Type 2 Diabetes Prevention & Management

Type II Diabetes Mellitus is a chronic disease that occurs when the pancreas can no longer make the hormone insulin, or when your body is unable to properly utilize the insulin it produces. Insulin helps glucose enter the cells. Not being able to produce insulin, or use it effectively, leads to elevated glucose (hyperglycemia) levels in the blood. Over the long-term these high glucose levels are associated with worsening damage to blood vessels and organs, and eventual failure of various organs and tissues. Blood glucose/sugar levels must be tightly controlled for your body to maintain physiological homeostasis.

The American Diabetes Association estimates that nearly 10% (29.1 million) of Americans have type II diabetes (T2D) and nearly a quarter of them (8.1 million) don ’t know it. The Centers for Disease Control estimates that 1 out of 3 adults have pre-diabetes and that 90% of them are unaware of it. Type 2 is the most common form—accounting for close to 90% of all diabetes cases. We will discuss this form of diabetes in this article. Please note: the information here is not relevant to those with type 1 diabetes, except for the dietary suggestions which are beneficial for everyone choosing health over disease.

Native Americans, African Americans, Hispanics and Asian Americans are at higher risk of diabetes than Caucasians. A child’s risk for diabetes may be greater if the mother has diabetes, and significantly higher (around 50%) if both parents have diabetes. Fortunately, T2D and its damage can often be delayed or prevented altogether—however, a smart diet, regular exercise and maintaining a healthy weight are essential.

Metabolic Syndrome

Metabolic Syndrome is the name of a potentially deadly combination of disorders that include:

1) High blood pressure

2) Obesity (esp. with a high waist circumference)

3) High triglycerides

4) Insulin resistance

It has been estimated that 25% of adults living in the United States have this combination of disorders, and most of us have at least one. Amazingly, a 2018 study showed that only 12% of us are “metabolically healthy”, including many people of normal weight. Metabolic Syndrome places people at increased risk of heart disease, kidney disease and T2D. Excessive production of triglyceride rich VLDL caused by dietary and/or alcohol overindulgence appears to be the trigger for Metabolic Syndrome. Obese people have higher levels of VLDL.

VLDL stands for very low-density lipoprotein. Lipoproteins are made up of cholesterol, triglycerides, and proteins. They move cholesterol, triglycerides, and other lipids (fats) around the body. VLDL is one of the three main types of lipoproteins. VLDL contains the highest quantity of triglycerides (60%). Triglycerides are also the main constituents of body fat—easily shunted into storage when excess is present in the blood. VLDL is dangerous because it helps cholesterol build up on the walls of arteries. Aim for normal levels of VLDL between 2 and 30 mg/dL.

VLDL Dietary and Lifestyle Offenders:

Processed grains and starches, along with added sugar– especially fructose** lead directly to elevated triglycerides. (Fruit contains a form of fructose that does not contribute to VLDL, unless you consume more than your body can use). On the other hand, high consumption of whole grains shows reduced risk for T2D, coronary disease, stroke, and various types of cancer.

To Reduce VLDL & the Damage It Causes AVOID:

Enriched or bleached white bread, wheat bread or pasta
Sugary cereals and granola
Instant rice
Bagels
Pizza
Pastries
Pies
Cake
Cookies, crackers, etc.
Sodas, sports drinks & other sweetened beverages

Starchy vegetables like potatoes, corn and peas can elevate triglycerides too, but not to the degree that processed foods can– due to the presence of dietary fiber. It is best to avoid beans cooked with brown sugar and pork fat. Beer, wine, and spirits also increase triglycerides. A pot belly or “beer belly“ is a sign of Metabolic Syndrome.

Insulin Resistance Leads to T2D — But What Leads to Insulin Resistance?

Insulin resistance is one of the four Metabolic Syndrome markers. Insulin delivers food-derived sugars into muscle and liver cells for energy. Insulin resistance happens when insulin released from the pancreas is unable to do its job.

