There is more to diabetes than elevated blood sugars; fat metabolism plays an important role as well. Since there has been quite a bit of discussion on this blog about Type II diabetes, especially in relation to being overweight, I have asked integrative physician Alexa Fleckenstein M.D. to explain the approach she has used successfully with her patients. Here is her response:
Conventional medicine manages diabetes – but it doesn’t cure it The conventional view of diabetes mellitus is as a disease of too much sugar in the blood. The medications designed to help the disease consequently lower blood sugar levels – by different mechanisms.
More recent research seems to imply that diabetes is more than elevated blood sugars – fat metabolism seems heavily involved too. But from the patient’s perspective, it looks like diabetes is a disease of too much appetite: Diabetics are hungry all the time. Ten percent of Type II diabetes patients are not overweight – but ninety percent are. Diabetes could be called a disease of abdominal fat leading to abominable consequences. Its poetic name honey-sweet (urine) flow certainly does not evoke the horrible consequences of this disease: amputations of limbs, blindness, kidney failure and dialysis, impotence, cancer, depression – to name a few.
But even in the light of these abominable consequences patients don’t stop eating. Diabetes is a billion dollar business for physicians and the pharma industry – no wonder a cure has not been found yet. And the patients “just won’t listen” to dietary advice. Why do they keep eating? Sebastian Kneipp (1821-1897) used to say “Large dinners fill coffins” – yet Sebastian Kneipp himself was overweight and could not refrain from eating his beloved dumplings, clearly unable to heed his own advice.
I am always struck by how much diabetics suffer when I talk to them. They seem to suffer from a profound fatigue – and eating seems to help. At least for a short while. They eat for energy. People have to make a living, take care of a family – and they are in a race to eat so they can function.
It turns out that diabetes affects the mitochondria, the energy factory of the cells – and diabetes reduces the energy output of the mitochondria. It is as if diabetics stack wood around the mitochondrial stove until that stove – buried under fuel that can’t be used – is unable to function any longer. Paradoxically, all the food hinders proper metabolism, and each too-large meal leaves the patient weaker and sliding further down the precipice to diabetic diseases. All that stoked wood is a fire hazard: Any moment the little energy factory can blow up into a catastrophic illness like heart attack, stroke or infection.
The low energy of diabetics affects their physical as well as their mental abilities. Exhausted as they are, diabetics scramble to make it through their daily activities – they just can’t face going to the gym as well . Of course, exercise would use up some of the stacked fuel and reduce the fire hazard – but they can’t bring themselves to move. Period.
Diabetics have the odds stacked against them even beyond poor mitochondrial function. I can think of several other mechanisms that would explain why diabetics overeat: Studies have shown that overweight people have different bowel bacteria than slim people, which means that the bacteria are craving their food. I liken it to a computer virus: The bacteria send their cravings to the patient’s brain and, obediently, the patient grabs for another piece of unhealthy junk. Furthermore, the abdominal fat is of a different quality than fat of other body parts: Abdominal fat sends out hormonal messages to the brain – again asking for more food since the fat cells need to be fed in order to grow.
Another strike against overweight people is that the more you eat, the hungrier you get. In times of scarcity such a mechanism that helped people survive. In lean times, one was less hungry; in times of gluttony (say, a mammoth needed to be devoured) people had more appetite. Nowadays, when lean times never occur, the overweight just suffer from incredible hunger pangs – which are largely not acknowledged by the medical community but are chalked up to “lacking willpower.”
Then there are food cravings induced by food allergies. We do not really know why this is so, but there is no doubt in my mind that you crave exactly the food you should not eat because it makes you sick. People usually don’t crave carrots and apples – they crave cheese and Twinkies and chicken wings.
And the above are just the innate reasons why overweight people cannot stop eating. Now consider the reasons which stem from our modern food production: New molecules are so alien to our bodies (either by themselves or in unnatural combinations) that more people than ever are experiencing food allergies – and food cravings. High fructose corn syrup and overly processed milk proteins lead the list, but artificial colors, artificial dyes, preservatives and altogether newly designed molecules are not far behind.
And the food industry uses to its advantages the ingredients people have a hard time saying “No!” Fat, sugar, salt make any food more yummy, regardless of its real nutritional value – which is usually nil.
In conclusion, diabetes is a genetic disease so with the above odds keeping up the damaging weight, diabetics have only one chance: To force “unnatural” changes on themselves, against their inclination. For the time being, medicine is no help – the pill that takes away those too large appetites has not yet been invented. So, this needs to be done: Feel your belly right now. If it is bulging at all, you are overweight. Then take your strenuous path: Get off the chair, away from the computer or TV, and start moving. And every time you want to eat, “need” to eat, grab your fat and convince yourself that you won’t starve if you don’t eat this moment. Keep to a schedule (three big meals or five small – but never a bite after dinner because the night is repair time for the body) and find a friend to walk with you – or kayak or swim or dance! This is your only chance for good health.
-Alexa Fleckenstein, M.D. author: Healthy to 100 and Health 2 0