As I read Mastering Diabetes (MD) by Cyrus Khambatta and Robby Barbaro and watching their Mastering Diabetes channel on YouTube I've been learning more and more about diabetes. I think the first thing I learned is that there isn't just type 1 or type 2. There is Pre-Diabetes, Type 1, Type 1.5, Type 2 and Gestational diabetes. Each of these require different approaches to the treatment plan.
Let's understand what they are first because that will provide insight as to suggested treatments. Although in the end the recommendation for all of them is eat more plants and fiber in a low fat diet. Before jumping into what the types are we should probably define diabetes more generally.
Diabetes is "a disease in which the body’s ability to produce or respond to the hormone insulin is impaired, resulting in abnormal metabolism of carbohydrates and elevated levels of glucose in the blood and urine."
According to Google and the Oxford Language Dictionary. In MD they attribute to disease to insulin resistance. Insulin is a hormaone created by beta cells in the pancreas whose job is to escort glucose that has been released by the kidney to the cells in your body that use the glucose for energy. I like to think of it like this: The insulin is like the key that opens the door to the mailbox and in normal circumstances the insulin places the mail in the mailbox as it were. When the body is insulin resistant the keys to the door no longer work so the mailman's bag (the bloodstream?) gets filled with more and more mail that can't be delivered. That back up of mail begins to cause problems for the whole postal system. We saw what happened to deliveries and store shelves when the system backed up somewhere during the COVID-19 Pandemic. Same thing with the human body and insulin resistance. The build up of glucose in the blood system creates problems for the body including brain fog, joint issues, circulation issues, and damage to the eyes. Untreated it can cause fainting, dizziness, hallucinations, heart attacks and strokes.
Having a really basic understanding of diabetes, aka insulin resitance and its effects, let's consider the different types of Diabetes. For me, I knew of Type 1, Type 2 and a vague idea that gestational diabetes existed. I had generally learned that type one was genetics, and type 2 was lifestyle. Gestational is certainly for very specific people, solely those that can have babies in their bellies. Doesn't apply to me :-). For those with Gestational Diabetes your blood sugar will return to normal after child birth. However, you will need to be attentice because according to the Mayo Clinic:
...if you've had gestational diabetes, you have a higher risk of getting type 2 diabetes.
What I also learned is that Type 1 and Type 1.5 are not really genetics, which I had thought. Rather they are an auto-immune disease. An auto-immune disease is a disease where you immune system thinks that a normal part of your body is a threat like a bacteria or virus and it responds accordingly. It begins to attack in this case the beta cells that create insulin in the pancreas. The problem with this is unlike other cells, beta cells don't grow back so if you lose 30% of your beta cells, you will only operate at 70% of the original capacity for the rest of you life. Eventually someone with Type 1 or 1.5 will require insulin and there is no way to stop this. There is a way to slow it down and perhaps reduce the amount of exogenous insulin you require, but insulin will be required.
The difference between Type 1 and Type 1.5 is the speed at which your natural insulin production decreases. In Type 1, from diagnosis it is as short as 6 months or even less. In Type 1.5 the process is slower and can take years or even decades to occur. You can get an anti-body test which MD recommends after several months of their plan if you haven't been able to get your blood sugar under control. At a minimum, knowing that it is 1 or 1.5 will change how you look at the problem and therefore the treatment.
Type 2 may have a "genetic" element in that you may be pre-disposed to it like other inherited traits, but it is clearly a lifestyle caused didsease. The results are exactly the same though, and untreated will cause many other problems and your beta cells will eventually die off and you will require insulin. My Mom had a good friend that had to have is foot amputated - I hadn't known that was a thing with diabetes! The lifestyle that causes diabetes is pretty simple - lack of consistent exercise, a sedentary lifestyle and diet. That standard American diet, also known as SAD because nutritionally that's what it is - sad, is high in processed food exceedingly low in vegetables and fiber in particular. In fact, I read somewhere that most Americans consume french fries as their only vegetable! French Fries are deep fried and loaded with saturated and transfat - which is why a Mickey D's french fry can last on your car floor for YEARS and not change(from personal experience). It doen't grow mold or rot, it stays the same. That stuff is in your body now, think about that. Yuck.
So endeth part 1. Hopefully there will be a part 2 because I'm not done with the book and my diabetic journey is just starting. So there will be more to share, I hope I have the discipline to write it down here.