The rate at which glucose is released after eating depends on many factors. As a general rule, whole plant foods such as whole grains, beans and legumes, fruits and vegetables and nuts and seeds– providing generous amounts of insoluble fiber (and/or resistant starch) will dramatically reduce blood sugar spikes, as compared to the processed foods listed above.

Beta Cells

Beta cells are found in the areas of the pancreas called the “islets of Langerhans”. These are special cells whose main function is to make and secrete insulin. Here is a simple explanation of the way it works: when your blood sugar levels start to rise during the digestion process, the beta cells quickly respond by releasing stored insulin while simultaneously increasing production of new insulin. This quick response to a spike in blood sugar commonly takes around ten minutes.

For years, scientists assumed the cause of T2D was that the beta cells (β-cells) in the pancreas have died, but new research shows this is not the case. They now hypothesize that it is more likely that the beta cells are simply not receiving the needed genetic information that tells them what to do. A protein called FoxO1 is necessary to maintain the identity of beta cells. This protein disappears in diabetics. Currently, the medical approach is to prescribe medications that demand the exhausted beta cells to work harder, but the results are limited.

Amylin and C-peptide

The beta cells also make and secrete the hormone Amylin, which slows the rate of glucose entering the bloodstream and is therefore more of a short-term regulator of blood glucose levels.

A molecule called C-peptide, a byproduct of insulin production, is understood to help prevent neuropathy (and other vascular complications of T2D) by assisting in the repair of the muscular layers of the arteries. It is secreted into the bloodstream simultaneously and in approximately equal volume to insulin.

The Role of Inflammation

Recent studies show that there is another cause to blame for Metabolic Syndrome/ insulin resistance: chronic low-grade inflammation. The pro-inflammatory state that accompanies Metabolic Syndrome correlates with insulin resistance and endothelial cell (interior surface of blood vessels and lymphatic vessels) dysfunction. This provides a connection between inflammation and metabolic processes which are damaging to vascular function. This inflammation contributes not only to T2D– but also to its devastating complications.

Researchers discovered that in people with type 2 diabetes, cytokine levels are elevated inside fat tissue. Their conclusion: Excess body fat, especially in the abdomen, causes continuous (chronic), low levels of abnormal inflammation that alters insulin’s action and contributes to the disease of T2D.

Dietary Offenders

Previously, I touched on the fact that one trigger for insulin resistance is when your body is unable to properly utilize the insulin it produces. There is now proof that dietary fat (especially from meat/processed meat, poultry, and dairy products such as cheese), *trans-fats and even most vegetable oils, contribute directly to insulin resistance. The typical process of becoming insulin resistant starts with the meat/processed meat, poultry, processed foods, and pasteurized cheese consumed from childhood until the present day.

It appears that an accumulation of microscopic fat particles within liver and muscle cells begins the insulin resistance problem. The fat particles block the insulin receptors in the cells so that the blood sugar cannot enter, creating elevated sugar and elevated insulin levels. Repeat daily for years and decades and the combined effects are highly undesirable: the pancreas becomes exhausted so that it can no longer keep up. It is the combination of insulin resistance and failure of the beta-cells in the pancreas that leads to T2D.

Saturated fat found in dairy products, eggs, meat (especially processed meat), poultry and coconut oil should be minimized, along with most cooking oils (walnut oil and extra virgin olive oil are okay) — at least until the Metabolic Syndrome symptoms disappear. By then, this lifestyle and way of eating (commonly referred to as the Mediterranean Diet) will become a “healthy habit” and hopefully you will choose to maintain it for a long and healthy life.

Processed meat is recognized to be significantly worse than other meat when it comes to health outcomes. Processed meats contain ingredients (and effects of processing) that are very damaging to the body. Eating processed meat is associated with high blood pressure, heart disease, COPD, bowel cancer, and stomach cancer. Meat consumption is proven to be pro-inflammatory.

