Atkins Diabetes Revolution (3 page)

It’s a frustrating fact of life: We don’t have much say over whether we fall victim to life-threatening diseases such as cancer, Alzheimer’s, or, to a large extent, some types of heart disease. However, there is one, all-too-common killer disease over which we have a great deal of say. Most people do have a choice when it comes to Type 2 diabetes.Astonishing as it sounds, this epidemic disease is almost entirely preventable. Of course, no one consciously chooses to get diabetes. Various factors—some in our control and some not—combine to create the unfortunate scenario. But if we all took proper care of our bodies and kept vigilant rein on the factors that are within our control, there would be no diabetes epidemic.Do you think we’re overstating things? No way. In fact, what we hope we have created with this book is a realistic and practical guide to wiping out Type 2 diabetes, one individual at a time.

According to the National Institutes of Health, in 2002, a record number of Americans—18.2 million, or 6.3 percent of the population—were thought to have diabetes.Of these,13 million were already diagnosed, while 5.2 million probably have diabetes but haven’t been diagnosed yet.
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That means many millions of Americans are blindly chugging down this dangerous road. Sadly, in our experience, many well-meaning health care professionals give their patients the standard information, some of which perpetuates the very disease it’s supposed to cure or prevent. That’s why Dr. Atkins felt it was crucial to write this book.

In 2002 and 2003, the American Diabetes Association redefined and standardized the criteria for blood sugar abnormalities. Unfortunately, none of these changes were implemented in order to find patients earlier in the process. Our interest is in
identifying
patients with these metabolic problems long before they advance to the “official” blood sugar level defined as diabetes.
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If you know what to look for, you can identify the metabolic sign- posts that signal trouble even earlier in the process—and intervene immediately. If you are reading this book, you are clearly concerned about your health or perhaps it’s someone you love about whom you’re concerned. Either way, congratulations to you for picking up this book. Let’s not waste another minute.

We will show you how to make relatively simple lifestyle changes that can significantly reduce your risk of ever getting diabetes, even if you already have some of the preliminary symptoms. And if you have already been diagnosed with diabetes, this book can help you mitigate its effects or maybe even stop further progression.

We can be your guides on the road to better health, but it is you who must take control of your destiny by making and implementing the right choices. Imagine that you are standing at a crossroads in the map of your life. Ahead of you lie two paths. One almost inevitably leads to diabetes and its accompanying health problems; the other leads to optimal health. Which will you choose?

THE RIGHT ROAD

Let us tell you about the path that Dr. Atkins recommended to his patients for decades. It differs dramatically from the treatment with drugs most health care practitioners have been taught. Instead, his path identifies risks for diabetes as early as possible, focuses on prevention, and involves
permanent
lifestyle changes to address the underlying metabolic problems that lead to diabetes. These lifestyle changes can be as simple as changing what you put on your plate—a better option, we think you’ll agree, than swallowing an array of expensive and potentially dangerous drugs. Those of you who have read Dr. Atkins’ other books will recognize a point he hammered home for decades: Instead of treating the
symptoms,
his approach can correct the
problem
itself.

Finally, for individuals whose blood sugar abnormalities are further advanced or who already have diabetes, this path decreases or eliminates the need for drugs to treat these conditions. (Did you know that some of these drugs actually make it harder to lose weight? Talk about a vicious cycle.) Whether you’re just beginning to be concerned about diabetes or you’ve already been handed the official diagnosis, controlling carbohydrates is the vehicle that will take you off the rutted road of self-destruction and onto the smooth one of recovery and excellent health.

The decision to improve your health is an obvious one, but to follow this “right road”—and stay on it—you need clear directions and a good map. That’s what the Atkins Blood Sugar Control Program (ABSCP) gives you. The ABSCP is a highly individualized approach to weight control and permanent management of the risk factors for diabetes and cardiovascular disease. And it works.

I’ve witnessed these life-changing improvements in patients such as this 45-year-old woman. Ruth L. weighed 375 pounds, with a body mass index (BMI) of 60.5 and uncontrolled Type 2 diabetes. Although Ruth took three medications daily in an effort to control her blood sugar, her glycated hemoglobin (A1C) was 11 (more than two times the norm, demonstrating very poor blood sugar control). The day she began the program, I had her stop all her blood sugar medications. After two months, her A1C was down to 7.7. After 18 months, she had lost 132 pounds, her lab values were normal, with an A1C of 5.4, and she remained off blood sugar medications.
    —M
ARY
V
ERNON

The ABSCP builds on the basic controlled-carbohydrate concepts of the famed Atkins Nutritional Approach and individualizes it specifically for people like Ruth who have—or are at risk for—blood sugar abnormalities and diabetes.

Once you’re heading in the right direction, the program helps you to stay with it and map your progress as you pass milestones along the way. The ABSCP includes controlled-carbohydrate nutrition; supplementation with vitamins, minerals, and other nutrients; and exercise—all of which are customized to your needs.

A WORLDWIDE PROBLEM

The diabetes epidemic is growing by leaps and bounds around the world. According to the World Health Organization, in 2000, the total number of people worldwide with Type 2 diabetes was 176 million plus. By the year 2030, that number is estimated to rise to some 370 million people.In 2025,the worldwide prevalence of diabetes in adults will have increased by 35 percent, and the number of people with diabetes will have increased by 122 percent.
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The countries with the largest number of diabetics in 2030 will be India (an estimated 80.9 million), China (an estimated 42 million),and the United States (an estimated 30 million).
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To begin, you need to understand more about this insidious disease. Let’s start with the basics.

WHAT IS DIABETES?

