August 2007

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Vol. 6, No. 8

Dr. McDougall's response to: Looking Past Blood Sugar to Survive With Diabetes by Gina Kolata in the August 20, 2007 New York Times

This article reads like a multimillion dollar sales promotion for the pharmaceutical industries by telling diabetics that they are being inadequately treated by their doctors who are focusing only on medications to lower their blood sugar.  To make matters right, primary medical attention must be shifted to the addition of even more drugs. She quotes an expert, ‘“We already have the miracle pills’ — statins and blood pressure medications…”

Kolata overlooked the scientifically established and well-accepted fact that type-2 diabetes, high cholesterol, and high blood pressure are all three due to eating the rich Western diet, and the obvious treatment used by responsible physicians would be to correct the patient’s diet.  There is an epidemic of diseases of over-nutrition—worldwide more than 1.1 billion people are overweight and 312 million obese, 197 million have diabetes, 1 billion have hypertension, and 18 million people die of heart disease annuallyOver the last two decades, there has been a 10-fold increase in the incidence of type-2 diabetes in children in the USA, because of the rapidly growing numbers who are obese from an escalating exposure to rich foods, compounded by a lack of exercise. 

The few references to diet she makes in this article are focused on the importance of counting carbohydrates, as if these were the “evil calories” that caused diabetes.  The truth is populations who consume diets highest in carbohydrates, like the people of rural Japan eating rice, Peru eating potatoes, and Mexico eating corn are essentially free of type-2 diabetes—and hypertension, obesity, and high cholesterol. When these people migrate to the USA or Europe and eat fewer carbohydrates and more fat, they lose their immunity to these illnesses. Commonly, patients at our live-in clinic with type-2 diabetes will stop taking 30 to 120 units of insulin and a bag full of “anti-diabetic pills” daily, and their blood sugars will become normal in as little as 7 days, as a result of eating a diet based on whole plant foods with a little exercise.  They also lose weight, reduce their cholesterol, and their blood pressure comes down.

Any well-read scientist or science writer would understand the benefits of carbohydrate.  As far back as the 1920s experiments showed carbohydrates make the body’s insulin work more efficiently, while fat paralyzes insulin’s actions. A recent thorough review of the use of high carbohydrate diets in the treatment of type-2 diabetes, published in the September 2003 issue of the American Journal of Clinical Nutrition, reported improvements in blood sugars in diabetics, with 39% stopping insulin and 71% stopping diabetic pills after three weeks of therapy.

To her credit, Kolata did point out several things: blood sugar control with medications is difficult and expensive and has not been proven to save lives.  With further study she can learn that the benefits from medications to treat cholesterol and high-blood pressure are also of limited value, especially when compared to those seen after a change in diet and lifestyle. Kolata writes that diabetes has little to do with an out-of-control diet and sedentary lifestyle and with the resulting overweight.  Furthermore, she believes patients are unable to control their disease, no matter what they do. Essentially they are trapped by genetics.  Their only hope is to buy drugs.  Fortunately, she is wrong. I believe people, if given the chance, would choose the most effective, least toxic, and most economical therapies—those focused on non-profit lifestyle medicine.  Unfortunately, “cash is king,” and the drug companies rule.

To learn more about diabetes, see my Hot Topics, diabetes.

 

John McDougall, MD

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