Diabetes is broadly classified into 'diabetes that causes weight gain' and 'diabetes that causes weight loss.' 

If you look around, you will see that there are so many people with diabetes. Many people live their lives unable to eat the food they enjoy because of diabetes, and they take handfuls of medication every day. They often say, “Because of this blood sugar issue, I’m not really living, just existing.” 

However, it is too early to be discouraged. If we have the right "concept" regarding diabetes, we can find a clue to escape from this tiresome cycle. 

Not all diabetes is the same. There are forms of diabetes that strictly require the help of medication or injections, while others can be overcome simply by giving our bodies the chance to recover on their own.

Diabetes (糖尿) but no sugar in the urine?

First, let’s revisit the term "diabetes." Literally, "diabetes" (糖, sugar + 尿, urine) is a disease where sugar is excreted in the urine. In the past, since there were no precise diagnostic tools like today, doctors would taste the urine or observe if ants swarmed around it to diagnose the condition. This is the traditional form of diabetes we are familiar with, known as "sogal" (wasting-thirst syndrome).

Surprisingly, however, most modern-day diabetes patients do not have any sugar detected in their urinalysis tests. If there is no sugar in their urine, how were they diagnosed with diabetes?

The reason is simple. Modern health checkups diagnose diabetes based solely on "blood sugar levels." The reason why blood sugar is high but no sugar appears in the urine is that the level has not yet exceeded approximately 180 mg/dL, which is the renal threshold for glucose reabsorption. Cases that would not have been considered diabetes in the past are now being diagnosed as such.

The representative self-diagnostic criteria for traditional diabetes (sogal) was the "3-poly, 1-loss" syndrome (polyphagia, polydipsia, polyuria, and weight loss). It refers to the symptoms of excessive thirst, hunger, frequent urination, and dramatic weight loss. However, modern diabetes patients tend to gain weight rather than lose it. Should both those who lose weight and those who gain weight be lumped together under the name of "diabetes" and forced to take medication for the rest of their lives?

Diabetes that causes weight loss vs. diabetes that causes weight gain

When I ask diabetes patients who visit my clinic when they were diagnosed, I hear two types of stories: first, those who had no symptoms but were diagnosed during a routine checkup with a fasting blood sugar of 130–140 mg/dL and have been taking medication for 5–10 years; and second, those who experienced business failure or extreme mental stress, followed by sudden weight loss, thirst, and foamy urine, leading them to be diagnosed after visiting a hospital.

These two are fundamentally different issues. To explain this, we need to redefine diabetes. We can call them "pancreatic damage-type diabetes" and "pancreatic non-damage-type diabetes."

The pancreas is the organ that secretes insulin, which pushes sugar into our cells. "If," due to certain causes, the beta cells of the pancreas are damaged and cannot secrete insulin, sugar overflows into the bloodstream.

High blood sugar damages blood vessels, so the body forcibly begins to excrete sugar through the urine for survival. As water is drawn into the blood vessels, the brain perceives a lack of water, causing extreme thirst and frequent urination corresponding to the amount of water consumed.

Furthermore, since glucose—which should be used as energy—is all lost through the urine, the body feels hunger and consumes "more" food. Even so, since there is still a lack of energy, the body begins to squeeze out the fat and protein stored in its tissues. This is why people lose 5–10 kg in 3 to 6 months.

This is what is called "pancreatic damage-type diabetes." This includes not only type 1 (juvenile) diabetes, where the pancreas is genetically damaged, but also modern-type 1.5 diabetes, where the pancreas is damaged acquiredly due to extreme stress, insomnia, heavy drinking, or active oxygen.

On the other hand, for patients whose diabetes causes weight gain, it is not a problem of pancreatic damage. When one consumes more carbohydrates than their activity level requires, the pancreas secretes massive amounts of insulin to process it, storing the excess sugar as visceral fat and glycogen in the muscles. Since the pancreas is intact, the body continues to gain weight due to the effect of insulin. Then, when the storage space is full, it begins to push sugar out of the body through the emergency exit of urine. This is what is commonly called "type 2 diabetes" or "pancreatic non-damage-type diabetes."

In the medical community, this is referred to as "insulin resistance" and viewed as the cause of diabetes, but in reality, it is merely a "resulting phenomenon" of consuming too many carbohydrates. If all cells required insulin to accept sugar, then when insulin resistance occurs, brain and heart cells would also stop functioning. However, because brain, heart, and muscle cells have different levels of insulin dependency, our bodies are designed not to collapse easily.

Modern diabetes is being diagnosed in a highly disorderly manner, with different causes and states mixed together. Clearly tracking and separating these mixed concepts is the true key to treating diabetes.

◆ Dr. Park Chan-young

Director of Eoseongcho Korean Medicine Clinic in Sadang-dong, Seoul. Holds a doctorate in Korean Medicine from Dongguk University. He created a "detox sensation" in Korea after appearing on TV health programs such as MBN's "King of Thumbs." He is the author of books including "Curing Atopy and Acne with Eoseongcho," "Seasoning is Medicine," and "The Miracle of Detox."