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Diabetes is More Than Just Controlling Blood Sugar

Diabetes is More Than Just Controlling Blood Sugar
February 4, 2019 Patrick Nemechek, D.O.

The growth in our understanding about why people develop Diabetes Mellitus Type 2 (DMT2) is greatly out-pacing our present treatment strategy.

In the early 1900’s, the primary fear about getting DMT2 was from the very elevated levels of blood sugar (glucose in the 400-700 mg/dl range) that would trigger a deadly condition called diabetic ketoacidosis.  Diabetic ketoacidosis is very different than the mild ketoacidosis that occurs from restricting carbohydrates in the diet.

In 1921 insulin was discovered and the fatal complication of diabetic ketoacidosis was now, in many cases, avoided.

Now instead of dying from a diabetic coma, patients were living longer and their more common cause of death from DMT2 was the consequence of chronically elevated blood sugar within the blood stream. 

Atherosclerosis in DMT2 occurs when the blood sugar (glucose greatly than 137 or a HgbA1c level greater than 6.4%) is not enough to trigger the deadly ketoacidosis but it is enough to act as a toxic irritant to the surface of the blood vessels.  The chronic toxic nature of this concentration in diabetes of blood sugar damages the inner lining of the blood vessels and leads to blindness, kidney failure, amputations, and premature death.

In the more modern era, the development of additional blood sugar-lowering medications has given diabetics the ability to maintain their blood sugar HgbA1C levels less than 6.4%.  Keeping one’s blood sugar in this range greatly reduces the toxic complications of blindness, numbness in the feet, kidney failure and amputations, and greatly increases survival.

Today our understanding about DMT2 has grown even further.  There is overwhelming evidence that DMT2 is fueled by a chronic elevation of inflammation chemicals released by white blood cells.  Known as pro-inflammatory cytokines, these chemicals circulate throughout the blood stream and are capable of triggering a wide array of genetic disorders including DMT2.

These proinflammatory cytokines not only turn on the gene(s) that trigger DMT2, they also influence the level of abnormal blood sugar elevation.  The higher the levels of inflammatory cytokines in someone with a gene for DMT2, the higher their blood sugar level.  And conversely, the lower the cytokine levels, the lower their blood sugar.

These inflammatory cytokines also activate other genes leading to the development of cancer, hypertension, Alzheimer’s dementia, and can cause direct damage to the tissues throughout the body which leads to sensory neuropathy (numbness in the feet), osteoarthritis, heart disease, osteoporosis and most dangerously, damage to the autonomic nervous system. 

Unfortunately, the present goal of diabetes management of reducing blood sugars without also focusing on the elevated cytokine levels has led to continued high rates of sudden death, cancer, and Alzheimer’s in patients whose blood sugar levels are “under control”.

Insulin, metformin, and the ever-growing number of prescription medications that lower blood sugar do little to nothing to lower inflammation.  The toxic effects of inflammatory cytokines continue to damage the body and activate other dangerous genes continues unabated.

The persistent elevation of inflammation is why patients with controlled diabetes have a much higher incidence of cancer, strokes, and heart attacks than people without a diagnosis of DMT2.

Furthermore, the single most common cause of death in individuals with DMT2 is due to direct inflammatory damage of the autonomic nervous system; a condition known as diabetic autonomic neuropathy or cardiac autonomic neuropathy (CAN). 

Cardiac autonomic neuropathy is a profound weakened state of the parasympathetic branch of the autonomic nervous system and results in the instability of heart rate control.  Diabetics have other autonomic issues from parasympathetic dysfunction such as bloating, heartburn, constipation, widely fluctuating blood pressure, and gastroparesis.

In fact, the autonomic nervous system of a diabetic prematurely ages because of inflammation and often has a functional capacity of someone approximately 20 years older than a person the same age without diabetes.  Autonomic function is critical to maintaining good health and a prolonged lifespan because a healthy autonomic nervous system is required for your brain to properly control your heart.