Sausages
Salami
Hot dogs
Ham
Cured bacon
Corned beef
Salted & cured meat
Smoked meat
Dried meat/jerky
Canned meat

Recent studies show that the only effective method of preventing and controlling T2D (without drugs) is through avoidance/minimization of high fat animal-sourced foods, trans-fats, and excessive added oils, along with significant increases in nutrients and dietary fiber from plant-based sources.

The Grim Reaper: Heart Disease

Insulin resistance creates many problems, often leading to T2D– which if uncontrolled, also triggers heart disease, the leading cause of death in the world. But remember, heart disease usually arises due to Metabolic Syndrome– which can be prevented and reversed– with the right diet and lifestyle choices.

Essential to Mention

Studies show that drinking filtered coffee (including decaf) may reduce the risk of developing T2D, but their effect on insulin activity in those with T2D is variable. For many, coffee can raise blood sugar and insulin levels, and caffeine may lower insulin sensitivity.

Coffee should not be consumed in place of pure water. Proper hydration is very important for all of us, and especially for those with T2D. Drinking half of your body weight in ounces of water (spread out as evenly as possible throughout your waking hours) will prevent blood sugar from concentrating. There is no valid reason to avoid drinking water.

“High blood sugar causes further dehydration as your kidneys attempt to unload glucose and ketones by producing large amounts of urine. Increased dehydration causes higher blood sugars, which in turn cause further dehydration.” From “Diabetes Solution” by Dr. Richard K. Bernstein, MD

Exercise is essential for both maintenance and prevention. Vigorous exercise lowers blood glucose levels and improves your body’s sensitivity to insulin. You may be surprised to learn that there is a 90% increased risk of T2D from sitting more than eight hours a day! Sitting for extended periods makes it easier for the arteries to become clogged, leading to an increased risk for heart disease. Get up and move around, ideally for 60 minutes daily. You can break it up into segments if doing a straight hour is not possible. Click here to learn more.

Alzheimer’s and Dementia– Please click here to discover the direct link between insulin resistance and dementia.

Sleep Problems– T2D has been associated with both an excess and deficiency of sleep.  A study showed that people who regularly slept for over 8 hours were twice as likely to have type II diabetes as individuals who slept 7-8 hours.

High Glucose Leads to High Blood Pressure

High blood glucose levels reduce the levels of the powerful vasodilator nitric oxide in the blood vessels. This reduction in nitric oxide increases the risk of high blood pressure because it leads to a narrowing of the blood vessels and impaired circulation. Poor circulation effects are extremely common among those with T2D, causing a great deal of suffering. (It has been observed that supplementing with beets or amino acids to increase nitric oxide will be minimally effective if blood sugar levels are too high.)

“Controlling Diabetes” vs. “Recovered Diabetic”

Naturally, it all comes down to the diet. When study participants were told to make moderate changes like “eat fewer carbs”, “remove the skin from chicken” and “get more exercise”, their results were mild at best. It all comes down to a simple question: Do I believe I can follow through with diet and lifestyle changes to reverse my metabolic syndrome symptoms? This question should apply to pre-diabetics and people with insulin resistance, obesity, and high blood pressure too.

Fiber is Your Friend!

It is estimated that the average American consumes a combined 15-20 total grams of fiber daily. To avoid a stroke, it is recommended to get 25 grams/day of soluble fiber from oats, nuts, beans, and berries and 47 grams of insoluble fiber, mostly from whole grains and vegetables. Meat, poultry, fish and seafood, eggs, cheese, dairy products, processed foods, and fats and oils contain no fiber.

A low fiber diet rapidly increases inflammation in the gut and negative immune reactions. It also leads to increased blood sugar levels and weight gain because chronic inflammation causes more of the calories we consume to be stored as fat instead of being used for energy. The result from consuming an abundance of whole plant foods each day include improved insulin sensitivity, reduced fasting blood sugar and fewer blood sugar spikes. (The optimal human diet includes beans & legumes, nuts & seeds, whole grains, and fruits & vegetables.) Add a fiber powder blend from diverse sources to your daily diet (with plenty of water) and avoid taking fiber capsules. Click here to learn more.

