Life Without Diabetes

Type 2 diabetes has reached pandemic proportions worldwide. In 1980 we estimated that there were fewer than 100 million people affected – but since then numbers have increased year by year so that we are now heading for 450 million plus as many again at high risk. No populations have been spared but figures are particularly high amongst countries in the Middle East and South Asians. What is the cause? The big increase has been related to the epidemic of obesity, lack of exercise and adoption of “modern” nutrition against a genetic susceptibility background. But the precise cause has not previously been identified. Indeed when WHO reclassified types of diabetes in 1979, type 2 diabetes was diagnosed by exclusion: it was what was left over after type 1 diabetes and other types with known causes were excluded. It was anticipated that the number of people in the type 2 category would fall as specific causes were found. However, in the intervening 40 years one could cynically suggest that not too much has changed. There has been a massive hunt for responsible genes with only limited success. The association with overweight/obesity has certainly been strengthened although many people with type 2 diabetes are not particularly overweight. Otherwise it has been a slightly gloomy picture particularly for those who have the disorder. There has also been the view that it is in most people an irreversible disorder. Professor Taylor in this book shows that the situation is more optimistic. With appropriate food habits and weight loss diabetes CAN be reversed in many people. This is encouraging for the many who have tried but failed due to lack of support and appropriate advice. Even more important he has identified the key role that fat deposits in the liver and pancreas are fundamental to the development of type 2 diabetes, explaining its hallmarks of diminished insulin secretion and insulin resistance. The book has something for everyone and is written in an engaging style. There is an excellent expose of how metabolism works and how glucose is made and used, and how this all goes wrong in type 2 diabetes. He then goes on to show how it can be controlled or indeed reversed by sensible lifestyle and diet choices. It is eminently readable and suitable for anyone with an interest be they people with diabetes, those with diabetes in the family, anyone curious as to what happens to food in their body or health care professionals. The book breaks new ground and is a compelling and instructive read.