. To achieve longevity—to live longer and live better for longer—we must understand and confront these causes of slow death.

When the American Dietetic Association (ADA) surveyed all the studies on food and health, they concluded not just that a vegetarian or vegan diet is as healthy as one that includes meat, but that “vegetarians have been reported to have lower body mass indices than non-vegetarians, as well as lower rates of death from ischemic heart disease, lower blood cholesterol levels, lower blood pressure, and lower rates of hypertension, type 2 diabetes, and prostate and colon cancer.

When Franklin D. Roosevelt signed the Social Security Act in 1935, old age was defined as sixty-five years, yet estimated life expectancy in the United States at the time was sixty-one years for males and sixty-four years for females.62 A senior citizen today, however, can expect to live eighteen to twenty years longer. The downside is that he or she also should expect to die more slowly. The two most common causes of death in 1935 America were respiratory diseases (pneumonia and influenza) and infectious diarrhea, both of which kill rapidly. In contrast, the two most common causes of death in 2007 America were heart disease and cancer (each accounted for about 25 percent of total deaths). Some heart attack victims die within minutes or hours, but most elderly people with heart disease survive for years while coping with complications such as high blood pressure, congestive heart failure, general weakness, and peripheral vascular disease. Many cancer patients also remain alive for several years following their diagnosis because of chemo-therapy, radiation, surgery, and other treatments. In addition, many of the other leading causes of death today are chronic illnesses such as asthma, Alzheimer’s, type 2 diabetes, and kidney disease, and there has been an upsurge in the occurrence of nonfatal but chronic illnesses such as osteoarthritis, gout, dementia, and hearing loss.63 Altogether, the growing prevalence of chronic illness among middle-aged and elderly individuals is contributing to a health-care crisis because the children born during the post–World War II baby boom are now entering old age, and an unprecedented percentage of them are suffering from lingering, disabling, and costly diseases. The term epidemiologists coined for this phenomenon is the “extension of morbidity.

I married him—despite all the very good reasons that no one should ever partner up for a third time—because early on, he reminded me of the best father figure of my life, my ninth-grade English teacher. When that man died, his friends (eighty-year-old poker buddies, pals from his teaching days, devoted former students of all ages and types) wept. He was old, fat, diabetic, and often brusque. Women desired him and my children loved him and most men liked his company a great deal. He was loyal, imperious, needy, charming, bighearted, and just about the most selfish, lovable, and foolishly fearless person I had ever known. And then I met Brian and found another.

So why are we unable to acknowledge the truth? Dr. Fung’s answer is simple: we doctors lie to ourselves. If type 2 diabetes is a curable disease but all our patients are getting worse on the treatments we prescribe, then we must be bad doctors. And since we did not study for so long at such great cost to become bad doctors, this failure cannot be our fault. Instead, we must believe we are doing the best for our patients, who must unfortunately be suffering from a chronically progressive and incurable disease. It is not a deliberate lie, Dr. Fung concludes, but one of cognitive dissonance—the inability to accept a blatant truth because accepting it would be too emotionally devastating.

All this to say, ADHD isn’t your fault. You aren’t selfish, reckless, or irresponsible by nature. Most people seem to have a double standard for chemical imbalances in the brain, as opposed to elsewhere in the body. One would not — we hope! — tell a person with Type I Diabetes to try harder because everyone’s blood sugar gets out of whack sometimes. We’d expect this person to maintain their condition with insulin and a healthy diet so they could live a normal life. Why would we expect someone with a chemical imbalance in the brain to correct it by sheer force of will when we don’t expect them to do it with their pancreas? The sooner you accept your ADHD as a part of your unique biology, not as a personal failing, the sooner you can begin to build a better life for yourself

And there were other neural implants being developed back then, including retinal implants, chips that enable a stroke patient to control his computer from his brain, an artificial hippocampus for boosting short-term memory, and many others. If you apply the approximately 30 million–fold increase in capability and over 100,000-fold shrinking in size that has occurred in the past quarter century, we now have much more capable devices that are the size of blood cells. Reader: Still, it’s hard to imagine building something the size of a blood cell that can perform a useful function. Terry2034: Actually, there was a first generation of blood cell–size devices back in your day. One scientist cured type 1 diabetes in rats with a blood cell–size device. It was an excellent example of nanotechnology from

As devasting as it is, cirrhosis is not the only end point I’m worried about here. I care about NAFLD and NASH — and you should too — because they represent the tip of the iceberg of a global epidemic of metabolic disorders, ranging from insulin resistance to type 2 diabetes. Type 2 diabetes is technically a distinct disease, defined very clearly by glucose metrics, but I view it as simply the last stop on a railway line passing through several other stations, including hyperinsulinemia, prediabetes, and NAFLD/NASH. If you find yourself anywhere on this train line, even in the early stages of NAFLD, you are likely also en route to one or more of the three Horsemen diseases (cardiovascular disease, cancer, and Alzheimer’s disease). As we will see in the next few chapters, metabolic dysfunction vastly increases your risks for all of these.

You leave the womb sterile, or so it is generally thought, but are liberally swabbed with your mother’s personal complement of microbes as you move through the birth canal. We are only beginning to understand the importance and nature of a woman’s vaginal microbiome. Babies born by Cesarean section are robbed of this initial wash. The consequences for the baby can be profound. Various studies have found that people born by C-section have substantially increased risks for type 1 diabetes, asthma, celiac disease, and even obesity and an eightfold greater risk of developing allergies. Cesarean babies eventually acquire the same mix of microbes as those born vaginally—by a year their microbiota are usually indistinguishable—but there is something about those initial exposures that makes a long-term difference. No one has figured out quite why that should be.

One of our greatest epidemics today is obesity. It is estimated that more than 500 million people suffer from obesity worldwide today, and that it kills more than three million people each year. In comparison, about 55,000 people are killed in war each year, which of course in no way suggests that we are overestimating the horror and seriousness of war – how could we? – but the little attention we give to obesity in comparison does suggest, however, that we are not taking the “war” we should be waging against obesity seriously. It seems that we overlook what a merciless killer and cause of pain that obesity and the overeating that leads to it really is: it increases the risk of heart disease (the most common cause of death worldwide), many kinds of cancer, type 2 diabetes, degenerative joint disease and mental problems such as depression and low self-esteem.[27] Fortunately, a lot seems to imply that we have a powerful and peaceful weapon at our hands that can help us overcome obesity: a vegan diet.

Human evolution is not over, but the chances of natural selection adapting our species in dramatic, major ways to common non-infectious mismatch diseases are remote unless conditions change dramatically. One reason is that many of these diseases have little to no effect on fertility. Type 2 diabetes, for example, generally develops after people have reproduced, and even then, it is highly manageable for many years.8 Another consideration is that natural selection can act only on variations that affect reproductive success and that are also genetically passed from parent to offspring. Some obesity-related illnesses can hinder reproductive function, but these problems have strong environmental causes.9 Finally, although culture sometimes spurs selection, it is also a powerful buffer. Every year new products and therapies are being developed that allow people with common mismatch diseases to cope better with their symptoms. Whatever selection is operating is probably occurring at a pace too slow to measure in our lifetimes.

