How I didn’t get diabetes
By: Reinoud Schuijers
Tags: Technology, Food, Health, Science, Healthcare

How I didn’t get diabetes

An easy to follow approach that most of you will ignore

I am supposed to be diabetic. I have had insulin resistance for years now, which is almost guaranteed to lead to diabetes. If you are an adult living in the U.S., chances are one in three that you have insulin resistance, too. But you probably don’t know. And you probably won’t know until it’s too late. By then, you will be diagnosed with diabetes, and you will be prescribed drugs (most likely insulin injections before or after meals, and something like metformin) to fight the symptoms of diabetes, but without addressing the causes.

You will live an increasingly limited life, and you will never get off the prescription drugs. You will gain additional weight, year after year, that you will carry around for the rest of your days. In time, you may lose mobility, your chances of developing cardiovascular disease skyrocket, you’re more likely to suffer damage to your nerves, kidneys, and eyesight. You may lose a limb, develop Alzheimer’s disease, and eventually, you’re at greatly increased risk to die young. (Source: Center for Disease Control and Prevention)

I have insulin resistance, and as a subject of our current medical landscape, I was destined to become diabetic. But I didn’t. Not because of luck, not because of some miracle drug, but because I drastically changed the way I eat and live.

Photo by Adrian Swancar on Unsplash

Next stop on the insulin resistance train: prediabetes

Insulin resistance could be seen as the very first stage of diabetes. It is a collection of the very first minor symptoms of prediabetes — a condition in which your blood glucose levels are elevated, but not badly enough to call it diabetes — yet. It is a misconception that prediabetes is the same thing as insulin resistance. They’re the same problem, but at a different moment in time. People with prediabetes (over one-third of the U.S. population) have a 70% chance of developing type-2 diabetes in the future. In other words: we are on track to welcome over 70 million diabetics in the U.S. over the next few decades (70% of 33% of 328 million).

Insulin resistance is a train with two stops: prediabetes and diabetes. Once you’re on the train, it’s difficult to get off, as shown by the statistics.

The problem with insulin resistance is that it’s much harder to diagnose than diabetes is, and there are no prescription drugs to treat it specifically. Coincidentally, the absence of a drug inherently means that there is no money to be made from insulin resistance, so people aren’t lining up to find better ways to diagnose it.

The difference in diagnosis (between I.R. and diabetes) is that the main symptom of diabetes is out-of-control blood sugar. The main symptom of insulin resistance is that some of the cells in your body (such as muscle cells, your liver, and fat tissue) have become less sensitive — resistant — to insulin. This causes them to become less efficient at removing excess sugar from the bloodstream. Keeping this balance in check is crucial because too much sugar in your blood (hyperglycemia) can induce a coma and even kill you.

As a result, your body keeps producing more insulin to keep your blood sugar in check, further bolstering your cells’ resistance to it, worsening the problem, and eventually causing you to develop diabetes.

There are no great ways to detect insulin resistance. Doctors may do a fasting plasma glucose test, in which they measure your blood sugar after you haven’t eaten for 8 hours. Mild insulin resistance, however, does not significantly alter your fasted blood glucose.

Another method would be to drink a sugary solution, two hours after which the doctor takes your blood. Same problem: mild insulin resistance will (hardly) show up.

Lastly, a hemoglobin A1c-test could be issued. This test reveals how well glucose (sugar) in your blood binds to your red blood cells. It’s a very accurate and effective method of diagnosing diabetes because it shows how high your blood sugar has been over the past two or three months. However, insulin resistance isn’t diabetes — yet. So, yes, if you have diabetes, you’re very likely to be insulin resistant, and the test will confirm this. However, if you don’t have diabetes, but you are insulin resistant, the test will come out negative and falsely assure that you are healthy.

The biggest problem, however, is that symptoms of insulin resistance are broadly accepted as “part of life.” We, as a culture, are overweight, tired, and depressed. We’re sluggish. We crave food throughout the day — and night. We are sailing from one high to the next, waiting for our next fix of sugar and starch, and if we don’t get it in time, we become agitated.

Those are the symptoms. They are real, and they are everywhere. But we, our parents and friends, and even many of our doctors turn a blind eye to them. Body positivity, among other things, drives diabetes. I support everyone’s right to be happy with the way they look, but I’m not a fan of those same people being devastated because they cannot play with their kids.

Slow, self-induced food poisoning is not what “freedom” is supposed to entail.

What my doctor did (and didn’t do) for me

I didn’t know any of the above before I started my journey. All I knew is that I suffered from increasingly crippling after-dinner dips — or postprandial somnolence, to be fancy. Technically, mine weren’t after dinner.