Patients die from sudden cardiac death due to cardiac autonomic neuropathy because their heart rates will suddenly jump to 300 beats per minute, so they cannot maintain any blood pressure at this point, and then they die of cardiovascular system collapse.  In 2016, the SAVOR-TIMI 53 Trial determined that approximately 1/3 of deaths in persons with DMT2 were caused by sudden cardiac death.

There are no symptoms or warning signs as cardiac autonomic neuropathy silently develops.  It can be easily detected with a physician’s common electrocardiogram (ECG or EKG) through a measurement known as heart rate variability (HRV).  If it is detected death can easily be prevented by reversing the underlying inflammation or blocking the arrhythmia with medication but unfortunately most modern ECG machines do not provide physicians with that simple information.

The Nemechek Protocol® was developed with this condition in mind, and CAN was the reason why I became interested in testing and treating the autonomic nervous system.  Cardiac autonomic neuropathy can easily be detected by assessing the autonomic nervous system with a simple 17-minute test known as spectral analysis. 

Once detected, my patients are started on The Nemechek Protocol® and their cardiac autonomic neuropathy (CAN) is often reversed in 3 to 5 months.  During that time, patients are temporarily placed on a medication that greatly reduces the risk of sudden cardiac death from occurring while the protocol allows the autonomic nervous system to recover.

Over the last few decades we have witnessed DMT2 is occurring in younger and younger individuals.  This is because the abnormal elevation of chronic inflammatory cytokines is beginning at younger and younger ages as well.

If you have diabetes, there are several things you can do to prevent yourself from dying from CAN and sudden cardiac death.

First, ask your physician to refer you to a cardiologist capable of determine whether cardiac autonomic neuropathy exists.  Second, study and learn everything you can about chronic metabolic inflammation and how it affects your health.

And finally, start developing a program to lower your inflammatory cytokines. The Nemechek Protocol® is a great place to start.  Supplementing your diet with omega 3’s (fish oil), omega 9’s (extra virgin olive oil) and reducing your intake of calories, carbohydrates, and advanced glycation end products (AGE’s are abnormal molecules formed when food is cooked quickly and at high temperatures) all have an additive effect on lower inflammation and helping your autonomic nervous system to recover.

With time you will be able to detect the reduction of inflammation in your blood work.  Look for reductions in your fasting blood sugar, HgbA1c level, and your triglycerides.  Reductions in those numbers are all indications that your inflammation is declining.  Additional tests such as the highly sensitive C-reactive protein (hsCRP) will also decline once your inflammation is lowered.

The Nemechek Protocol® also encompasses the use of transcutaneous Vagus nerve stimulation to provide a significant reduction in pro-inflammatory cytokines and is often required to get substantial recovery of autonomic function.  This is a type of electric neuromodulation to the Vagus nerve which completely controls inflammation throughout the body.

Diabetes management is no longer just about taking pills to keep blood sugar levels low, because diabetes is never under control in a high inflammation environment.  Diabetes management must include a focus on inflammation control by the combined benefit of calorie reduction, carbohydrate reduction, AGE reduction, and improvement of autonomic nervous system health to prevent death from sudden cardia death. 

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Marianne D.
Marianne D.

Does your protocol work for estrogen dominance in women? I have tried many things to relieve hot flashes, mood swings, and even PMDD so bad that it results in psychosis for 1 week out of every month. My alternative health doctor said my estrogen is causing this, but all the medications I have tried failed to help. Does inulin have some anti-estrogen effects, or is it more the omega-3 and omega-9 oils which can do this?

Joe
Joe

Dr. N, you say that: “patients are temporarily placed on a medication that greatly reduces the risk of sudden cardiac death”. Which medication are you using for this? I bought your book but didn’t find the name of the medication in it. Also, will your protocol work without the fish oil, so just inulin and olive oil… can it still produce improvements?