Homologous recombination occurs naturally to create genetic diversity in our offspring and is also conveniently harnessed by scientists to introduce experimental DNA into cells or animals. We do not yet know if this occurs with the contaminating human DNA found in some of our vaccines, and if so, to what extent. Imagine the potential consequences of human DNA from a vaccine, a vaccine that is given to children at an average age of 15 months, being incorporated into a child’s developing brain. One does not need to be a rocket scientist to know that this potential has to be studied. In addition to the potential for homologous recombination, DNA is known to be a powerful immune stimulant. Diseases like graft versus host, juvenile (type I) diabetes, multiple sclerosis, lupus and some forms of arthritis are what are called auto-immune diseases. These are diseases driven by immune attack from our own immune system on our own organs, a system normally responsible to attack invading bacteria and pathogens. Targeted self-destruction, if you will.

Although these digital tools can improve the diagnostic process and offer clinicians a variety of state-of-the-art treatment options, most are based on a reductionist approach to health and disease. This paradigm takes a divide-and-conquer approach to medicine, "rooted in the assumption that complex problems are solvable by dividing them into smaller, simpler, and thus more tractable units." Although this methodology has led to important insights and practical implications in healthcare, it does have its limitations. Reductionist thinking has led researchers and clinicians to search for one or two primary causes of each disease and design therapies that address those causes.... The limitation of this type of reasoning becomes obvious when one examines the impact of each of these diseases. There are many individuals who are exposed to HIV who do not develop the infection, many patients have blood glucose levels outside the normal range who never develop signs and symptoms of diabetes, and many patients with low thyroxine levels do not develop clinical hypothyroidism. These "anomalies" imply that there are cofactors involved in all these conditions, which when combined with the primary cause or causes bring about the clinical onset. Detecting these contributing factors requires the reductionist approach to be complemented by a systems biology approach, which assumes there are many interacting causes to each disease.

REPROGRAMMING MY BIOCHEMISTRY A common attitude is that taking substances other than food, such as supplements and medications, should be a last resort, something one takes only to address overt problems. Terry and I believe strongly that this is a bad strategy, particularly as one approaches middle age and beyond. Our philosophy is to embrace the unique opportunity we have at this time and place to expand our longevity and human potential. In keeping with this health philosophy, I am very active in reprogramming my biochemistry. Overall, I am quite satisfied with the dozens of blood levels I routinely test. My biochemical profile has steadily improved during the years that I have done this. For boosting antioxidant levels and for general health, I take a comprehensive vitamin-and-mineral combination, alpha lipoic acid, coenzyme Q10, grapeseed extract, resveratrol, bilberry extract, lycopene, silymarin (milk thistle), conjugated linoleic acid, lecithin, evening primrose oil (omega-6 essential fatty acids), n-acetyl-cysteine, ginger, garlic, l-carnitine, pyridoxal-5-phosphate, and echinacea. I also take Chinese herbs prescribed by Dr. Glenn Rothfeld. For reducing insulin resistance and overcoming my type 2 diabetes, I take chromium, metformin (a powerful anti-aging medication that decreases insulin resistance and which we recommend everyone over 50 consider taking), and gymnema sylvestra. To improve LDL and HDL cholesterol levels, I take policosanol, gugulipid, plant sterols, niacin, oat bran, grapefruit powder, psyllium, lecithin, and Lipitor. To improve blood vessel health, I take arginine, trimethylglycine, and choline. To decrease blood viscosity, I take a daily baby aspirin and lumbrokinase, a natural anti-fibrinolytic agent. Although my CRP (the screening test for inflammation in the body) is very low, I reduce inflammation by taking EPA/DHA (omega-3 essential fatty acids) and curcumin. I have dramatically reduced my homocysteine level by taking folic acid, B6, and trimethylglycine (TMG), and intrinsic factor to improve methylation. I have a B12 shot once a week and take a daily B12 sublingual. Several of my intravenous therapies improve my body’s detoxification: weekly EDTA (for chelating heavy metals, a major source of aging) and monthly DMPS (to chelate mercury). I also take n-acetyl-l-carnitine orally. I take weekly intravenous vitamins and alpha lipoic acid to boost antioxidants. I do a weekly glutathione IV to boost liver health. Perhaps the most important intravenous therapy I do is a weekly phosphatidylcholine (PtC) IV, which rejuvenates all of the body’s tissues by restoring youthful cell membranes. I also take PtC orally each day, and I supplement my hormone levels with DHEA and testosterone. I take I-3-C (indole-3-carbinol), chrysin, nettle, ginger, and herbs to reduce conversion of testosterone into estrogen. I take a saw palmetto complex for prostate health. For stress management, I take l-theonine (the calming substance in green tea), beta sitosterol, phosphatidylserine, and green tea supplements, in addition to drinking 8 to 10 cups of green tea itself. At bedtime, to aid with sleep, I take GABA (a gentle, calming neuro-transmitter) and sublingual melatonin. For brain health, I take acetyl-l-carnitine, vinpocetine, phosphatidylserine, ginkgo biloba, glycerylphosphorylcholine, nextrutine, and quercetin. For eye health, I take lutein and bilberry extract. For skin health, I use an antioxidant skin cream on my face, neck, and hands each day. For digestive health, I take betaine HCL, pepsin, gentian root, peppermint, acidophilus bifodobacter, fructooligosaccharides, fish proteins, l-glutamine, and n-acetyl-d-glucosamine. To inhibit the creation of advanced glycosylated end products (AGEs), a key aging process, I take n-acetyl-carnitine, carnosine, alpha lipoic acid, and quercetin. MAINTAINING A POSITIVE “HEALTH SLOPE” Most important,

American Dietetic Association (ADA) surveyed all the studies on food and health, they concluded not just that a vegetarian or vegan diet is as healthy as one that includes meat, but that “vegetarians have been reported to have lower body mass indices than non-vegetarians, as well as lower rates of death from ischemic heart disease, lower blood cholesterol levels, lower blood pressure, and lower rates of hypertension, type 2 diabetes, and prostate and colon cancer.

Phlebotomy. Even the word sounds archaic—and that’s nothing compared to the slow, expensive, and inefficient reality of drawing blood and having it tested. As a college sophomore, Elizabeth Holmes envisioned a way to reinvent old-fashioned phlebotomy and, in the process, usher in an era of comprehensive superfast diagnosis and preventive medicine. That was a decade ago. Holmes, now 30, dropped out of Stanford and founded a company called Theranos with her tuition money. Last fall it finally introduced its radical blood-testing service in a Walgreens pharmacy near the company headquarters in Palo Alto, California. (The plan is to roll out testing centers nationwide.) Instead of vials of blood—one for every test needed—Theranos requires only a pinprick and a drop of blood. With that they can perform hundreds of tests, from standard cholesterol checks to sophisticated genetic analyses. The results are faster, more accurate, and far cheaper than conventional methods. The implications are mind-blowing. With inexpensive and easy access to the information running through their veins, people will have an unprecedented window on their own health. And a new generation of diagnostic tests could allow them to head off serious afflictions from cancer to diabetes to heart disease. None of this would work if Theranos hadn’t figured out how to make testing transparent and inexpensive. The company plans to charge less than 50 percent of the standard Medicare and Medicaid reimbursement rates. And unlike the rest of the testing industry, Theranos lists its prices on its website: blood typing, $2.05; cholesterol, $2.99; iron, $4.45. If all tests in the US were performed at those kinds of prices, the company says, it could save Medicare $98 billion and Medicaid $104 billion over the next decade.

