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This article is part of a series on whole food, plant-based (WFPB) nutrition. For related topics, see Discovering the Word of Wisdom Topics A-Z.
Being diagnosed with diabetes can feel like a life-long sentence to discomfort, inconvenience, and stress. This disease affects almost all of us. For those personally afflicted, it can be a daily, grinding challenge. The physical, emotional, and financial toll can be tremendous. For those who believe that the best they can do is to manage this difficult and potentially life-threatening disease, a future full of medications and insulin shots can seem bleak.
Fortunately, there is another way. In fact, seen from one perspective, type 2 diabetes is one of the best diagnoses to receive because it so readily responds to the cheapest, safest, and most effective treatment of all: diet.
Diabetes is a classic example of a Western-diet induced chronic disease. Although there is a genetic component to diabetes, the foods we eat determine whether those genes are expressed or not. It is good to know we are not completely controlled by our genetic endowment. In fact, with a whole food, plant-based diet one can not only prevent type 2 diabetes but often reverse it as well. This is well documented by medical experts who have assisted thousands of diabetics over the course of the last few decades. Beyond their own patients, thousands more who have read of their work and followed their guidelines have experienced the same outcomes. Here are typical results:
- “I no longer had any symptoms of type 2 diabetes or required any medications.” — Eric O’Grey
- “My blood glucose went from 382 to 100 and my A1C went from 15.6 to 5.9. . . . In six weeks!” — Betsy Hatcher
- “In less than two months, I was off of all my medications, and I have been med-free for over three years. I am proud to say that I am no longer diabetic.” — Marc Ramirez
According to the Physicians Committee for Responsible Medicine,
In studies using a very-low-fat, plant-based diet, along with regular walking, cycling, or other exercise, 90 percent of people with adult-onset diabetes using oral medications were able to stop them in less than a month. Of those who had been taking insulin, 75 percent no longer needed it. The benefits hold up over the long term, and for many patients, the disease simply remits.
All the major medical associations agree that lifestyle medicine (e.g. changing one’s diet and activity level) is the best way to treat diabetes. Yet doctors continue to primarily emphasize diabetic medications to control this disease. One reason they do this is they don’t believe people will make the necessary lifestyle changes. Perhaps there are some who would rather have this crippling and potentially fatal disease than the radiant health that comes from eating a healthy diet, but what about the rest of us? What about you? What are you willing to do to enjoy the best health possible?
Why Should We Care?
The rate of people suffering from diabetes in the U.S. and around the world has climbed dramatically higher over the past few decades. By 2012, more than half of American adults had diabetes or prediabetes. Of the 86 million US adults with prediabetes, 90% of them don’t even know it.
According to the CDC, the “health and economic costs for [diabetes] are enormous.” They cite these statistics:
- Diabetes was the seventh leading cause of death in the United States in 2013 (and may be underreported).
- Diabetes is the leading cause of kidney failure, lower-limb amputations, and adult-onset blindness.
- More than 20% of health care spending is for people with diagnosed diabetes.
One of the tragedies of diabetes is that elevated blood sugar is damaging to the arteries and is potentially devastating to every organ connected to the arteries, primarily the heart, eyes, kidneys and the extremities. According to the CDC, diabetic complications include:
- Heart disease and stroke: People with diabetes are twice as likely to have heart disease or a stroke as people without diabetes—and at an earlier age.
- Blindness and other eye problems: Diabetic retinopathy (damage to blood vessels in the retina), cataracts (clouding of the lens), and glaucoma (increase in fluid pressure in the eye) can all result in vision loss.
- Kidney disease: High blood sugar levels can damage the kidneys long before a person has symptoms. Kidney damage can cause chronic kidney disease, which can lead to kidney failure.
- Amputations: Diabetes damages blood vessels and nerves, particularly in the feet, and can lead to serious, hard-to-treat infections. Amputation is sometimes necessary to stop the spread of infection.
Type 2 diabetes used to be diagnosed only in adults. Today, children as young as 8 are being diagnosed with this serious disease. A 15-year follow-up of children diagnosed with type 2 diabetes found an alarming rate of blindness, amputation, kidney failure, pregnancy loss, and death by the time they were young adults. This is particularly tragic since type 2 diabetes is preventable.
What’s the Cause?
Glucose (sugar) is the energy that fuels the cells in our bodies. This glucose comes from the foods we eat. During digestion, our body breaks food down into simpler molecules and moves the glucose into the bloodstream where it can be transported to the cells of our body for fuel. But much of this glucose can’t freely enter the cells without the help of a hormone called insulin. Insulin acts like a key to open a door to the cell and allow glucose to enter.
Type 2 diabetes occurs when insulin fails at the task of opening the door to the cells to allow glucose to enter. When this happens, the glucose begins to build up in the bloodstream and starts to pass through the kidneys and into the urine. This condition is called insulin resistance because the cells have become resistant to the job insulin is trying to do.
