Diabetes has reached crisis levels in the U.S., with 10.5% of Americans affected.1 That data came from 2018 — before the pandemic — and the problem has only worsened since. Diabetes was the seventh leading cause of death in the U.S. in 2017,2 but diabetes deaths surged during the COVID-19 pandemic, rising 17% in 2020.3
While COVID-19 was a problem — 39.5% of COVID-19 deaths occurred among people with diabetes4 — even diabetics who didn’t get COVID-19 suffered, often falling victim to isolation, social distancing, lack of medical care and fear, instead.
Younger people have been disproportionately affected, with diabetes deaths among 25- to 44-year-olds jumping 29% in 2020. Other deaths from everything, excluding COVID-19, rose 6% that year,5 highlighting the dismal public health failure that accelerated the diabetes pandemic.
Medical System, Dietary Advice Failing People With Diabetes
Even prior to the pandemic, diabetes was on an alarming trajectory that saw hospitalization for hyperglycemic crises increase by 73% from 2009 to 2015. Diabetes deaths rose by 55% during that time.6
Inactivity and poor diet are fueling the diabetes crisis, causing people to develop the condition at younger ages. Diets focused on ultraprocessed foods and fast foods are the root of the problem, as they’re loaded with seed oils — misleadingly known as “vegetable oils” — that contain toxic oxidized omega-6 linoleic acid (LA) that accelerate metabolic dysfunction.7
Yet, the American Diabetes Association continues to recommend seed oils like canola as “part of a healthy, balanced diet.”8 Diabetes is a manageable — and often reversible — condition, provided you make positive lifestyle changes and get proper medical care and advice.
However, many people are limited by their insurance plans as to which care providers they can see, and others forgo medical care entirely to avoid having to pay out-of-pocket costs. As it stands, diabetes treatment costs top $230 billion a year in the U.S., yet the diabetes mortality rate is 42% higher than it is in 10 other industrialized countries.9
“The focus in U.S. health care on treating crises over preventing them doesn’t help, downplaying the importance of lifestyle changes that could lessen the severity of the disease,” a Reuters investigation reported. “‘Over and over again, the problem is worse in young adults, and there isn’t improvement in older adults,’ Ed Gregg, a former CDC researcher, told Reuters. ‘The magnitude of the increase has set us back 15 to 20 years.’”10
In fact, in 2020 only accidents and overdose deaths rose faster than diabetes deaths, which beat out Alzheimer’s disease, flu and pneumonia, stroke, heart disease, kidney disease and cancer for the dubious title of fastest-rising deaths.11
Fearful of COVID, People Died of Diabetes Instead
The Reuters investigation follows the case of a 42-year-old woman whose death from complications of Type 2 diabetes during the pandemic was the result of isolation and fear. Locked down in her home, fearful of COVID-19, she ordered fast food and lost the motivation to eat better and exercise, and had difficulty getting adequate medical care.
Ultimately, “the isolation and the financial and logistical issues proved overwhelming.”12 In another case, a 68-year-old man with Type 2 diabetes had his leg amputated after avoiding medical care for a chronic sore out of fear of COVID-19.
These stories aren’t unique. Sandra Arevalo, director of community and patient education at Montefiore Hospital in Nyack, New York, told Reuters that diabetes deaths, amputations and intensive care admissions had plagued several patients she knew of after they delayed medical care during the pandemic.
“The diagnosis was uncontrolled diabetes, but it was caused by COVID fear. COVID caused more damage than we realized,” Arevalo said13 Giuseppina Imperatore, with the CDC’s Division of Diabetes Translation, also told Reuters that “the impact of the COVID pandemic on people with diabetes cannot be overstated.”14
Diabetes Cases Tripled Among Youth in 2020
Young people are also suffering. Among 8- to 20-year-olds, Type 2 diabetes diagnoses tripled in 2020 at Children’s National Hospital in Washington, D.C., and they’re showing up sicker than they did in the past, with 23% affected by diabetic ketoacidosis, compared to 4% in 2019.15 School closures and reduced physical activity triggered by the pandemic were likely factors in the sudden rise.
“It was really pointing us to the indirect effect of social distancing,” Dr. Brynn Marks, a pediatric endocrinologist at Children’s National, told Reuters.16 Weight gain has been another consequence, with significant increases in the rate of body mass index (BMI) change noted during the pandemic among 2- to 19-year-olds, according to the CDC. The CDC noted:17
“The COVID-19 pandemic led to school closures, disrupted routines, increased stress, and less opportunity for physical activity and proper nutrition, leading to weight gain among children and adolescents.
Among persons with overweight, moderate obesity, and severe obesity, pandemic rates of BMI increase more than doubled, compared with prepandemic rates … similar effects were observed for weight change … Compared with other age groups, children aged 6-11 years experienced the largest increase in their rate of BMI change … with a pandemic rate of change that was 2.50 times as high as the prepandemic rate.”