According to the surgeon general, obesity today is officially an epidemic; it is arguably the most pressing public health problem we face, costing the health care system an estimated $90 billion a year. Three of every five Americans are overweight; one of every five is obese. The disease formerly known as adult-onset diabetes has had to be renamed Type II diabetes since it now occurs so frequently in children.

By 2004, one in three Americans was considered clinically obese; two in three were overweight. One in ten adult Americans had Type 2 diabetes—one in five over the age of sixty. It is now clear that the roots of this epidemic are evident even in infants and in the birth weights of newborns. Among middle-income families in Massachusetts, for example, as a team of researchers led by Matthew Gillman of Harvard reported last year, the prevalence of excessively fat infants increased dramatically between 1980 and 2001. This increase was most conspicuous among children younger than six months of age.

The GTT he administered showed severe reactive hypoglycemia (RHG). At that time, one of the many criticisms of Dr. Atkins was that he diagnosed many with RHG. For this he was called a “quack”. After seeing the lab results, I immediately began the Induction phase of his diet and soon felt better, just as his patients did. As long as I ate correctly and didn’t skip meals I rarely experienced my prior symptoms. That remains true to this day. This was my first lesson in the power of practical nutrition (albeit outside of mainstream medical opinion). I am convinced that if I hadn’t followed Dr. Atkins advice I would have had type 2 diabetes long ago. I can thank him for many things but most especially for that.

Now fast forward to the present. The United States is currently re-assessing a 3-decade, uncontrolled experiment in which carbohydrates were lauded and fats demonized. Concurrently we have become one of the most obese countries in the world. And across the globe, tragically, indigenous peoples with historically low carbohydrate intakes now have extremely high prevalence rates of obesity and type-2 diabetes (e.g., the Gulf States in the Middle East, Pacific Islanders, First Nations in Canada, and Australian Aborigines).

The Right Intake Protein, protein, protein. Is there any other food group that causes so much angst? Have too little and you may be in trouble, have too much and you may be in greater trouble. Proteins are the main building blocks of the body making muscles, organs, skin and also enzymes. Thus, a lack of protein in your diet affects not only your health (think muscle deficiency and immune deficiency) but also your looks (poor skin and hair). On the other hand, excess protein can be harmful. “High protein intake can lead to dehydration and also increase the risk of gout, kidney afflictions, osteoporosis as well as some forms of cancer,” says Taranjeet Kaur, metabolic balance coach and senior nutritionist at AktivOrtho. However, there are others who disagree with her. "In normal people a high-protein natural diet is not harmful. In people who are taking artificial protien supplements , the level of harm depends upon the kind of protein and other elements in the supplement (for example, caffiene, etc.) For people with a pre- existing, intestinal, kidney or liver disease, a high-protein diet can be harmful," says leading nutritionist Shikha Sharma, managing director of Nutri-Health.  However, since too much of anything can never be good, the trick is to have just the right amount of protein in your diet.  But how much is the right amount? As a ballpark figure, the US Institute of Medicine recommends 0.8 gm of protein per kilogram of body weight. This amounts to 56 gm per day for a 70 kg man and 48 gm per day for a 60 kg woman.  However, the ‘right’ amount of protein for you will depend upon many factors including your activity levels, age, muscle mass, physical goals and the current state of health. A teenager, for example, needs more protein than a middle-aged sedentary man. Similarly, if you work out five times a day for an hour or so, your protein requirement will go up to 1.2-1.5 gm per kg of body weight. So if you are a 70kg man who works out actively, you will need nearly 105 gm of protein daily.   Proteins are crucial, even when you are trying to lose weight. As you know, in order to lose weight you need to consume fewer calories than what you burn. Proteins do that in two ways. First, they curb your hunger and make you feel full. In fact, proteins have a greater and prolonged satiating effect as compared to carbohydrates and fats. “If you have proteins in each of your meals, you have lesser cravings for snacks and other such food items,” says Kaur. By dulling your hunger, proteins can help prevent obesity, diabetes and heart disease.   Second, eating proteins boosts your metabolism by up to 80-100 calories per day, helping you lose weight. In a study conducted in the US, women who increased protein intake to 30 per cent of calories, ended up eating 441 fewer calories per day, leading to weight loss. Kaur recommends having one type of protein per meal and three different types of proteins each day to comply with the varied amino acid requirements of the body. She suggests that proteins should be well distributed at each meal instead of concentrating on a high protein diet only at dinner or lunch. “Moreover, having one protein at a time helps the body absorb it better and it helps us decide which protein suits our system and how much of it is required by us individually. For example, milk may not be good for everyone; it may help one person but can produce digestive problems in the other,” explains Kaur. So what all should you eat to get your daily dose of protein? Generally speaking, animal protein provides all the essential amino acids in the right ratio for us to make full use of them. For instance, 100 gm of chicken has 30 gm of protein while 75gm of cottage cheese (paneer) has only 8 gm of proteins (see chart). But that doesn’t mean you need to convert to a non-vegetarian in order to eat more proteins, clarifies Sharma. There are plenty of vegetarian options such as soya, tofu, sprouts, pulses, cu

You’d have to be living under a rock not to know that we are getting fatter and fatter every year despite all the information sold to us about how to stay slim and trim. You’d also be hard-pressed to find someone who doesn’t know about our soaring rates of type 2 diabetes. Or the fact that heart disease is our number one killer, trailed closely by cancer.

One mechanism through which tight junctions are opened is zonulin. Zonulin, a protein secreted into the gut by the enterocytes, is supposed to regulate the rapid opening and closing of tight junctions. However, it is now believed that zonulin may play a critical role in the development of autoimmune disease. Patients with celiac disease are known to have increased zonulin levels, stimulating the opening of more tight junctions and probably keeping them open longer. In these patients, the secretion of zonulin is stimulated by the consumption of gluten (or, more specifically, the protein fraction of gluten called gliadin). Increased zonulin production, also in response to gluten, also causes a leaky gut preceding type 1 diabetes.

Type 2 diabetes has been called the “Black Death of the twenty-first century” in terms of its exponential spread around the world and its devastating health impacts. Instead of the bubonic plague, though, the pathological agents in obesity and type 2 diabetes are identified as “high-fat and high-calorie diets,” and instead of fleas and rodents, the causes are “advertisements and inducements to poor lifestyle.”1 More than twenty million Americans are currently diagnosed with diabetes, a tripling of cases since 1990.2 At this rate, the CDC predicts that one in three Americans will be diabetic by midcentury.3 Currently in the United States, diabetes causes about 50,000 cases of kidney failure, 75,000 lower extremity amputations, 650,000 cases of vision loss,4 and about 75,000 deaths every year.

you view the current status of the human body as a whole, many countries, like the United States, now confront a novel paradox. On the one hand, more wealth and impressive advances in health care, sanitation, and education since the Industrial Revolution have dramatically improved billions of people’s health, especially in developed nations. Children born today are far less likely to die from infectious mismatch diseases caused by the Agricultural Revolution and they are much more likely to live longer, grow taller, and be generally healthier than children born in my grandfather’s generation. As a consequence, the world’s population tripled over the course of the twentieth century. But on the other hand, our bodies face new problems that were barely on anyone’s radar screen a few generations ago. People today are much more likely to get sick from new mismatch diseases such as type 2 diabetes, heart disease, osteoporosis, and colon cancer, which were either absent or much less common for most of human evolutionary history, including most of the agricultural era. To understand how and why all this happened—and how to address these new problems—requires considering the industrial era through the lens of evolution. How did the Industrial Revolution along with the growth of capitalism, medical science, and public health affect the way our bodies grow and function? In