Beware of Artificial Sweeteners!

“Changing our diet to include low-calorie sweeteners, such as sucralose and aspartame, should be a good way to get all the sweet taste without any of the guilt. Instead, the new study suggests that eating these sweeteners could do the opposite and increase the chance of us accumulating fat in our bodies, in a “dose-dependent” fashion. In other words, the more artificial sweetener you consume the more fat your body creates and stores.” From “Your Low-Calorie Sweetener Could Be Making You Fat”, Smithsonian.com

Aspartame may act as a chemical stressor by increasing cortisol levels; and may induce systemic oxidative stress by producing excess free radicals; and it may also alter gut microbial activity and interfere with the N-methyl D-aspartate (NMDA) receptor, resulting in insulin deficiency or resistance. It becomes more dangerous when added to hot beverages.

Sucralose (Splenda) is one of the most heavily advertised sweeteners, known for being suitable for baking. It is made by replacing three specific hydrogen-oxygen groups on the sugar molecule with three chlorine atoms.  Chlorine is added to water as a disinfectant since it kills bacteria. Unfortunately, it also kills the beneficial bacteria that are supposed to be flourishing in your gut. Use of sucralose can lead to long-term diarrhea and an unhealthy imbalance in the microbiome. It can negatively alter the pH level in the intestines and have a harmful effect on an important glycoprotein needed for proper function of the body. Please be wary of this sweetener; it is not close to being as safe and healthy as they would have you believe.

Check the fine print on your medications because aspartame and sucralose are often added to medications. If you have unexplained diarrhea or other problems, ask your pharmacist if any of your prescriptions contain these sweeteners. Have your doctor find a replacement option without it. To learn which sweeteners are healthy and which are not please click here.

