Summary of Rethinking Diabetes by Gary Taubes: What Science Reveals About Diet, Insulin, and Successful Treatments

By Justin Reese

DISCLAIMER

 

This book does not in any capacity mean to replace the original book but to serve as a vast summary of the original book.

Summary of Rethinking Diabetes by Gary Taubes: What Science Reveals About Diet, Insulin, and Successful Treatments

IN THIS SUMMARIZED BOOK, YOU WILL GET:

• Chapter astute outline of the main contents.
• Fast & simple understanding of the content analysis.
• Exceptionally summarized content that you may skip in the original book

 

Gary Taubes's book, Rethinking Diabetes, delves into the history of diabetes research and treatment. Before insulin, diabetes was treated primarily through diet, with most authorities now believing that those with diabetes can have the same dietary freedom as the rest. However, this has led to an explosive rise in diabetes, particularly among underserved populations. Taubes's work suggests a reimagining of diabetes care, advocating for a recentering of diet, particularly fewer carbohydrates and more fat, over reliance on insulin. He calls for doctors and researchers to question established wisdom and focus on clinical trials to resolve controversies.

• Language: English
• Publisher: jUSTIN REESE
• Release date: Jan 4, 2024
• ISBN: 9798224136124

Book preview

The Nature of Medical Knowledge

A 32-year-old white male from Montana with severe diabetes was diagnosed at the Mayo Clinic in 1921. Despite his symptoms, he was losing weight. The case study highlights the remarkable aspect of the patient's case, which occurred when he reappeared at the clinic in 1950. The patient had been following a diabetic diet since 1921, which was considered unbelievable by modern standards. The Mayo staff began treating the diabetes by fasting the patient until all signs of sugar disappeared from his urine.

They then served small amounts of carbohydrate foods daily to establish how much he could metabolize without the sugar reappearing. Once the patient was established, they added protein and fat to his diet. When the combination of protein, fat, and carbohydrates led to ketones in his urine, the Mayo doctors assumed the patient had reached the limit of how much fat he could eat safely. The patient was allowed to eat 15 grams of carbohydrates a day, 45 grams of protein, and 150 grams of fat, which added up to 1,590 calories a day. He was instructed to fast one day a week.

When he returned to the Mayo Clinic in December 1922, insulin was available, and he was among the first patients to receive it. The patient followed the new diet, consuming over 80 percent of his calories from fat, and fasted from a half to one day a week.

In 1950, the Montana farmer's diabetes diagnosis changed dramatically as his physicians realized they were in the midst of a new kind of diabetes epidemic. The discovery of insulin and insulin therapy in the early 1920s transformed the patient experience with diabetes, with patients living longer and dying from complications due to their bodies' inability to control their blood sugar. By 1934, diabetic patients were reporting retina lesions, hemorrhages, and obscuring vision. By 1936, Harvard pathologists reported a new type of kidney disease in patients with diabetes, with 80 percent of patients using insulin for at least twenty years having hypertension and over 20 percent having kidney disease. By 1950, coronary artery disease in diabetics on insulin therapy had become so common that Joslin suggested cardiologists study these young diabetics on insulin therapy to understand the fundamental cause of the disease.

The Montana farmer's examination revealed normal results, including a healthy weight, blood pressure, neurologic and ophthalmoscopic findings, blood vessels, urine, protein albumin, cholesterol levels, and blood fats. The most important question in the field of diabetes was whether these tragic complications could be prevented or minimized if diabetic patients would make the necessary effort to control their blood sugar.

In 1950, the Montana farmer's diet was deemed too low for diabetes, leading to a change in treatment. The Mayo Clinic physicians instructed the farmer to eat carbohydrate-rich foods to prevent insulin shock and prevent low blood sugar. As the epidemic of diabetic complications filled waiting rooms, physicians and diabetologists argued for more carbohydrates in the diabetic diet and less fat. The farmer's physicians, including Joslin and his colleagues, worried that the fat their patients consumed pre-insulin was making them fat and causing heart disease. They advised the farmer to eat more carbohydrates, take higher doses of insulin, and eat less fat to balance out the calories. The farmer's physicians reported that for the first time in twenty-nine years, he ate a normal meal.

The question at the heart of any medical progress is how physicians know enough to decide which therapy to use or prescribe. If an intervention restores the patient to health but is associated with premature death or disease, the treatment might still be readily justified. However, the ultimate complications cannot be ignored. The invention of the modern clinical trial in the late 1940s provided a means to assess the long-term risks and benefits of medical interventions and establish the safest, most effective one for an idealized, average