One way to quantify the extension of morbidity currently occurring is a metric known as disability-adjusted life years (DALYs), which measures a disease’s overall burden as the number of years lost to ill health plus death.65 According to an impressive recent analysis of medical data worldwide from between 1990 and 2010, the burden of disability caused by communicable and nutrition-related diseases has plunged by more than 40 percent, while the burden of disability caused by noncommunicable diseases has risen, especially in developed nations. As examples, DALYs have risen by 30 percent for type 2 diabetes, by 17 percent for neurological disorders, such as Alzheimer’s, by 17 percent for chronic kidney disease, by 12 percent for musculoskeletal disorders, such as arthritis and back pain, by 5 percent for breast cancer, and by 12 percent for liver cancer.66 Even after factoring in population growth, more people are experiencing more chronic disability that results from noncommunicable diseases. For the diseases just mentioned, the number of years a person can expect to live with cancer has increased by 36 percent, with heart and circulatory diseases by 18 percent, with neurological diseases by 12 percent, with diabetes by 13 percent, and with musculoskeletal diseases by 11 percent.67 To many, old age is now equated with various disabilities (and

Diabetes is actually a group of diseases, all of which are characterized by the inability to produce enough insulin. Type 1 diabetes, which mostly develops in children, occurs when the immune system destroys cells in the pancreas that make insulin. Gestational diabetes arises occasionally during pregnancy when a mother’s pancreas produces too little insulin, giving both her and the fetus a dangerous, prolonged sugar rush. My grandmother had the third and most common form of the disease, type 2 diabetes (also called adult onset diabetes or diabetes mellitus type 2), which is the focus of this discussion because it is a formerly rare mismatch disease associated with metabolic syndrome that is now one of the fastest growing diseases in the world. Between

Coffee If you don’t drink coffee, you should think about two to four cups a day. It can make you more alert, happier, and more productive. It might even make you live longer. Coffee can also make you more likely to exercise, and it contains beneficial antioxidants and other substances associated with decreased risk of stroke (especially in women), Parkinson’s disease, and dementia. Coffee is also associated with decreased risk of abnormal heart rhythms, type 2 diabetes, and certain cancers.12, 13 Any one of those benefits of coffee would be persuasive, but cumulatively they’re a no-brainer. An hour ago I considered doing some writing for this book, but I didn’t have the necessary energy or focus to sit down and start working. I did, however, have enough energy to fix myself a cup of coffee. A few sips into it, I was happier to be working than I would have been doing whatever lazy thing was my alternative. Coffee literally makes me enjoy work. No willpower needed. Coffee also allows you to manage your energy levels so you have the most when you need it. My experience is that coffee drinkers have higher highs and lower lows, energywise, than non–coffee drinkers, but that trade-off works. I can guarantee that my best thinking goes into my job, while saving my dull-brain hours for household chores and other simple tasks. The biggest downside of coffee is that once you get addicted to caffeine, you can get a “coffee headache” if you go too long without a cup. Luckily, coffee is one of the most abundant beverages on earth, so you rarely have to worry about being without it. Coffee costs money, takes time, gives you coffee breath, and makes you pee too often. It can also make you jittery and nervous if you have too much. But if success is your dream and operating at peak mental performance is something you want, coffee is a good bet. I highly recommend it. In fact, I recommend it so strongly that I literally feel sorry for anyone who hasn’t developed the habit. Pleasure

MK-2866 With multiple published human trials under its belt, MK-2866, also known as the drug Ostarine, is one of the best-studied SARMs. Though it is weaker than many others on this list, it still has been shown to offer powerful results. In studies, Ostarine has few meaningful side effects and is very effective at building muscle. Healthy elderly men and women who took Ostarine for twelve weeks saw significant increases in lean body mass and a decrease in fat mass, and were better able to climb stairs.8 Interestingly, these men and women also had an average decline of 11 percent in fasting blood glucose, a 17 percent reduction in insulin levels, and a 27 percent reduction in insulin resistance. This suggests that SARMs might be able to impact type 2 diabetes.

About the Author : Type-1 diabetic, diabetes educator, author, Lee walks in your shoes every day. He writes from both clinical and personal experience with honesty, compassion, and humor. He works full time running the diabetes program for a rural nonprofit clinic in one of the poorest counties in the United States, and is a tireless advocate for diabetes care and awareness.

Alzheimer’s is being called type 3 diabetes, linked to a gluten-rich, wheat-based diet and a stressed-out brain.4 And these are just a few of the diseases that are killing us prematurely and compromising our quality of life.

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The main finding was that vegan and lacto-ovo vegetarian diets were associated with a nearly one-half reduction in risk of type 2 diabetes compared with the risk associated with nonvegetarian diets after adjustment for a number of socioeconomic and lifestyle factors, as well as low BMI, that are typically associated with vegetarianism. Pesco- and semi-vegetarian diets were associated with intermediate risk reductions: between one-third and one-quarter. These data indicate that vegetarian diets may in part counteract the environmental forces leading to obesity and increased rates of type 2 diabetes, though only vegan diets were associated with a BMI in the optimal range. Inclusion of meat, meat products, and fish in the diet, even on a less than weekly basis, seems to limit some of the protection associated with a vegan or lacto-ovo vegetarian diet. These findings may be explained by adverse effects of meat and fish, protective effects of typical constituents of vegan and lacto-ovo vegetarian diets, other characteristics of people who choose vegetarian diets, or a combination of these factors.

The main finding was that vegan and lacto-ovo vegetarian diets were associated with a nearly one-half reduction in risk of type 2 diabetes compared with the risk associated with nonvegetarian diets after adjustment for a number of socioeconomic and lifestyle factors, as well as low BMI, that are typically associated with vegetarianism.

She spent the next hour dividing her time between the phone and the computer; scaring the ever-loving shit out of herself while waiting on hold by investiGoogling type 2 diabetes on her laptop. She found one nut who claimed diabetes was a governmental plot to extract billions of dollars from the unsuspecting public in order to wage the war for oil.

The writers in this book share the common belief that diabetes does not need to be chronic and progressive. We also share the common belief as to how. We know that the macronutrient that diabetics (both types) are least able to handle is carbohydrate. We therefore cannot understand that dietary advice for diabetics is to eat the majority of one’s diet in the form of carbohydrate – the very substance that cannot be handled. (This is the same advice for non-diabetics, which is why we continue to make more people diabetic daily).

As it got away from its founders, chaos magic came to mean ‘doing whatever you want’ in popular parlance, which is probably close to the opposite of its original formulation. In the modern world, ‘doing whatever you want’ leads to Type II diabetes and very public bankruptcies. But the supposed freedom that chaos magic offers -the apple in its garden- is a stark one. Chaos magic is not ‘doing whatever you want’, it is ‘trialling a lot of things and retaining those that work’. It is entirely unforgiving of failure or –more specifically- excuses for failure. Chaos magic lacks any certificates of participation. You achieve what you set out to do or you have failed. Success could be lasting apotheosis or it could be bedding your secretary. This only looks like elitism to failures. To scientists, it looks like science.

