Diabetes mellitus is a disease characterized by chronically elevated levels of sugar in the blood. This occurs because the pancreas either does not make enough insulin or because the body becomes resistant to the effects of insulin. Insulin is the hormone that keeps blood sugar in check.

Type 1 Diabetes: This insulin-deficiency disease occurs when the immune system mistakenly destroys the insulin-producing beta cells in the pancreas. Type 1 diabetes, previously called juvenile-onset diabetes, represents approximately 5% of all diagnosed diabetes cases. Because the body does not produce insulin, type 1 diabetes is treated with insulin injections. The exact cause of type 1 diabetes is unknown, though a genetic predisposition combined with exposure to environmental triggers such as viral infection and/or cow’s milk may play a role.
Type 2 Diabetes: In type 2 diabetes, the pancreas can make insulin, but the body does not use it well. This insulin-resistance disease accounts for 90–95% of diabetes cases and was previously known as adult-onset diabetes. The accumulation of fat inside the cells of the muscles and liver interferes with the action of insulin. Saturated fat appears to gum up the locks on cells that would otherwise allow glucose to enter. The fat inside the muscle cells can come from the fat you eat or the fat you wear (body fat). The prevention, treatment, and reversal of type 2 diabetes depends on diet and lifestyle.
How the Body Uses Glucose
The digestive system breaks down carbohydrates into glucose, a simple sugar that is the primary fuel powering all the cells in the body. To get from the bloodstream into your cells, glucose requires insulin. Insulin acts like a key that unlocks the doors to your cells to allow glucose to enter. Every time you eat a meal, insulin is released by the pancreas to help shuttle glucose into your cells. Without insulin, your cells cannot accept glucose, and as a result, glucose builds up in your blood. Over time, this excess sugar can damage the blood vessels throughout the body. This damage can lead to blindness, kidney failure, heart attacks, and stroke. High blood sugar can also damage the nerves, creating a condition known as neuropathy that can cause numbness, tingling, and pain. Diabetics may also suffer from poor circulation and lack of feeling in the legs and feet, which can lead to poorly healing injuries and, in turn, amputations.
Diabetes as a Modern Epidemic
Type 2 diabetes has been called the “Black Death of the twenty-first century” because of its exponential spread around the world. More than 20 million Americans are currently diagnosed with diabetes, a tripling of cases since 1990. At this rate, the CDC predicts that one in three Americans will be diabetic by midcentury. Currently in the United States, diabetes causes about 50,000 cases of kidney failure, 75,000 lower extremity amputations, 650,000 cases of vision loss, and about 75,000 deaths every year. The CDC estimates that 37 percent of U.S. adults—and 51 percent of adults over sixty-five—have prediabetes.
Reversing Diabetes
The sources discuss the reversibility of diabetes through diet.
Extreme Calorie Restriction: Type 2 diabetes can be reversed by an extreme reduction in food intake. Blood sugar levels can normalize within a week of eating 600 calories daily. This occurs because fat is pulled out of the muscles, liver, and pancreas, allowing them to function normally again.
Gastric Bypass Surgery: Gastric bypass surgery is one of the most successful treatment methods for type 2 diabetes, with reported long-term remission rates of up to 83 percent. However, the success of the surgery may be due to the severely limited diet required for recovery following the procedure.
Plant-Based Diets: People who eat plant-based diets have a much lower rate of diabetes than those who regularly eat meat. As diets become increasingly plant-based, there appears to be a stepwise drop in diabetes rates. Flexitarians appear to cut their rate of diabetes by 28 percent; those who cut out all meat except fish appear to cut their rates in half; those who eliminate all meat, including fish, appear to eliminate 61% of their risk; and those who also drop eggs and dairy appear to drop their diabetes rates by 78 percent.
Low Fat, Plant-Based Diet: In addition to improving insulin sensitivity better than conventional diabetic diets, plant-based approaches can also lead to a significant drop in LDL cholesterol, thereby reducing the risk of heart disease, the number-one killer of diabetics.
