Wednesday, March 26, 2014

The Nutrition Debate #195: “I did it myself, with no help from doctor”

The other day I had an email exchange with someone I’ve never met. It began like this:
“I was diagnosed with Type 2 Diabetes 9 months ago. Dr gave me 3 months to see what a diet might do before putting me on meds. Just stopped eating bread, potatoes, pasta, and ice cream. Been 9 months, lost 20 pounds, A1C totally normal (5.7) and fasting glucose at 100-105 over 3 blood works.”
I said: “Good story. And your ‘diet’ doesn't sound too restrictive. That's good. One thing I'd like to know is WHO told you to try ‘low carb.’ Was it someone specific (e.g. your doctor), or was it just what you've been hearing and reading increasingly in the media these days. Your answer is important to me.”
He replied: “I did it myself with no help from Doctor. Just made sense since I was a big white carb eater and knew that was a big sugar source.”
There, you see. I’m not that crazy fanatic that you all think I am. And youdon’t have to be one either. Here’s this regular guy, with a regular work and family life, who saw what had happened to him (he was “diagnosed”), he saw what he was doing (he was a “big white carb eater”), and he saw where it was leading (being put on meds by his doctor).
So, he decided to DO something about it. He “just stopped eating bread, potatoes, pasta and ice cream” for 9 months and lost 20 pounds! And his A1c’s returned to “normal” (clinically “non-diabetic” on the ADA scale), and his fasting blood glucose just barely inched into the low end of the pre-diabetic scale “over 3 (successive) blood works.” That, as I said, is a “good story.” It could be yours too, if you did the same.
Notice, though, that his doctor didn’t give him orders to eat low carb. He just gave him 3 months to get his act together before putting me on meds.” I think this is typical. In fact, I think that’s the ADA protocol: Try “lifestyle changes” (diet and exercise) first, and then start a regimen of meds. The problem is thatthe ADA medical protocol doesn’t advocate the right dietary changes.Surprised? No. Doctors aren’t trained in nutrition. But the ADA’s newNutritional Guidelines” (#155, #156#157)prepared by an enlightened group of the ADA’s RDs and CDEs, however, no longer prescribe a “one size fits all” approach.  So, your doctor is now free to sanctionand even advocate, low carb lifestyleif she wants to.
In my opinion, though, It’s immaterial. What your doctor wants to see areresults. Good labs: A1c’s and fasting blood glucose, and other markers, like weight, waistline and BMI. And blood pressure. She is probably also testingyour cholesterol, and if she is paying attention to more than total cholesterol and LDL, she will note improvements in HDL and triglycerides, as well as inflammation markers like hsCRP. She will also likely test kidney and thyroid function annually.
So, how complicated is this? To quote my correspondent: “(It) just made sense since I was a big white carb eater and knew that was a big sugar source.” What did he have to do to turn his health around? He Just stopped eating bread, potatoes, pasta, and ice cream.” In nine months he lost 20 pounds, just doing this (I take him at his word). But whatever, the important thing is, he said“I did it myself with no help from Doctor.” I would argue, though, that the doctordid help. He made an explicit threat: “Dr gave me 3 months to see what a diet might do before putting me on meds.
That kind of motivation (coercion?) works for many people: the kind of people who want to have control over their own lives, who don’t see themselves as victims, who don’t want to be dependent on others or other things. I rememberthinking when I was in my early 40s that I would never be someone who had to take medications or supplements every day for the rest of my life. LOL. Such is life. We are invincible, until we are no longer invincible. But as long as I can, I want to be able to say, as my email friend” (and new reader) said, “I did it myself…” I say, props to you!
Note to regular readers: With this post (#195) I will begin to post shorterentries to my blog, still twice a week. They will generally be 800 to 850 wordsin length instead of the 900 to 1,000 words they have been for the last couple of years. I am not getting tired of writing; I just want to try this out to see if myon-line readership increases. It will also conform my column to a more typicallength for print publication, as a newspaper publisher once told me. It’s just an experiment.

1 comment:

  1. Make sure to inform your primary care physician regarding any current and past medicinal services issues or concerns. It's essential to share any data you can, regardless of whether you're humiliated. Make sure to tell your PCP if your medication causes you to feel wiped out or if you figure, you might be adversely affected by it.