This document provides a summary of a presentation on unraveling the sugar cube and diabetes. It discusses the history of diabetes, current statistics showing rising rates associated with obesity and poor diet, pathophysiology, complications, and treatments. It emphasizes that type 2 diabetes is largely preventable and reversible through lifestyle changes like adopting a plant-based diet, regular exercise, and achieving a healthy weight. The presentation aims to educate and empower people to take control of their health and potentially reverse diabetes.

1. A presentation at the North
American Vegetarian Festival
2011
Stephan Esser MD
www.esserhealth.com

2. Unraveling the Sugar Cube
Stephan Esser MD
www.esserhealth.com

3. Intentions
• Educate
• Empower
• Motivate

4. Objectives
• Provide background:
– History, Statistics Fun
– Anatomy, Patho-physiology
– Risks/Complications
– Treatment/Prevention Options
• Provide you tools to:
– Facilitate personal and societal change

5. History
• 1552 B.C. 3rd Dynasty Egyptian Hesy-Ra describes
the condition
• 1st Century A.D. Arateus 'the melting down of flesh
and limbs into urine’ Diabetes “siphon”
• 164 A.D. Galen describes diabetes as an ailment of
the kidneys.
• 11th Century:
– Diabetes “Mellitus” and water tasters
• 19th Century first chemical tests to indicate and
measure the presence of sugar in the urine.

6. • Late 1850s French physician, Priorry says eat
extra large quantities of sugar as a treatment.
• 1870s French physician, Bouchardat, notes
disappearance of glycosuria during the rationing
of food in Paris while under siege by Germany
• Late 19th Century Italian diabetes specialist,
Catoni, isolates his patients under lock and key in
order to get them to follow their diets.
• 1869 Paul Langerhans, a German medical
student, describes 'islets of Langerhans’ in the
pancreas

7. • 1921 Insulin is 'discovered’
• 1955 Oral drugs are introduced
to help lower blood glucose levels
• 1959 Two major types of
diabetes described

8. • ADA 2009: “Diabetes is a disease in which the
body does not produce or properly use
insulin.”
• NIH 2009: “Diabetes is a group of diseases
marked by high levels of blood glucose, also
called blood sugar, resulting from defects in
insulin production, insulin action, or both.”

9. Types of Diabetes
• Type 1: Insufficient or non-existent Insulin
production
• Pancreatic destruction (autoimmune, cancer etc..)
• 5-10% of all cases
• Type 2: Insulin is unable to work
• Insulin insensitivity/resistance
• 90-95% of all cases

10. Statistics
• 2007
– 7.8% of the population
– 23.6 million US citizens
– 17.9 mill. diagn. 5.7 mil. undia.
– 23.1% age > 60 have DM2
• 7th Leading Cause of Death

13. Overweight ↑ risk of DM2 by 3 fold
Obesity ↑ risk by 9 fold

14. Michelangelo’s David:
12 month 20 city tour of the US

16. Cost to the Nation
• Healthcare is 2-3 times that of those without DM(WHO)
• 2007: Total costs exceeded $174 billion dollars
• Projected costs by 2020 of $192 billion
• “Without preventive action, 1 in 3 children born in 2000
will develop diabetes in their lifetime.” (HHS)
• Perspective
• Cost of DM2 care in 2005 > budget of the D. of Ed.
• Diabetes care is 12 percent of the total health care
spending nationwide—roughly one of every eight dollars.

17. Complications
• Heart Disease: 2-6 ×’s higher
• Stroke: 2-6 ×’s higher
• Hypertension/Elevated Cholesterol
• #1 Cause:
– Blindness
– Kidney Failure
– Neuropathy
– Amputation (60%)
• Dental Disease
• ……..and on and on………….

