Do you fear for your health or feel exhausted all the time? Are you overweight? Or do you just have too much belly fat? Do you suffer from diabetes, monitor your blood sugar all the time, have serious blood sugar and insulin imbalances, or have elevated cholesterol, blood pressure, and triglyceride levels? If so, you may find this remarkable story of one my patient's very interesting.

One evening, after a lecture in New York, a man approached me about becoming my patient. He was rotund, with a round, ruddy face, a booming voice, and a gentle manner. Everything about him was large--his appetite, his belly, and his heart.

Sam was nearly 60 years old, and his love of everything big was waning as he felt the encroachment of death. As we talked, he described years of feeding his fat, drinking a pint of heavy whipping cream every night before bed to keep his weight up.

In the end, the big presence that Sam's 300-plus pound corpus gave him was not worth the infirmities he suffered. He was diabetic. His insulin was over 200, normal is less than 20. He also had dangerous cholesterol levels, angina, sleep apnea, a sluggish thyroid, and was doggedly fatigued, short of breath at nearly every step, had nasal congestion, swollen legs, dry skin, and yeast grew all over his body.

Sam may sound like a hopeless case, but the truth is that everything Sam had done to his body he did himself and could undo. I told him that if he did everything I suggested he would lose weight, feel better, and all his symptoms would go away.

Enthusiastic, though somewhat skeptical, he left my office determined. Three months later when I spoke to him again, he lost 30 pounds, had more energy, his nasal congestion was gone, his fluid-filled, swollen legs were better, and all of his cravings were gone--he never felt hungry, and he found the program I prescribed to him easy to follow.

Fourteen months later I saw him again and repeated his blood tests. I was shocked when he weighed in. He had lost 110 pounds without being on a strict deprivation diet. He simply changed his eating and his lifestyle. His diabetes was CURED. His blood sugar dropped from 130 to 74 (greater than 126 fasting denotes diabetes). His HDL and LDL cholesterol and triglycerides were normal without any medication. And he was exercising vigorously three to four times a week.

After a lifetime of uncontrollable appetites, Sam finally found balance and health without suffering. Yes, he changed his diet and lifestyle, but he was able to continue taking pleasure in food. Most importantly, he looked and felt twenty years younger.

Now, I know Sam's story is an extreme one. You may or may not be suffering from problems as severe as those he faced. Even so, I'm sure you can relate to some of what Sam experienced if you are overweight, have high blood pressure, elevated cholesterol, have problems with your blood sugar, or have been diagnosed with type 2 diabetes ...

You may feel twenty years older than you are, and, deep down, you may even be terrified by the possibility of additional health complications like heart disease, stroke, dementia, nerve damage, blindness, and amputation or even cancer. Like so many others that suffer with this condition, you just want to live a normal life and get back some of your energy and vitality; you want to turn back the clock and reverse your diabetes ...

You can do that. I know most people are skeptical when a doctor tells them they can reverse diabetes, but over the course of this three-part series of blogs I'm going to show you how. You can have the same experience Sam did, and you don't have to suffer or starve to make that happen.

Later in this blog series, I will tell you how you can do that. Today, I want to explain what I mean by the term "diabesity". If you have diabetes you have it. But you don't have to have diabetes or even have symptoms to be suffering from diabesity. In fact most people who have it don't know they are suffering from a deadly condition that is 100% reversible.

Many Names, One Disease-Defining Diabesity

You may be one among millions of people who are suffering from a health problem that is now epidemic in our country. Your doctor might have diagnosed you with one of many seemingly different diseases. He may have said you have:
  • Insulin resistance
  • Pre-diabetes
  • Metabolic syndrome
  • Obesity
  • Syndrome X
  • Adult onset diabetes
  • Type 2 diabetes
What he likely didn't tell you is that ALL of these conditions are basically the same thing-just with varying degrees of severity. The underlying causes of ALL of these conditions are the same. And because they are all the same condition, the treatment for all of them is also the same.

That is why I have set aside these conventional diagnoses in place of a new name that more accurately defines the health problems you may suffer from. That term is diabesity. [i]Diabesity is the condition of metabolic imbalance and disease that ranges all the way from mild blood sugar imbalance to full blow diabetes.

Whether you are suffering from a little extra weight around the middle or you have been diagnosed with insulin resistance or even type 2 diabetes, the fundamental underlying biological causes of ALL of these conditions are the same. This is what I've discovered in over 20 years seeing thousands of patients.

Diabesity, in its various forms, affects over 1 billion people worldwide. It is a massive global problem, and our current approach to prevention and treatment is obviously not working because millions more are affected every year in a dramatic increase of a condition that was once very rare.

