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Hello everyone, it's Dr. Pradip Jamnadas, MD, here from Orlando, from Cardiovascular Interventions, and thanks for tuning in. Today I'm going to talk about diabetes and the effects of diet versus medications, diet versus drugs, to see which one you can really choose. I want to empower you all to make this decision. In the September article here in the New England Journal of Medicine, which was a beautiful article, it discusses glycemic reduction in type 2 diabetes, and I want to discuss this with you so that you can know the effects of diet versus drugs in diabetes.
Diabetes is a huge problem, especially for cardiologists, because we know that it causes cardiovascular disease, which is the number one cause of death. It causes heart attacks, congestive heart failure, blindness, dementia, and proof of vascular disease. We know that diabetes is on the rise, and that there are half a billion people on this planet who have diabetes. This burden is huge, and we know that there are one and a half million new cases of diabetes every year. This is an epidemic we've never seen before; even 40 years ago we didn't have this type of diabetes. We talked about this in my previous videos, where I said that it is mostly the diet and the lifestyle, what we're eating, how we're eating, and how frequently we're eating, and that this is the root cause of the problem. It's happening all over the world.
In this article they talk about the medications and how good they are for your diabetes. What I talk about in my previous videos is how good diet is, and how it can completely reverse your diabetes. I'm not saying that you shouldn't take drugs. I'm saying the drugs have a place, absolutely, but so does diet, and diet is not emphasized. So let me show you some of the data that we came up with.
This is the Great Study research group. They took a five-year study and put a lot of patients into it. In fact, there were over 5,000 patients, and all of them were diabetic. These diabetic patients had a hemoglobin A1c between 6.8 and 8.5. For those who don't know, hemoglobin A1c is the test you look at to see how good or bad your diabetes is, and you want your hemoglobin A1c to be less than 6.4. These patients all had diabetes for 10 years. The researchers studied the hemoglobin A1c levels, dividing the patients into four groups. All of them got metformin, a medication for diabetes. One group got insulin in addition to metformin. The second group got a GLP-1 receptor agonist, a group of drugs used for diabetes. Another group got glimepiride plus metformin. The last group got sitagliptin, which is also a diabetes medication, and there is a whole group of those. So there were basically four groups of medications plus metformin, and they combined the medications to see whether it made much difference and which combination was best.
When they studied these over five years, the goal was to bring the hemoglobin A1c down to less than seven. I remember it should be less than 6.4 or 6.5, but they said less than seven. However, the results show that 71 percent of the participants did not reach a hemoglobin A1c below seven using this combination of medications. Any reduction in your hemoglobin A1c is of course good, but if it doesn't come down to less than seven, can I really call that good diabetes control? No, I don't. Thousands of patients around the world have been following my diet. They do intermittent fasting, they watch what they eat, they stay away from preserved food, and they eat only whole foods. They have had dramatic reductions in their diabetes, and their A1c levels have come down to less than 6.5. Thousands of patients have done this.
Let's look at the study even more. What's worse is that those who started out with a hemoglobin A1c of 6.8 on medicines, the majority of them progressed and went even higher during the test. Overall, less than seven percent of these patients actually kept their hemoglobin A1c below where they started. Less than seven percent. This was the goal of the study, and yet it was not achieved in most of the patients. The overall reduction in hemoglobin A1c with the medicines was 0.3, a 0.3 reduction, and the progression of the disease in terms of A1c overall was less than 0.3. There was no major difference between any of the combinations. So yes, the study did show a small reduction in hemoglobin A1c, and some combinations were slightly better than others. I think the GLP-1 receptor agonist reduction was probably because of weight loss, but we don't have that specifically in the data in the article.
I want to share something else with you. The adverse effect rates were all greater than 30 percent, meaning more than 30 percent of patients in each group had side effects. Weight gain was between 9 and 13 percent of the patients, so they all had weight gain instead of weight reduction, and GI symptoms affected at least 30 to 35 percent of patients on the medications. So what I'm saying is that yes, the study did show a small reduction in hemoglobin A1c, but am I happy with that? Is that progression of disease being cured by this process? My dietary program, which you have all heard about, means no concentrated sugars, no concentrated simple carbohydrates, no high fructose corn syrup, no processed foods, and no refined products, because these are the things that cause intense insulin secretion in the body and cause insulin resistance. When you don't secrete excessive amounts of insulin, you will not develop insulin resistance. You prevent insulin resistance by cutting down on sugar. You have to cut down on sugar.
