The Diabetes Cure: The 5-Step Plan to Eliminate Hunger, Lose Weight, and Reverse Diabetes--for Good

Many doctors tell their patients how to manage diabetes, but why should they simply manage it when they can be rid of it once and for all? In the Diabetes Cure, Alexa Fleckenstein presents a groundbreakingplan to do just that by targeting the realcause of diabetes: inflammation.

The book instructs readers on how to use the five essentials of health to achieve a diabetes-free life. Through easy, quick exercises (how does 5 minutes a day sound?); tasty, anti-inflammatory recipes; and many other innovative tips, Dr. Fleckenstein lays out a clear, manageable plan to leave diabetes behind. And ending the struggle with blood sugar is just the start, as this 5-step plan also teaches readers how to shed 5, 10, or even 50 pounds along the way.

Complete with success stories featuring people who followed the plan and not only lost weight (up to 50 pounds) but were also no longer diagnosed as diabetic, the Diabetes Cure teaches readers what's really causing their diabetes, shows them how to banish cravings once and for all, and provides the tools to help them take back control of their lives.

Alexa Fleckenstein, MD, is board certified in internal medicine and also holds a degree in natural medicine. She practiced integrative medicine in the Boston area for more than 30 years, using both conventional and natural treatments. Dr. Fleckenstein has been a featured health expert on radio and TV shows and has contributed to magazines such as Bodyand Soul and Bottomline Health. She is the author of Healthy to 100 and Health20. She lives in Brookline, MA.

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The Real Cause of Diabetes

As I see it, every day you do one of two things: Build health or produce disease in yourself.

—A DELLE DAVIS (1904-1974)

You're in the doctor's office for a routine physical exam when you receive the diagnosis: type 2 diabetes. Sure, you have heard of diabetes before and may even have a general idea of what led to this diagnosis--maybe you have family members with diabetes or have been fighting your weight and a sweet tooth unsuccessfully for years. Or perhaps you've just been living a sedentary lifestyle. In fact, your doctor may have even warned you that in most cases, developing the disease is a direct result of poor nutrition and lack of exercise. But you didn't really listen, because you've been living this way for years and things seemed fine. How did you miss the warning signs? And what exactly went wrong? To find the answer, we need to go back to the basics and look deep inside your body at its building blocks: your cells.

Diabetes and Inflammation

Contrary to popular belief, diabetes is not just the result of having high blood sugar and an insulin-deficient pancreas. Instead, it is a chronic state of widespread inflammation--a direct result of your body not being used to its original design. We have ancient bodies and ancient souls, and in these modern times, we don't use them in the way in which they were intended. The little-acknowledged truth is that our bodies are made for outdoor living (i.e., hunting and gathering), not for sitting in a cubicle day in and day out, eating fabricated "food," and watching TV until late in the night. Did you ever think that this kind of lifestyle hurts your body-- and that it deprives you of productivity, creativity, and happiness?

Risk Factors for Type 2 Diabetes

There are several risk factors linked to the development of diabetes. Take a look at the list below to determine how many apply to you.

• Family history. Both your genes and your childhood environment (learned eating habits, outdoor activities, sleeping patterns, reward mechanisms, etc.) can increase or decrease your risk of developing diabetes.

• Weight and fat distribution. The more fat you have (especially around your middle), the more resistant your body becomes to insulin and the hunger-regulating hormone leptin.

• Sedentary lifestyle. Prolonged periods of sitting increase your chances of developing diabetes. Why? Working your muscles squelches the fire of inflammation. Not using your muscles leads to the development of diabetes. And when you sit, you barely use any muscles.

• Race. Certain races are more prone to the ravishments of the Western diet than others: Hispanics, blacks, Hawaiians, Native Americans, and Asians have an increased risk of developing diabetes.

• Age. Beginning at age 45, your risk for diabetes grows considerably. At this time in your life, you have likely eaten too many cupcakes with icing and walked too few miles--and the effects of this lifestyle are beginning to show. And retirees have an even higher risk of developing diabetes because they can easily fall prey to the damages of a sedentary lifestyle.

• Gestational diabetes. Diabetes during pregnancy is like an early warning shot: You have the genes, and if you are not careful with what you eat and how you live, you will eventually develop diabetes.

• Giving birth to a large baby. Having a baby who weighs more than 9 £ds puts you at risk for developing diabetes later in life.

• Prediabetes. When your hemoglobin A1c hovers close to 6.0, consider yourself at risk.

• An overweight peer group. People have a tendency to adopt the lifestyle habits of those closest to them, including family members, friends, and co- workers.

• Hypothyroidism. An elevated TSH (thyroid-stimulating hormone) level and/or antibodies against thyroid tissue are often found in patients with diabetes. And many have gluten intolerance. Be sure your doctor addresses all of these problems.