The study found that a ketogenic diet can lead to insulin resistance, fatty liver, a pro-inflammatory state, type 2 diabetes, heart disease, and unhealthy fat regulation, as well as elevated levels of cholesterol, triglycerides, and leptin.

The main finding was that vegan and lacto-ovo vegetarian diets were associated with a nearly one-half reduction in risk of type 2 diabetes compared with the risk associated with nonvegetarian diets after adjustment for a number of socioeconomic and lifestyle factors, as well as low BMI, that are typically associated with vegetarianism. Pesco- and semi- vegetarian diets were associated with intermediate risk reductions: between one-third and one-quarter.

Okay, time for action. Having gained an understanding of how the body works and why diabetes occurs, we can now look at how to get rid of it. In this chapter, I outline the “1,2,3” approach, originally designed to identify the cause of type 2 diabetes but found to be successful in real life. This is a simple program, with clearly defined stages—first, lose weight rapidly with a clear end point; second, reintroduce ordinary foods step by step; third, keep the weight down long term. A rapid weight loss phase followed by a stepped return to normal eating is very different from the standard advice of “slow and prolonged” of recent years. The 1,2,3 approach recognizes that losing weight is a distinct activity, separate from the matter of keeping the weight steady in the long term, and that there are many benefits from losing weight fast in the first instance. There are other approaches to losing weight. However, several high-quality studies have shown that going on an intensive rapid weight loss diet for a period is not only effective for most people but extraordinarily motivating. How to Do It Recognize the problem: If you have type 2 diabetes you have become too heavy for your body Write down your target weight: Usually a weight loss of around 33 pounds Recognize that food intake has to be decreased for 2–3 months: Think when it may suit you to do this Discuss with family and friends: Support is one of the secrets of success Decide: Do you really want to do this? Prepare for action: Clear the cupboards Action: Do it

The Karlshamn Study One well-known study, the Karlshamn Study, convincingly demonstrates the benefits of a specific diet for type 2 diabetics.

In one analysis, a typical American population that departed even modestly from the Western diet (and lifestyle) could reduce its chances of getting coronary heart disease by 80 percent, its chances of type 2 diabetes by 90 percent, and its chances of colon cancer by 70 percent.

I threw the chips in the garbage and the beer down the drain. Then I started my research. I needed clear, simple answers to many questions that would guide me to my goals. What is diabetes? What causes it? What are the symptoms and complications? How does one get rid of it? Then I made a list of goals.

-2 inhibitors The newest class of medication for type 2 diabetes is the SGLT-2 (sodium-glucose linked transporter) inhibitors. These drugs block the reabsorption of glucose by the kidney, so that it spills out in the urine. This lowers blood sugars, resulting in less insulin production. SGLT-2 inhibitors can lower glucose and insulin levels after a meal by as much as 35 per cent and 43 per cent respectively.21 But what effect do SGLT-2 inhibitors have on weight? Studies consistently show a sustained and significant weight loss in patients taking these drugs.22 Unlike virtually all dietary studies that show an initial weight loss followed by weight regain, this study found that the weight loss experienced by patients on SGLT-2 inhibitors continued for one year and longer.

there is a cultural perception that we deserve this because we overeat or lack self-control and it is bullshit. diseases will affect almost half of all americans. it is no one’s fault

THERAPEUTIC #2: METFORMIN—THE LOW-RISK WONDER DRUG “Metformin may have already saved more people from cancer deaths than any drug in history.”12 —LEWIS CANTLEY, director of the Meyer Cancer Center at Weill Cornell Medical College Now let’s take a look at another amazing medicine, one that our friend Dr. David Sinclair and millions of other people utilize every day… metformin. The FDA-approved, first-line treatment for type 2 diabetes, metformin, is wildly popular in the longevity field. My coauthors Bob Hariri and Peter Diamandis have been taking it for years. So have futurist-par-excellence Ray Kurzweil and biotech entrepreneur Ned David. And so does Nobel Prize winner James Watson of double-helix fame, who once went so far as to say that metformin might be “our only real clue into the business” of beating cancer. When a recent anti-aging forum of 300 people was asked who was using this medicine to extend their healthspan, half the audience raised their hands. As David Sinclair says, metformin “might work on aging itself.”13

One can of soda a day increases a woman’s risk of type 2 diabetes by 80 percent.

For the most part, dietary prevention of cancer boils down to one key strategy: avoiding diseases of hyperinsulinemia, including obesity and type 2 diabetes.

Magnesium is often called "the great relaxer" because of the calming effect it has on the nervous system and muscles. Take a dose of magnesium with lunch and another one with dinner to improve the quality of your sleep.

Insulin is the primary hormone that tells your body whether to store energy or burn it. When you eat—particularly when you eat the typical high-carb, heavily processed foods that most Americans eat at all hours of the day—your blood glucose levels become elevated to unhealthy ranges. Your body then increases your insulin in an effort to lower those glucose levels. Sadly this results in an enormously foolish medical strategy that many physicians use to treat tens of millions of diabetics—they frequently put type 2 diabetics on insulin in an effort to lower their blood sugar. What they fail to realize is that higher insulin levels, and secondary insulin resistance, are a far more serious issue than elevated glucose. The way to lower insulin and glucose and to treat insulin resistance is to lower your carbohydrate intake and become metabolically flexible, as co-author of The Complete Guide to Fasting and a nephrologist (kidney specialist) in Canada, so eloquently demonstrated in his 2018 case report published in the British Medical Journal. In this report, Dr. Fung was able to use intermittent fasting to reverse insulin resistance and resolve type 2 diabetes for three patients who had their diabetes for 10 to 25 years. All were taking insulin.1 One result of insulin resistance is that you gain weight because higher levels of insulin signal your body to store energy as fat. Another result is that the receptors for insulin in your cells begin to get desensitized, so you need to release more and more insulin in order to move the glucose out of your bloodstream and into your cells. As a result of the insulin resistance, your body is in constant fat-storing mode.

vitamin or mineral yet identified that is not available from low-carbohydrate sources—and many grain foods only appear to have a good nutritional profile because they’ve been enriched at the factory. Enrichment was instituted when it became clear that people whose diets depended on milled grains were developing nutritional deficiency diseases. It is likely that your nutritional profile will improve. That said, we do recommend taking a well-formulated, iron-free multivitamin daily. WHAT ABOUT “GOOD CARBS”? No doubt you’ve heard that there are “good carbs.” It may come as a shock, then, to learn that once they are digested and absorbed there is chemically no difference between one source of sugar and another. A molecule of glucose derived from brown rice is identical to a molecule of glucose derived from a convenience store slushy. The brown rice brings a few vitamins along with

SUGAR Because of the term “blood sugar,” many believe that sugar is the enemy. It is, but not the only one. All carbohydrates are composed of sugar. Starches—potatoes, bread, cereal, and the like—are simply a lot of sugar molecules strung together. Digestion quickly converts them to glucose. Starches raise your blood sugar as much as any sugar. Doubt it? The journal Diabetes Care states that whole-wheat bread will raise your blood sugar more rapidly than an equivalent quantity of table sugar. Yikes.