Diabesity is also the leading cause of most chronic disease in the 21st century. [ii] Those with diabesity are at an increased risk of heart disease [iii],[iv] , stroke, dementia [v], cancer [vi], high blood pressure, blindness, and kidney failure. Nervous system damage also affects 60 to 70 percent of people with diabetes and can lead to a loss of sensation in the hands and feet, slow digestion of food in the stomach, carpal tunnel syndrome, sexual dysfunction, and other nerve problems.

So this is VERY real and VERY serious for those who suffer from the condition. Given all of this, one would think the questions on everyone's mind would be: Why is this happening? What has caused this diabesity epidemic? Why are our current approaches to treating the problem failing so miserably? And what new approaches could we take that would more effectively treat the problem?

Few in medicine today are asking these questions, yet their answers are disarmingly simple.

The Problems with Diabesity Treatment - Symptoms, Not Causes

The reason our current approach to treating diabesity fails is because it focuses on treating the symptoms or risk factors of the disease rather than the causes. All of our attention is on treatments that:
  • Lower blood sugar (diabetes drugs and insulin)
  • Lower high blood pressure (anti-hypertensive drugs)
  • Lower cholesterol (statins)
  • Thin the blood (aspirin)
But we never ever ask the most important question: Why is your blood sugar, blood pressure, or blood cholesterol too high and why is your blood too sticky and likely to clot? Put another way: What are the root causes of diabesity?

Answering that question must be the focus of our diagnosis and treatment of this disease if we are going to solve this global epidemic.

In truth, diabetes, elevated blood sugar, blood pressure, and cholesterol are simply downstream symptoms that result from problems with our diet, lifestyle, and environmental toxins interacting with our unique genetic susceptibilities. These are the real causes of diabesity. Unfortunately, few are taking the time to treat them.

Using medication or surgery to treat symptoms like imbalanced blood sugar, high cholesterol, high blood pressure, and the other complications of diabetes is like mopping up the floor while the sink overflows.

In medicine today we have a choice. We can continue to mop up this overflow, or we can deal with the source of the problem and turn off the faucet--that is, treat the root problems that are causing your illness. In this three-part blog series, I am going to show you how to turn off the faucet so you can heal from your diabesity and achieve optimal health.

The real solution for diabesity is a comprehensive diet and lifestyle program. And in this series of three blogs I am going to teach you how you can integrate such an approach into your life to heal from your symptoms. I will show you why conventional treatments typically fail, what you can really do to treat diabesity, and explain how healing the 7 key underlying systems in your body is the real solution to the problem.

By following this system you may see many of your lifelong health symptoms evaporate in a matter of weeks or even days in some cases, and you may -for the first time- achieve vibrant health.

Part 2

Diabetes & Obesity: Why Conventional Medicine Makes Things Worse

If you are diabetic, overweight, or suffer from insulin resistance, metabolic syndrome, or any of the other conditions conventional medicine associates with "elevated blood sugar," I want to share a startling new discovery with you: Lowering your blood sugar may increase your risk of death.

These are the findings from an extraordinary new study that was recently published in The New England Journal of Medicine, and in this blog, the second in my three-part series on diabesity, I am going to tell you all about that study and its profound implications for the treatment of obesity, diabetes, and other related conditions.

In last week's blog you were introduced to the concept of diabesity, and learned that conventional treatments typically don't work to treat it. Today we'll see WHY those treatments don't work and look at the REAL way to treat the problem. Let's start with one of the most fascinating medical studies published in recent times ...

The ACCORD Study: 'Revolutionizing Our Understanding of Diabesity'

In 2008, an extraordinary study was published in The New England Journal of Medicine. It is called the ACCORD study [i], and it is one of the most profound pieces of literature that exists regarding why conventional treatments for diabetes simply do not work.

In the study 10,000 patients with diabetes were designated to receive intensive or regular therapy to lower blood sugar. These patients were monitored and their risks of heart attack, stroke, and death were evaluated. The patients who had their blood sugar lowered the most had a higher risk of death.

Let me repeat that, because I really want you to understand it: The patients who had their blood sugar LOWERED the most had a HIGHER risk of death. How could this happen if, as we believe, elevated blood sugar is the cause of all the evils of diabetes? Why would lowering blood sugar lead to worse outcomes?

Amazingly, the study had to be stopped after three and a half years because it was evident that the aggressive blood sugar lowering led to more deaths and more heart attacks. This completely explodes the way conventional medicine understands and treats diabetes. It's a revolutionary study. Yet for those of us who have been working to understand the REAL causes of diabesity, it isn't all that surprising.

