What women should know about lowering their risk of type 2 diabetes and metabolic
by Marcelle Pick, OB/GYN NP
It’s sad to me that most of the women we see at our clinic either aren’t
concerned about type 2 diabetes — or they already have it. I so wish that
all women in the first group would learn from the women in the second. The key lesson
is that your risk of developing type 2 diabetes is greater than you probably realize.
The good news is you can prevent it, and the path to prevention will awaken you
in so many ways.
I see patients who are not overweight and who think they’re leading fairly
healthy lives end up with high blood sugar. In fact, some people who have prediabetes
or metabolic syndrome are not obese, and may even be considered “thin.”
Yet these women can go on to develop type 2 diabetes.
How does that happen? And how do you make sure it doesn’t happen to you? In
my view, there are several factors behind the diabetes epidemic. Women don’t
realize how much sugar — in all its forms — they are feeding their bodies.
Of course, obesity and lack of exercise are enormous issues as well. But few people
— and not many doctors — realize that diabetes is a metabolic disorder
that has multiple causes.
Twenty years ago very few practitioners were aware of metabolic syndrome. In fact,
it was a controversial idea. Today it’s a diagnosis that’s broadly accepted
in conventional medicine. The new idea today is that there are many metabolic syndromes
— a family of related disorders which lead to diabetes as well as to other
chronic and degenerative diseases. That may sound scary, but it’s actually
good news. It means that medicine is getting insight into how the body works, how
to see problems much earlier, and how to prevent disease.
So let’s look into what you can learn now about your risks of developing type
2 diabetes — and how to make sure it doesn’t happen to you.
What is diabetes?
If I told you that people with untreated diabetes were literally starving, would
you believe me? It may sound extreme, but it’s true. The term diabetes mellitus
is actually derived from the Greek words meaning “to run through.” And
this is exactly what’s happening. In diabetes, the nourishment we take in
cannot get into our cells, and literally runs through the body instead of feeding
Think of feeding your hanging plants with too much nutrient-rich water. Instead
of the roots drinking in the nutrients and water, the nourishment runs straight
through the soil and trickles out onto the floor. No matter how much you feed the
plant, the water runs through it. Eventually its leaves start to yellow, shrivel,
or drop. Like your plant, the cells of a diabetic patient can’t absorb the
nourishment they need.
Under normal circumstances, our bodies break down food we eat into potential energy.
That energy enters the blood stream mostly in the form of glucose. Glucose
is then escorted into our cells with the help of the hormone insulin, where
it becomes the fundamental fuel for all cell activity. In diabetes, our cells can’t
access glucose because insulin is either absent or unable to open the cell door
to let it in.
The result is excess glucose or “sugar” floating around in the blood
with no place to go. In a desperate effort to restore blood sugar levels to normal,
our bodies end up eliminating the unused glucose, allowing it to “run through”
our bodies, depriving us of the energy and nourishment we need.
Just as the leaves shriveling on your houseplant signal trouble, your body will
try to alert you when it isn’t getting enough fuel. The following are warning
signals that your body may already have type 2 diabetes:
- Increased hunger (especially in the form of carbohydrate cravings)
- Increased thirst
- Frequent urination
- Weight loss or gain
- Blurry vision
- Cuts or sores that won’t heal
Because your cells aren’t being fed, your brain sends out the message that
you’re hungry, tired and thirsty. And though you may be eating and drinking
more, your cells are literally starving. This faulty insulin signaling is the thread
common to all forms of diabetes.
There are three main types of diabetes: type 1, type 2 and gestational diabetes.
Type 1 is characterized by a defect in the islet cells of the pancreas that makes
them unable to produce any insulin at all. Previously referred to as juvenile diabetes,
type 1 is thought to be autoimmune in nature and is generally diagnosed in
early childhood. Type 2, also commonly referred to as adult onset diabetes mellitus
or noninsulin-dependent diabetes, develops when cells become resistant to insulin.
And gestational diabetes occurs late in pregnancy when a mother’s hormones
interfere with her ability to utilize insulin. All forms of diabetes, if left untreated,
can lead to serious complications — including eye problems, compromised circulation,
kidney damage, and nerve damage.
It may give you some comfort to know that type 2 diabetes doesn’t just hit
overnight, but develops gradually over time. And though there are several risk factors
that can increase your likelihood of developing it, the progression toward type
2 diabetes begins when you become resistant to your own insulin. In functional medicine,
insulin resistance is an early indication of metabolic syndrome.