What causes cells to become insulin resistant? The answer is fat. Both high levels of dietary fat and excess fat in our bodies can lead to excess fat in our muscle cells. Excess fat in our muscle cells gums up the lock in the doors that normally allow glucose to enter. When these locks are gummed up, the insulin can no longer work as a key to open them. There is nothing wrong with the insulin or the glucose; the problem is with the lock. So much fat has accumulated that the lock is no longer sensitive to insulin, so insulin can’t do its job.
For an excellent overview of how this process works, check out this 5-minute video: What Causes Insulin Resistance?
Not all fats are the same. It’s saturated fat, found almost exclusively in animal foods, that appears to be especially deleterious with respect to fat-induced insulin insensitivity. People who eat no saturated fat have significantly better blood sugar control and insulin sensitivity than those eating saturated fat, even if they are at the same weight. Saturated fat can also be toxic to the insulin-producing beta cells in the pancreas, explaining why animal fat consumption can impair insulin secretion, not just insulin sensitivity.
Diabetic patients are often counseled to restrict carbohydrates, as these foods are the source of glucose in the diet. The reasoning is that if too much glucose is accumulating in the bloodstream, it makes sense to tightly regulate the amount of glucose we are consuming. The problem with this reasoning is that insulin resistance is not caused by the amount of glucose in one’s diet. The human body can handle (and even prefers) a diet very high in carbohydrates, and most type 2 diabetics produce more than enough insulin to get all the glucose they eat into the cells. Neither the glucose nor the insulin is the problem. Instead, the problem is the amount of fat that has accumulated in the cells, gumming up the locks so that insulin can’t do its job.
When patients are told to control the amount of carbohydrates they consume, this advice may lead to a lower, more predictable level of glucose in the bloodstream, but it does absolutely nothing to address the source of the problem. In fact, it may exacerbate insulin resistance because when we reduce carbohydrates, we almost inevitably increase the amount of fat in the diet, and fat in the diet is the source of the problem.
What’s the Cure?
Excess fat in our diets and in our bodies is the primary cause of diabetes, so reducing fat is the primary cure. Fortunately, eliminating excess fat in the diet goes a long way toward eliminating excess fat in the body. As the intake of fat decreases, the fat inside the cells dissipates. As this happens, the cells start to regain their normal function, becoming sensitive to insulin, thus allowing insulin to do its job of getting glucose into the cells.
Below are the most important changes experts recommend for preventing and reversing type 2 diabetes. PLEASE NOTE: If you are diabetic and switch to a much healthier diet as outlined below, you need to monitor your blood sugar carefully. This diet is so powerful, your need for medication/insulin can change very quickly. It could result, for example, in reducing your blood sugars too much. Consult with your medical professional before changing your diet to receive assistance in making adjustments to your medications as your diet improves.
1. Dramatically Reduce Fat in the Diet
As discussed above, a dramatic reduction in the amount of fat in the diet helps insulin work better. Whole, relatively unprocessed fruits, vegetables, legumes, and grains are the most wholesome low-fat foods.
Many processed foods are high in fat and very low in nutrients. Vegetables oils are among the worst of the processed foods. These oils, along with other concentrated fats like lard and butter, contain 100% pure fat and next to no nutrients. These foods, and all trans fat, should be totally eliminated. If you are trying to lose weight, you may also want to restrict use of high-fat plant foods like nuts, olives, avocados, and nut butters. While these whole foods are high in nutrients, they are also very high in fat.
2. Dramatically Reduce and Preferably Eliminate Animal Foods
In answer to the question, “Is it safe for someone with diabetes to follow a vegetarian diet?” the American Diabetics Association gave a resounding “Yes!” They conclude:
A vegetarian diet is a healthy option, even if you have diabetes. Research supports that following this type of diet can help prevent and manage diabetes. In fact, research on vegan diets has found that carbohydrate and calorie restrictions were not necessary and still promoted weight loss and lowered participants’ A1C.
All animal foods are naturally high in fat (since, with rare exception, they contain no carbohydrates). This includes meat, diary, and eggs. Even lean meats are high in fat. All animal fats also contain saturated fat, the kind of fat most related to insulin resistance. Even modest amounts of meat increase the risk of diabetes.
Fat is not the only problem with animal foods, because animal proteins, like milk casein, also reduce insulin sensitivity.. Animal protein consumption can also exacerbate the insulin spike from high glycemic foods like white rice.
Beyond insulin resistance, animal foods are linked to heart disease, cancer, and other chronic diseases. Reducing or eliminating these foods provides multiple health benefits with no negative side effects. Anyone following this advice should also add a vitamin B12 supplement or foods fortified with B12.
3. Concentrate on Unrefined Starchy Foods
Starchy foods (e.g. wheat, rice, corn, potatoes, beans) cause the body’s own insulin to become more powerful, increasing insulin sensitivity.. Starchy foods are complex carbohydrates that contain natural sugars chemically linked together in a chain. Unlike table sugar, candy bars, and sodas, which release sugar that is absorbed into the bloodstream abruptly, the sugars in starchy foods gradually come apart and pass into the blood a bit at a time, which reduces blood sugar spikes. The sugar in whole fruit also tends to break down more slowly than refined sugar.