Nutritional Support for Metabolic Syndrome, Insulin Resistance & T2D

Magnesium—frequently, people with T2Dtend toward magnesium deficiency due to low dietary intake combined with increased urinary loss. Low magnesium intake is understood to contribute to metabolic syndrome and T2D and increasing magnesium intake is linked to lower rates of T2D. Magnesium is deeply involved in many of the processes involved in the function of insulin. Diabetes doctors frequently ignore the status of this essential mineral, a dangerous blind-spot on their part. Click here to learn more.
Chromium– Chromium levels in T2D and insulin resistance are often below normal. This may be because dietary chromium is poorly absorbed, and levels naturally decrease with age. Chromium has been shown to effectively regulate insulin and enhance insulin activity.
Thiamine (vitamin B-1) administration can prevent the formation of harmful by‐products of glucose metabolism, reduce oxidative stress (elevated in T2D) and improve endothelial function. It may also reduce cardiovascular risk and damage from diabetic complications!
Zinc plays an important role in activating cellular pathways involved in the secretion and action of insulin. Zinc deficiency is linked to glucose intolerance and insulin resistance.
Ceylon cinnamon supports a decline in fasting blood sugar levels, andworks best in combination with other nutrients and plant extracts. A well-designed formula creates synergy that is balanced and able to lead to more normal blood glucose levels, especially when combined with smart diet and lifestyle changes.
Corosolic Acid (from Banaba Leaf extract) is shown to support healthy blood sugar levels by improving insulin sensitivity and stimulating glucose uptake.
Gymnema sylvestre supplements can lower blood sugar in people with T2D. If you take insulin, watch your blood sugar carefully since your dose of insulin might need to be changed. Its nickname in Hindi is “sugar destroyer”.
Alpha Lipoic Acid has been shown to improve insulin resistance, and supplements may help with the nerve damage (neuropathy) caused by diabetes or cancer treatment.
Berberine taken in three separate doses during the day is shown to be beneficial for stabilizing blood sugar and works well combined with the drug Metformin. There is also evidence that berberine has a beneficial effect on the gut microbiome, another important factor with multiple benefits—including prevention of blood sugar spikes and improved magnesium absorption.
Vanadyl sulphate is a chelated form of the mineral vanadium– frequently recommended for those with pre-diabetes and T2D because studies show it improves insulin sensitivity.
Pine bark extract is shown in studies to be more potent for suppressing carbohydrate absorption in T2Dthan synthetic prescription alpha-glucosidase inhibitors. Pine Bark extract is the second ingredient in StemCell Maxum.
Indian Kino Tree Extract is one of the only botanicals found to be able to regenerate the beta cells in the pancreas. Numerous human studies have demonstrated that it helps prevent long term complications of type 2 diabetes by reducing both fasting and postprandial (after a meal) blood glucose with no reported side effects. Other benefits include reduction in appetite, a lessening of burning pains in limbs; reduction in polyuria (production of abnormally large volumes of dilute urine); reduced thirst and dry mouth, and a decline in general weakness. Diabetic patients on prescription medication who choose to take Indian Kino Tree extract should keep a close eye on their declining blood sugar levels and adjust their meds accordingly. Indian Kino Tree extract is the first ingredient in StemCell Maxum by Healthy Habits®.
Apple Cider Vinegar (ACV) human studies show that organic raw apple cider vinegar can lower blood sugar levels and improve insulin sensitivity. A glass of water containing no more than one to two teaspoons of ACV on an empty stomach before a meal is shown to significantly reduce post-meal blood glucose levels. Bedtime is another good time to drink ACV due to its ability to reduce fasting blood sugar by 4% in the morning and support a good night’s sleep. But remember not to overdo it, since vinegar in excess can potentially erode tooth enamel, trigger stomach upset, lower potassium levels, or irritate the throat. Drink some pure water afterward to remove the acidity from your mouth and throat.
Ground flax seeds—One to two tablespoons of freshly ground flax seeds daily appears to improve fasting blood sugars, triglycerides, cholesterol, and hemoglobin A1c levels in diabetics. It also has a beneficial effect on high blood pressure. Ideally, purchase whole flax seeds and grind them in small batches in a home coffee grinder, then refrigerate in an airtight container.

Weak Digestion

Stomach acid with a very low pH (between 1.5 and 3) is required in order to properly digest protein and assimilate the nutrients you eat. Strong stomach acid is normal in healthy young people, but as we age the pH of our stomach acid begins to rise, becoming more alkaline. Some practitioners observe that by the age of 50 we have lost 50% of our acidity and it continues to worsen. Mental, emotional, or physical stress and trauma can also reduce stomach acid, as can a variety of prescription medications.

Based on testing thousands of patients, Dr. Jonathon Wright, MD estimates that at least 90% of American adults have low stomach acid and that high stomach acid is rare.  Pepsin is the protein digesting enzyme which cannot be released in the stomach without adequate acidity. Insufficient stomach acid leads to protein (amino acid) deficiency, causing the body to steal protein from the surface of joints to transfer it to where it is most needed. This potentially contributes to arthritis.

Researchers have found strong links between low stomach acid levels and some serious health problems. Among them are Type 2 diabetes, Lupus, Addison’s disease, asthma, celiac and gluten intolerance, food allergies, rosacea, vitiligo, eczema, and leaky gut syndrome.

Maximize Your Stomach Acid

Eat protein foods first so that your stomach acid is not wasted. Vegetables and other carbs do not require an acid pH to digest, so eat them last. Avoid drinking beverages with meals since it dilutes stomach acid making it too weak to do its job. A few sips of water during and after a meal are fine, but consuming soft drinks, iced tea, coffee, beer or too much water will dilute the digestive juices. Iced beverages are the worst offenders.