• Polycystic Ovary Syndrome (PCOS). This syndrome manifests itself more in your ovaries and your skin, but it still has many features of diabetes. And the treatment is also the same: improved lifestyle.

• High blood pressure. This is part of the metabolic syndrome (overweight, hypertension, high lipids, and insulin resistance), so having one of them sets you up for developing the rest.

• A history of stroke. If you've experienced a stroke, your odds of developing diabetes automatically increase.

• Acanthosis nigricans. This is a skin condition in which skin located under the armpits and in folds of the body is dark, thicker, and velvety.

• Gluten intolerance. Those who are gluten intolerant are at an increased risk of developing diabetes as well.

• Poor sleeping habits. Lack of sleep promotes weight gain and obesity.

You may wonder how so many different things go haywire in a diabetic's body, all seemingly unconnected, like high blood pressure, arthritis, and cancer. What is the unifying process underlying all of those divergent diseases? It is inflammation. And a January 2013 meta-analysis of 10 studies with more than 19,000 participants showed that raised levels of inflammation markers were significantly associated with an increased risk of having type 2 diabetes.1 Included in this meta-analysis was a 2001 study published in the Journal of the American Medical Association showing that the levels of interleukin-6 and C-reactive protein (two of the major markers of inflammation) were considerably higher in women who subsequently developed diabetes.2 Researchers found that women with higher baseline levels of interleukin-6 were at 7.5 times greater risk of becoming diabetic than those with the lowest levels of inflammation. Furthermore, women with higher levels of C-reactive protein were at 15.7 times greater risk of developing diabetes. After adjusting their findings for known risk factors, the researchers reported that the women with the highest levels of interleukin-6 were 2.3 times more likely to become diabetics, while those with highest levels of C-reactive protein were 4.2 times more likely to develop diabetes.

But where does all of the inflammation come from? This widespread and sneaky inflammation stems from an accumulation of fat and waste debris in and around every cell in your body that affects every single organ in your body. It also prevents your mitochondria (those specialized subunits in all of your cells that produce energy like little batteries) from generating the energy you need. Mitochondria are intimately involved in the insulin secretion process and are affected negatively by a too-nutritious (or high- calorie) diet. As a result, your damaged mitochondria hinder proper insulin secretion, which leads to the development of diabetes.3 And sooner or later, the breakdown of your mitochondria will cause all kinds of other diseases as well, including heart disease, stroke, and even cancer.

How you choose to live your life either increases or decreases the inflammation in your body. Every day--every moment--you are making a decision to either put out the fire of inflammation or stoke it.

Inflammation: Acute versus Chronic

Have you ever had an area on your body that's painful, red, swollen, and hot? These are the classic four cardinal signs of inflammation, established by the Roman physician Celsus (circa 25 BC to 50). And in the second century AD, Galen (129 AD to circa 200 AD) added a fifth: penuria, which means loss of function.

In an acute infection, such as a bee sting, an infected tooth, or an acutely inflamed knee, all five signs are often there. In chronic inflammation, those signs may be harder to spot, mainly because the inflammatory process takes place inside your body and is, therefore, less visible. But even though you can't see it, this chronic inflammation is causing insidious damage inside your body.

What Role Does Genetics Play?

Many people blame their diabetes on their genes: "I just have bad genes. After all, my mother and my grandmother had diabetes, too."

On one level they are right: You can weigh 300 pounds and as long as you don't have a genetic predisposition, you will never develop diabetes. Genes and their DNA carry the blueprint for everything that we have inherited and everything that makes up our bodies. Certain genes can increase your risk of developing diabetes, while other genes can cause you to gain weight more easily than other people.

Your genome--the strand of DNA in each cell that carries all your genes and some junk DNA, the non-gene "empty" areas between genes--is so well packed that in each cell, only the parts that are urgently needed are exposed to the surface. The rest is tucked away. (In a liver cell, for example, everything that pertains to your heart or your hair color is stowed away and only the liver genes are exposed.)

What we are learning is that, on one level, the junk DNA and the packaging is even more important than the original strand of DNA. And this packaging (called epigenetics) is influenced by lifestyle factors, such as what you eat (and even what your mother ate), how often you exercise, and how much you sleep.4 So, in a way, you are responsible for your own genes because you can influence them--to a certain degree. Further, some scientists think that your lifestyle influences most of your total health outcome, including your epigenetic packaging, especially if your mother and your grandmother had diabetes!5 So while you may not be able to change your genes, you can change your lifestyle and, subsequently, your epigenetics. And you can even hand these epigenetic changes down to your children and grandchildren.

