A different look at Type 2 Diabetes

By Dr. Paul Gloe

Last week I discussed the process of developing insulin resistance and Type 2 Diabetes, and the significant health implications of this. Thank you for taking the time to now read part two of my discussion. This is the more empowering article in which I hope to offer solutions for individuals and maybe even some perspective on how society can start looking at this disease process differently.

First, I want to say that diabetes is a disease and it does not differentiate between ethnicity or gender.  It can affect any individual who is exposed to excess carbohydrates and other simple sugars. I can say, though, that individuals of a lower socioeconomic class are unfortunately at a higher risk of developing diabetes.

That is because carbs and simple sugars are some of the least expensive food sources. They make of the bulk of processed foods. And they have a shelf life that allows them to last at grocery stores for months to years in remote Alaska villages, or any other place in the world where shipment of fresh foods is challenging.  

An important take-home point that I want to share with you all is that there is no “essential carbohydrate.” There are essential amino acids (proteins) and essential fatty acids, but again, no essential carbohydrate.

When we use the word “essential” in nutrition we are referring to the fact that the body cannot make it, so we must get it from an external source. Carbohydrates provide the energy building block glucose, but the body has other ways of creating glucose and energy. Therefore, carbohydrates are not essential for survival.


Carbs do deserve credit though — they are a fantastic, rapid source of energy if we are exercising, but they are also a rapid source of fat production if we are watching Netflix.  

As we talked about last week, insulin resistance is directly proportional to the amount of excess glucose that body is exposed to, but also importantly, how intense of a burst of glucose we are exposed to. The opposite of insulin resistance is insulin sensitivity. So let’s talk about how you can improve your insulin sensitivity. 

Well, the main principle with this is decreasing excess blood glucose. All forms of exercise decrease excess circulating glucose, but resistance training (lifting weights) has been shown to improve insulin sensitivity more than cardio exercise. Intermittent fasting is a great way to have a positive effect on insulin sensitivity, but before you start exploring this diet strategy talk to your health care provider and do your research, since it is not safe for everyone.

Eating a diet higher in fat can actually help — since fat does not convert to glucose, but provides energy by another pathway of ketone metabolism. And speaking of that, ditch all the foods that boast being “low fat.” The reason why is because the fat that has been taken out of these processed foods generally has been substituted with added carbs. Some supplements have been associated with improved insulin sensitivity, which include apple cider vinegar, cinnamon, omega-3, and Vitamin D. 

Another thing that is certainly easier said than done — is do not take life so seriously.  Stress leads to a release of cortisol, and cortisol raises blood sugar.  

I am by no means advocating for anyone to give up carbs and sugars. I know I have no interest in giving up on carbs, but for the vast majority of us we all could eat a lot less of them.

So what foods are carbs and what foods are other harmful sugars? Common food sources high in carbs include pasta, rice, and potatoes. Rice actually is a very sneaky one.  There are a lot of individuals around the world who eat rice with two or three meals a day, who have Type 2 Diabetes, but are not overweight. Eating inexpensive white rice is essentially like drinking a soda with every meal, since it carries the same carb load and spike in blood glucose.

I am not going to go into too much detail about eating excess sugar — since it is so straightforward and we all know the importance of moderation — but do not forget that it is not just refined sugar. We are also talking about honey, maple syrup, and absolutely do not discount corn syrup and its effects on the diabetes epidemic!

So since essentially all of us (including myself) plan to spend a long life enjoying carbohydrates and sugars, we should spend a little time talking about glycemic index and glycemic load. This is a quantifiable number that explains how powerful the spike in blood sugar is for any food with carbs or sugar in it.

There are charts that break down all of these foods that can be easily found on the internet. This spike in sugar causes a roller coaster of blood glucose that our pancreas does not handle well. These spikes in blood glucose are actually even more detrimental than the overall amount of carbs we ingest any given day.

For example, when looking at glycemic index numbers, a white bread bagel has the same blood sugar spike as an orange crush soda — so in regards to diabetes, a white bread bagel is as dangerous as soda!

We will not go into a list of comparisons for glycemic index, but if this article is motivating you, then you absolutely must learn what carbs have the highest and lowest index and modify your diet to eat foods with a lower glycemic index/load. Choosing to eat carbs that release glucose slower decreases insulin resistance and makes a person feel full longer. Some of the best ones are quinoa, barley, brown rice, and oats.

To some extent, foods packaged as “whole grain” also decrease this spike, but many labels are stretching the whole grain concept — and the carbs and glycemic index is similar between “white” and “wheat” bread, for example.

The second important concept is decreasing the quantity of carbs you eat with your meal. They should really be more like 25% to 33% of the meal portion, not half or more of your meal portion, as is traditionally seen in a modern diet.

Third, if you are not planning on exercising that day, choose snacks that have more protein or fat in them.

Fourth, vegetables have carbs, but the quantity of the carbs is much lower since a bulk of the food is fiber. Eat more vegetables and keep eating fruit.

Lastly, talk to your health care provider about screening for diabetes. There are lab tests that can be done that can diagnose diabetes or give some clues if you are starting down the path toward insulin resistance.

Thank you for taking the time to read these articles, be empowered, and please share this information with your friends and loved ones.

In last week’s diabetes column the Cordova Times labeled Dr. Paul Gloe as the medical director of the Cordova Community Medical Center. Dr. Paul Gloe is the chief of staff for the Cordova Community Medical Center, and a physician who sees patients both in the clinic and hospital settings.