By 1970, around the time I was born, its prevalence was up to one in every fifty people. Today over 11 percent of the US adult population, one in nine, has clinical type 2 diabetes, according to a 2022 CDC report, including more than 29 percent of adults over age sixty-five.

the odds are overwhelming that you will die as a result of one of the chronic diseases of aging that I call the Four Horsemen: heart disease, cancer, neurodegenerative disease, or type 2 diabetes and related metabolic dysfunction. To achieve longevity—to live longer and live better for longer—we must understand and confront these causes of slow death. Longevity has two components. The first is how long you live, your chronological lifespan, but the second and equally important part is how well you live—the quality of your years. This is called healthspan,

When insulin is chronically elevated, more problems arise. Fat gain and ultimately obesity are merely one symptom of this condition, known as hyperinsulinemia. I would argue that they are hardly even the most serious symptoms: as we’ll see in the coming chapters, insulin is also a potent growth-signaling hormone that helps foster both atherosclerosis and cancer. And when insulin resistance begins to develop, the train is already well down the track toward type 2 diabetes, which brings a multitude of unpleasant consequences.

Another 38 percent of US adults—more than one in three—meet at least one of the criteria for prediabetes. That means that nearly half of the population is either on the road to type 2 diabetes or already there.

One quick note: diabetes ranks as only the seventh or eighth leading cause of death in the United States, behind things like kidney disease, accidents, and Alzheimer’s disease. In 2020, a little more than one hundred thousand deaths were attributed to type 2 diabetes, a fraction of the number due to either cardiovascular disease or cancer. By the numbers, it barely qualifies as a Horseman. But I believe that the actual death toll due to type 2 diabetes is much greater and that we undercount its true impact. Patients with diabetes have a much greater risk of cardiovascular disease, as well as cancer and Alzheimer’s disease and other dementias; one could argue that diabetes with related metabolic dysfunction is one thing that all these conditions have in common.

According to the CDC, 41 percent of women 21 and older are obese. Forty-five percent have high blood pressure. One out of two will develop cancer in their lifetimes. One out of five will develop Alzheimer’s. One out of nine will get type 2 diabetes. One out of eight will develop a thyroid problem. Eighty percent of all autoimmune conditions occur in women.1

type 2 diabetes doubles or triples your risk of developing Alzheimer’s disease, about the same as having one copy of the APOE e4 gene. On a purely mechanistic level, chronically elevated blood glucose, as seen in type 2 diabetes and prediabetes/insulin resistance, can directly damage the vasculature of the brain. But insulin resistance alone is enough to elevate one’s risk.

A person who exercises frequently in zone 2 is improving their mitochondria with every run, swim, or bike ride. But if you don’t use them, you lose them. This is another reason why zone 2 is such a powerful mediator of metabolic health and glucose homeostasis. Muscle is the largest glycogen storage sink in the body, and as we create more mitochondria, we greatly increase our capacity for disposing of that stored fuel, rather than having it end up as fat or remaining in our plasma. Chronic blood glucose elevations damage organs from our heart to our brain to our kidneys and nearly everything in between—even contributing to erectile dysfunction in men. Studies have found that while we are exercising, our overall glucose uptake increases as much as one-hundred-fold compared to when we are at rest. What’s interesting is that this glucose uptake occurs via multiple pathways. There is the usual, insulin-signaled way that we’re familiar with, but exercise also activates other pathways, including one called non-insulin-mediated glucose uptake, or NIMGU, where glucose is transported directly across the cell membrane without insulin being involved at all. This in turn explains why exercise, especially in zone 2, can be so effective in managing both type 1 and type 2 diabetes:

, not fat utilization. When insulin is chronically elevated, more problems arise. Fat gain and ultimately obesity are merely one symptom of this condition, known as hyperinsulinemia. I would argue that they are hardly even the most serious symptoms: as we’ll see in the coming chapters, insulin is also a potent growth-signaling hormone that helps foster both atherosclerosis and cancer. And when insulin resistance begins to develop, the train is already well down the track toward type 2 diabetes, which brings a multitude of unpleasant consequences.

In Canada, an estimated one in three people lives with at least one chronic disease. Conditions that appeared to increase the risk and severity of COVID-19 included type 2 diabetes, obesity, high blood pressure and other heart conditions, chronic obstructive pulmonary disease (COPD), chronic kidney disease and cancer. All of these conditions have been shown to be associated with inadequate diets and malnutrition, either as a cause or consequence of the disease. We normally associate the word "malnutrition" with undernutrition or starvation. However, malnutrition also applies to overconsumption of calories, protein or fat and frequently results in overweight or obesity. A well-primed immune response depends on good nutrition to function, and malnutrition is known to increase susceptibility to infections. In turn, infection can aggravate malnutrition, since it increases the body's demand for nutrients. This creates a vicious cycle, further increasing vulnerability to infection. In Canada, malnutrition is much more widespread than we would like to believe. A cross-Canada study conducted in eighteen hospitals screened patients for malnutrition on admission and found 45 per cent of them to be malnourished. Those who were malnourished had significantly longer hospital stays than those who were not.

For example, a study conducted in northern Finland collected data from more than 10,000 children. One of their findings was that children who took 2,000 IU of vitamin D during the first year of life had less than 80% chance of developing type 1 diabetes.[153]

It is no coincidence that virtually all plant foods, in their natural, unrefined state, contain fiber. Mother Nature has pre-packaged the ‘antidote’ with the ‘poison.’ Thus, traditional societies may follow diets high in carbohydrates without evidence of obesity or type 2 diabetes. The one critical difference is that the carbohydrates consumed by traditional societies are unrefined and unprocessed, resulting in very high fiber intake.

During this struggle I could not help thinking about the birth of functional medicine, in which a physician determines the root causes of illnesses and treats all contributing factors. Drs. Jeffrey Bland, David Jones, David Perlmutter, Mark Hyman—starting about two decades ago, they began treating complex chronic problems like type 2 diabetes, lupus, and obesity with unprecedented success. Yet medical schools had virtually no interest in teaching about this approach. As the pioneers of functional medicine discovered, you know you are doing something that is paradigm changing when you are doing it right in front of everyone but no one can see it.

Beyond its role in building muscle, protein may have beneficial effects on our metabolism. One study found that giving elderly people supplements containing essential amino acids (that is, mimicking some effects of increasing dietary protein) lowered their levels of liver fat and circulating triglycerides. Another study in men with type 2 diabetes found that doubling their protein intake from 15 to 30 percent of total calories, while cutting carbohydrates by half, improved their insulin sensitivity and glucose control. Eating protein also helps us feel satiated, inhibiting the release of the hunger-inducing hormone ghrelin, so we eat fewer calories overall.

driving, the odds are overwhelming that you will die as a result of one of the chronic diseases of aging that I call the Four Horsemen: heart disease, cancer, neurodegenerative disease, or type 2 diabetes and related metabolic dysfunction. To achieve longevity—to live