The connection between metabolic syndrome and type 2 diabetes
Twenty years ago, metabolic syndrome was almost an unknown idea among conventional
practitioners. Today it is recognized as the precursor to full-blown diabetes. This
is gratifying because it means conventional medicine accepts the idea that diabetes
develops over time — it doesn’t just appear overnight.
The diagnosis of metabolic syndrome is made when three or more of five disorders
are present in the patient: high triglycerides, low HDL cholesterol, high blood
sugar, high blood pressure and an above-average waistline.
In functional medicine, insulin resistance and metabolic syndrome are the same thing.
We view them this way because they begin with the same faulty cell signaling that,
over time, causes metabolic disorders and damage, symptoms such as those used in
the conventional diagnosis of metabolic syndrome, and eventually, degenerative diseases.
New research is showing that we can use specific nutrients to sort out the mixed-up
cell signaling that occurs in metabolic syndrome and reverse the problem. This is
fascinating to me because it promises that we can use food and supplements to prevent
or reverse insulin resistance and other metabolic disorders instead of medication
with its unwanted side effects! We will be hearing more about this in the next few
years, but in the meantime following a Mediterranean diet can help provide similar
Interestingly, making poor food choices is one of the big culprits leading to insulin
resistance in the first place.
What causes prediabetes and the diabetes progression?
Type 2 diabetes manifests itself differently in each individual. And though symptoms
and severity may vary, the starting point for most women is a diet with a high glycemic
load (high in refined sugars and carbohydrates), combined with inactivity and a
family history of type 2 diabetes. Next, the body reacts to high blood sugar by
producing more insulin. With persistently high insulin levels, cells eventually
build up a resistance to it and stop opening their doors. This stage, known as insulin
resistance, is when glucose begins to pass through the body without being absorbed.
Soon enough, the pancreas gets the message and decreases insulin production. As
insulin levels drop and diet remains high in glucose, blood sugar continues to creep
up. Ultimately, insulin levels drop and blood sugar jumps dramatically. This is
the point where the official diagnosis of diabetes is typically made. Since the
harmful effects of insulin resistance cut across all the body’s systems, the
severity at this point varies widely from individual to individual based on the
health of their other systems. While some people with diabetes continue to make
small amounts of insulin and can control their blood sugar through diet, others
stop producing insulin altogether and have to rely on outside sources of insulin.
The progression is shown in the following diagram.
Numbers may differ from lab to lab, but type 2 diabetes is generally diagnosed when
fasting blood glucose has reached 126 mg/dL or higher (compared to a normal range
blood sugar level between 70 and 99 mg/dL). At Women to Women, we feel it’s
much more beneficial to watch trends in blood glucose over time than to stick with
In other words, if I see a woman’s blood glucose going up a little every year
— even if those levels are still well under 99 mg/dL — I begin working
with her right away to make healthy changes in her life. A gradual increase in blood
sugar means that her cells are already insulin resistant, though the degree depends
on her unique situation. And this is our chance to intervene early!
Fortunately, there are several stops on the pathway to type 2 diabetes and, as with
any good road trip, there are various routes available and opportunities to turn
around. The problem is that many conventional healthcare practitioners don’t
step in early enough to change a patient’s course until it becomes difficult
Waiting for sugar
It makes sense that if one out of every three of us is walking around with prediabetes,
healthcare practitioners would be prepared to implement strategies to halt its progression
to type 2. But this isn’t always the case. Standard blood tests look at blood
sugar, among other things, but leave out one of the first indicators of prediabetes:
insulin. Remember that insulin levels are among the first markers of change on the
pathway to diabetes. At first they increase as insulin resistance sets in, then
they start to decrease. So understanding how your insulin is working can help you
to make important changes early on.
Sadly, many conventional practitioners lack the time to look closely at a patient’s
lifestyle to determine if they could benefit from an insulin test. In fact, there
is no set protocol for intervention until blood sugar begins to creep up, which
means the patient has passed insulin resistance already. And though you can still
reverse the problem, you’re much further along by then.
At Women to Women, we encourage our patients to take the driver’s seat when
it comes to their health. Oftentimes, this means taking an honest look at your symptoms,
nutrition and exercise habits, and it could also mean deciding for yourself that
you could benefit from an insulin test. There is nothing wrong with requesting an
insulin test from your healthcare provider yourself.
