Sunday, November 4, 2012

The Nutrition Debate #73: Newly Diagnosed Type 2 or Pre-Diabetic? Scared?

I wasn’t (scared).  And I paid a price. I did just what my doctors told me to do, mostly. I took the pills they prescribed and continued going to see them regularly. I continued to eat the same types of foods I ate before (a “balanced” diet, as they recommended); and I tried to lose weight, as they also recommended. But my body didn’t want to be starved, so the weight loss part didn’t work out so well.

The result: I continued to gain weight and over the years my diabetes got worse. As my blood sugars got worse, I was prescribed more types of oral diabetes medications and larger doses. Eventually, I was maxed out on two types and starting a third. In those days the only option, when the third med failed to control my blood sugar, would have been to inject insulin. I was that close 10 years ago when I found another way. I found a way to both lose weight and manage my diabetes. My doctor suggested I try the Atkins diet.

Today, with a Type 2 diagnosis, if “diet and exercise” doesn’t work after one or two office visits, many physicians prescribe Metformin and then injected insulin as a primary treatment. That may be a good idea if you continue to eat a balanced diet.  It would scare me, nevertheless, knowing that there’s an alternative as I do. You don’t have to do the same old, same old “restricted-calorie balanced diet” in which you starve your body and you are always hungry. It doesn’t work, or at least not for long. If you lose weight, you soon gain it back. And exercise just makes you hungry and justifies eating more as a reward for good behavior. Whew…

 Alternatively, many patients who are newly diagnosed with Type 2 Diabetes go home and immediately go on line to learn for themselves how best to treat their condition. They take charge of their own health. In doing this they avoid expensive medications and manage their diabetes through diet alone. I say “manage” ‘cause ONCE YOUR METABOLISM HAS BEEN DAMAGED BY BETA CELL LOSS AND INSULIN RESISTANCE, YOU WILL BE CARBOHYDRATE INTOLERANT FOR THE REST OF YOUR LIFE. You MUST accept this. If you want to manage this disease without drugs, or with minimum doses), and without the dreaded complications (blindness, amputations and/or end-stage kidney disease), you can do it, but you MUST make VERY dramatic changes in your diet. You must drastically reduce the carbs you eat at every meal.

There is a learning curve to the low and very low carbohydrate Way of Eating, and you will need to keep an open mind and relearn a lot of behaviors if you are going to succeed. There’s lot of help on-line, though, and the best advice I think comes from forums like Dr. Bernstein’s Diabetes Forum (registration required), but there are other good ones as well. I migrated to Dr. B’s forum and have been a regular there for almost 6 years. And over the course of the last 10 years I managed to lose 170 pounds, all without hunger, because I was NOT starving my body. My body was getting the energy it needed from its own fat storage. That’s what it’s there for, in the evolutionary sense, if you think about it.

More importantly, almost as soon as I started eating Very Low Carb (+/- 20 net grams of carbohydrate a day on Atkins Induction), I needed much less medication. I know this because I was getting hypoglycemia (very low blood sugars) from the very beginning. I called the doctor and he told me successively to lower or eliminate all the diabetes meds I was taking. This all happened before I lost weight. And after I lost a lot of weight my blood pressure also improved a lot (on the same meds), and my blood lipids (cholesterol) improved dramatically, especially my HDL and triglycerides.

The key to losing weight without hunger is getting access to your body fat. And the key to that is not eating carbs (both simple sugars and complex carbohydrates), which all convert to glucose. Eating carbohydrates has two effects: 1) they cause the pancreas to secrete insulin which carries the glucose (that the carbohydrates all break down into) to their destination cells. These carbs provide “quick energy.” Our body “craves” them (making us “feel hungry”) if it is in a “glucogenic” state because it relies on glucose as the primary source of energy; and 2) when the body is in a glucogenic state, the insulin blocks fat (both our body fat in storage and that which we eat) from being broken down and used for energy. If we have enough “ready energy” from carbs, we don’t need to use stored energy from body fat. It’s the way our bodies work. Our body fat remains as stored fat, and the fat we eat and the carbs we overeat make more body fat.  Insulin stops our body from being in a “ketogenic” state where it burns both the fat we eat and our body fat for energy.
So, by eating a VERY LOW CARB diet, and losing a lot of weight, all these good things happen. My body is happy. My DOCTOR is happy. I have lots of energy, and I am much healthier today in every sense (BS, cholesterol, BP) than I was when I was fat and heavily medicated. All I had to do was take charge of my own health and use the internet, my meter and my scale to figure out what to do. Your meter and your scale will give you the feedback you need too, if you decide not to be scared and to take control of your own health and what you put into your body. It’s your life, after all.             

© Dan Brown 11/3/12


  1. Excellent post! You made it very clear. Although I do not have diabetes, I have a husband and father who are. I will be sharing this post with them.

    1. Thanks, zanjabil. It's comments like yours that keep me writing. Tell your friends about The Nutrition Debate too*. It is also very encouraging to see my viewership increase.

      * If any of them are a little or a lot overweight, or have "high cholesterol" (especially high triglycerides and low HDL),is is likely they have or are developing Metabolic Syndrome, a precurser to Type 2 diabetes. I have written alot about Metabolic Syndrome multiple posts. See the Index of Columns in the upper right hand corner of the blog for a list. I think #9 would be a good place to start.