When Cyrus first started his doctorate in nutritional biochemistry, he had a difficult time understanding why insulin resistance was such a problem. Only after thousands of hours of research did the answer to this question become extremely clear. Insulin resistance is a major condition that underlies many chronic metabolic diseases, including (but not limited to) type 1 diabetes, type 1.5 diabetes, type 2 diabetes, prediabetes, gestational diabetes, coronary artery disease, atherosclerosis, cancer, high cholesterol, high blood pressure, obesity, polycystic ovary syndrome (PCOS), peripheral neuropathy, retinopathy, Alzheimer’s disease, chronic kidney disease, and fatty liver disease.
Think of insulin resistance as the central culprit that elevates your risk for most chronic diseases and as the root condition that accelerates the development of cardiovascular disease, cancer, type 2 diabetes, and obesity—our planet’s leading causes of death. More than any other condition, insulin resistance is the strongest predictor of chronic disease, and recent research suggests that 65 percent of all people living with type 1 diabetes for more than 20 years will die of cardiovascular disease and that more than 50 percent of people living with type 1 diabetes for more than 30 years will die of kidney failure. And unfortunately, achieving tight blood glucose control without reversing insulin resistance is not enough to minimize your risk for future diabetes complications, as you will learn in detail in chapter 7.
The good news is that insulin resistance is often detectable up to twenty years before the symptoms of diabetes and heart disease become noticeable, which means that controlling and reversing insulin resistance today can prevent the onset of many chronic metabolic diseases in the future.
Insulin resistance influences your risk for the development of a number of chronic health conditions in addition to diabetes.
How Many Types of Diabetes Are There?
Even though most people have heard of type 1 and type 2 diabetes, it turns out that there are many types of diabetes—and that they can all be improved using the Mastering Diabetes Method. That’s because there are many reasons why your blood glucose can increase, and taking the time to understand which specific tissues in your body are affected is your key to understanding which type of diabetes you are living with. Throughout this book, we’ll refer to various types of diabetes, but before we go any further, let’s get clear about the differences between each type.
Type 1 diabetes is commonly referred to as juvenile onset diabetes because it has traditionally affected young children and adolescents. It is an autoimmune condition that can completely destroy insulin-producing beta cells in your pancreas, dramatically decreasing endogenous (self-made) insulin production, while increasing the need for exogenous insulin (insulin injected through a syringe, pen, or insulin pump). When you are living with type 1 diabetes, the goals of following the Mastering Diabetes Method include increasing your carbohydrate-to-insulin ratio; maximizing your insulin sensitivity; making your blood glucose extremely predictable; preventing common complications such as heart disease, neuropathy, retinopathy, and kidney disease; reaching your ideal body weight; and dramatically increasing your energy levels.
Type 1.5 diabetes, or latent autoimmune diabetes in adults (LADA), is also an autoimmune version of diabetes that destroys insulin-producing beta cells.
Unlike type 1 diabetes, however, type 1.5 diabetes affects people over the age of 30 and is a slower-progressing autoimmune reaction that gradually destroys beta cells and decreases endogenous insulin production, often over the course of five to ten years.
Think of type 1.5 diabetes as an adult-onset, slow-progressing version of type 1 diabetes that is often misdiagnosed as type 2 diabetes.
As is true with type 1 diabetes, when you are living with type 1.5 diabetes, the goals of following the Mastering Diabetes Method are to preserve beta cell function for as long as possible; increase your carbohydrate-to-insulin ratio; maximize your insulin sensitivity; make your blood glucose extremely predictable; prevent common complications such as heart disease, neuropathy, retinopathy, and kidney disease; reach your ideal body weight; and dramatically increase your energy levels.
Prediabetes is a condition that precedes type 2 diabetes and is diagnosed when your fasting blood glucose is between 100 and 125 mg/dL, or when your A1c value is between 5.7% and 6.4%.
Prediabetes occurs when your muscles and liver have become resistant to the effects of insulin, resulting in a minor traffic jam of both glucose and insulin in your blood that slightly elevates your fasting blood glucose.
Think of prediabetes as a warning sign that type 2 diabetes is fast approaching.
The goal of following the Mastering Diabetes Method living with prediabetes is to eliminate insulin resistance and avoid the transition to type 2 diabetes altogether.