Supplement at the start of each protein meal with a digestive aid containing Betaine HCL with Pepsin, or drink lemon juice or apple cider vinegar in water. Experiment with the dosage of Betaine HCL w/Pepsin to find the most effective potency for you. Click here to learn more. If you suffer from acid reflux– click here to learn how to resolve it naturally.

Quick 20th Century Dietary History

Heart disease was quite rare until the early 20^th century– when it began showing up more and more frequently. Our ancestors lived much closer to the earth and most of their food came from plant sources. They rarely ate meat– often in soup or for a holiday. Wild game is very lean, unlike modern genetically altered high fat meat and poultry. The wealthiest and most powerful people were most likely to eat a lot of meat, and they were the ones whose bodies gave out early due to obesity, chronic inflammation, gout, dementia, Metabolic Syndrome, T2D, and heart disease.

After surviving the Great Depression, followed by food rationing and years of hardship during WWII –and then the dramatic increase in quality of life combined with advent of supermarkets – we and our parents began eating much more animal protein than ever—from the 1950’s until today. US taxpayers subsidize the livestock and poultry industries, so meat prices are artificially low. Have you ever wondered why a hamburger is cheaper than a salad? The dramatic alteration of the American diet since WWII has led to the unfortunate state of overall health in the USA today.

It is Too Easy to be “Cheesy”

Cheese is another problem food. Because our tax dollars subsidize the dairy industry, the price of cheese is incredibly low. Most cheese is very high in saturated fat. In 1975, an average of 14.3 lbs. of cheese were consumed per person– compared to nearly 37 lbs. in 2017. It is also highly addictive, loaded with salt–and it is everywhere! No wonder so many people are overweight, and T2D and high blood pressure rates continue to increase. I understand how difficult this is, but strict portion-control is essential when it comes to cheese.

Even though we do not get much glucose from fat, a meal that is high in fat can affect how fast our bodies digest carbohydrates. Because fat slows down the digestion of carbohydrate, it also slows down the rise in blood sugar levels. This sometimes can cause a high blood sugar level several hours after eating.

Eating balanced meals combining low-fat protein, carbohydrates (in the form of vegetables and whole grains), and a small amount of healthy fat can help keep your blood sugars from rising too high or too quickly. Equally important is a focus on eating colorful fruits and veggies for the antioxidants they provide — essential to prevent cellular damage.

Relevant Healthy Habits® Products:

StrictionD is a synergistic formulation that combines chromium, thiamine, zinc, Ceylon cinnamon and Corosolic Acid. Click here now to learn more.
StemcellMaxum, our #1 best-seller, provides meaningful doses of Indian Kino tree extract and pine bark extract, plus two more synergistic and supportive botanicals: Astragalus root and L-Theanine. Click here now to learn more.

The Bottom Line

The health of Americans is currently the worst (#35) among the wealthiest nations on Earth (Spain is #1). The foundation of health is your diet, of course, and most of us could easily make changes to support healthier and happier lives. Switching to a Mediterranean diet high in whole plant-based foods (with occasional small servings of animal foods, especially ocean fish) is proven to reduce risks of Metabolic Syndrome and its painful and life-shortening outcomes of cardiovascular disease, kidney disease and T2D. May you and your family be blessed with health and happiness! The power is yours.

Resources: Risk factors, Foods Lists, Artificial Sweeteners & Glycemic Index

Risk Factors Associated with Type II Diabetes:

Family history of diabetes
Ethnicity
Obesity
Physical inactivity
Unhealthy diet
Impaired glucose tolerance (IGT / pre-diabetes)
History of gestational diabetes
Poor nutrition during pregnancy
Age
High blood pressure

*Sources of Dangerous Trans-Fats: (Limit consumption to less than 2 grams/day. Opt for natural & organic brands that do not contain trans-fats.)

Crackers, cookies, cakes, frozen pies, and other baked goods
Snack foods
Frozen pizza
Fast food
Vegetable shortenings and some stick margarines
Non-dairy coffee creamer
Refrigerated dough products (such as biscuits and cinnamon rolls)

* *Sources of Unhealthy Fructose: (Check labels & opt for natural & organic brands that do not contain fructose. “Fruit juice sweetened” is okay.)