Staying on top of insulin early can help you avoid type 2 diabetes, insulin imbalance
— and the problems associated with it, including imbalance of your
Insulin and hormonal balance
The hormonal systems in our bodies are intricately linked by what is called the
endocrine system. And contrary to what many practitioners think, when one aspect
of the endocrine system is off-kilter, it can throw other parts out of balance as
well. This is the case with diabetes and menopause. Insulin interacts with estrogen,
testosterone, DHEA and thyroid hormones. When insulin is out of balance from a poor
diet, it can interrupt the regulation of estrogen, testosterone and other hormones.
This can make the already bumpy hormonal path during perimenopause even more difficult.
Over time, poor insulin control can send all the body’s systems — neuroendocrine,
cardiovascular, digestive and immune — out of balance, worsening your menopausal
What many women don’t realize is how nutrition is integrally connected to
the web of hormonal balance. Put simply, if you change your diet, you can change
your hormones. By eating balanced meals, including complex carbohydrates and high
quality protein and fats, you can regulate the insulin your body releases and keep
estrogen and testosterone in balance.
Getting back on track starts with making healthier choices.
The pillars of diabetes control
How many times have you reached for a cookie or a bag of potato chips after a bad
day? We’ve all been there, and I’m the first to admit that these foods
feel good in the short-term. But preventing diabetes means focusing on long-term
solutions — nutrition, exercise, balance!
In fact, a recent study done on over 3000 people at risk for diabetes showed that
lifestyle interventions, such as weight loss and regular exercise, reduced the incidence
of type 2 diabetes by 58%, whereas Metformin, a common antidiabetic drug, reduced
it by only 31%. Additionally, whole foods rich in phytonutrients — such as
those emphasized in the Mediterranean diet — have been shown to be favorable
in lowering markers of insulin resistance. What all this research tells us is something
that makes complete sense — that preventing diabetes through a holistic lifestyle
approach is far easier and more effective in the long-term than any drug solution
could ever be. And the first cornerstone of diabetes control is diet.
Nutrition — our food talks to our genes. If
I had to pick the gold star in preventing diabetes, it would be food. What you eat
can prevent and even control type 2 diabetes. At Women to Women we view food as
complex information that our cells have been primed through the ages to receive.
In other words, good food talks to your genes to keep things going just the way
Mother Nature intended. Rising rates of type 2 diabetes should come as no surprise
when you consider that the ways in which we grow and process our food have changed
so drastically in just one or two generations, while our human genetic constitution
hasn’t changed much in 40,000 years!
This might seem like a novel idea, but there is nothing revolutionary about the
concept of balanced meals. This means that each time you sit down to eat, you should
include protein, complex carbohydrates, healthy fats, and as many non-starchy fruits
and vegetables as you can. This will help to keep your insulin levels in balance
and make it less likely for you to store too much energy in the form of fat. And
with insulin in good control, you will have better balance throughout your endocrine
system, including other hormones like cortisol, estrogen and progesterone.
Insulin control is strongly affected by the glycemic index of the foods
you eat. The glycemic index of a food is a measure for how quickly insulin rises
in response to the amount of glucose entering your blood stream after you eat it.
Foods high in protein tend to have a lower glycemic index than carbohydrates. Simple
carbs, like white flour and sugar, have a higher glycemic index than complex carbs
like whole grains and fresh fruits. Simple carbs can overload your insulin receptors
and make insulin resistance more likely to develop. To prevent the quick sugar surge
from high glycemic foods, balance each snack and meal with all four basic groups.
But it’s about more than just the ratio of protein to carbohydrate to fat
in your diet. The plant kingdom has been quietly evolving alongside us humans for
many years, and the micronutrients available in fresh, richly colored, organically
grown fruits and vegetables are instrumental in preventing the diseases of modern
life — including type 2 diabetes. So choose the best information your food
dollar can buy, and remember that all four food groups play key roles in your digestion,
metabolism and hormonal balance.
Exercise — move your body. Getting regular exercise
is another excellent way to help prevent yourself from developing type 2 diabetes.
