In August, 2002, I had been a morbidly obese Type 2 Diabetic for 16 years when my physician, who had tried for years (without success) to get me to lose weight on a “balanced” diet, said “Have I got a diet for you!” At 375 pounds I had been taking progressively more and more oral diabetes medications since my diagnosis in 1986. I was maxed out on a sulphonylurea (20 mg micronase), maxed out on Glucophage (2000mg metformin) and had recently started to take Avandia in failed attempts to control my progressively worsening blood sugar. When Avandia didn’t work, I was then (in 2002) going to be left with only one option: become an insulin dependent T2, injecting both basal and mealtime boluses.
It turns out, though, that my doc had recently read Gary Taubes’s July 7, 2002 cover story “What If It’s All Been a Big Fat Lie?” in the New York Times Magazine, and had decided to try the recommended diet for himself. I think it was the New York strip steak pictured on the cover that got him hooked. He’s an internist and cardiologist and had probably been carefully watching his saturated fat and dietary cholesterol intake for years. Anyhow, the Very Low Carb diet advocated in the cover story worked for him, and he thought it might work for me too. And as he walked me down the hall to schedule a follow-up appointment, he said, “It’ll probably be good for your diabetes too.”
Gary Taubes’s 2002 NYT Magazine cover story was a “game changer” in the world of Very Low Carb eating. It reached his target audience: clinicians, or at least mine. Taubes went on to write “Good Calories – Bad Calories” (“The Diet Delusion” in the UK), but he admitted in an Afterwords to the paperback edition that he considered he had failed to reach as many clinicians as he would have liked. Very Low Carb dieting is a tough sell. It is not the “standard of practice,” and the Public Health Establishment in the US and Britain and almost everywhere else (Sweden excepted) has not waivered much from the Lipid Hypothesis popularized by Ancel Keys about 50 years ago.
Taubes’s cover story touts, indeed lauds the principles behind The Atkins Diet, and that is the diet that my doctor had successfully tried himself, at least from a weight loss perspective. He lost 17 pounds. I don’t know if he did a complete blood chemistry and lipid panel on himself or even if he had been on it long enough to make a difference. But, I give my doctor his due for testing it on himself before departing from the “standard of practice” and recommending it to me.
Of course, within a day or two on strict Atkins Induction (20g carbohydrate a day), as a heavily medicated Type 2 diabetic I was experiencing “hypos” (dangerously low blood sugars). I called my doctor and he told me to stop taking the Avandia. The next day, when I was still having hypos, he said to cut the micronase and metformin in half and a few days later to cut them in half again. After that he saw me monthly for a year to monitor my blood and kidneys and other health markers. In the course of that year I further reduced the micronase from 5mg to 2.5 to 1.25mg and finally phased it out completely. I still take 500 metformin with dinner to suppress gluconeogenesis if (when) I eat too much protein.
In the first 9 months on The Atkins Diet I lost 65 pounds. I then retired from work and kept that weight off for several years. Then I slowly added back about 20 pounds (mostly from eating ice cream before bed, as I recall). By this time I had also been participating in an online diabetes forum, Dr. (Richard K.) Bernstein’s Diabetes to learn all that I could about eating Very Low Carb. I had also read Bernstein’s “Diabetes Diet” and the first edition of his “Diabetes Solution,” so I decided to try his program. It is similar to Atkins but a lot more focused than Atkins was on blood sugar control.
On Bernstein I lost 100 pounds in just under a year (50 weeks). Altogether I lost 170 pounds, settling in at 205 pounds. Today, I have regained some of that weight. Frankly I have been “off the ranch” for long awhile, but I am still much healthier than before. I eat very low carb most of the time and have retained most of the health benefits. My average HDL has more than doubled (from +/- 40 to +/- 84) and my triglyceride average has been cut by more than 2/3rds (from +/- 150 to +/- 42). I try to limit my carbs to about 5% of my diet and my protein to 25%, leaving 70% for fat. I do not limit salt, dietary cholesterol or saturated fat. I eat eggs and bacon and coffee with half and half and Splenda for breakfast, and a can of sardines for lunch. For dinner, it’s just meat and a low carb veggie with lots of butter or tossed in olive oil and roasted. In a restaurant I’ll have a drink (or 2) or two glasses of wine. The only dessert I’ll eat is berries (with cream) on a very special occasion. I love a cheese plate, but it’s just too much food. I always regret if I occasionally order it.
© Dan Brown 9/2/12