In my view, Type 2 diabetes is a lifestyle situation, not a hormonal disease called “insulin resistance.” Consider a few case studies that go a long way to proving that lifestyle is at the root of high blood sugar and Type 2 diabetes.
When Native Americans were moved to reservations in many states in the 1800s and 1900s, they often received complete physical examinations. The records of these exams show that from 1832–1939, Type 2 diabetes was extremely rare among Native Americans. However, after living on these reservations, Type 2 diabetes in Native Americans occurred in 16% of the population, compared to just 8% among Whites. It was clear that genetic changes among the tribes in such a short period could not explain this level of incidence. The most obvious cause was the lifestyle change the tribes underwent, particularly the profound dietary change they had to adopt in eating “Westernized food,” especially the grain-based complex carbohydrates that they were given on the reservations. Compare it to their ancestral way of living when Native Americans did not cultivate grains but hunted, fished, and farmed crops other than grains such as wheat.
The results of a study of dietary changes among 18,090 adults by the Indian Council of Medical Research, published on August 27, 2022, give further credence to this. That study had some of the adults eating a control diet consisting of 65–70% carbohydrates with little protein or fat. Meanwhile, the other adults had a diet consisting of 54–57% carbs, 16–20% protein, and 20–24% fat. This simple dietary change of reducing the daily carbohydrate intake by just 8–16%, mostly from eating less rice and wheat, resulted in the latter group of people significantly lowering their blood sugar levels.
I suggest this experiment shows that the key to reversing Type 2 diabetes is to lower your intake of carbohydrates such as rice and wheat, even by minimal amounts. The current US guidelines for dietary changes for blood sugar control recommend reducing your intake of refined sugar, but in my view, this sidesteps the most significant source of high blood sugar in the modern-day meal: complex carbohydrates from grain-based items. The dietary guidelines even encourage people to consume whole grains—the very food item that contains more glucose molecules than refined sugar, gram for gram.
What is the connection between Type 2 diabetes, weight gain, and obesity?
In the United States, approximately 85% of people with Type 2 diabetes are overweight or obese. What is the connection? And which comes first—obesity or Type 2 diabetes?
According to the “insulin resistance” theory, it is suggested that the location of fat accumulation in the abdomen predisposes one to develop Type 2 diabetes. But to date, no one has demonstrated a difference in the type of fat stored in the abdominal fat cells vs. other fat cells in the body. Nor has anyone demonstrated that a difference in their metabolic functions among fat cells accounts for the development of Type 2 diabetes. So this simplistic theory of the connection between abdominal fat and diabetes seems unlikely.
I have a different explanation for the association between weight gain and Type 2 diabetes. I suggest that weight gain occurs when adults consume an excess of calories that the body is forced to store as fat, which could be anywhere in the body, not just the abdomen. In the modern diet, the culprit in a high-calorie diet is most often complex carbohydrates—grains and grain-flour foods—which for some people can be 50% or more of their daily caloric intake.
When digested, complex carbohydrates release voluminous amounts of glucose that enter the bloodstream. After cells have absorbed whatever glucose they need immediately under the direction of insulin, the liver keeps a small amount in the form of glycogen, to be released back into the bloodstream if the blood glucose level falls low, such as before lunch or dinner time. But the rest of the excess glucose is converted into fatty acids for long-term storage in our fat cells. However, if this fat is not burned off through exercise at some later time, it results in gradual weight gain—and eventually obesity.
Meanwhile, it also occurs in many overweight or obese individuals that their fat cell storage eventually fills up. When it happens, the fatty acids that were supposed to be stored in the fat cells remain in circulation in the bloodstream. Muscle cells begin using those fatty acids for their fuel rather than glucose, which is a normal body metabolism, similar to a car with a hybrid engine using either gasoline or electricity to power the engine. I call this natural change the “fatty acid burn switch.” The result: the burning of fatty acids leaves glucose in the bloodstream, leading to high blood sugar (hyperglycemia) and eventually, Type 2 diabetes.
This is the real connection between obesity and Type 2 diabetes. It also explains why even thin people can develop diabetes. Each person has only a certain amount of fat storage capacity based on their body type. Thin people can equally fill their smaller fat cells, and while they do not become obese, they may equally develop Type 2 diabetes when their fat storage capacity is filled, leaving glucose in the bloodstream. The same mechanism can also explain gestational diabetes which affects 10% of pregnant women.
As a best-selling author and Nationally Syndicated Columnist, Dr. John Poothullil, advocates for patients struggling with the effects of adverse lifestyle conditions.
Dr. John’s books, available on Amazon and in bookstores, have educated and inspired readers to take charge of their own health. There are many steps you can take to make changes in your health, but Dr. John also encourages the public to demand certain changes in our healthcare system as well. This article is an excerpt adapted from “Diabetes: The Real Cause and the Right Cure”, now available in a second edition.
Follow or contact Dr. John at drjohnonhealth.com.
John Poothullill practiced medicine as a pediatrician and allergist for more than 30 years, with 27 of those years in the state of Texas. He received his medical degree from the University of Kerala, India in 1968, after which he did two years of medical residency in Washington, DC and Phoenix, AZ and two years of fellowship, one in Milwaukee, Wisconsin and the other in Ontario, Canada. He began his practice in 1974 and retired in 2008. He holds certifications from the American Board of Pediatrics, The American Board of Allergy & Immunology, and the Canadian Board of Pediatrics.During his medical practice, John became interested in understanding the causes of and interconnections between hunger, satiation, and weight gain. His interest turned into a passion and a multi-decade personal study and research project that led him to read many medical journal articles, medical textbooks, and other scholarly works in biology, biochemistry, physiology, endocrinology, and cellular metabolic functions. This eventually guided Dr. Poothullil to investigate the theory of insulin resistance as it relates to diabetes. Recognizing that this theory was illogical, he spent a few years rethinking the biology behind high blood sugar and finally developed the fatty acid burn switch as the real cause of diabetes.Dr. Poothullil has written articles on hunger and satiation, weight loss, diabetes, and the senses of taste and smell. His articles have been published in medical journals such as Physiology and Behavior, Neuroscience and Biobehavioral Reviews, Journal of Women’s Health, Journal of Applied Research, Nutrition, and Nutritional Neuroscience. His work has been quoted in Woman’s Day, Fitness, Red Book and Woman’s World.Dr. Poothullil resides in Portland, OR and is available for phone and live interviews.
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