Riddhima
Riddhima

Hello Dr. Nemechek, my 5 yr old son’s stool test came back positive for Dientamoeba fragilis parasite. I tried searching on this blog and FB group, but can’t find any answer. Do you think your protocol will help in killing/decreasing those parasites? Or, should I do the parasite cleanse along with your protocol? Please advise.

Riddhima
Riddhima

I am in the U.S. I will get that antibiotic. Thank you so much.

Rose Smithson
Rose Smithson

Dr Nemechek, about extreme instability in a child: My son with autism cycles between “stable” normal days, and extremely bad days, without any apparent reason. We’ve tried many approaches, diets, supplements over the years. All supplements produced very bad side-effects, like even B-vitamins produced some strange behavioral reactions that don’t make any sense. Even a simple food, like eating a food like banana or apples, will make him agitated, sweating, and confused (even though he doesn’t test positive on classic food allergy tests). But even with a diet which is exactly the same every day, he may have 2 good… Read more »

Vincent Finlay
Vincent Finlay

Dr. Nemechek – I believe I’m in a more advanced stage of autonomic dysfunction. I’ve tried to schedule an appointment, but I was told you don’t have anything available until February 2020. I feel I may need the vagus nerve stimulator, but I can’t purchase unless I see you in person first. My health is steadily declining. I don’t know if my body can hold off until next year. I’m willing to be put on your waiting list, but there’s no guarantee I’ll be able to get anything sooner. Are there any other doctors that you are aware of who… Read more »

Nimya
Nimya

Dear Dr, In some blog, have read about cookie test. My son used to response for cookies before we start NP. Last Aug 2018, we have started the full protocol with approved brands. He is in 4 years and 8 months. We started Now Inulin with 1/16 tsp and increased to 1 tsp by last Jan 2019, along with California Olive oil and 1 ml Ultimate Omage FO. But we never see any progress. From Last Feb 2019, onward, after reading some blogs , have reduced the inulin slowly and now we are with 1/4 tsp. After reduced to 1/2… Read more »

Rose Smithson
Rose Smithson

Hello Dr. Nemechek. 2 questions. What is your opinion on “LDN” (low dose naltrexone), for autism and other neurological conditions, for children and adults? Is it OK to combine your protocol together with LDN?

Renalda
Renalda

Hello Doctor, My daughter 3 years old has multiple food intolerance, By multiple I mean more then 150 in red zone. We are 4 months following your protocol and recently have repeated Food intolerance test and nothing change. Could you please share your opinion regarding that? When we could see improvement in for those intolerance? I know healing takes time, I just want to be sure we are going in right direction. Time is precious for all of our kids. Thank you so much!

Verna
Verna

My son’s doctor recently prescribed retinin a for my 8 y.o. asd son’s white spots on his face. Will this interfere with protocol? Thank you.

Verna
Verna

Thank you!

Geri
Geri

as per ONE Test done one month prior to beginning protocol showing very low levels in both proprionic acids , in fact one type barely traceable , in my 8 year old boy , might adding inulin affect him negatively? in other areas where the body requires having proprionic acid for other functions. thank you !

Geri
Geri

thank you for that. have a good day

Marco S
Marco S

Hello Dr. Nemechek We started the protocol (ASD) several month ago, strictly following the book’s raccomandations. The awakening came very quickly, in less than a week. All the family was amazed to see our 5 yo child completely transformed and able to communicate so well. Unfortunately it all lasted 4 days then he fall back into his own world, very sad to see. We kept the protocol, slowly increasing the inulin (we started at 1.5 grams/day gradually up to 10 grams/day) but the “awakening” we saw at the beginning never came back in the following 2 months. Then we completely… Read more »

Marco S
Marco S

Good morning Dr Nemechek,
Following your advise, we went to our pediatrician and we got our Rifaximin prescription, as follow:

Spiraxin 200 mg – 1 pill every 6 hours, for 10 days.