Not only does it keep your weight down, but it lowers blood sugar, helps you utilize
insulin more efficiently, keeps your cholesterol levels balanced, and improves
circulation, thereby keeping your heart and blood vessels healthy and strong. Exercise
also supports nervous system health and releases positive endorphins to boost your
mood! The benefits are endless.
While cardiovascular exercise is specifically beneficial to your heart, toning muscle
— through weight training, yoga, Pilates or swimming, for example —
is also a great way to increase the activity of your insulin receptors and prevent
insulin resistance. This is because of all the tissues in your body, your muscles
use the most glucose, so they are most important for keeping your blood glucose
levels steady. And once you learn how good it feels to move your body, you’ll
be looking forward to fitting exercise into your schedule as much as possible!
Blood glucose — better regulation through diet and lifestyle.
Of course blood glucose is important as well — it’s what we’ve
been talking about getting into balance. For women who already have diabetes, it’s
important to check blood glucose daily. But for those concerned with preventing
diabetes, I recommend getting it checked a couple times a year to see if it’s
As I mentioned above, a normal fasting blood glucose should be well under 100 mg/dL,
but it is much more important to watch the trend. Once you go above 100 mg/dL, you
are considered prediabetic, which usually means that your blood glucose levels are
somewhere between 100 and 126 mg/dL — higher than normal, but not high enough
to be considered diabetic. You are insulin resistant at this point and much more
likely to develop type 2 diabetes and other factors associated with metabolic syndrome
— unless you step in.
Rather than focus on the numbers, know that you have much more control over blood
glucose by eating well and getting more exercise. Astoundingly, 65% of diabetes
patients die from heart disease or stroke, which tells us that treatment should
be about more than just glucose control. Making lifestyle changes allows you to
reap huge benefits in blood sugar control right away.
Emotions — feed your soul! You can’t go wrong
with good diet and plenty of exercise, but at Women to Women, we understand that
there’s more to this equation than just eating right and exercising. And that’s
the emotional piece. Reaching for sugar may be a sign that you’re lacking
sweetness in your life. I want you to think about all the things that make you happy
and consider the possibility that these things nourish you in profound ways that
your food — no matter how impeccable — cannot. Whether it’s spending
more time with your children, relaxing on your own, painting or digging around in
the garden, giving yourself time to do the things you love will have a positive
effect upon all your systems — from your heart to nerves to immunity to metabolism.
Just remember that feeling better means looking at the whole picture — your
happiness, nutrition, exercise habits, hormonal balance, blood pressure, and cholesterol.
But while we always encourage women to start inward on a quest for overall health
and diabetes prevention, it also makes sense to look at what’s all around
Diabetes and our environment
From the four pillars outlined above, we can begin to see how the rising rates of
diabetes may be the result of a complex interplay between our genes and environmental
influences. It stands to reason, then, that scientists are starting to look more
closely at how our environment affects our risk of diabetes. No one will argue with
the fact that as modern technology surges on, we benefit from lots of conveniences.
But along with all these conveniences we’re also taking in the heavy metals
and manmade toxins that come with them. Materials used to create plastics, pesticides,
household cleaners, flame retardants, rugs and furniture, computers — even
white paper — all contain what are known as endocrine disruptors. And many
of these foreign molecules have been shown to mimic the action of hormones in our
Since hormones turn on and off bodily functions, open cell doors, keep our moods
stable, and so much more, it makes sense that endocrine disruptors could contribute
to a shift in insulin production or utilization in the body. In fact, a recent study
found that exposure to the specific kind of endocrine disruptors known as persistent
organochloride pollutants (POP’s) may contribute to the development of type
Keep in mind, however, that endocrine disruptors are most likely not the primary
cause of type 2 diabetes, though they certainly may contribute. And the good news
is that there are many things you can do in your life to limit your exposure to
these unwanted disrupters. Start by throwing out your plastic food containers and
replacing them with glass, avoiding the use of plastic in the microwave, and giving
your body a chance to recover by implementing regular detox and drinking more water.
There are lots of ways to help yourself when it comes to the prevention of type
2 diabetes. Just remember to look at the whole picture.
The Women to Women approach to reducing your risk of diabetes
At Women to Women, we believe you are the most important caretaker of your
body. This leaves you with choices when it comes to what you eat, whether you exercise,
and the spaces with which you surround yourself. This can be a powerful —
and, for some women, overwhelming — concept.
But making better choices doesn’t have to be difficult. Start by determining
where you are and what your goals are. You may want to put it all down on paper.
