Wednesday, June 5, 2013

The Nutrition Debate #114: My Insulin-dependent Type 2 Pharmacist

When I was first diagnosed a type 2 diabetic in 1986, my doctor gave me a prescription for an oral anti-diabetic drug (Micronase, a sulfonylurea) and another for a meter and test strips. I asked the pharmacist, a friend, for his advice on which meter to buy. As we were looking over my choices, to my utter amazement he mentioned to me in passing that he was also a type 2 diabetic – in fact, an insulin-dependent type 2 diabetic.

In retrospect, I’m not sure what was so shocking to me: Dick wasn’t especially fat. He was overweight but not more than “normal” for someone of our age and generation. We were both in our mid-40s. Maybe what shocked me was that his disease had ‘progressed’ as far as it had; was ‘this’(becoming insulin-dependent) an omen of what was to come for me? Maybe that was Dick’s message to me. If so, it was a friendly warning, and it worked. I never forgot it.

After buying my meter and start-up supplies from Dick, I went into a mail order program for ongoing drugs and supplies and never had occasion to discuss the disease we shared again. Years later, Dick retired and moved to Florida. In 2010, I read in the local paper that, “after a long illness,” my former pharmacist and friend had died at age 72 (my age today). I don’t know this for a fact, but in all likelihood, Dick died of one of the complications of the disease we shared, type 2 diabetes mellitus.

I recall and tell this story because that is how I got into writing about type 2 diabetes. I was initially stunned that this disease had advanced in my friend to the point where he was insulin dependent. And today, knowing what I know and what I think he should have known (as I see it today), I am flabbergasted that Dick allowed his disease to progress to the point that he was insulin-dependent, and then to where he likely became a victim of one of its tentacles: the myriad causes of morbidity and all-cause mortality that are associated with “controlled” diabetes – “controlled,” that is, as defined by the medical establishment and our government. His loss was such a waste, and so unnecessary. With Dick, it was personal for me, but this is a tragedy of immense proportions being repeated all over the world today, and it doesn’t need to be

So, a few weeks after learning of his death, I was talking informally with the publisher of a local weekly newspaper who “knew” me, and I him, by reputation only. He knew me because he had read many letters-to-the-editor that I had written to another then-defunct weekly. He knew that I knew how to write, and he invited me to write “on any subject” for his fledgling newspaper. Thinking of my friend Dick, the insulin-dependent type 2 diabetic pharmacist who never should have allowed his diabetes to progress to that point, I said that I wanted to write about diabetes. I wanted to educate people so that they did not have to blindly follow the prescription for “control” that leads to more and more maxed-out anti-diabetic medications (up to 3 types, usually) – and then to becoming insulin-dependent – all the while allowing blood glucose levels, that are dangerously high on average, to course through the veins doing untold damage, until it is too late

There is an alternative. We know it today. To be fair, “low-carb” and Atkins were “out-of-favor” in 1986 when Dick was already insulin-dependent. But today, we (many practitioners and patients) know that “progression” is not the natural or necessary or inevitable course of type 2 diabetes, IF WE TAKE CORRECTIVE ACTION. Unless you have an enlightened physician, or you are willing to “go it alone,” that is an unlikely scenario. But, if you decide to take charge of your own health, and avail yourself of all the resources (on-line especially, but there are many good books as well), you can beat this thing. You can put your type 2 diabetes in remission. And along the way, you will lose a lot of weight easily and greatly improve other health markers such as blood lipids (cholesterol) and high blood pressure, as you lose weight.

As my regular readers know, eleven years ago I was maxed out on two anti-diabetic medications and starting a third and had A1c’s in the 8s. I was also, at 375 pounds, morbidly obese (BMI=52), had borderline cholesterol, and was taking 3 BP meds and was still poorly controlled. Today, my A1c is 5.6, I weight 235 (BMI=33), I’ve doubled my HDLs and cut my TGs by 2/3rds, and my BP has dropped from 130/90 to 120/80 on the same meds. And I feel great. I am healthier today at 72 than I was when I retired 10 years ago. THE SIMPLE REASON: I changed from eating a “balanced diet” to a “Very Low Carb” diet.

The key to a healthy body is what you put into it. Whole foods are good, in fact essential, to transforming our health. If you are a little overweight, with marginal cholesterol, or mildly elevated blood pressure (symptoms of Metabolic Syndrome), you may well be pre-diabetic, or even an undiagnosed full-blown type 2. Ignore carbohydrate intolerance at your peril. You can live and eventually, but prematurely, die a diabetes related death, as Dick did, if you continue to eat a “balanced” diet, or you can wake up and do something about it. I did.
Do you track your blood sugar levels as a pre-diabetic or diabetic? Have you experimented with reducing the carbs in your diet?

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