Although Type 2 Diabetes (T2D) was thought to involve genetic components, it is a becoming clear that, if genes are involved, it is epigenetic modifications – factors that turn genes on or off – that create the tendency. Epigenetic influences are primarily environmental including diet, chemical exposures, medications, sedentary lifestyle, family history of diabetes, high blood pressure, etc.
However, the leading cause of T2D is excess weight or obesity – being overfed but undernourished, over-agitated but underactive. Approximately 80% of people with T2D are overweight or obese. Eating too much (often due to inadequate nutritional value of the foods – really nonfoods) results in more fat storage as subcutaneous fat (beneath the skin) and visceral fat in and around organs and tissues such as the liver, heart muscles digestive tract. Notable, “excess visceral fat and insulin resistance, were independently associated” with pre-diabetes and insulin and T2D. Excess stored fat may block an insulin-signaled glucose transporter that normally ferries blood sugar into the cells.
Numerous toxins can play a role in causing or worsening T2D such as: inorganic arsenic, persistent organic pollutants (such as pesticides that accumulate in the environment), bisphenol A and phthalates (from plastics), dioxins, fresh-water contaminated with DDE (major breakdown product of DDT), and a number of organophosphate pesticides. Avoiding toxic exposures and periodic detoxification programs may help. Various drugs can increase T2D risk including antidepressants, ADHD medications and statins. Some drugs can worsen diabetes by interfering with insulin or blood sugar levels, including: diuretics, over-the counter decongestants, steroids (cortisone, prednisone) and beta-blockers. Others can alter effects of diabetes medications.
Gastric bypass surgery for the obese may lower blood sugar and eliminate the need for diabetes drugs. Nevertheless, nutrient deficiencies and other complications can develop. There are many antidiabetic drugs. Some stimulate the pancreas to produce more insulin; others work on the liver to decrease the amount of sugar released into the blood. Some “insulin sensitizers” attempt to make cells more sensitive to available insulin. Starch-blocking drugs slow carbohydrate digestion. The popular Metformin lowers blood fat levels and attempts to prevent the body from producing more sugar. Insulin lowers blood sugar though this does not address the underlying cause of T2D. Actually, none of the drugs approach underlying causes; they don’t cure diabetes and can have many side effects.
Lifestyle is the foremost and often only cause of T2D. Studies show that intense lifestyle intervention is very effective in preventing T2D and improving the health of people with diabetes.
T2D is also associated with processed-foods, so eating whole, natural foods to optimized nutrients status can have profound effects. Avoiding refined sugars like sucrose, corn syrup, high-fructose corn syrup, soda and other refined and highly-processed items including white rice, white bread, processed meats, refined salt, and the like makes a big difference in turning around T2D. Also ingesting artificial sweeteners disturbs areas of the brain that control the appetite and satiety and cause other imbalances. So instead include plenty of fresh vegetables and fruit (restricting fruit does not improve glycemic control), legumes, whole grains, nuts, and seeds.
There is also a direct link between fiber – soluble and insoluble – and the glycemic response to specific foods. Foods containing fiber are vegetables, fruits, whole grains and legumes: fiber supplements such as insulin or psyllium can also helpful. The recommended amount of fiber is 25-35 grams per day.
The American Diabetes Association recently updated its nutrition guidelines for diabetics. Rather than a one-size-fits-all diet, the new recommendations favor individualized plans that take into account a person’s lifestyle and metabolic needs.