Every day, shortly after having lunch, I would crash, feeling overwhelmingly tired, agitated, foggy, and even desperate. This would last anywhere between 30 and 120 minutes. It would get so bad that I’d feel panicky, and at times I’d tear up because I didn’t understand what was going on — but I knew it was something that I couldn’t fight, let alone ignore. Yes, I was so incapacitated by tiredness that I’d cry.

At first, I thought it had to do with caffeine (or coming down from it), so I cut down on coffee, hoping that it would make a difference. It didn’t. As the symptoms crept up to me, it took me a couple of months to finally see my doctor. I underwent a general medical exam, and the doctor issued a blood test. I was also tested for about 50 food intolerances. All results, including blood sugar, came back fine.

Meanwhile, my symptoms didn’t decline. If anything, they got worse. As a result, I was forwarded to a psychologist to see if any underlying mental issues held a connection to my energy crashes. I had several sessions with a therapist, took a multi-day I.Q. test (up to this day, I still don’t know why), and was tested for ADD and a variety of other disorders.

Again, all tests came back fine. There I was: a 26-year old guy, declared completely healthy and sound, feeling absolutely devastated daily. In addition to feeling devastated, I also couldn’t help but feel left behind by the medical system. The process so far took well over a year, and thanks to my insurance, it only cost me € 385. If it weren’t for the insurance, the medical bills would’ve easily surpassed € 6.000,- without getting me much further.

Photo by Joel Filipe on Unsplash

How I helped myself, step 1

It was time to take matters into my own hands. The first (and only) clue I had was food. I knew eating induced the crashes. So I started experimenting with my breakfast, having none, more, or less, finding that a bigger breakfast would make the crashes occur earlier in the day — right after breakfast, to be precise. Also, breakfasts higher in carbohydrates had a much bigger impact than low- (or no-)carb breakfasts. The same held for lunch, so I stopped eating bread, and forewent high-carb breakfasts like cereal or oatmeal.

My approach worked amazingly well. I finally regained some control over my energy levels. Still, the underlying problem persisted: eating a very big meal, even low in carbs, or eating foods such as pasta, bread, rice, or potatoes, would still cause the same extreme crashes in energy.

Thus, I dug deeper. The last piece of the puzzle was somewhere to be found in research and textbook information. While I was learning about basic metabolism (thanks, Khan academy!), it all started to make sense. I got familiar with the basic mechanisms responsible for storing and withdrawing energy, the role of insulin in this process, and what could go wrong.

How I helped myself, step 2

I didn’t invent anything. None of the things I did to prevent becoming diabetic are new or groundbreaking in any way. Nearly every country has some sort of Diabetes Association with crystal clear guidelines on how to prevent diabetes. To summarise, here they are:

Lose weight;

Stop smoking;

Eat healthily.

But those things are hard. Moreover, many people are too late to embrace these changes. They start when they already have diabetes. While it’s better than doing nothing, it’s not great. Had they started this change five or ten years earlier, many would not have become diabetic.

I adopted a ketogenic diet and introduced intermittent fasting to my day-to-day. Both of these things helped my insulin-resistant cells regain some of their sensitivity — because I gave them a break from the otherwise non-stop supply of sugar to the bloodstream.

It also changed my relationship with food for the better. I regained control over food instead of food controlling me.

Last, but not least, I started lifting weights. I learned that muscle cells are crucial in your body’s efforts to transport glucose out of the blood, into storage. Muscles are a great place to store sugar, in the form of glycogen. Bigger muscles mean more capacity.

To summarize, here’s how I didn’t get diabetes:

I greatly cut down on carbohydrates, adopting a ketogenic diet;

I lost weight due to this diet, and;

I increased my muscle mass by lifting weights, creating more cells to store sugar in.

Endnote: I was never diagnosed, but does it matter?

You may have noticed that I never mentioned being officially diagnosed with insulin resistance. I wasn’t. But, as I explained, people mostly get diagnosed with (pre)diabetes, not with insulin resistance, because I.R.’s symptoms are accepted to be “normal.”

Nevertheless, I am confident to say that I have insulin resistance. It all adds up and living my life in a way that (theoretically) prevents insulin resistance from worsening has proven to work wonders for me. My symptoms have almost fully disappeared, and I even started to regain some insulin sensitivity. I can tell, because I can now enjoy a meal rich in carbohydrates now and then, without feeling terrible.

However, sometimes I overdo it, and the crash is just as real as it used to be. To me, this is fine. If anything, it’s a reminder of where I came from, it’s a reality check, and it tells me what my body can handle and what it can’t.