On November 21st, the Washington Post ran a Special Report on diabetes, featuring a series of supposedly informative articles. The report was sponsored by Novo Nordisk, a big name (maybe the biggest) in diabetes care. No doubt, they have every interest in getting people off their meds...
To be kind, the report was a profound waste of time, and very much in keeping with so-called "diabetes education," provides zero takeaway for the diabetic. I vented a bit via e-mail to the report's editor, Mary Jordan.
Dear Ms. Jordan--
Talk about a missed opportunity! As one who writes a weekly health column for a major website, perhaps I was naive to think that your coverage of this topic would include something other than the tired old cliches, which—by the way—have only worsened public health. Here is why there is an "epidemic" of diabetes:
1. The conflation of the very real and devastating autoimmune condition of Type 1 (real) diabetes with the lab finding of hyperglycemia, which has quite cynically been named "Type 2 diabetes." After all, it is so much easier to build a brand with 29 million sufferers than less than 1 million.
2. The criminal advocacy of a low-fat/ high carb diet by both the ADA and AHA, despite mountains of evidence to the contrary.
3. The advocacy of expensive, harmful, and often avoidable pharmaceutical therapy to promote glycemic control. Might I suggest that you actually read the papers, endlessly cited, which are purported to "prove" the necessity of tight glycemic control, but in fact do no such thing.
Moreover, the record of pharmaceutical therapy in this area is far from stellar. Indeed, there is really only one drug that probably is safe and effective, and that is Metformin. Ironically, though, Metformin does little to directly lower blood glucose. Instead, it mitigates so-called "liver dump," whereby for many people, during a period of not eating, the equivalent of as much as 70 grams of carbs is forced into the blood by the liver.
Of course, as Diane Kress has pointed out, the same mitigation effect can be achieved by consuming 15-20 grams of carbs.
4. As to insulin therapy for type 2s, this is the single most absurd aspect of the "epidemic." To be sure, insulin will almost instantly lower blood glucose, and that is why it is essential therapy for type 1s. But, consider this: 80% of type 2s are obese. Insulin lowers blood glucose by forcing the glucose into the cell. In other words, insulin will make a fat person more fat! But then, he will need even more insulin, which will make him still fatter...
His insulin resistance occurs *because* he is fat, as the body's defense to prevent him from gaining more weight.
5. However, the most basic reason for our "epidemic" is that the "diabetes" blood glucose level has been lowered from 160 milligrams per deciliter to 140 milligrams per deciliter to 125 milligrams per deciliter. Good luck finding any scientific evidence behind this. It sure does create more diabetics, though, right? Bear in mind that dozens of things can temporarily raise blood glucose, including stress. Stress can easily raise this number by 30 points.
OK, then. What if someone who is already stressed gets his blood tested to discover it is 126? He is now given the provisional diagnosis of type 2 diabetes, and I promise you is more stressed. He comes back a few days later, and this finding is confirmed.
You might ask: What if he never shows this hyperglycemia ever again? It doesn't matter. He is now a diabetic for life, which means at the very least that his life insurance will be forever rated.
We have more treatment, more drugs sold, and higher insurance rates for life, regardless of any other health findings. Cool racket, no?
You might try doing some real journalism next time.