How could LOWERING blood sugar INCREASE your risk of death?

The reason is simple: Elevated blood sugar is actually a symptom of underlying metabolic, physiologic, and biochemical processes that are out of balance ... and lowering blood sugar with medications does not address the underlying issues that gave rise to the high blood sugar in the first place. This may surprise you, but many of the methods used to lower blood sugar such as insulin or oral hypoglycemic drugs actually make the problem worse by increasing insulin levels.

Type 2 diabetes is a disease of too much, not too little, insulin. Insulin is the real driver of problems with diabesity. That means you don't simply need more insulin in your blood to lower your blood sugar. Instead, what you need to do is treat the underlying causes that gave rise to the high blood sugar and insulin in the first place. And that is insulin resistance.

Insulin Resistance: The Real Cause of Diabesity

Insulin resistance occurs when your diet is full of empty calories and has an abundance of quickly absorbed sugars, liquid calories [ii], and carbohydrates (like bread, pasta, rice, and potatoes). When this happens, your cells slowly become resistant to the effects of insulin. You need more and more to do the same job of keeping your blood sugar even. Thus you develop insulin resistance.

High insulin levels are the first sign of a problem. The higher your insulin levels are, the worse your insulin resistance. As a result your body starts to age and deteriorate. In fact insulin resistance is the single most important phenomena that leads to rapid and premature aging and all its resultant diseases including heart disease, stroke, dementia, and cancer.[iii],[iv]

As your insulin levels increase it leads to an appetite that is out of control, increasing weight gain around the belly, more inflammation and oxidative stress, and myriad downstream effects including high blood pressure, high cholesterol, low HDL, high triglycerides [v], weight gain around the middle, thickening of the blood, and increased rates of cancer, Alzheimer's, and depression. These are all a result of insulin resistance and too much insulin. Elevated blood sugar is not the source of the problem.

Understanding this has a profound impact on the whole way we think about diabesity. It's not simply a matter of shifting our focus from one type of medication to another. This completely alters the fundamental way we understand the disease.

In fact, in some sense, diabesity isn't a "disease" at all. It's simply a continuum that stretches from optimal health to full-blown illness. Let me take a few moments to explain this, because it is essential for you to understand if you want to fully realize the potential of this new paradigm to prevent or reverse diabesity.

The Continuum Concept

Most medicine is based on clear-cut, on-or-off, yes-or-no diagnoses. Most conventional doctors are taught that you have a disease or you don't, you have diabetes or you don't. There are no gray areas. This approach is not only misguided, it is dangerous, because it misses the underlying causes and more subtle manifestations of illness.

Practicing medicine this way completely ignores one of the most fundamental laws of physiology, biology, and disease: The continuum concept. There is a continuum from optimal health to hidden imbalance to serious dysfunction to disease. Anywhere along that continuum, we can intervene and reverse the process. The sooner we address it, the better.

When it comes to diabesity most doctors just follow blood sugar, which actually rises very late in the disease process. Conventional medicine tells us if your blood sugar is 90 or 110, you don't have diabetes; if it is over 126, you do have diabetes. But these distinctions are completely arbitrary, and they do nothing to help treat impending problems.

I remember one patient, Daren, came to see me with mildly elevated blood sugar. I asked Daren if he had seen his doctor about this. He said, "Yes". I then asked "What did your doctor say?" Daren's doctor told him, "We are going to wait and watch until your blood sugar is more elevated, then we are going to treat you with medication for diabetes."

Given our current level of scientific understanding of diabesity, I find this concept of watching and waiting until more serious disease occurs unfortunate, misguided, and in some cases it's deadly.

It is also why diabesity is so woefully and inadequately diagnosed and treated. Millions of Americans are suffering needlessly from chronic symptoms. Nearly half of all diabetics are undiagnosed. Nearly ALL of the 100 million Americans with pre-diabetes are undiagnosed.

Why? Most doctors just don't know how to diagnose it, or what to do about it, because there is no good drug treatment.

The truth is the road to diabetes starts as early as childhood.[vi] We now know that there is an epidemic of type 2 diabetes in children as young as eight years old [vii], and pediatric diabetic specialists who used to only care for type 1 diabetes, now find their offices are overwhelmed with cases of type 2 diabetes.

By the time you get diagnosed with diabetes you have had problems with insulin and blood sugar that could have been detected twenty to thirty years earlier. That is, if you knew where to look, which most doctors are not trained to do.