SRT Once again, I hope you are filling in your sleep diary and that if you are doing SRT, your sleep efficiency is back up to near 85%, despite the fact that you are now spending more time in bed. If it is, reward yourself with another 20 minutes in bed. By now you should definitely be seeing improvements in the quality of your sleep, and you will be finding it easier to fall asleep and stay asleep. You should be feeling less tired during the day, which in turn will motivate you to do more of the exercises that I have been recommending. As I have said, most people will find that four weeks of SRT is enough to mend their sleep problems, although you can continue for up to eight – it very much depends on how you are getting on. Looking after your Old Friends If you have been eating meals from the recipe section in this book, I would also expect your gut microbiome to have changed radically, and for the better. Your levels of “good” bacteria should have increased, reducing inflammation and making you feel more cheerful, while the “bad” ones, that cause inflammation, will have been displaced. So keep munching those legumes! Remember that quite apart from the positive impact that these foods have on your sleep, they will also help cut your risk of type 2 diabetes, heart disease and dementia. Treat this way of eating as a way of life, not just a quick fix when it comes to improving your sleep. Eating for better health and weight loss As we have seen, if you are overweight

And, even more important for our purposes, these facts are sturdy enough that we can build a sensible diet upon them. Here they are: FACT 1. Populations that eat a so-called Western diet—generally defined as a diet consisting of lots of processed foods and meat, lots of added fat and sugar, lots of refined grains, lots of everything except vegetables, fruits, and whole grains—invariably suffer from high rates of the so-called Western diseases: obesity, type 2 diabetes, cardiovascular disease, and cancer. Virtually all of the obesity and type 2 diabetes, 80 percent of the cardiovascular disease, and more than a third of all cancers can be linked to this diet. Four of the top ten killers in America are chronic diseases linked to this diet. The arguments in nutritional science are not about this well-established link; rather, they are all about identifying the culprit nutrient in the Western diet that might be responsible for chronic diseases. Is it the saturated fat or the refined carbohydrates or the lack of fiber or the transfats or omega-6 fatty acids—or what? The point is that, as eaters (if not as scientists), we know all we need to know to act: This diet, for whatever reason, is the problem. FACT 2. Populations eating a remarkably wide range of traditional diets generally don’t suffer from these chronic diseases. These diets run the gamut from ones very high in fat (the Inuit in Greenland subsist largely on seal blubber) to ones high in carbohydrate (Central American Indians subsist largely on maize and beans) to ones very high in protein (Masai tribesmen in Africa subsist chiefly on cattle blood, meat, and milk), to cite three rather extreme examples. But much the same holds true for more mixed traditional diets. What this suggests is that there is no single ideal human diet but that the human omnivore is exquisitely adapted to a wide range of different foods and a variety of different diets. Except, that is, for one: the relatively new (in evolutionary terms) Western diet that most of us now are eating. What an extraordinary achievement for a civilization: to have developed the one diet that reliably makes its people sick! (While it is true that we generally live longer than people used to, or than people in some traditional cultures do, most of our added years owe to gains in infant mortality and child health, not diet.) There is actually a third, very hopeful fact that flows from these two: People who get off the Western diet see dramatic improvements in their health. We have good research to suggest that the effects of the Western diet can be rolled back, and relatively quickly.

The transition from the fed state to the fasted state occurs in several stages:3 1.Feeding: During meals, insulin levels are raised. This allows glucose uptake by tissues such as the muscle or brain for direct use as energy. Excess glucose is stored as glycogen in the liver. 2.The post-absorptive phase (six to twenty-four hours after fasting starts): Insulin levels begin to fall. The breakdown of glycogen releases glucose for energy. Glycogen stores last for roughly twenty-four hours. 3.Gluconeogenesis (twenty-four hours to two days): The liver manufactures new glucose from amino acids and glycerol. In non-diabetic persons, glucose levels fall but stay within the normal range. 4.Ketosis (one to three days after fasting starts): The storage form of fat, triglycerides, is broken into the glycerol backbone and three fatty acid chains. Glycerol is used for gluconeogenesis. Fatty acids may be used directly for energy by many tissues in the body, but not the brain. Ketone bodies, capable of crossing the blood-brain barrier, are produced from fatty acids for use by the brain. Ketones can supply up to 75 percent of the energy used by the brain.4 The two major types of ketones produced are beta hydroxybutyrate and acetoacetate, which can increase more than seventy-fold during fasting.5 5.Protein conservation phase (after five days): High levels of growth hormone maintain muscle mass and lean tissues. The energy for maintenance of basal metabolism is almost entirely met by the use of free fatty acids and ketones. Increased norepinephrine (adrenalin) levels prevent the decrease in metabolic rate.

She thought about how hno one had taught us to grow old, how we didn't know what it would be like. When we were young we though of old age as an ailment that affected only other people. While we, for reasons never entirely clear, would remain young. We treated the old as though they were responsible for their condition somehow, as though they'd done something to earn it, like some types of diabetes or arteriosclerosis. And yet this was an ailment that affected the absolute most innocent.

If you have diabetes, reduce or remove dried fruit from your menu. In general, diabetics should have only one fruit serving with each meal. I strongly recommend that people with both type 1 and type 2 diabetes read my book The End of Diabetes.

In medical jargon, this longer period of illness prior to death is termed the extension of morbidity. Among westernized populations, many people become sick for a long time before they die from heart disease, type 2 diabetes, Alzheimer’s, and chronic respiratory disease; many also suffer from osteoarthritis, osteoporosis, and a growing list of autoimmune diseases.56 At least one in five Americans over the age of sixty-five is in fair or poor health. Despite this high morbidity, we nonetheless live much longer than our farmer ancestors, and a little longer than hunter-gatherers. The average American in 2018 lives to be seventy-eight years old, almost twice as long as one a hundred years ago.57 This shift, in which more of us live longer but die from chronic rather than infectious diseases, thus extending morbidity, is known as the epidemiological transition and widely hailed as medical progress. By not dying rapidly from smallpox in our youth, aren’t we fortunate to die slowly from heart disease at an older age? This thinking is mistaken.

Having type 2 diabetes raises a person’s risk of dying, in some cases to a small degree, in other cases substantially, but it is treatable using drugs, diet, and exercise. Although drugs help, they aren’t always necessary. Diet and exercise can sometimes allow the body to heal itself. In one dramatic test of this concept, ten overweight Australian aborigines with type 2 diabetes reversed their disease after just seven weeks of returning to an active hunting and gathering lifestyle.20 The mechanisms by which physical activity helps prevent and treat type 2 diabetes are well studied. Most basically, exercise (in conjunction with diet) can ameliorate every characteristic of metabolic syndrome including excess organ fat, high blood pressure, and high levels of blood sugar, fat, and cholesterol. In addition, exercise lowers inflammation and counteracts many of the damaging effects of stress. And most remarkably, exercise can reverse insulin resistance by restoring blocked insulin receptors and causing muscle cells to produce more of the transporter molecules that shuttle sugar out of the bloodstream.21 The effect is akin to unclogging a drain and flushing out the pipes. Altogether, by simultaneously improving the delivery, transport, and use of blood sugar, exercise can resuscitate a once resistant muscle cell to suck up as much as fiftyfold more molecules of blood sugar. No drug is so potent.

In one compelling study, Danish researchers randomized patients with type 2 diabetes into two groups: both were given advice on how to eat a healthy diet, but one group also labored through five or six 30- to 60-minute-long sessions of aerobic exercise a week plus two or three weight sessions per week. After a year, half of those who exercised were able to eliminate their diabetes medications, and another 20 percent were able to reduce their medication levels. Further, the more they exercised, the more they recovered normal function. In contrast, just one-quarter of the dieters were able to reduce their medication, and 40 percent had to increase their medication levels despite receiving excellent, standard health care.24 As we have repeatedly seen, some exercise is better than none, and more is better.

controls us. Diabetes is the Honey Badger….it just does not care!  It is like putting the reins on an untamed horse.  Sometimes, pulling on the reins will work, sometimes the horse will buck the other way.  As parents, because we love our children, we try everything to keep Diabetes under control (see # 3 above). The only control we have is consistency, timing and SWAG’ing!

