Findings from the Diabetes Control and Complications Trial (DCCT) and the United Kingdom Prospective Diabetes Study (UKPDS) have clearly shown that aggressive and intensive control of elevated levels of blood sugar in patients with type 1 and type 2 diabetes decreases the complications of nephropathy, neuropathy, retinopathy, and may reduce the occurrence and severity of large blood vessel diseases. Aggressive control with intensive therapy means achieving fasting glucose levels between 70-120 mg/dl; glucose levels of less than 160 mg/dl after meals; and a near normal hemoglobin A1c levels (see below).
The ketogenic, or keto, diet calls for dramatically increasing your fat intake and consuming a moderate amount of protein and a very low amount of carbs, with the aim of kicking your body into a natural metabolic state called ketosis, in which it relies on burning fat rather than carbs for energy. Ketosis is different from diabetic ketoacidosis, a health emergency that occurs when insulin levels are low in conjunction with high levels of ketones. (37) Ketones are by-products of metabolism that are released in the blood when carb intake is low.
Chronic pain can reflect injury that hasn’t completely healed. More often, it is caused by nerves that have become oversensitive or by a brain that is misreading the signals it receives. If acute pain goes on too long, nerves and brain can tire of the constant signals and just decide the injury is permanent. That’s why it’s important to treat acute pain seriously. For example, if you injure your foot or your back and don’t treat it promptly — with adequate rest, other first-aid measures, and seeing a doctor if the pain is severe or persists — mild pain can become severe, and acute pain can become chronic.
In the picture to the right you can see the lunch that I was unbelievably served at the 11th International Congress on Obesity in Stockholm 2010. This is a major international conference for obesity doctors and scientists. The food contains almost exclusively energy from sugar and starches, things that are broken down to simple sugars in the stomach.
For a wellness festival, there was an unexpected amount of talk about the importance of suffering and pain. In one panel about addiction, the ultramarathoner Charlie Engle, who ran 30 marathons in his first three years of sobriety, told the story of his first son being born. “He was gonna save me,” Engle recalled, “and then six days later, after a crack binge, the police are searching my car, and I had to choose between living and dying. And I chose running ... I wanted to pound that part of me out and never visit it again.”