We find that articulating and defining what we want and don’t want in life
can help us more easily achieve our greatest desires.
Here are a few ideas to get you started:
- Move toward healthier meals and snacks. It may be true
that fast food is less expensive and more expedient than buying fresh whole foods
and cooking yourself, but keep in mind the old adage: Food is the cheapest medicine
you can buy. And when you do need to eat in a hurry, even making different
fast food choices can make a world of difference. Chose the grilled chicken instead
of a cheeseburger next time. Or simply drink water instead of soda with your meals.
Be sure to include the four food groups in all your meals, and don’t forget
to check the labels for trans fats and high-fructose corn syrup. Remember that you
don’t have to do everything all at once. Little by little, making better food
choices will help you reverse your insulin resistance within weeks. (You may find
our articles on nutrition helpful as
you prepare to balance your meals.)
- Strive for regular physical activity. We don’t advise
jumping right into the recommended 40 minutes a day if you haven’t exercised
in a while. Just start by doing something active a few days a week. Getting
into the habit of moving your body and increasing your heart rate is what counts.
Be sure to talk with your healthcare practitioner about what forms of exercise are
safe for you. Proceed from there to find an activity that fits your life. Nearly
everyone can benefit from walking more. Before you know it, you’ll work up
to a longer period of exercise and start to feel all the positive results!
- Enhance your nutrition with vitamins and minerals. Our
cells are constantly using micronutrients in their everyday functions to produce
energy and keep us thriving. Diabetes and prediabetes compromise the nutrients our
bodies are able to take up, which can lead to nutritional deficiencies. Adding a
high-grade multivitamin/mineral complex and supplemental omega–3 fatty acids
will help fill in any nutritional gaps, regulate hormones such as insulin, and protect
your body from the complications associated with diabetes. In fact, certain vitamins,
minerals, and phytonutrients have been shown to be particularly helpful in terms
of insulin resistance and diabetes.
- Detox your personal environment. Avoid unnecessary chemical
exposure by using glass instead of plastic to store your food and drink. Never use
plastic in the microwave, or avoid the microwave altogether. Make a point to use
all-natural cleaning products and cosmetics. Drink plenty of water, and try our
two-week Quick Cleanse to detox your
It will also help your health on all levels, including your endocrine system, to
limit time you spend in stressful relationships and environments. As scientists
are now discovering, stress takes a heavy toll on our bodies. Ironically, the very
technology invented to save us time, such as laptops, cell phones and e-mail, may
afford us less time to decompress. Make time to relax and get away from the pressures
of life. Even if it’s just a one-day yoga retreat, a walk on the beach or
an hour-long bubble bath, taking a holiday from stress is never a bad thing for
- Consider other complementary treatments. As you may understand
by now, diabetes is a complex disease. It manifests itself differently in each individual
and the preventative methods that work for some may not be enough for you. Certain
complementary treatments have shown positive effect in managing the risk factors
leading to diabetes, and may be worth looking into. Whatever course of treatment
you pursue, remember to work closely with an experienced practitioner for the best
Find the sweetness in your life!
Learning how to prevent type 2 diabetes changes the way we look at everything —
the way we eat, travel, exercise, work, and view the world around us. And, trust
me, all of this is for the better! It can certainly feel overwhelming sometimes.
It helps to remember that you can’t change everything in one day — nor
should you try. Revising our habits takes time and commitment.
At Women to Women we believe in balance, which is achieved through a dynamic equilibrium
between forces. There are positives to every negative, and though preventing diabetes
may seem daunting, what it requires is for you to pay more attention to your body
and do what makes you feel good in the long run. This is never a bad thing. Embrace
the chance to take better care of yourself, and before you know it life will be
sweeter than you ever imagined possible!
Our Personal Program is a great place to start
The Personal Program promotes natural hormonal balance with nutritional supplements,
our exclusive endocrine support formula, dietary and lifestyle guidance, and optional
phone consultations with our Nurse–Educators. It is a convenient, at-home
version of what we recommend to all our patients at the clinic.
If you have questions, don't hesitate to call us toll-free at
1-800-798-7902. We're here to listen and help.
Related to this article:
References & further reading on preventing
type 2 diabetes
Last Modified Date: 05/26/2011
Principal Author: Marcelle Pick, OB/GYN NP