Insulin resistance and diabesity is often accompanied by:
  • Belly fat
  • Fatigue after meals
  • Sugar cravings
  • High triglycerides
  • Low HDL
  • High blood pressure
  • Problems with blood clotting
  • Increased inflammation
These clues can often be picked up long before you ever get diabetes and may help you prevent the disease entirely. Why is this important? Because insulin resistance can cause SUBSTANTIAL health risks even in the absence of full blown diabetes.

In part one of this blog series I reviewed some of the common complications of diabetes. But what most people (including most doctors) don't realize is that insulin resistance or pre-diabetes can be just as bad and can lead to nearly ALL of these complications even in the absence of a technical diagnosis of diabetes.

In fact, many people with pre-diabetes never get diabetes, but they are at severe risk just the same. We could eliminate many of the long-term complications of diabesity if we simply addressed these symptoms and diagnosed the problem much earlier in the process--that is to say, much earlier on the continuum.

This leaves us with a couple of questions:
  1. What is causing our insulin resistance?
  2. How can we address the fundamental underlying problem of our bodies resisting the effects of its own insulin?
It is only by answering these questions and addressing the real causes of diabesity--the factors that are leading to this problem with insulin resistance--that we will effectively treat this terrifying disease.

Any hope we have for resolving this pandemic must use a new approach to the diagnosis and treatment of diabesity. That approach is called Functional medicine. And I am going to explain what it is and how you can use it to help you heal from diabesity in the next blog in this series.

By applying this new form of medicine to your health problems you may overcome diabesity and become vibrantly health once again.

Now I'd like to hear from you ...

Are you taking insulin and if so, how has it helped, or not, with your diabesity?

What do you think about conventional medical approaches to treating this problem?

What do you think about the continuum concept? Has your experience with diabesity reflected this continuum?

To your good health,

Mark Hyman, MD

References Part 1

(i) This term was first coined by Shape Up America, former Surgeon General C. Everett Coop's foundation.

(ii) National Diabetes Fact Sheet 2007

(iii) CDC Diabetes Statistics

(iv) Lakka HM, Laaksonen DE, Lakka TA, Niskanen LK, Kumpusalo E, Tuomilehto J, Salonen JT. The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA. 2002 Dec 4;288(21):2709-16.

(v) Ott A, Stolk RP, van Harskamp F, Pols HA, Hofman A, Breteler MM. Diabetes mellitus and the risk of dementia: The Rotterdam Study. Neurology. 1999 Dec 10;53(9):1937-42.

(vi) Key TJ, Spencer EA, Reeves GK. Symposium 1: Overnutrition: consequences and solutions Obesity and cancer risk. Proc Nutr Soc. 2009 Dec 3:1-5.

References Part 2

(i) Action to Control Cardiovascular Risk in Diabetes Study Group, Gerstein HC, Miller ME, Byington RP, Goff DC Jr, Bigger JT, Buse JB, Cushman WC, Genuth S, Ismail-Beigi F, Grimm RH Jr, Probstfield JL, Simons-Morton DG, Friedewald WT. Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med. 2008 Jun 12;358(24):2545-59.

(ii) Chen L, Appel LJ, Loria C, Lin PH, Champagne CM, Elmer PJ, Ard JD, Mitchell D, Batch BC, Svetkey LP, Caballero B. Reduction in consumption of sugar-sweetened beverages is associated with weight loss: the PREMIER trial. Am J Clin Nutr. 2009 May;89(5):1299-306.

(iii) Bhashyam S, Parikh P, Bolukoglu H, Shannon AH, Porter JH, Shen YT, Shannon RP. Aging is associated with myocardial insulin resistance and mitochondrial dysfunction. Am J Physiol Heart Circ Physiol. 2007 Nov;293(5):H3063-71.

(iv) Ryan AS. Insulin resistance with aging: effects of diet and exercise. Sports Med. 2000 Nov;30(5):327-46. Review.

(v) Gaziano JM, Hennekens CH, O'Donnell CJ, Breslow JL, Buring JE. Fasting triglycerides, high-density lipoprotein, and risk of myocardial infarction. Circulation. 1997 Oct 21;96(8):2520-5.

(vi) Nelson RA, Bremer AA. Insulin Resistance and Metabolic Syndrome in the Pediatric Population. Metab Syndr Relat Disord. 2009 Nov 29.

(vii) Silverstein JH, Rosenbloom AL. Type 2 diabetes in children. Curr Diab Rep. 2001 Aug;1(1):19-27. Review.

About the author

Mark Hyman, M.D. practicing physician and founder of The UltraWellness Center is a pioneer in functional medicine. Dr. Hyman is now sharing the 7 ways to tap into your body's natural ability to heal itself.