Diabetes and Kidney Health
High blood sugar associated with diabetes can damage blood vessels throughout the body, including the kidneys. The kidneys are highly vascular organs, meaning they are packed with blood vessels. When kidneys leak protein into the urine, it is a sign they may be starting to fail. People with diabetes are at elevated risk for such health problems as kidney disease, premature death, blindness, and amputations. Diabetes causes about 50,000 cases of kidney failure each year in the United States.
Kidney Function: Healthy kidneys work to retain protein and other vital nutrients, preferably filtering toxic or useless wastes out of the bloodstream via urine. If the kidneys are leaking protein into urine, it is a sign that they may be starting to fail.
Dietary Factors: The sources indicate that three dietary components are associated with declining kidney function: animal protein, animal fat, and cholesterol. Each of these is found only in animal products. There is no association between kidney function decline and the intake of protein or fat from plant sources.
Hyperfiltration: High animal protein intake can induce a state called hyperfiltration, which is a dramatic increase in the workload of the kidney. Within hours of consuming meat, the kidneys go into hyperfiltration mode. Beef, chicken, and fish appear to have similar effects. However, an equivalent amount of plant protein causes virtually no noticeable stress on the kidneys. The hyperfiltration response disappears when study participants are given a powerful anti-inflammatory drug along with animal protein.
Acid Load: Meat protein increases the acid load to the kidneys, boosting ammonia production and potentially damaging kidney cells. A higher dietary acid load is associated with a significantly higher risk of protein leakage into the urine, an indicator of kidney damage. Diets high in animal products produce acid, while plant-based diets produce base in the kidneys.
Plant-Based Diet: A plant-based diet alkalinizes the kidneys, whereas a nonvegetarian diet carries an acid load. A plant-based diet can also help to reverse the effects of kidney disease. Within days of eating healthier meals, blood flow may improve to the extent that neuropathy disappears.
Kidney Stones: Eating a plant-based diet to alkalinize urine may also help prevent and treat kidney stones, which are hard mineral deposits that can form in the kidneys when the concentration of certain stone-forming substances in urine becomes so high that they start to crystallize. A plant-based diet can alkalinize urine in less than a week.
Dietary Fat: Fat in the blood can cause insulin resistance, and being obese can be like eating bacon and butter all day even if you are eating healthfully because an obese person's body may be constantly spilling fat into the bloodstream, which can cause insulin resistance and type 2 diabetes.

Other Factors in Kidney Health
In addition to diabetes and dietary factors, other factors can influence kidney health.
High Blood Pressure: High blood pressure can damage the kidneys. When kidneys show signs of damage due to blood pressure, eating lots of whole, healthy foods each day might stop or even reverse the damage.
Kidney Function: Kidneys are nonstop water filters for blood, processing up to 150 quarts of blood every 24 hours. Most people with deteriorating kidney function, however, do not experience any symptoms. Approximately one in three Americans over the age of 64 may suffer from chronic kidney disease (CKD), though three-quarters of the millions affected may not even know they have it. More than half of American adults currently aged 30 to 64 are expected to develop chronic kidney disease during their lifetimes.
Cardiovascular Disease: Kidney malfunction can be so damaging to the rest of the body that most people do not live long enough to reach kidney failure. In a study in which more than a thousand Americans over age 64 with CKD were followed for a decade, most of the others had already died, with cardiovascular disease killing more than all other causes combined.
Meat Consumption: A meat-rich diet contributes to chronic, low-grade metabolic acidosis, which helps explain why people eating plant-based diets appear to have superior kidney function.
Conclusion
The sources demonstrate that diet is a critical component of both diabetes and kidney health. The consumption of animal products is associated with declining kidney function, while plant-based diets can improve kidney function, reverse diabetes, and prevent kidney stones. Plant-based diets do not cause the hyperfiltration response seen with animal proteins. In addition, a plant-based diet is typically high in fiber, which is also associated with improved kidney function.
References
Greger, M., & Stone, G. (2015). How not to die: Discover the foods scientifically proven to prevent and reverse disease. Flatiron Books.
Greger, M. (2023). How not to age: The scientific approach to getting healthier as you get older. Flatiron Books.
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