Translated into the resulting weight gain, the figures reveal that 22% of children and teens were obese in 2020,18 up from 19% in 2019. Average annual weight gain among healthy weight children was 3.4 pounds prior to the pandemic, which rose to 5.4 pounds in 2020. Among children who were already obese, the acceleration was even greater.
For moderately obese children, expected annual weight gain rose from 6.5 pounds in 2019 to 12 pounds in 2020, while severely obese children’s expected annual weight gain increased from 8.8 pounds to 14.6 pounds during the pandemic.
The Pandemic Made Obesity Worse
Americans are also facing an obesity crisis, which goes hand in hand with the diabetes crisis. The latest figures from the CDC state that 42.4% of Americans were obese in 2017 to 2018, an increase from 30.5% in 1999 to 2000.19
The pandemic has made these numbers even worse, as 42% of U.S. adults who responded to the American Psychological Association’s 2021 Stress in America poll said they had gained more weight than they intended since the pandemic started.20
The average weight gain among this group was 29 pounds, with 10% stating they gained more than 50 pounds during the pandemic.21 The CDC also announced September 15, 2021, that the number of states with high obesity prevalence — defined as at least 35% of residents with obesity — has nearly doubled since 2018.22
There are now 16 states where at least 35% of the residents are obese, up from nine states in 2018 and 12 in 2019. “These and other emerging data show that the COVID-19 pandemic changed eating habits, worsened levels of food insecurity, created obstacles to physical activity, and heightened stress, all exacerbating the decadeslong pattern of obesity in America,” Trust for America’s Health reported.23
Experts: ‘Quarantine’ From Ultraprocessed Foods
Eliminating ultraprocessed foods is an essential part of tackling both obesity and Type 2 diabetes, as it lowers your intake of toxic seed oils. Dr. Chris Knobbe, an ophthalmologist and the founder and president of the Cure AMD Foundation, explained the complex process behind seed oils’ toxicity in his presentation at the ALLDOCS annual 2020 meeting:24
“Here's what excess omega-6 does in a westernized diet: induces nutrient deficiencies, causes a catastrophic lipid peroxidation cascade … This damages … a phospholipid called cardio lipid in the mitochondrial membranes. And this leads to electron transport chain failure … which causes mitochondrial failure and dysfunction.
And this leads first to reactive oxygen species, which feeds back into this peroxidation cascade.
So you're filling up your fat cells and your mitochondrial membranes with omega-6, and these are going to peroxidize because of the fact that they are polyunsaturated … next thing that happens, insulin resistance, which leads to metabolic syndrome, Type 2 diabetes … Your mitochondria are failing to burn fat for fuel … this is a powerful mechanism for obesity.”
While the CDC and other health officials aren’t sounding the alarm about the risks posed by ultraprocessed foods and other toxic exposures, the scientific community is taking note. As noted by a team of researchers in the journal Food and Chemical Toxicology, the role of toxic substance exposures, which includes ultraprocessed foods and poor diet, is underreported in the COVID-19 pandemic.25
“In short, it is the pervasive, constant exposure to toxic stressors in our environment, in combination with genetic factors, that cause us to develop diseases that impair our immune systems and make us susceptible to serious COVID-19 infection,” reported the Alliance for Natural Health.26
As the researchers noted, this includes lifestyle factors such as inactivity, smoking, excessive alcohol consumption, poor diet including ultraprocessed foods and refined grains and chronic sleep deprivation — all factors that also affect your weight and risk of diabetes.27
In order to protect the public, a “quarantine” from toxins like ultraprocessed foods, environmental chemicals and more would be far more effective than quarantining from one virus,28 and for long-term pandemic prevention, the researchers believe, and I would strongly agree, that such toxicology-based approaches should be given priority over virology-based approaches.29
Healthy Lifestyle for Type 2 Diabetes Prevention
Many aspects of the COVID-19 pandemic response, from lockdowns to school closures, have worsened the already perilous diabetes and obesity epidemics, but you can take action to protect your health. In addition to eliminating ultraprocessed foods — including fast foods and most restaurant foods — from your diet, give intermittent fasting a try.
Time restricted eating (TRE) is a simple powerful intervention that mimics the eating habits of our ancestors and restores your body to a more natural state that allows a whole host of metabolic benefits to occur.30
TRE involves limiting your eating window to six to eight hours per day instead of the more than 12-hour window most use. Research shows, for instance, that TRE promotes insulin sensitivity and improves blood sugar management by increasing insulin-mediated glucose uptake rates,31 which is important for resolving Type 2 diabetes.
In another study, when 15 men at risk of Type 2 diabetes restricted their eating to even a nine-hour window, they lowered their mean fasting glucose, regardless of when the “eating window” commenced.32
Remember when you eat is also important. I recommend adopting a cyclical ketogenic diet, which involves radically limiting carbs (replacing them with healthy fats and moderate amounts of protein) until you’re close to or at your ideal weight, ultimately allowing your body to burn fat — not carbohydrates — as its primary fuel.
And always remember the most dangerous foods in your diet are seed oils, commonly hidden in all chicken, pork, salad dressings and any sauces or dressings at a restaurant.