Diabetes — Who’s To Blame?

Two weeks ago I looked at what’s a bigger factor in Type 2 diabetes, genes or food. Because I ranked food higher, several people accused me of “blaming the victim.” I don’t blame people with diabetes. But I do blame some other people.


First, I blame myself for oversimplifying the question. It’s not genes versus food as the cause of Type 2. It’s genes AND food, and stress, and physical movement (or lack of it.) And it’s also the load of chemicals in our environment and our food. So who is to blame for all of that?

I blame people in the food industry who create and market unhealthy food. Grown with chemicals, processed, stripped of most nutrition, filled with taste-good chemicals, packaged, and heavily marketed, this food promotes diabetes and other illnesses for profit.

Then there is the social environment that stresses people out, makes them feel overwhelmed and unloved, and then says, “Here, feel better with sugar and television.” Social, economic, and environmental stress hit poor people the hardest, which is why they have so much diabetes. But the same factors affect all of us.

There are the people who designed and built our environment to serve cars, but make it nearly impossible to walk. Some cities have no sidewalks; huge streets have no traffic lights to help you cross. I blame the auto industry and the people who built our cities this way.

There are all the toxic chemicals that are dumped into our environment and sometimes directly into our food. As Jan Chait wrote about here, plastics such as those used in water bottles can promote diabetes. So can agricultural chemicals and air pollution. I blame the people who expose us to all these toxins.

Most of all, I blame the medical establishment, including the American Diabetes Association (ADA). For forty years, they promoted starchy diets for people with diabetes. Until 2006 or 2007, they used to say “Make starches the star” of a diabetic diet. Until 1994, they recommended that 55% to 60% of calories should come from carbs, more than in the average American diet.

The reason they prescribed a low-fat diet was that most people with diabetes eventually die from heart disease or stroke. Back then, high fat and cholesterol were thought to be the causes of heart disease. So the “experts” preached low-fat, high-carb diets.

But we have known for 20 years now that high blood glucose levels are the main causes of heart disease in people with diabetes. Why haven’t they loudly changed the recommendations and told the world? Is it because they don’t want to admit a mistake? Whatever the reason, I blame them.

They also still tell people that you can eat anything on a diabetic diet, as long as you do it in moderation. Many people believe them, but I don’t. (What do you think?) Of course it’s no disaster to eat a cookie once in a while, but diabetes is a disease of carbohydrate metabolism. That means people with diabetes can’t handle carbs well, especially refined carbs. Insulin doesn’t work well or isn’t there. You eat refined carbs at your own risk.

It’s true that genes cause these insulin problems. I could probably eat all the sugar I wanted and never get diabetes. My A1C is 4.1%. (My genes have gone wrong in other ways.) Stress turns on those diabetes-promoting genes, usually in childhood, infancy, or even in the uterus. Chemicals in the environment make them worse. But even if those genes are turned on full-blast, they usually won’t cause diabetes without sugars and/or starches in the diet. It’s the combination of food, stress, lack of exercise, chemicals, and genes that cause Type 2.

Fiber and vegetables, on the other hand, help with blood glucose control and help the body deal with toxic chemicals. (So does vinegar.) So eat more of those.

I don’t blame people for eating food that is affordable, available, and promoted. I blame the people who promote it (whether the medical or food industry). I don’t blame people for eating what makes them feel better when they’re stressed. I blame the people who are stressing them.

But I do recommend that you eat what your genes want you to eat. Since we can’t change our genes, I recommend going high-fiber, no sugar, and low-flour. You may not be cured, but it can’t hurt, and hundreds of thousands of people say it’s helped them.


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  • Jan Chait

    David, you reference one of my blogs about food additives, plastics, and Type 2 diabetes. I wrote three in a row. The one referenced was the last one. The others should have run on April 3 and April 10 (if those were Tuesdays). Sorry not to provide links, but I’m on a cruise ship at the moment, on an unfamiliar computer.

    Jan Chait

    Editor’s Note: Jan’s full series on food additives, plastics, and Type 2 is comprised of the following three blog entries:
    “‘Should You be Eating That?’ Could Have a New Meaning”
    “Wish I Could (Still) Eat That”
    “Should You be Putting Food in That”

    And for my blog entry on the plasticizer bisphenol A and Type 2 diabetes, click here.

  • calgarydiabetic

    The ultimate cause of everything God is to blame ?

    Obesity is hard to say my friend Ben who is the same height but genetically much more muscular was at least 50 lb heavier than me has perfect blood sugars. I never ate at fast food but have severe diabetes. My wife who is skinny has an A1c of 6.0%. The overkalix study suggested that the amount of food in the near ancestors affected the incidence of diabetes in the offsprings. And it was different for male and female. Who knows what to make of this. But food does affect the expression of the gene so if America is eating badly beware the coming generations.

  • jim snell

    How idiotic.

    Identifying food and I would say energy ingested – calories is not blaming life style although it ends up agitating all those “blamed for their problem.”