IN CLOSING, LET’S TAKE a brief look back at where we began: with 10 children who developed type 1 diabetes in 24 months within two miles of one another in the upscale suburbs of Boston. Rather than bemoan their fate, parents there organized and asked for an investigation to be conducted by the state, which is ongoing. Among those who have participated in organizing meetings are Ray Allen, the Celtics star, and his wife, Shannon, whose son, Walker, was the seventh child diagnosed there. “Shannon and Ray have turned out to be the most incredible advocates,” Ann Marie Kreft recently told me. “We have fabulous people on board who are spending inordinate amounts of their time on advocacy.” I asked her what they are advocating for. “I think we all agree that mandatory case reporting would be the ideal,” she said. “That would be the dream come true. I think we may be building up to that.” Rather than have to design a special survey every time an apparent cluster of type 1 cases emerges, mandatory case reporting, on a national level, would permit the CDC to automatically track cases as they emerge, to see not only the big national picture, but also local variations that could prove crucial in unraveling the riddle of why type 1 diabetes continues to rise, each and every year, by 3 percent. Presently, however, no national organization is advocating for mandated case reporting of type 1. Where is the line of protesters holding placards, marching outside the Atlanta offices of the CDC? Perhaps we need to look farther back, to the period before the diabetes pandemic began. In 1866, you might recall, the death rate from diabetes in New York City was 1.3 per 100,000 residents. If that rate held today for the 306 million residents of the United States, there would be 4,284 deaths due to diabetes each year. Instead, in 2006, there were 72,507 death certificates on which diabetes was listed as the underlying cause. The official national death rate from diabetes now stands at 23.3 per 100,000, according to the CDC — nearly 19 times higher than it was following the Civil War. And that doesn’t count the additional 200,000 or so deaths each year for which diabetes is listed as a “contributing” cause.

One recent study performed by the American Medical Association and published in the _Archives of Internal Medicine_ in January 2012 demonstrated an astounding 48 percent increased risk of diabetes among women taking statin medications. This study involved big numbers -- more than one hundred sixty thousand postmenopausal women -- making it hard to ignore its significance and gravity. Recognizing that type 2 diabetes is a powerful risk factor for Alzheimer's disease, a relationship between statin drugs and cognitive decline or cognitive dysfunction is certainly understandable. ~ David Perlmutter, M.D., _Grain Brain_

Americans are consuming a diet that is at least half sugars in one form or another—calories providing virtually nothing but energy. The energy density of these refined carbohydrates contributes to obesity in two ways. First, we consume many more calories per unit of food; the fiber that’s been removed from these foods is precisely what would have made us feel full and stop eating. Also, the flash flood of glucose causes insulin levels to spike and then, once the cells have taken all that glucose out of circulation, drop precipitously, making us think we need to eat again. While the widespread acceleration of the Western diet has given us the instant gratification of sugar, in many people—especially those newly exposed to it—the speediness of this food overwhelms the ability of insulin to process it, leading to type 2 diabetes and all the other chronic diseases associated with metabolic syndrome.

Indigenous peoples' DNA is seen as a resource for use in medical, behavioral, anthropological, and genetic variation studies. Kanaka Maoli DNA has been sought for research at UH. For example, Dr. Charles Boyd, who was a researcher at UH's Pacific Biomedical Research Center, drafted a proposal for a Hawaiian Genome Project seeking $5–10 million to produce an annotated map of the entire genetic makeup of the Hawaiian people. Boyd stated, “There are many communities now with their own unique genetic history imprinted into their genomes and these include Asians, Europeans and the peoples of Oceania. The Hawaiian genome represents an important example of one of these communities of the Oceania people.”12 Boyd was hoping to target residents of the Hawaiian Homestead communities because they are seen as being the most purebred native Hawaiians. He hoped to find a genetic basis for the high rate of obesity, diabetes, renal disease, and hypertension in Kanaka Maoli.13 This type of research essentializes the role of genes, while devaluing key environmental and lifestyle factors, including the role dispossession of land has had in traditional diet and activities.

Today we want to glue some wood to some wood. We will get all the surfaces clean with sanding and then by wiping the wood with our coarse brown paper toweling, which itself is limp wood. We will apply the good wood glue, which is the color of banana pudding, to both surfaces, liberally, and align the pieces and press them together. Before the final fit it is important to slide the pieces back and forth just a bit, or twist them a bit, depending on the configuration of the pieces; this lateral friction, as it were, is to displace small pockets of air that may be trapped in the glue if the pieces of wood merely come together head-on. Once we have a good airless fit with plenty of squeezeout we should wipe the excess glue with more paper and clamp the pieces firmly together or effect a clamping by means of weight upon the pieces. Clamping can also be effected by tying the pieces together, often with bungies. The pressure should be that of a very firm handshake. Wood being married to wood likes a good handshake. If there is more squeezeout it may be addressed after this clamping or the dried excess glue may be sanded off later. You can use your anytime minutes on small squeezeout. If one of you would go get me a Musketeers the morning would be better. Some of you know how I put a Musketeers in a Dr. Pepper and how the acid in the Dr. Pepper will make the Musketeers into something like a very tasty sea slug. Which if it goes too long though it can be difficult to lift it out in one piece. I call that the Drooping Musketeer and I don’t really like it, I don’t. At a certain point you have to just stir the Musketeer into the Dr. Pepper. A Baby Ruth looks like a turd. A Butterfinger is wont to explode. Never recap your Dr. Pepper if you are using Butterfinger. I must tell you that because the Surgeon General won’t. The cleaning industry tells you not to combine its stuff but the candy industry does not. If there is no caution statement on a candy bar telling you that it is bad for your health in several ways, chief among them obesity and type II diabetes, it is not finally surprising that they not tell you that under certain conditions the candy unit will explode and perhaps blow your pop bottle apart and blind you, or worse. The good wood glue we use here is pretty set up in an hour. Tomorrow we will start in on the router. The router is essential but many a one thinks it is just some kind of dangerous cosmetic tool. It is not. Get your wood and get to gluing and stop wasting time.

Alzheimer’s is being called type 3 diabetes, linked to a gluten-rich, wheat-based diet and a stressed-out brain.4

Humans went from experiential and physical beings to conceptual ones, and one could surmise that in the future we will become even more brainy still. The changes in sedentary lifestyle alone are staggering. Dietary changes might have led to a diabetes since there may be different levels of pancreatic reserve. The explosion of carbohydrate intake that moderns indulge in may surpass the limit of the pancreas to endure, resulting in either childhood diabetes or later onset type 2 diabetes. We must be careful not to outsmart ourselves and in vanquishing the predators that plagues us for millions of years to create new ones. Having moved from chaos to order, we need to appreciate order’s value, to protect and enhance it. Any slide into chaos may well be swift and irreversible.

Studies have shown that just one night of sleep deprivation can make you as insulin resistant as a person with type 2 diabetes. This translates directly to aging faster, decreased libido, and storing more body fat than you want to (say it ain’t so!).