Diabetes is defined as a condition in which blood sugar (glucose) levels are above the normal range.In a minority of cases,this happens because your body is no longer producing the hormone insulin, which carries glucose into your cells where it can be converted into energy. This is known as Type 1 diabetes, sometimes called juvenile diabetes or insulin-dependent diabetes mellitus (IDDM). In Type 1 diabetes, the specialized beta cells of the pancreas stop producing the hormone insulin,which is necessary for moving glucose into the cells,where it is burned for energy. Type 1 diabetes usually starts in childhood; currently people with this form of diabetes require lifelong insulin administration and careful dietary management to survive. Recently, it has been reported that stem-cell transplants have been successful in curing this disease. Type 1 diabetes accounts for about 5 to 10 percent of all cases of diabetes.
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The cause of Type 1 diabetes is in most cases an autoimmune disease in which the body mistakenly attacks and destroys the cells in the pancreas that produce insulin. Type 1 diabetes usually strikes very suddenly—the person may appear fine one day and be very sick just a few weeks or even days later.

GESTATIONAL DIABETES

Each year some 4 percent of pregnant women, or about 135,000 women in the United States, develop gestational diabetes.
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If you’re over age 25, are obese,have blood sugar or blood pressure problems,a family history of diabetes, or belong to certain ethnic groups, you may be at risk for gestational diabetes.

Gestational diabetes can be a serious problem, because it can result in an infant with a dangerously high birth weight,which causes difficulties during labor, including a higher risk for cesarean delivery. These women are also more likely to develop hypertension during pregnancy and have it persist after delivery.
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There is also risk to the infant. Babies exposed to high concentrations of glucose before birth may have problems maintaining their blood sugar in the first few days after delivery. They are also more likely to have breathing problems and require oxygen supplementation if born early.

Gestational diabetes can generally be controlled by diet and sensible exercise during pregnancy. Blood sugar levels usually return to normal after delivery.If you had gestational diabetes,however,you have about a 20 to 50 percent chance of developing Type 2 diabetes within the next five to ten years.
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Also, your baby may be more likely to become over- weight and develop diabetes later in life because he or she has inherited your metabolic tendencies.

Because Type 2 diabetes is by far the most common type of diabetes, and because it can be prevented and treated through diet and lifestyle changes, it will be the focus of this book. Although some of the advice in this book can be helpful for people with Type 1 diabetes as well, in general, whenever we talk about diabetes we are referring to Type 2 diabetes.

POLYCYSTIC OVARY SYNDROME

Women who have polycystic ovary syndrome (PCOS) have a high risk of developing Type 2 diabetes. Like diabetes, PCOS is associated with increased insulin resistance and high insulin secretion.
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PCOS is a hormonal imbalance that can cause irregular menstruation,infertility,weight gain,and excessive hair growth.PCOS is surprisingly common—estimates are as high as 11 percent of all women aged 20 to 40.
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Fortunately, PCOS responds extremely well to a controlled- carbohydrate approach. Many of our PCOS patients return to normal blood sugar levels within a few months of doing Atkins, and their other symptoms often improve as well. Some patients even report being able to conceive when following this approach.

Of women who have PCOS, 35 percent have been shown to progress to diabetes five to ten times faster than women without this condition.
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Ninety to 95 percent of the people with diabetes have Type 2, a disease that is quite different from Type 1.
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In the large majority of cases of the Type 2 variety, the individual still makes insulin—in fact, he or she may make large amounts of it—but the cells respond more slowly to its presence. This slowed response is called
insulin resistance.
If you have Type 2 diabetes, over time, as your cells become more resistant to the insulin signal, blood sugar rises above normal levels. What’s happening? It’s as if the insulin knocks at the doors of the cells and asks that the glucose be let in, but the cells don’t answer the door. So the amount of glucose circulating in the blood increases—you become hyperglycemic—and that causes a lot of damage. To force the glucose to enter the cells, your pancreas pours out more insulin. Eventually, the pancreas becomes unable to produce such high levels of insulin; as a result, insulin must be administered in order to control the blood sugar level.

Kids and Diabetes

Until recently, Type 2 diabetes was primarily a problem for older adults. It was very rare for children and people in their twenties or even thirties to have Type 2 diabetes.Today,even children are being diagnosed with this disease. Some experts now suggest that as much as 45 percent of all children with newly diagnosed diabetes have Type 2.
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The causes are similar to those for adults: obesity, a sedentary lifestyle, and a high-carbohydrate diet. Kids with Type 2 diabetes are more likely also to have a family history of the disease. Children with this disease face a future of serious health problems that will likely shorten their life spans and significantly affect their quality of life. Fortunately, as we’ll explain in Chapter 25, the Atkins Blood Sugar Control Program is very effective for young people.

THE LOW-DOWN ON LIPIDS

The term
blood lipids
(lipid is another word for fat) is used as an overall way to describe the various types of cholesterol and fat that are normally found in the bloodstream. People with blood sugar abnormalities or diabetes typically have characteristic abnormalities in their blood lipid profiles. We’ll be discussing lipids in detail in other parts of this book, especially Chapter 9 on heart disease,but for now let’s go over the main types:

Cholesterol.
Technically, cholesterol isn’t a fat. It’s a waxy substance that’s a sort of kissing cousin to fat—the main difference is that you don’t burn cholesterol for energy in your cells as you do fat. Cholesterol is essential for your health.Among the many other functions it serves in your body,it’s used to make the membranes of your cells,to form the insulating layer of your nerve cells, and to manufacture many hormones, including the sex hormones testosterone,estrogen,and progesterone.
Low-Density Lipoprotein, or LDL Cholesterol.
To move the waxy cholesterol around in your watery blood to where it needs to go, your liver coats it with protein. LDL cholesterol is often simplistically called the “bad” cholesterol, because high levels of it in the blood are statistically associated with an increased risk of heart disease.