10. Diabetes — Avoidable Killer

10. Diabetes — Avoidable Killer

It used to be thought (and many behind-the-times doctors still think) that diabetes is a failure of the pancreas to produce enough insulin, which allows blood sugar to rise. When there is too much sugar in the blood, it binds to proteins, creating “advanced glycation end-products” (AGEs) which damage organs, nerves, and muscles.

The traditional drug for diabetes was oral sulfonylureas, which stimulate the pancreas to produce more insulin (a hormone). For more severe cases, animal-derived or synthetic insulin was directly injected. The result of both is to store more blood sugar as fat, which makes you fatter, and therefore sicker in a different way. Nonetheless sulfonylureas are still widely prescribed because they are cheap. Insulin is expensive but given as the last line of defense for uncontrolled diabetes, on the supposition that getting fatter is less bad than immediately damaging muscles, nerves, and organs.

There is a new class of drugs called SGLT2 inhibitors (best-known brand name Jardiance, scientific name empagliflozin), which appear to be far superior. Instead of producing more insulin, they reduce blood sugar by passing it out through urine. For anyone who can afford it (about P50 daily), this is a far better medication. There is a slight risk of urinary tract infection, but good hydration and personal hygiene lowers this risk.

New clinical trials not only confirm the efficacy of SGLT2 inhibitors but have also proven that they lessen cardiovascular mortality and help rid the body of senescent cells (unhealthy cells no longer capable of propagating by cell division, which are just hanging around consuming resources and causing inflammation). This is believed to have an anti-aging effect. Laboratory mice (with or without diabetes) fed with SGLT2 inhibitors lived 20% longer than other mice.

Again contrary to majority medical advice, Plantation Bay’s opinion, also aligned with a very large minority view, is: For anyone who can’t afford SGLT2s and even for those who can, a preferred or parallel course of action is to drastically reduce carbohydrate intake so that less insulin is needed.

This paradigm sees the disease not as insulin deficiency but as too much insulin release, too often, to the point that cells become insulin-resistant. Insulin resistance leaves blood sugar high, leads to obesity, worsens blood pressure, and promotes fatty liver disease, which are all summed up as Metabolic Disease.

Constant eating signals your body to keep releasing insulin. The way out? Stop eating for a while; practice some form of regular Intermittent Fasting. Since carbs trigger insulin release much more than proteins, cut net carbs significantly, to less than 60 grams, or certainly less than 100 grams daily (instead of the old recommendation to consume 250-300 grams daily).

Even when consuming those 60 grams of carbs, choose carbs with a lower glycemic index (meaning they take longer to enter the bloodstream and cause less of a spike in blood sugar). Also, consume protein, fats, and fiber before the carbs, to further slow absorption.

Many people fail as Intermittent Fasters because they eat too much during their “eating-allowed window” or convince themselves that “a small bite won’t disrupt my eating-not-allowed fast”. If it’s any kind of carbohydrate, or more than a tiny nip of meat, it will.

On blood sugar: the “old school” focuses on FBS, Fasting Blood Sugar. This measures how much sugar is in your blood now, when you haven’t eaten for 12 hours. An FBS that is consistently over 100 indicates some diabetic dysfunction, but note that this threshold used to be 140. It was progressively lowered by authorities in an attempt to diagnose diabetes early (or to sell more drugs), but at whatever level it can be misleading, because in the middle of the night your liver, sensing low glucose in the blood, will release new glucose from its stores of glycogen. If your liver is slightly over-eager, you might have high FBS without any real health problem.

A better indicator of the severity of the dysfunction (or of how bad your eating habits are) is HbA1C, which measures how much sugar has been in your blood during the past 2-3 months. “Normal” HbA1C is 4.5 to 6.0. Up to 7.0, diabetic dysfunction is considered well-managed. An HbA1C over 8.0 is cause for alarm and calls for immediate medical or dietary measures to avoid an elevated risk of stroke, kidney damage, gangrene in extremities, and vision loss.

There are many popular remedies for high blood sugar, such as bitter melon (ampalaya in the Philippines). The herbal remedy reasonably well-proven in clinical trials is Berberine (https://journals.sagepub.com/doi/full/10.1089/met.2012. 0183), at a dosage of 500-1000 mg (depending on body size) before each heavy meal. However, vendors of Berberine supplements are sneaky, and often try to make you believe their capsules contain more Berberine by mixing it with other herbs, notably Ceylon Cinnamon, and confusing you with different purity percentage claims. Look for one that is a 10:1 or 20:1 extract, and the capsule should contain “the equivalent of” at least 500 mg of raw Berberis aristata root.

Dihydroberberine is somewhat new on the market, but is a preferable form, being 3 to 5 times more bioavailable.