Once you are told that having chronic inflammation in your body leads to the development of numerous health problems such as diabetes, you may naturally want to expel all inflammation from your body. After all, if it causes diabetes, it is as desirable as a case of head lice or bedbugs. But as hot and raging as inflammation is, it is also an extremely useful tool in your body. Without it, nothing could heal in your body--not even a simple scratch. You're already aware of the inflammation that occurs from infection (when white blood cells and cascades of chemical processes rid your body of intruders such as viruses, bacteria, and fungi). But infection is only one example of inflammation.

Triggers of Inflammation

Below is a list of the wide range of triggers that can incite the white blood cell response and the cascade of chemical processes of inflammation.

• Alcohol
• Allergens
• Artificial colors and flavors
• Bacteria
• Burns
• Chemicals
• Dairy
• Dirt
• Drugs
• Exercise: Both too much and too little can be harmful.
• Fats: Certain dietary fats heal, while others cause harm.
• Frostbite
• Fungi
• Herbicides
• Insulin: Although we need insulin to process dietary sugars, too much insulin damages your cells.
• Molds
• Molecules: Certain molecules are foreign to your body, such as some modern drugs and food additives.
• Obesity
• Parasites
• Pesticides
• Pollutants
• Preservatives: Man-made preservatives are often damaging, whereas plant- derived preservatives like curry, which is used in India to preserve food, are beneficial in lower doses. Often, they are antioxidants.
• Radiation
• Rancid foods
• Skin irritants
• Sleep: Not getting enough sleep is harmful to our bodies on many levels.
• Stress: There is good stress and bad stress. Take the example of antioxidants, which are not just superbly beneficial com£ds. Plants manufacture antioxidants when germs and insects nibble on their leaves. These antioxidants act as weapons against invaders and kill unwanted pests. When we consume small amounts of antioxidants in our food, our bodies send small stress signals to fight off the com£ds. These stress signals stimulate our immune systems and cause them to function at a better rate. But in larger doses, antioxidants can cause us harm as well. So good stress comes from things like cold showers, limited exposure to antioxidants, and small amounts of exercise, while bad stress results from too little sleep, too much exercise (or none at all), unlimited exposure to antioxidants, and bland, processed foods.
• Sugars, especially HFCS (high-fructose corn syrup)
• Sunlight: Finding the right balance of exposure to natural sunlight is important--both getting too much and getting too little can be harmful.
• Toxins
• Trauma
• Viruses
• Wounds

Inflammation protects you from germs, foreign bodies, and a host of other dangers, and it is the reason that a cut will heal in a timely manner. But imagine if this hot and raging swelling takes place in your joints, your heart, your brain, your kidneys, and your liver. It's invisible to you because this kind of inflammation only occurs deep inside your body where it can't be seen. You can feel it, though, in all those aches, pains, and discomforts you experience. They are signals that something is wrong and inflamed, even if your doctor can't find a fitting diagnosis. And this ongoing, chronic inflammation is the kind that you don't want to have smoldering in your body.

How Inflammation Works

To explain how inflammation works, let's look at an example of acute inflammation. When a splinter lodges in your finger, your body immediately begins to build a wall of inflammation around it by attracting white blood cells to the site of the splinter. The white blood cells gobble up the germs and toxins that otherwise would spread throughout your entire body. Once the white blood cells are filled with toxins, they die. And this mass of dead cells is called pus. Next, your skin breaks and the splinter is expelled from your finger, along with the pus. Then the tissue closes and your skin heals over.

Sounds straightforward, right? Well, it's actually a bit more complicated than that. For inflammation to work, an intricate dance between blood cells and plasma proteins (also known as mediator chemicals) has to ensue. If germs invade your body and your body cannot mount an inflammatory defense, you will die.

An intruding germ carries chemicals on its surface that the body recognizes as foreign. And defense starts immediately: These invaders attract the two prongs of inflammation--cells and biochemicals--that trigger the intricate cascade of recognizing the invader, mounting the forces, attacking, ingesting, destroying, and cleaning up. Then the healing begins.

First, the blood vessels around the pathogens dilate to bring more blood to the site, and arriving with the blood are white blood cells (the defenders) and mediator chemicals (the messengers). The enlarged vessels seep plasma (the watery part of blood) into the surrounding areas until only the white blood cells are left, packed tightly in the capillaries. Now you have a swollen wall around the germs. The mediator chemicals have numerous supportive functions such as attracting more white blood cells, dilating the vessels even more, producing heat so that germs are killed, and stimulating the nerve endings susceptible to pain. Feeling pain is important for two reasons: to call attention to the fact that something is wrong and to remind you to keep the affected body part still. If you didn't feel pain, you would go on with your busy life and your body would have a harder time healing.