    The data known so far is:

    a) hunter gatherer body digestion/gene system was optimized 10,000 years ago for times of low grade fuel and intermittent scarce volumes of that gruel. The system is optimized to prevent starvation – hold it off as long as possible given all the stratagies for fat to energy, muscles to energy conversion stratagies.

    b) this system is highly efficient system and dumps every bit of calories it can find converted to glucose into blood system. NONE is bypassed!
    If energy balance control had been factored in years ago, today the excess glucose would get dumped out of system when system doesn’t need any more. Since it does not, the human needs to practice this manually externally to prevent overloading system chronically in a day and age of 24/7 highly refined high energy foods, grains, rice, sugars etc coupled with low energy burn in this couch potato era.

    c) I as old goat, was always fed like horse as a child and told to eat everything up on ones plate.
    That advice today is useless, unhelpful and wrong.

    d) this is not issue about life style; not about fat versus lean but about energy balance and chronically overloading ones body. Unfortunately getting the monster under control does from all my experience requires one to practice portion control – specially on high glycemic foods and ernsure sufficient hearty exercise to offload glucose stored in skeletal muscle cells so that there is always room to store more glucose and keep body blood system regulation under control. If you are working on the pharoh’s tombs and monuments moving 2 ton stone blocks by hand, none of this discussion applies to you as you will waste away to shadow unless you are eating all the high energy foods you can get your hands on.

    e) there is no warning light, sight glass, gauge on the front panel of your human starship enterprise control panel that lights up to show one is continuously overloaded with excess glucose/energy. The first sign is pre-diabetes as control wanders out and up and finally when hard saturation sets in; your body rots out as veins and arteries go soft and rubbery from excess glucose levels.

    f) current focus by some of the lobbiests has got lost on pancreas- insulin control for type 1’s; body fat as culprit and of course the fat in ones diet and the fat police. Constantly large increases in type 2 numbers are suggesting something else.

    g) medical science for reasons that escape me miss the fact that insulin is only a transfer hormone to signal to the distributed storage system of human body to uptake more glucose into the storage sites of the skeletal muscles if they have room. Insulin resistance is a control strategy factor of normal skeletal muscle cells and their glucose storage sites to control glucose transfer and prevent these cells getting overloaded and poisoned on excess glucose. These storage sites are finite and fixed and can hold only so much glucose. These sites regularly based upon fill – I am told; can upgrade and downgrade the sensitivity of the insulin receptors to obtain necessary control. The other dirty secret is that insulin does not get rid/burn off glucose – only hearty exercise/process burn can do that. Yes you can transfer it elsewhere but it still needs to get burnt – exhausted off.

    My take is that there are few choices here except if one enjoys rich food and lots regularly – be sure you are burning it off regularly with lots of hearty exercise or else size the energy ingestion to match your average daily energy burn
    and not let glucose back up in body.

    Other medical conditions and misfire of liver – leaky livers, other organs, hormones may require medical intervention to help assist get human chemical plant back on track.

  • Joe

    Interesting thoughts on city design and automobiles. My city recently suffered through a Mayor who didn’t drive, and figured no one else should, either. Bicycles were given automatic right-of-way. Any accident involving a car and a bicyclist was automatically considered the driver’s fault, even if the cyclist ran a red light or cut the driver off. All the streets in town were narrowed to install bicycle lanes. The city’s major artery was reduced from six lanes to four, resulting in massive daily traffic jams. The bicycle lanes remain virtually unused. He also arranged speed traps set up on the expressway during rush hour, again resulting in gridlock and huge delays. The straw that broke the camel’s back, however, was when during a major storm that dumped nearly three feet of snow on us, mostly during the morning rush, the Mayor ordered the city’s plows to clear all bicycle paths before working on the roads. It cost him re-election. The moral is extreme positions, no matter what the issue, generally do more harm than good.

    And one more thought on city design and diabetes: Take a look at the rates of diabetics in cities vs. those in rural areas. You may gain a new perspective on whether or not having limited opportunities to walk places is as big an influence as one might suppose.

  • Ferne

    The blame game doesn’t help. Those who are diabetic have to learn to just live with it and try to follow guidelines. I can’t go by what the dietitician tells me. So many diabetic recipes have pasta and rice in them which sends my BS sky high. I am handicapped so can’t walk so all the pushing to walk more just irritates me because we don’t all fit in to one bracket. I have to do things other ways but don’t see any suggestions. I really get depressed reading all the “stuff” about “this and that”. By the way, I never read much about the importance of good dental care. I go to a dentist for diabetics and have learned so much about that and how important good dental care is for preventing bacteria getting into the blood stream. That is very very important!!

  • John_C

    David, I hear you about the ADA! Was on their diet several years ago and even with insulin it was a roller coaster — just could not control my blood sugar the way I needed to.

    It does help to know your family background and what your gene pool looks like too. I found a low carb diet a MUCH easier way to level off my readings all the time. A1c was over 12 and now hangs around 5. Of course I have become accustomed to living my life 2 or 3 hours at a time (except overnight). You do get to understand your body; most of the time anyway.

    I don’t restrict good fats (pretty close to everything except trans fats) and even stay away from supposedly good carbs like whole grains (they do a job to).

    BTW my Lipid Profile did not change very much when I changed my diet either — well Triglycerides went WAY down (nice).

    Lucky the diabetic who finds a doctor who understands what people really require for food depending on who they are. Of course the best doctor (I’ve found) is the one who is diabetic and knows what the end of life is like if you don’t mimic a normal person (as best you can).

    Anybody care for “southern banana crepes” ??
    I for one will pass on that… well maybe just tiny taste. I just look at these recipes and mutter, “you’ve got to be kidding”.

  • jim snell

    Ferne shares most important comments.

    Blame game is off base, misdirected, useless and achieves no good. Look at the rising numbers by 200 and 300 percent.

    I have run into same stupid food recommendations about food and eating and find a disgrace.

    Best wishes and good luck.