Type 2 diabetes (non-insulin-dependent
) occurs when your fasting blood glucose increases beyond 125 mg/dL or when your A1c level is 6.5% or greater, yet you are still producing sufficient quantities of endogenous insulin.
A type 2 diabetes diagnosis follows when prediabetes progresses beyond mild insulin resistance, often resulting in an increased risk for high blood pressure, high cholesterol, atherosclerosis, weight gain, fatty liver disease, chronic kidney disease, and low energy.
The goals of following the Mastering Diabetes Method living with non-insulin-dependent type 2 diabetes are to maximize your insulin sensitivity until you no longer require diabetes medications, drop your A1c to 5.6% or below, and remove type 2 diabetes from your health record.
If you have been diagnosed with type 2 diabetes, eating to reverse insulin resistance is your ticket to becoming nondiabetic.
Type 2 diabetes (insulin-dependent) occurs when your fasting blood glucose increases beyond 125 mg/dL or when your A1c level is 6.5% or greater, and you are not producing sufficient quantities of endogenous insulin.
Insulin-dependent type 2 diabetes occurs when beta cells have overproduced insulin for a long period of time, resulting in an inability to produce sufficient insulin.
In this situation, managing your blood glucose with precision can be accomplished only by using your diet in combination with insulin and/or oral medications.
As is true in type 1 and type 1.5 diabetes, the goals of following the Mastering Diabetes Method living with insulin-dependent type 2 diabetes are to maximize your insulin sensitivity; make your blood glucose extremely predictable; minimize or eliminate oral diabetes medications; prevent common complications such as heart disease, neuropathy, retinopathy, and kidney disease; reach your ideal body weight; and dramatically increase your energy levels.
Gestational diabetes is a version of diabetes that affects pregnant women and usually disappears after giving birth.
Gestational diabetes can occur at any stage of pregnancy, but it is more common in the second half, when a woman fails a diagnostic screening known as a glucose tolerance test.
Much like prediabetes and type 2 diabetes, gestational diabetes can result when a pregnant woman develops insulin resistance, and can be managed, prevented, and even reversed using the Mastering Diabetes Method.
Even though gestational diabetes often disappears after birth, it’s still important to address it during pregnancy because it can increase the risk for premature birth, preeclampsia (high blood pressure), and stillbirth, and can dramatically increase the risk for developing type 2 diabetes in the months and years after pregnancy.
The Mastering Diabetes Method
Like our coaching program, this book is designed to help you create a long-term and sustainable lifestyle that is very effective at decreasing or eliminating your biological need for oral medications and insulin while increasing your intake of carbohydrate-rich foods.
Using evidence-based research and making the information easily understandable for anyone who isn’t a scientist, we’ll help you understand why you’ll benefit from changing the way you eat and how to do it successfully and safely.
All of the expertise, planning, strategies, tips, tools, and tricks that we’ve acquired living this very same lifestyle will be there for the taking, just as they are for our coaching clients.
And by following this step-by-step process, you’ll be setting yourself up for success more effectively than any other program that promises a “quick fix.”
Ultimately, at the foundation of this process is what we have personally experienced to be true—your diabetes health is only as good as your daily habits. If you have taken the time to create strong, effective, and reliable habits that improve your blood glucose control and metabolic health, then you’re likely to reap the rewards of this lifestyle for a long time. If instead you speed through making lifestyle changes and don’t take the time to create a collection of long-lasting habits, then you’re likely to revert back to your old habits when confronted with challenging situations.
Understanding exactly what components of your diet affect your blood glucose is more powerful than any medication you can buy, and it can save you thousands of dollars on test strips, oral medications, and insulin every year.
In addition, you’ll learn exactly which foods will help your body repair long-standing metabolic damage, how to easily integrate them into your daily life, and how to maximize these effects with other highly effective lifestyle changes, including intermittent fasting and exercise.
And if you choose to join our online coaching program, we’ll connect you with an online community so that you have plenty of support, and we’ll include a number of case studies throughout the book so you can learn from others about how to apply these teachings in real life.
So settle in, peel yourself a mango, and let’s get started.
To view the 25+ scientific references cited in this chapter, please visit us online at www.masteringdiabetes.org/bookinfo .