Type 2 Diabetes Bill of Rights

Proclamation

Whereas in the U.S. type 2 diabetes is present in more than 10% of adults over 18, and more than 25% of those over 65, affecting over 30 million people¹;
Whereas it is predicted that for children born in the U.S. after the year 2000, as many as 40% will develop type 2 diabetes, with even higher estimates for African American, Hispanic, and Native American children^2,3;
Whereas published evidence reveals the world-wide epidemic of type 2 diabetes is approaching half a billion people⁴, and is common where people have been encouraged to adopt a diet of highly processed and predominantly animal-based foods^5,6;
Whereas type 2 diabetes is one of the top risk factors for heart disease^7,8 and a leading cause of blindness1 amputation^9,10, painful neuropathy11, and kidney failure¹², leading to dialysis and renal transplantation;
Whereas most current treatments of type 2 diabetes assume it to be an irreversible chronic illness13 which will require ever-increasing levels of medical intervention¹⁴;
Whereas the cost of insulin has tripled in the last decade in the U.S.¹⁵;
Whereas diabetes results in $237 billion in direct medical costs per year in the US, with 43% of those costs due to diabetes medications¹⁶;
Whereas genetics may make type 2 diabetes more likely^17,18, the disease is largely a result of diet and lifestyle choices^19,20, thus changes in behavior can prevent it from ever occurring21,22; and even reverse it once it has occurred. ^23-25
Whereas many people with type 2 diabetes may be able to reduce or eliminate their medications if they are successfully treated with inexpensive low-tech lifestyle measures^26-28;
Whereas evidence-based lifestyle therapies such as a whole food, plant-based diet and physical activity are far safer and more cost effective than drugs for control of diabetes^27,29;
Whereas most people with type 2 diabetes report never being told^14,30,31 their disease may be prevented, arrested, and even reversed^23-25 with a predominantly whole food, plant-based diet^32-34 and other lifestyle interventions^35-37;

Now therefore be it known that the President and Board of Directors of the American College of Lifestyle Medicine do hereby declare the following:

Diabetes Bill of Rights

You have the right to be fully informed about all treatment options for Type 2 Diabetes before consenting to treatment.
You have the right to be given accurate, complete, and unbiased information about Type 2 Diabetes, pre-diabetes, and insulin resistance, including the benefits of treatment with a predominantly whole food, plant-based diet and other Lifestyle Medicine interventions such as physical activity, sleep hygiene, and stress management.
You have the right to know the full effects of all medications prescribed to you, including the side effects that can accelerate and
exacerbate the underlying causes of Type 2 Diabetes.
You have the right to know that certain foods increase your risk of developing Type 2 Diabetes.
You have the right to have your Type 2 Diabetes medications reduced or eliminated, if you undergo lifestyle therapies that successfully treat the underlying causes of your condition.
You have the right to work with doctors and health care professionals who understand the links between lifestyle choices and Type 2 Diabetes, and who are equipped with the knowledge and strategies to treat and reverse disease through therapeutic lifestyle change.
You have the right to ongoing education on whole food, plant-based nutrition, meal planning, and culinary skills.
You have the right to know that the same diet and lifestyle changes that can prevent, arrest and, often reverse Type 2 Diabetes may do the same for other chronic conditions—coronary artery disease, obesity, high cholesterol, high blood pressure, arthritis, even some cancers and autoimmune conditions—leading to the best chance of overall good health.

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References

1. Centers for Disease Control and Prevention. National Diabetes Statistics Report A, GA: Centers for Disease Control and Prevention, U.S. Dept of Health and Human Services; 2020.
2. Gregg EW, Zhuo X, Cheng YJ, Albright AL, Narayan KM, Thompson TJ. Trends in lifetime risk and years of life lost due to diabetes in the USA, 1985- 2011: a modelling study. Lancet Diabetes Endocrinol. 2014;2(11):867-874.
3. Turin TC, Saad N, Jun M, et al. Lifetime risk of diabetes among First Nations and non-First Nations people. CMAJ. 2016;188(16):1147-1153.
4. Saeedi P, Petersohn I, Salpea P, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9(th) edition. Diabetes Res Clin Pract. 2019;157:107843.
5. Sami W, Ansari T, Butt NS, Hamid MRA. Effect of diet on type 2 diabetes mellitus: A review. International Journal of Health Sciences. 2017;11(2):65-71.
6. Talaei M, Wang Y-L, Yuan J-M, Pan A, Koh W-P. Meat, Dietary heme iron, and risk of type 2 diabetes mellitus: The Singapore Chinese Health Study. Am J Epidemiol. 2017;186(7):824-833.
7. Cardiovascular Disease and Diabetes. American Heart Association. https://www.heart.org/en/health-topics/diabetes/why-diabetes-matters/ cardiovascular-disease–diabetes. Published 2015. Updated 30 August 2015. Accessed 11 May, 2020.
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9. Geiss LS, Li Y, Hora I, Albright A, Rolka D, Gregg EW. Resurgence of diabetes-related nontraumatic lower-extremity amputation in the young and middle-aged adult U.S. population. Diabetes Care. 2019;42(1):50-54.
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24. Lean ME, Leslie WS, Barnes AC, et al. Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster- randomised trial. Lancet. 2018;391(10120):541-551.
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