Agave nectar, brown sugar, caramel fructose, High Fructose Corn Syrup (HFCS), Honey Karo® corn syrup, Palm (coconut) sugar, sorbitol, Splenda® (sucralose)
Sodas and many bottled teas & beverages, including kombucha
Many types of candy
Flavored sweetened yogurt
Salad dressing
Sauces & Condiments (barbecue sauce, ketchup, etc.)
Breads
Canned fruit (look for brands containing natural juice)
Some fruit juices (check labels)
Boxed meals (like mac ‘n cheese)
Granola bars & cereal bars
Breakfast cereal
Store-bought baked goods
Chips, cookies & crackers
Artificial coffee creamer
Protein bars or “energy bars”
Energy drinks/sports drinks
“Emergen-C” supplements (Check the label & choose the kind w/out fructose)
Jams & jellies
Ice cream

Glycemic Index

The higher the glycemic index the more insulin is required to balance blood glucose/sugar levels. This is particularly important for those with T2D and insulin resistance (pre-diabetes) to carefully monitor. If this is an issue for you — look for foods and sweeteners low on the GI scale. Once the liver is loaded with glycogen it begins to convert the glucose it absorbs from the blood into fatty acids for long term storage as body fat. Check out this website for the GI for specific foods. https://www.health.harvard.edu/diseases-and-conditions/glycemic-index-and-glycemic-load-for-100-foods

The Glycemic Index for sweeteners is determined by these three things:
1. The amount of carbohydrate present.
2. The type of carbohydrate present.
3. The presence of other substances (such as soluble fiber) that slow metabolism of carbohydrates.

Many in the US die from diabetes-related causes every day. Cardiovascular disease is the leading cause of death among type II diabetics (and everyone else). Understanding how to prevent (and potentially reverse) Metabolic Syndrome and T2D is to everyone’s benefit and should be considered a priority if you want to live a long and healthy life.

Healthy Habits® has been here for nearly 20 years to support you to stay vitally healthy during your golden years. Thank you for sharing our articles and information with your loved ones. We pride ourselves on being a quality resource for you and your family.

References:

This short video is a must-watch for everyone with T2DM: https://nutritionfacts.org/video/benefits-of-a-macrobiotic-diet-for-diabetes/

https://jasn.asnjournals.org/content/15/11/2792

https://www.ncbi.nlm.nih.gov/pubmed/18497882

https://academic.oup.com/advances/advance-article/doi/10.1093/advances/nmz061/5527771 High fat diet and gut permeability 2019 study.

https://nutritionfacts.org/video/the-best-diet-for-diabetes/ The #1 cause of death for T2DM is heart disease, and a plant-based diet is proven to reduce mortality from heart disease and cancer.

https://www.hsph.harvard.edu/nutritionsource/disease-prevention/diabetes-prevention/preventing-diabetes-full-story/

https://www.ncbi.nlm.nih.gov/pubmed/18533366

https://www.ncbi.nlm.nih.gov/pubmed/30215149 Altered Gut Microbiota in T2D,

https://www.sciencedaily.com/releases/2007/11/071106133106.htm

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2036265/

https://www.ncbi.nlm.nih.gov/pubmed/15673055

https://www.forksoverknives.com/sugar-cause-diabetes/#gs.83yas3

https://wa.kaiserpermanente.org/healthAndWellness/index.jhtml?item=%2Fcommon%2FhealthAndWellness%2Fconditions%2Fdiabetes%2FglucoseSources.html

https://nutritionfacts.org/video/the-safety-of-heme-vs-non-heme-iron/

https://www.ncbi.nlm.nih.gov/pubmed/18220605

https://www.sciencedaily.com/releases/2018/11/181128115045.htm

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4549665/