Diabetes
The McDougall Program:
Diet and Lifestyle Implications:
www.drmcdougall.com
Both forms of diabetes, childhood and adult, are rare in
parts of the world where people's meals are based on starches. This rarity
is easy to understand as far as adult-type diabetes is concerned, since
the primary cause of that illness is the rich Western diet. Fat inhibits
action of the body's insulin, and the lack of fibers allows rapid passage
of glucose from the gut into the blood at which point the blood sugar
content rises rapidly. Carbohydrates surprisingly stimulate insulin
activity, thereby lowering blood sugar levels, and making the diabetic
feel better.
For cases of childhood diabetes the explanation is cow's
milk consumption. Cow's milk protein fed to young children causes an
autoimmune reaction that causes the body to direct antibodies to the
child's pancreas.
Many of the complications that occur in both forms of
the disease are the consequences of a rich diet burdening a weakened
system. A diabetic person cannot defend himself from the harmful American
diet or repair the damages it causes as well as can someone who does not
have diabetes. Consider how a small infection in a diabetic's toe can soon
extend to the point where amputation of the foot or of the leg will be
necessary. The various manifestations of atherosclerosis can progress much
more rapidly in a diabetic. Even mild variations in blood sugar-control
are associated with an increased rate of heart attacks in Americans.
Atherosclerosis is remarkably uncommon in the few cases
of diabetes found in counties in Africa and Asia where the diet is largely
starch-based. These few diabetics live almost free of heart disease,
strokes, and gangrene which are too common among diabetics indulging in
the unending American feast.
In Childhood Diabetes: These patients will usually drop
their insulin needs by 30%, and their blood sugar levels will be more
stable (less "brittle") on a starch-based diet. Most important, their risk
of complications is markedly decreased with a low-fat, low-cholesterol
diet. Insulin adjustments are made as usual, with the aid of urine-sugar,
and blood sugar tests, under a doctor's supervision.
In Adult Diabetes: Change in diet will allow 75% of
these patients to stop taking all insulin, and more than 95% to stop
taking all diabetic pills. (The few who continue to need medication should
be treated with small doses of insulin.) Insulin adjustments are made as
usual, with the aid of urine-sugar and blood-sugar tests, under a doctor's
supervision.
My Recommendations: Never take oral hypoglycemic drugs,
because they increase your chances of dying sooner. Change to a low-fat,
high-complex carbohydrate diet (starches, vegetables, and about 3 fruits a
day). If you're obese, lose weight, for added health and blood
sugar-control. You should also be physically active. Exercise, in addition
to helping you lose weight, has independent benefits that increase the
activity of insulin and improves your diabetic condition.
Childhood-type diabetics will continue to need insulin!
If a childhood diabetic stopped all insulin they would likely develop
ketoacidosis, slip into a coma and soon die. Insulin in this disease is
lifesaving, because these childhood-onset diabetics make little or none of
their own.
Adult-type diabetics will need insulin if they suffer
from the most obvious symptoms of their disease--such as too much weight
loss too soon (you should be so lucky), too much thirst, and too frequent
urination. The question of better control, meaning fewer complications,
has not been settled. I believe the closer to normal, the blood sugar
level is kept the better. But blood sugar levels should not be under such
"good" control that the patient runs the increased risk of suffering
damaging hypoglycemia from over zealous use of insulin. More specifically,
damage to the eyes is more severe and more common when blood sugar levels
are too low. Blood sugar levels, if you are taking insulin, should be
controlled at 150 mg/dl to 300 mg/dl.
People with diabetes are usually experts at adjusting
their own medication and rarely have trouble making necessary changes. I
usually stop adult-diabetic's pills the very day they start the Program.
Adult diabetics on insulin should cut their dosage at least in half upon
starting the Program. They will find themselves lowering (rarely raising)
their intake of insulin, depending on what level their blood and/or urine
sugars are each day. If your urine sugars were 0 and +1 all day long, a 5
unit drop will probably be suggested by your doctor for tomorrow. If you
had a hypoglycemic reaction, then as an adult-type diabetic, you will be
told to lower your dosage even more (10 to 20 units) and possibly told by
your doctor to stop the insulin altogether. Blood sugar levels can also be
used to regulate insulin dosage. You will want to keep your sugar between
150 mg/dl and 350 mg/dl while you are changing your diet these days
(higher levels are safer than lower levels.) I have seen adult diabetics
come off of more than 75 to 180 units of NPH insulin within 3 days of a
change in diet and exercise. Be careful to lower the dosage quickly
enough. Have sugar (hard candy) around for all too likely hypoglycemic
reactions.
Childhood diabetics should reduce their insulin dosage
by 30% when beginning the program, then make further adjustments as
indicated by blood sugar or urine sugar readings. As a general posture, it
is safer to be undermedicated with a slightly higher blood sugar, than
overmedicated with hypoglycemia that causes sweating, confusion and
finally coma.
For more details on diabetes see McDougall's Medicine--A
Challenging Second Opinion.
DO NOT TAKE THIS INFORMATION AS PERSONAL MEDICAL ADVICE.
DO NOT CHANGE YOUR DIET, IF YOU ARE ILL, OR MEDICATION WITHOUT THE ADVICE
OF A QUALIFIED HEALTH CARE PROVIDER (YOUR PHYSICIAN, FOR EXAMPLE). MORE
DETAILED INFORMATION IS FOUND IN THE MCDOUGALL PROGRAM--12 DAYS TO DYNAMIC
HEALTH (PLUME 1990), IN YOUR BOOKSTORE OR CALL (800) 570-1654 TO ORDER
BOOKS
REFERENCES:
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implications of UGDP results. JAMA 218:1400, 1971
Noth, R. Diabetic nephropathy: hemodynamic basis and
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Editorial--Insulin dependent? Lancet. 2:809, 1985
Leslie, P. Effect of optimal glycaemic control with
continuous subcutaneous insulin on energy expenditure in Type I diabetes
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The DCCT Research Group. Weight gain associated with
intensive therapy in the diabetes control and complications trial.
Diabetes Care 11:567, 1988
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population with a high carbohydrate/cassava diet. Lancet 1:765, 1987
Bodansky, H. Insulin dependent diabetes in Asians. Arch
Dis Child 62:227, 1987
Snowdon, D. Does a vegetarian diet reduce the occurrence
of diabetes? Am J Public Health 75:507, 1985
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Stern, M. Lack of awareness and treatment of
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Steiner, G. From an excess of fat, diabetics die. JAMA
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The Kroc Collaborative Study Group. Diabetic retinopathy
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Barnard, R. Response of non-insulin-dependent diabetic
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Kiehm, T. Beneficial effects of a high carbohydrate,
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Ney, D. Decreased insulin requirement and improved
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high-fiber, low-fat diet. Diabetes Care 5:529, 1982
Parillo, M. Metabolic consequences of feeding a
high-carbohydrate, high-fiber diet to diabetic patients with chronic
kidney failure. Am J Clin Nutr 48:255, 1988
Anderson, J. Dietary fiber and diabetes: a comprehensive
review and practical application. J Am Diet Assoc 87:1189, 1987
Karjalainen J. A bovine albumin peptide trigger of
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