Diabetes and Pre-Diabetes: Looking at the Whole Spectrum
Porter was in his early sixties. He was about 25 pounds overweight, rarely exercised, and sustained a high-stress job as a trial lawyer. For years, Porter’s blood sugar readings had been in the “high-normal” range, but according to conventional medicine, he was a few points below the “danger zone” and so was considered safe. His readings had been slowly creeping up year after yearand now he had been officially diagnosed with Type 2 diabetes.
Marie-Alise was in her late forties. Through vigorous exercise, she maintained a healthy weight, but her diet was high in fats and starches. Her teenaged daughter had recently been having serious problems at school, and the extra stress for Marie-Alise had pushed her blood sugar up to a significantly higher level.
Jared was in his mid-thirties when he came to see me, worried about a family history of diabetes. He was about thirty pounds overweight, with moderately high blood sugar levels. A bond salesman on Wall Street, Jared told me jokingly that he lived on “Scotch, Red Bull, and French fries,” and his biomarkers reflected both his high stress levels and his poor diet.
The Diabetes Spectrum
In conventional medicine, you either have diabetes, like Porter, or you don’t, like Marie-Alise and Jared. But rather than regarding diabetes as an “either-or” condition, I see it as a spectrum. In my view, Jared and Marie-Alise were both traveling down the same road—the road that Porter had just traveled.
Following the same logic, conventional medicine sees Type 2 diabetes as irreversible. I don’t agree with that perspective at all. With the right approach to diet, exercise, stress, and inflammation, we can have great success in reversing Type 2 diabetes, to the point where many patients don’t even need supplemental insulin.
In other words, you can travel down the road toward Type 2 diabetes or you can travel back up the road, away from diabetes and towards optimal health. The body doesn’t care about arbitrary terminology or abstract numbers. It only experiences various levels of function or dysfunction.
Moving Along the Spectrum
What links one end of the spectrum to the other? The usual suspects: nutritional deficiencies, lack of exercise, environmental toxins, insufficient sleep, an imbalanced microbiome, physical and psychological stress. These factors keep your body from functioning at peak levels, moving you along the spectrum from “optimal function” to “significant disorder.”
At the Kellman Center we can move you along the spectrum in the other direction, from inflammatory disease back to optimal function. Nutritional therapies, detoxification, natural anti-inflammatory compounds, probiotics, and prebiotics are just some of the treatments that can make a significant difference.
The Importance of Personalized Medicine
The notion of a diabetes spectrum makes even more sense if you believe, as I do, in practicing personalized medicine. The blood-sugar readings that might be safe for one person might be too high for another. Our goal at the Kellman Center is not to make sure everyone stays just barely on the correct side of an arbitrary line. Instead, we focus on each individual patient, helping him or her to achieve optimal health.
After all, every one has different genes, stresses, attitudes, needs, and wants. At a particular blood sugar reading, you might experience no symptoms, while I am already struggling with several. We can’t just look at the numbers. We have to look deeper, to see how your particular blood sugar reading is affecting you.
Personalized Medicine: What Factors Do We Consider?
- Ability to rid the body of toxins: measured in levels of glutathione, a key detoxifier
- Lipid peroxidation: the extent to which blood fats have been disrupted by oxidative stress
- Level of inflammation: as mentioned by such biomarkers as C-reactive proteins (CRP) and Interleukins (IL6)
The Role of the Microbiome
Both diabetes and heart disease are affected by the interaction between glucose (blood sugar) and insulin (the hormone that moves blood sugar into our cells). When insulin levels are too high, that sparks inflammation…and when inflammation levels are high, that triggers excess insulin.
A typical trigger for high insulin levels is a diet high in sweets and starches. But many of my patients with high insulin levels avoid sweets and starches—yet the problem persists. Why?
The answer can often be found in the microbiome, the community of trillions of bacteria that live within us. If the microbiome is out of balance, it might be silently creating inflammation, which in turn drives insulin levels. That’s why microbial imbalance can be a risk factor for both diabetes and cardiovascular disease. Rebalancing the microbiome can have profound effects for a wide variety of seemingly unrelated conditions.
Another risk factor for diabetes—ignored by conventional medicine—is environmental toxins. Our food, air, and water are loaded with heavy metals and industrial chemicals, many of which serve as endocrine disrupters: substances that disrupt our hormones. Since insulin is a hormone, its function can be disrupted by exposure to these toxins.
Taking the Wide View
At the Kellman Center, our approach is successful in large part because it is so comprehensive. We take the widest possible view in the treatment and prevention of diabetes, looking not just at blood sugar readings but also at toxic challenges, microbial health, and a host of other factors. My years of experience have given me the knowledge to fine-tune an approach for every patient, helping each one overcome his or her particular challenges along the diabetic spectrum.