19. Knowledge is Power
Power is responsibility

22. Digestion
Cephalic
Gastric
Intestinal

23. Pancreas
• Secretes digestive enzymes into the intestine
• Amylase, lipase, trypsin, chymotrypsin, bicarbonate,
water
• digestion, neutralize acid
• Secretes hormones into the blood
• Insulin, glucagon, somatostatin
• Blood sugar control, neuro-hormonal control

24. Visceral Adiposity/Belly Fat/Apple
Fat

26. What we know
• Diabetes is an age old disease
• The pathophysiology
• Dramatic  in ♯’s associated with obesity,
SAD,  activity
• Cost is bankrupting America

27. Risk Factors
In your control Out of your control
• Weight • Genetics
• Exercise Habits • Age
• Diet: • Race
– Total calories
– Fat Consumption
– Refined
Carbohydrates
• Elevated Lipids
• Elevated Blood Pressure

28. Pima Indians

29. Treatments
• Allopathic: Drugs…..drugs….drugs
• Naturopathic: herbs, supplements
• Homeopathic: tinctures, elixirs, extracts
• Acupuncture: needles
• Hypnosis: ? ? ? ? ? ? ?
• Chiropractic: ? ? ? ? ?
• Ayurvedic: cinnamon, bitter lemon, herbs

30. Allopathic
• Oral Hypoglycemics:
– Metformin
– Glyburide
– Glipizide
– Repalinide, Nateglinide
– Rosiglitazone (Avandia),
Pioglitazone( Actos)
• Action:  Insulin sensitivity/production
• Injectables: Insulin

31. Allopathic
• T
• To do list:
– Check Blood Sugar 4-8 ×’s/day (1460/yr)
– Inject yourself with Insulin 3-5 times/day
– Go to your doctor for blood work every 3 months
– Get HBA1C, foot and retinal exam yearly
– And more………

32. Increases Appetite
’d Insulin Weight Gain
Fat Causes
Secretion
Causes Insulin Resistance

34. Reversing Diabetes

35. Essentials
• Remove insult
• Adopt healthful behaviors
• Restore normal/near-normal physiology

36. • Joel Fuhrman MD:
– “ 95% of Type II Diabetics can come off
medications”
– “Type 1 diabetics can reduce their insulin doses by
almost half.”

37. • John McDougall MD
– The majority of pt’s with Type 2 Diabetes have
“normalization
of blood sugar in
approximately 1 week’

38. • Dr. Alan Goldhamer DC:
– DM2 is dramatically influenced by a brief 7-14 day
stay
– Most pts have normal blood sugars in days
without need for medications

39. Tree of Life Rejuventation Center
• Dr. Gabriel Cousens MD
– 21 day Diabetes Reversal Program
– Raw Cuisine

40. • Dr. Neal Barnard MD
– DM2 Reversed with Vegan Diets
– Extensive Studies on diabetes reversal
and elimination

41. Living a Diabetes-free life

42. Getting Started
• 1: Assessment
• Self/Other
• 2: Defining Success
• Establish parameters
• 3: Goal Setting
– SMART (specific, measureable, achievable, realistic, timely)
• 4: Establishing Priorities
• 5: Take Control/ Application

43. Assesment
• Do/did I have DM2?
• Has my blood sugar been tested?
• If with DM2 what is my A1C?
• How many close family members have DM2?
• Am I my ideal weight?
• Is my diet SAD, moderate or plant based?
• How often do I exercise

44. Defining Success
• Reversing Diabetes
• Reducing Insulin/Medication need
• Stopping the progression/avoid complications
• Improve Quality of life/energy/clarity
• Preventing Diabetes

45. Goal Setting
• Specific
• Measurable
• Achievable
• Realistic
• Timely

46. Establish Priorities
• Balance, prioritize
• Be flexible/dynamic

47. Taking Control
• Network
• Create support team
• Catalog/Notate/Document
• Re-assess intermittently

48. Essentials
#0: Get informed
#1: Adopt a plant based diet
#2: Begin a regular exercise program (>150)
#3:Achieve a more “ideal” body weight
#4: Chart/Monitor/Catalog/Re-assess

49. What we know
• We can prevent/reverse/eliminate some 90+
% of Type 2 Diabetes
• We can dramatically reduce the need for
Insulin in Type 1 Diabetes
• This takes work………
but it is all worth it!!!!!!

50. The Answer……….

51. Thank you!

52. Enjoy more powerpoints and
educational resources at
www.esserhealth.com