As the dosage of Rifaximin available here in Spain is different that the 550 mg (twice a day) that you suggest in the book, I would ask if the prescription that we got still fits the Nemechek Protocol. (By the way, my son weights 22 Kg and is physically very healthy, almost bulletproof and is not taking any other drugs)
Thank you for your kind answer.

L. B. Dahle
L. B. Dahle

I have Ehlers Danlos-hyper mobility type. Now in my sixties and have had a partial knee replacement. I have been using supplements to control the breakdown of my joints and muscles, and to counteract my inability to form collagen. Also have POTS and Mast cell. We learned about the NP and I began the full protocol in early October 2018. Felt like it was helping. However, in the past few weeks I have gotten progressively much worse, even though I eat very healthy and have stayed 100% on the protocol. On my second Rifaxamin round it was like I was… Read more »

Mimi
Mimi

Hello there, Dr. Nemechek! I have taken Rifaximin several times in the last yr but am still burping (since end of April 2018) with increased heartburn all the time. I’ve since been on herbal “antibiotics” & the excess hunger has improved 40% in the last 2 wks but the burping & heartburn continue (& left side back of neck pain). Inulin makes it worse & makes the SIBO appear or reappear. I’m already barely eating carbs or sugar so that’s not the issue. On top of that multiple Rifaximin causes severe yeast overgrowth & vaginal streptococcus issues/discharge, etc. My questions… Read more »

Verna
Verna

Hello. I am the mother of twin ASD 8 y.o. boys. They’ve been on protocol since May 2018. Prior to protocol they just completed Brain balance and had made lots of progress (more awareness, swimming, etc). Recently, my younger twin has been smacking his head on the floor, table and per teacher on the corners of chairs but not too hard and maybe averages 4 to 5 times an hour. This has been happening for a month. His older twin brother was almost potty trained November 2017 then kind of lost some of those gains June 2018 shortly after beginning… Read more »

Fernandez
Fernandez

Dear Dr. Nemecheck,
First of all I would like to thank for your protocol, my daughter (7Y) in the protocol for last six months. Last week we changed our fish oil brand (earlier Nordric Natural- 450DHA/650EPA and changed to NOW 500DHA/250EPA).

We see unusual hyper active on her since this change, is their any relation to hyper active and combination of EPA&DHA?

(current dose ½+ tsp Inulin, 15 mil EVOO and 500DHA/250EPA).

Thanks

Fernandez
Fernandez

Dear Dr. Nemecheck,
Thank you very much for the reply, but i’m really sorry to say that my english understanding is poor, i,m not able to catch your second statement (“I would attribute to the brand of fish oil if switched”).
Just to clarify further, in this case do we need to switch back to original brand? or is this hyper active is a sign of improvement?
Thank you very much for your time

Anonymous
Anonymous

My son is 3.6 year old he is dignose with autism i purchase inulin now fish oil and olive oil can u tell me the dose….?

Georgia
Georgia

Dear Dr Nemechek, Hello again, it’s Georgia (27) from Australia here. I thought I’d give you a quick update as you and your amazing Protocol have completely changed my life for the better. I have now been formally assessed and diagnosed with quite severe Autism. I am so deeply grateful to finally understand myself, and to be healing my brain and body every day! My Autism is reversing, and it seems my Hyperhidrosis is also healing (I now believe this is a symptom of my Autism). It’s all falling into place thanks to you. I’m studying to be an Opera… Read more »

Nawshad
Nawshad

Dear Dr. Nemecheck,

My daughter (7Y) in the protocol for 5 months, there are some gains but she is playing with her fingers regularly, this was started 2.5months before when we switch the Inulin dose 1/2tsp to ½+1/8 tsp. We thought that it is a part of awakening, but now it is more than two months which is worrying since she is not concentrating in school works indeed focusing on fingers.

Please need your advice (current dose ½+1/8 tsp Inulin, 15 mil EVOO and 1180mg fish oil).