Some patients come to me and say, "Look, I have to be on so many carbs, simple carbs, I'm a diabetic." Why? You do not need simple carbs if you're diabetic, because you're simply going to stimulate more insulin production in the body. Type 2 diabetes is hyperinsulinemia, too much insulin production, because you have insulin resistance. The way you make yourself sensitive to insulin again is by changing your diet, so you're not stimulating your body to make so much insulin. Eat foods that are more complex carbohydrates, with lots of fiber in them: whole foods, no processed foods, no refined products, no powdered stuff, no ground-up stuff. Real food, which when you swallow it and eat it goes down, will not cause a tremendous surge in your insulin. Why? Because it's mixed with fiber. The soluble fiber forms a mesh around the food molecules so that it does not stimulate the production of insulin, because the K cells in the duodenum don't see all that concentrated sugar there. So you get less insulin production. Secondly, the absorption rate is much slower. And thirdly, whole foods have soluble fiber that goes down into your colon, and who eats and digests the soluble fiber? Not you. Your bacteria do. The good bacteria in your gut consume the soluble fiber and produce short-chain fatty acids. These short-chain fatty acids improve the health of the lining of your intestines and increase mucus production, so you get less intestinal permeability and less immune stimulation. Short-chain fatty acids are also anti-inflammatory, and they improve insulin resistance. So by reducing the amount of insulin production through choosing the right types of foods, you're producing less insulin through hormonal regulation, and your bacteria, by consuming the fiber that is missing in processed foods, are doing their part.
What is processed food? A processed food is one in which the fiber has been removed. A refined food is one in which there is no fiber. There are two issues with processed foods. One is that the fiber has been taken out, and the second is that they've added other things like preservatives, colorings, and flavorings. You really don't need those things. It's not a nutritional requirement, but it's put there to make the food highly palatable, so you're going to buy it and become addicted to the taste. We talked about that in my other videos. The real food that you need is not only for you. In the upper part of your intestines you absorb the sugar, carbohydrates, proteins, and some vitamins, but the fiber is what you really need to feed your other buddies, your bacteria. Remember that there are 10 trillion human cells, but there are a hundred trillion bacterial cells inside your intestines. These bacteria are not just having fun. They're there for a real reason: they have a symbiotic relationship with you, and they produce chemicals which you in turn absorb, and which help you.
When I was in college, I used to ask my professors how fiber really helps you, and the answer was that you get big, bulky stools, so the toxins get out and you don't get constipated. That's fine, but does it really affect your physiology? Now we know that it does. These bacteria are not just sitting there. They consume the fiber and produce short-chain fatty acids and a ton of other molecules. They are also the ones that consume your polyphenols and other things we know are good for us. Those compounds are not really for you; they're for the bacteria you're feeding for yourself and your bacteria.
With the dietary program I've recommended, which means eating whole foods and eating infrequently, so you're not eating every three or four hours, you do intermittent fasting and time-restricted feeding. I have many videos on these. With this approach you get a sudden change in physiology due to a combination of less insulin production, more anti-inflammatory molecule production through short-chain fatty acids in the gut, and a changed entire microbiome. You're feeding your microbiome, and the fasting itself has an effect on the microbiome as well as on insulin sensitivity. It's a win-win all round. When you think about it, this is how your body was supposed to be: you eat your feast, then you fast, then you feast again. From thousands of testimonials, thousands of people have completely reversed diabetes, not just gotten their hemoglobin A1c down to less than 6.5. A 0.3 reduction is not enough, not enough for me and not enough for my patients. I want to completely reverse your diabetes.
If you are overweight, if you have diabetes, or if you have complications of diabetes, you have to look at medicines. Yes, talk to your doctor about the medicines and find out which one will be suitable for you. You may get side effects, and remember that a third of them cause side effects, but you have to change your diet. Once you get your insulin sensitivity back, and your weight back to where it should ideally be, and you've restored your sensitivity, your body will be completely different than it was before. I've gone over some of the mechanisms of action, and I'm going to make more videos on this. I hope you enjoyed this. Remember, drugs are helpful, but diet and nutrition top drug therapies by far, and you have to do both. It's the diet that really works. If you like this video, please click thumbs up, and I'll see you again on our next journey. Take care. If you liked this video, here's one I would recommend, and if you want to see my latest video, please click here.