DIABETES A LA MODE

From the Great Falls Tribune today (March 18, 2008):

WASHINGTON (AP) You’ve heard of Type I and Type 2 diabetes, but what about a kind called MODY?

Diabetes is undergoing a genetics revolution that suggests there actually are many subtypes of the disease.

The discoveries already trigger important changes in treatment for a fraction of patients with some rare diabetes types caused by single genes gone awry -- if they have a doctor aware of the findings.

“We’ve got a whole group of diabetologists who have never heard of this,” laments Dr. Andrew Hattersley, a British physician-scientist who pioneered how to treat single-gene subtypes collectively known as MODY.

Yet the vast majority of diabetes is caused by complex interactions among numerous genes and modern lifestyles -- and a flurry of genetic discoveries in the past year finally points to new ways of attacking the epidemic.

So this week, U.S. health officials are bringing 20 drug companies together with international gene specialists to jump-start the hunt for new therapies.

Why does diabetes strike one person who’s overweight but not another who’s equally heavy? Why does one diabetic need dialysis while another has healthy kidneys despite decades of bad blood sugar? The newest gene work suggests there are even more sub-types that explain the differences and that in turn may require personalized treatment just as MODY does.

Some 21 million Americans have diabetes, meaning their bodies cannot properly turn blood sugar into energy. Either they don’t produce enough insulin or don’t use it correctly.

With the Type 1 form, the body’s immune system attacks insulin-producing pancreatic cells, so that patients require insulin injections to survive. It usually, but not always, strikes in childhood.

With the most common Type 2 form, the body gradually loses its ability to use insulin, so the confused pancreas churns out extra until eventually its cells wear out. Most at risk are the overweight.

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While this story is welcome recognition of ideas that the sharpest diabetes bloggers have been looking at for quite a while, many stubborn concepts are still embedded in it, most obviously that:
1. The problem is due to the person. (Blame the victim. Operator-error.)
2. It can be “fixed” with medication (at considerable profit to the pharm corps).

Instead, what many people are beginning to believe is that:
1. The problem is due to the rising tide of disruptive chemicals in our food, our environment, our clothes, and so on.
2. This is a problem -- like global warming -- that must be addressed in the environment itself. We cannot “evolve” fast enough to adapt to the contaminations, so therefore large sections of people (the ones now made vulnerable by previously okay genes) will sicken and die. That’s the way evolution works: those who don’t “fit” are dropped out. The ones who by chance have lucky genes will go on, thus changing what human beings are like. (The tests for genetic vulnerability cost $600 each and most people need six tests. A whole new industry.)

All these things (including Alzheimers) that are called “diabetes” so far, only entered awareness through this door because doctors routinely test for and are aware of glucose levels. ALSO, that’s what Big Pharm pushes medicine for -- that and demonized cholesterol, until they killed over eighty people with their untested convictions. If they don’t have medicine for something, they don’t address it. I’m of two minds that the government is calling together Big Pharm: I fear they will invent and promote meds that haven’t got a decent research background and thereby again kill more people than would have died otherwise, and that they will confuse the issue by announcing too early research results.

When I Googled MODY, I found it was the acronym for "Maturity Onset Diabetes of the Young" and was defined as diabetes in people who are not fat. The medical people (and their media) are CONVINCED that fat causes diabetes (and sell a lot of products by fanning fat phobia), but I’m reading convincing arguments for the idea that it is the diabetes (or connected metabolic syndrome) that causes the fat. We’ve got the connection, but we’ve got it backwards. I don’t think what this article is talking about is MODY but rather Metabolic Syndrome, which means that several molecular feedback loops are disturbed, some of them invisible to us and certainly unknown as to deepest cause. The whole internal system is out of whack. It’s not just the doctors who are confused by all this stuff.

But I know from my own experience that losing weight greatly improves whatever it is. I started to write “simply” losing weight, but I think that the way one loses fat is significant. I cut out all white sugar, white flour, corn syrup, and as much processed food as possible. This probably cut down the level of internal contamination in my blood. I also could feel, quite literally, things happening in my body that were almost mechanical. Part of it was my organs having enough room again as the fat left. Part of it was the actual sensation of the fat leaving, which might or might not have been imagination. My legs had a kind of “streaming-up” sensation. And there was a kind of soreness up under my ribs for a while -- maybe liver or pancreas. This doesn’t happen all at once, but over a period of years.

I moved to Valier thinking that I would be escaping much of the city air, water, and environmental contamination, but what I find is that this wheat-based community is poisoning itself at a great rate. One of the few prosperous businesses in town is at the little airport at the head of my street: they sell herbicides and pesticides which they mix with water through the city system, besides spilling aeronautic fuel. At the last town meeting a water engineer was closely questioning these people about their backflow filter, which they have been inadequately monitoring. A backflow of contaminated water would probably hit the school first. The area has high rates of cancer and Type 2 diabetes. I’m probably lucky that I spent ten formative years (my twenties) on the rez where there was little spraying because the economy was grazing-based. I do NOT want to move, but neither do I want to start the kind of fight that would put some caution into the locals. They are already freaked out by the destruction of their stubborn conviction that global warming in a political invention. And the old ladies insist on spraying every dandelion, a practice they equate with respectability.

We need to start a slow, calm revolution that begins with ourselves. The real key is getting a blood glucose monitor (since that’s one thing you can test at home, quietly) and see what your scores are. Test foods by reading your scores after you eat them. If you come to my house, I’ll give you a cup of coffee (though some are ready to blame it) or tea, but there won’t be any nice sweet rolls. How do you feel about bran muffins full of walnut bits but no sugar? I scarf down peanuts all day, but we know about peanut allergy. My muffins might not be the right thing for you to eat! I figure it’s best to go to basics: eat like a gorilla or a grizzly with a lot of green stuff, roots, and a bit of meat. And luckily my genes allow cheese and eggs. Yours might not.