As early as two weeks into the program, success was remarkable.
Blood glucose dropped an average of 71 mg/dl (3.9 mmol/l).
A measure of inflammation known as hsCRP went down almost 40 percent.
A measure of insulin resistance (HOMA-IR) fell over 40 percent.
Participants reported dramatic reductions or complete disappearance of pain in their legs, arms, and joints, and walking became much easier.
Almost everyone reported increased energy and greatly improved regularity.
Weight loss averaged about five pounds (2.25 kg).
Almost 90 percent of the participants stopped taking oral medications, both for diabetes and other diabetes-related issues.
After twelve weeks, average weight loss was approximately ten pounds (4.5 kg) per person. Blood sugars were still down about 48 mg/dl (2.7 mmol/l) from baseline, and HbA1c was down an average of nearly two points. Every percentage point drop in HbA1c can reduce the risk of complications in the small blood vessels of the eyes, kidneys, and nerves by 40 percent, so a two-point drop is extraordinary. For many participants, these changes seemed nothing short of a miracle.
These pioneers of the Pacific provided hope amid a deep sense of hopelessness. They overcame seemingly insurmountable mountains of Spam, doughnuts, ramen noodles, and cola. They managed despite the high cost of fresh produce and the lack of fitness facilities or walking trails.
Some people ask if this type of program could work at home.
The answer is simple: If there is hope in the Marshall Islands, considering the enormous barriers they face, there is hope at home.
But that hope rests on the integration of lifestyle medicine into our health-care systems.
It must be offered as a treatment option, and preferably as the first line of treatment.
If you do find such a program in your area, get on board!
The added support from a like-minded community will help guide you and keep you on the road to recovery.
Additional support can also be found online with one of many whole-food, plant-based programs that have reported success in treating, and often reversing, type 2 diabetes.
Their websites, along with excellent general informational websites, are listed in the resources on page 231 .
Anecdotal evidence does not provide scientific proof; however, it often provides the inspiration and information needed to affect change in individuals. My favorite testimony from my own personal clinical experience is the story of Carlos. These are his words:
CARLOS’S STORY
I was diagnosed with type 2 diabetes when I was fifty.
For the next twenty years, I was injecting between 35 and 40 units of insulin (both L and N) per day.
I was also on other diabetic medications, including DiaBeta and metformin.
In total, I was taking seventeen pills a day.
I had coronary artery disease and had already had one heart attack.
I also had high blood pressure, early signs of kidney failure, peripheral artery disease, and chronic gout, among other ailments.
I believed that my conditions were irreversible and progressive.
With respect to my diabetes in particular, based on what my doctors told me and on the widely distributed literature about diabetes, I “knew” that diabetes was an irreversible disease.
Then, my oldest son was diagnosed with cancer, and he decided to adopt a whole-foods, plant-based diet.
To support him, my wife and I changed our diets as well.
I was being treated at UC San Francisco, so I was confident that I needed the medication I was taking and that my conditions could be managed to some extent but not reversed.
What happened after I changed my diet was unbelievable to me.
Within weeks I had cut my medication significantly, lost weight, and started feeling a fundamental change in my body.
Today, after about a year and a half on a whole-foods, plant-based diet, I’m taking zero insulin and zero pills.
My fasting glucose is now between 80 and 87 on a daily basis and my A1c is normal.
My average blood pressure is now 115/70. (Even with all the medication, my blood pressure was high and never reached an average normal range.) My arteries have opened up, and I needed no procedures or surgeries.
The scar tissue resulting from my heart attack has shrunk, indicating potential tissue regeneration.
My kidney function is now perfectly normal, and I’m no longer taking the medication I had been prescribed for this problem.
I averted (and possibly reversed) peripheral artery disease.
In short, I reversed all the conditions that I “knew” were progressive and irreversible.
Today I had to go to the DMV to renew my driver’s license.
I could not believe that I answered no to the question “Do you have diabetes?” I am no longer diabetic.
This all may sound incredible, but it’s true.
My story is supported by medical exams and records that reflect my conditions before and after I changed my diet.
It’s been over seven years since Carlos began this healing journey. He remains free of the chronic diseases that nearly took his life, and his son Andres is still in remission from his cancer.
THE LOW-CARB CAMP
L ow-carbohydrate (commonly referred to as low-carb) and very low-carbohydrate or ketogenic diets have recently gained tremendous favor as treatments for people with diabetes.
The basic premise is that if someone can lower carbohydrate intake sufficiently, their blood sugar will also naturally stay low because there is less available glucose.
As a result, the body will have to use an alternative fuel called ketone bodies (or ketones).
In theory, the need for insulin or diabetes medications will plummet, and diabetes will be reversed.
Ketone bodies, or ketones, are formed during starvation or fasting, when the body’s primary fuel source, glucose, is not available. When blood glucose drops and no source of carbohydrate is consumed, the body uses up its stored glucose (glycogen stores). When glycogen stores are depleted (usually within twenty-four hours of carbohydrate deprivation), the body generates glucose through a process called gluconeogenesis (literally, “the making of new sugar”) that utilizes amino acids (from muscle stores), lactate (a by-product of glucose metabolism), and glycerol (the backbone of triglycerides from fat stores).
Gluconeogenesis is necessary for survival because only cells with mitochondria can use fatty acids as an energy source; red blood cells, which do not have mitochondria, must use glucose.
However, gluconeogenisis does not produce enough glucose for the whole body, so the body is forced to rely more heavily on ketones.
Ketones are a by-product of fatty acid breakdown that can be used as fuel by muscle and other body tissues, including the brain and central nervous system.
As with episodes of fasting or starvation, low-carbohydrate diets also trigger the production of ketones because sources of dietary glucose are not consumed.
Not surprisingly, prolonged strenuous physical activity will also induce ketone formation if glucose is not replenished.
When the levels of ketones in the body are high, it is referred to as ketosis.
In a person who does not have diabetes, ketosis is a normal adaptation to starvation.
However, in someone with type 1 diabetes, or in someone with sudden intractable insulin resistance (perhaps from an infection or steroid use), the levels of ketones in the body can get so high that a life-threatening condition called diabetic ketoacidosis (DKA) can emerge.
DKA is generally the product of severe hyperglycemia (high blood glucose levels) in the absence of insulin.
The body begins burning fatty acids at a very high rate, and ketone production goes through the roof.
Ketosis is not the same as ketoacidosis, which is much more dangerous.