I learned in medical school that diabetes was influenced by genetics. But when I began to practice, and saw for myself that spouses of diabetic patients were also likely to have a problem with their blood sugars, I began to understand that the environment played a much larger role than I had been taught. Now, so many Americans are unable to make sufficient insulin to meet their need that diabetes can no longer be said to be due to genetics. If current trends continue, one-third of 15-year-olds are expected to become diabetic in their lifetimes. If you would like to avoid becoming diabetic, you must begin to conserve your insulin.
You may have heard of insulin spikes, which happen when you eat items that get absorbed quickly. Orange juice, white flour, sugar, corn syrup, corn starch and white rice are all absorbed rapidly, so I limit them to occasionally. Not never, just sometimes. Shift your daily choices in the direction of slowly-absorbed foods, like fruits and vegetables, beans and whole grains,
high-quality protein sources, and nourishing fat sources like avocado, olive oil, nuts, seeds and fatty fish.
Insulin plays many critical roles in your body, and while you need it to live, but it is not your friend. Like blood sugars, it has a safe range, and levels outside that range can, over time, be dangerous to your health and wellbeing.
The amount of insulin you are capable of making over a lifetime is limited. If and when the demand exceeds your capacity, your blood sugars will begin to rise. Just sometimes at first, but more with time. What if your supply is mostly depleted by age 40? Or 50? Then what? Then your doctor may prescribe medication(s) to keep your blood sugars in the normal range. Some medicines work by improving the efficiency of your remaining insulin supply, others by stimulating the pancreas’s “beta islet” cells, which secrete insulin.
Or, imagine that your pancreas contains fewer beta islet cells than average. You were born that way. It happens. So whereas many of your friends and neighbors still manage to keep their blood sugars in the normal range despite that they mostly eat the typical American diet, which wastes insulin, your blood sugars start rising in your 20s, or even earlier.
Elevated insulin levels are identifiable by abdominal obesity (even in otherwise slender individuals), marked swelling around the eyes (periorbital edema), extremely prominent cheeks (buccal fat pads), and/or a double chin. That is, people with high insulin levels tend, to some degree, to resemble babies. Because insulin is a growth hormone, and babies are growing, their insulin levels are naturally high. But those levels start to fall as they begin walking, which is one reason a 2-year-old looks different than a baby.
The less often your insulin spikes, the more you will have to use in the years to come. The less insulin you waste, the more likely you are to have enough to last a lifetime. Next month, I’ll talk about how certain items increase insulin levels and why high levels are dangerous.
Dr. Roxanne Sukol writes about adult health, preventative medicine and wellness for the Cleveland Jewish News. She is a retired internal medicine physician from Cleveland Clinic.