The fiber in starchy foods keeps the absorption of sugar slow and steady. Fiber is the plant roughage, the outer coating of grains, which is retained in whole wheat bread and brown rice, but has been eliminated in white bread and white rice. Aim for 40 grams of fiber per a day, but you may want to increase the amount slowly to allow the body time to adjust to increased levels of fiber. Animal foods have no fiber.
4. Reduce or Eliminate the Use of Refined Carbohydrates
Refined carbohydrates (white flour, sugar, sodas, and processed foods) are high glycemic foods which can cause the blood sugar to rise more quickly. These foods are also very low in nutritive value as compared to whole, unrefined fruits, vegetables, legumes and grains.
5. Engage in Regular Physical Activity
Physical exercise is another mechanism that can be used to increase the insulin sensitivity of our muscle cells. Adding exercise to your regimen brings further benefits, because working muscles pull sugar out of the blood, even with very little insulin present. In fact, while you are exercising, muscles can even use glucose without insulin.
You may need to increase physical activity slowly at first. A half-hour walk every day or one hour three times per week is a good regimen for most people. You can do more as your exercise capacity increases.
6. Reduce Stress
High stress levels flood the body with hormones that raise blood sugar levels. Stress can also encourage overeating. Fortunately, when you eat a healthier diet, you lose weight and feel better. This is a great stress-reliever!
Top Resources for Learning More
The best source of information on diabetes and the use of a healthy diet to prevent and reverse it is the book Dr. Neal Barnard’s Program for Reversing Diabetes: The Scientifically Proven System for Reversing Diabetes without Drugs by Neal Barnard, M.D. You can also find several excellent free videos by Dr. Barnard, including:
- TEDxFremont: Tackling Diabetes with a Bold New Dietary Approach (18 min. video)
- A New Nutritional Approach to Type 2 Diabetes (45 min. video)
Michael Greger, M.D. has created a series of excellent short articles and videos which feature the scientific evidence on the cause, treatment, and prevention of diabetes. Here are three of them:
- What Causes Insulin Resistance? (5 min. video)
- How Exactly Does Type 2 Diabetes Develop? (article with links to videos)
- Plant-Based Diets for Diabetes (4 min. video)
Here are resources created by Physician’s Committee for Responsible Medicine (PCRM) that provide guidance for changing diet and lifestyle to maximize the prevention and reversal of diabetes:
- The Vegan Diet How-To Guide for Diabetes
- Diet and Diabetes: Recipes for Success
- Frequently Asked Questions about Diabetes
For more resources see the topic guide for “Diabetes Type 2” found on Discovering the Word of Wisdom Topics A-Z.
There are hundreds of success stories of people who have reversed diabetes by switching to a whole food, plant-based diet. Here are three of them:
- How I Lost 140 Pounds, Cured My Type 2 Diabetes, and Saved Thousands in Medications by Eric O’Grey. Eric was only 51, but his health was falling apart. He was diabetic and morbidly obese. His doctor suggested he start preparing his funeral. Fortunately, by going whole food, plant-based he was able to lose the weight and regain his health.
- After Battling Type 2 Diabetes, My Lab Results Improved Dramatically in Just Six Weeks by Betsy Hatcher. Betsy already had high blood pressure and cholesterol when she was diagnosed with diabetes. Trying to manage these diseases was “limiting and frustrating.” Then, after watching Fork Over Knives, she switched to a whole food, plant-based diet and witnessed a major turnaround in her medical conditions in just six weeks.
- How I Reversed My Diabetes and Stopped All Medications With a Plant-Based Diet by Marc Ramirez. Marc and his entire extended family struggled with diabetes and other chronic diseases. Marc was taking five oral medications and insulin injections. His doctor told him it could never be cured. But in less than two months after gong whole food, plant-based he was off of all medications.
For help getting started on a healthy whole food, plant-based diet, see: “Getting Started on a WFPB Word of Wisdom Diet.”
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Jane Birch is the author of Discovering the Word of Wisdom: Surprising Insights from a Whole Food, Plant-based Perspective and many articles on the Word of Wisdom. She can be contacted on her website, Discovering the Word of Wisdom. Watch the video “Discovering the Word of Wisdom: A Short Film.”
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 Andy Menke, et al., “Prevalence of and Trends in Diabetes Among Adults in the United States, 1988-2012,” JAMA 314(10) (September 8, 2015): 1021-1029.
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 John McDougall, “Simple Care for Diabetes,” McDougall Newsletter (December 2009).
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 Thomas Campbell, “12 Questions Answered Regarding Vitamin B12,” NutritionStudies.org
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 Physicians Committee for Responsible Medicine, “Diet and Diabetes: Recipes for Success,” PCRM.org, accessed June 22, 2017.
 Lisa M. Leontis, “Type 2 Diabetes and Exercise: Exercise Makes It Easier to Control Your Diabetes,” EndocrineWeb, accessed June 22, 2017.
 “Diabetes and Stress,” Diabetes.co.uk, accessed June 23, 2017.