In my recent diary,
Are You Falling For a Health Care Con?
http://www.dailykos.com/...
I described what I think is the biggest health care con going on today: statins for cholesterol lowering.
We are constantly being told the Cause of the Health Care Crisis is that it is so friggin' expensive. pResident Bush tells us it is our fault, dammit: We keep consuming it! While in all other matters economic we have the principle: Consuming More Brings the Price Down, health care must be that exception that proves the rule. Or something.
So whenever something gets expensive, let's see if we are getting our money's worth.
Let's talk about:
Diabetes.
Follow me to the flipmobile:
Diabetes is a systemic disease that leads to just about anything you'd rather not have: heart disease, stroke, high blood pressure, nerve damage, kidney failure, blindness, lower limb amputation, complications in pregnancy (for the ladies,) impotence (for the gentlemen,) and eventual immune system dysfunction, which brings in anything left behind.
The incidence of diabetes has gone up 60% in the last decade. (Center for Disease Control, 2004.)
Holy roasted death rate, Batman!
If decapitations, dog bites, or poor cable reception had gone up 60% in the last decade, it would be a crisis. Yet, outside of the public health sector, there isn't much notice taken.
People who don't have diabetes don't think about it. People who do have diabetes don't think about it enough. That's because, early on, symptoms are hidden, and even though it is deadly, its progress is sloooooooooooooooow.
By the time a diabetes patient hears the Bill Paxton* voice in their heads -- "Game over, man!" the game IS over. They're looking at losing a limb, their sight, or their kidneys, and the rest of their health is headed downhill with no brakes.
With such a demonic, devastating, and deadly disease increasing throughout the land, let's all thank goodness there's the American Diabetes Association. Right? Right? Can I get an amen?
No.
Following the ADA guidelines is the worst way for a diabetic to manage their condition.
Well, let me qualify that. Eating nothing but Smartees, becoming a Christian Scientist, or bingeing on Jack Daniel's are all worse ways. But none of them are quite as cruel as the ADA guidelines, which the diabetic will follow faithfully, unknowing that they will still be at risk for the full menu of diabetes complications.
Here's what causes diabetes complications: high blood sugar. A normal body keeps a tight control over blood sugar; too little, and we get dizzy and fall over. Too much, and there's protein glycation.
The excess sugar in the blood binds with our body's proteins. And basically, that's everything. Glycation stiffens protein bonds and messes up the whole delicate balancing act, as efficiently as... well... sugar in a carburetor. That's how it damages so many body systems, and why the list of diabetes complications is so long.
Normal blood sugar is 85mg/dl. That's the optimum level that's neither too high nor too low. But the ADA puts diabetic's target blood levels between 90 and 130. A diagnosis of diabetes is made if your blood glucose reading is 126 mg/dl or higher. (In 1997, the American Diabetes Association lowered the level at which diabetes is diagnosed to 126 mg/dl from 140 mg/dl.)
So why, if we know what the optimum blood sugar level is, does the ADA targets go from 90, which is higher than normal, to 130, which is diabetes by their own definition?
Because that's the best a diabetic can do eating the way the ADA tells them to. Which is the way we are all being told to eat: low fat, moderate protein, and high carbohydrate. In fact, the ADA asks and answers:
Can I eat foods with sugar in them?
For almost every person with diabetes, the answer is yes! Eating a piece of cake made with sugar will raise your blood glucose level. So will eating corn on the cob, a tomato sandwich, or lima beans. The truth is that sugar has gotten a bad reputation. People with diabetes can and do eat sugar. In your body, it becomes glucose, but so do the other foods mentioned above.
The reason all these foods mentioned above turn to glucose in the body, and its blood, is because even these foods, which don't contain what we think of as sugar, do have its to-the-body-identical-twin, starch. Carbohydrates, in other words.
A normal body eats carbohydrates and it turns into blood sugar. And the body immediately swings into action, because while the sugar represents energy to the body, (through the Krebs sugar-acid cycle) it has to get where it's going and get out, NOW. The longer it lingers, the greater the risk of glycation. Now you know why the body keeps such a tight grip on that 85 blood sugar level.
In a diabetic body, people still produce some insulin, and take more to compensate, but it doesn't work as quickly or as well. It's the difference between the fire department roaring to the rescue and one person getting off the couch, hooking up the hose, and having at it. Too little, too late.
The diabetic is earnestly doing what they are told, tickled by a 90 and reassured that they aren't over 130, and all the time those wild, unfelt, blood sugar swings are hacking away. An average of 130 means they are often OVER it. And the volume of uncontrolled sugar in the blood multiplies its damage the higher it goes. While the diabetic is still eating that blessed-by-the-ADA cake, protein glycation is actually having it.
But people have to eat, right? Of course they do. And the diabetic could have had a nice juicy steak, with bernaise sauce, an endive salad with chunky blue cheese dressing, and a slice of brie for dessert, and get a fraction of the blood sugar increase they got from ONE bite of that cake.
So why doesn't the ADA tell diabetics to eat that way? It would keep their blood sugar under much tighter control. The body makes any sugar it needs from protein, a process known as glycolosis, and doesn't let any of it get into the bloodstream. And fats do not raise blood sugar either. In fact, they contribute to the body's satiation process, and can keep people from overeating. This can actually help a diabetic lose weight, something they are constantly urged to do.
Why not? Because eating low fat/high carb is supposed to prevent heart disease, the number one complication in diabetes. And so the diabetic eats in a way that makes their diabetes control worse, to prevent a complication caused by poor control of blood sugars.
It doesn't make any sense, does it?
But is it possible for a diabetic to have that much control over their blood sugars? Can they shoot, and hit, the 85 target and have a body that functions NORMALLY?
Ask The Man: Dr. Bernstein
Dr. Bernstein's Diabetes Solution
--
*Bill Paxton played Hudson in the movie Aliens, who spoke the line he is most known for.