Minisha
Minisha

We have been following your protocol from past 4.5 months. I do see gains but not much in Speech. She is preverbal but non conversational. we give 1/2 teaspoon inulin, 1ml ultimate omega FO, 7.5ml EVOO. I read on faceook that some people are using supplement DMG with your protocol for Speech. Should I use it ? If yes then how much ? Currently I don’t do any supplements. My 4 year old sometimes holds her heads ,doesn’t pay attention. She is often lost in her imagination(sings songs and seems like she is role playing something but doesn’t listen to… Read more »

Linda
Linda

Hi Dr Nemechek, I’m writing to you from South Africa, my son is 13 years old, he started the protocol early in January this year, he’s on the dosages recommended in your book for the olive oil and omega and 1/4 tsp of inulin. We have kept him at that dosage of inulin, not much has changed, (I realise it’s early) he’s still extremely anxious (this is the reason why we started the protocol and for digestive issues, bloating and loose stools). Should we wait longer on 1/4 tsp of inulin, more than happy to do so, or, should we… Read more »

Linda
Linda

Thanks Dr Nemechek, we reduced the inulin right down to try and alleviate the anxiety and slowly went back up to 1/4tsp, the 1/4tsp dose gave some great improvements after a few weeks, much calmer, and happier, better bowel movements and less emotional upset generally but the anxiety was still there. We went up to 1/2tsp a few days ago but we have had quite intense behaviour, increased anxiety, intense fluctuations of emotions and a lot of bloat and tummy discomfort also he feels too alert.. If we can’t get Rifaximin, do we see how this 1/2 tsp dose goes… Read more »

Linda
Linda

Hi Dr Nemechek, thanks for your response, because of his age (13) and anxiety, it was recommended on the group to increase the inulin. There has been such a great change though, since I wrote to you, earlier this week. He is now calm, rational and when he wakes up in the morning, he is happy (usually he is very irritable in the mornings), his anxiety is also way down and he is handling situations with a level head, previously he would spiral into an anxious meltdown. Now we can sit and have a discussion/conversation and he seems way more… Read more »

N. Panayotova
N. Panayotova

Hello dr Nemechek! Should I avoid walnut oil in your protocol? It contains polyunsaturated fatty acids (72% of total fats), particularly alpha-linolenic acid (14%) + linoleic acid (58%), oleic acid (13%) and saturated fats (9%). Also I have not found information about avoiding or not gamma linolenic acid GLA, which is an omega-6 fatty acid but also can reduce inflammation in brain cells. Thank you in advance!

Serene
Serene

Hi Dr Nemechek,
My son is only 8 months old. He is currently constipated. PD has prescribed him with lactulose. Is it okie to use it to treat constipation during protocol? If not is magnesium citrate safe for a 8 month old kid and what is the dose to give? Thanks

Rohma
Rohma

Hello. My 4 year old daughter is on protocol for 5 months now. Alot of gains but one thing bothers me alot. Wheneevr she sits to study or write she would yawn constantly. If this period is extended for more than 20 mins she would have water coming out of eyes due to yawning. I dont understand why. What do i need to do to fix this? Please help. I understand gaining more concentration would take longer time. Thanks alot!!

Bill
Bill

Hi Doc,
For the adult protocol, can I take the fish oil pills maybe 2 at a time spread throughout the day? Getting close to starting and worry taking 6 at the same time might be sort of a gut bomb. Thanks.

Katie McCollum
Katie McCollum

We are scheduled to come see you in August. (SO excited) We just got my son’s genetic test back and his results showed a huge mitochondrial dysfunction. His mitochondrial are functioning so low that his current dr. thinks he may have mitochondrial disease (cirtrate synthase 25%, RC-IV 336%, RC-I 34%). Now, I know your views are that mitochondrial dysfunction is a downstream effect of the ANS dysfunction, however, in my son’s case, I think his low functioning mitochondrial may be causing the majority of his issues. My son has been on the protocol for 1.5 years and I would think… Read more »

Rosita
Rosita

Thank you Dr. I believe we need to visit you for the VNS machine. Can one VNS machine be used for the entire family? Thanks.

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