Monday, June 10, 2019

Retrospective #115: “My Doctor Never Told Me…”

Sound familiar? In a class given by a Certified Diabetes Educator (CDE), I heard the phrase “My doctor never told me…” a few times from newly diagnosed Type 2 diabetics. I sensed palpable anger among my classmates. They are still in shock and looking for help trying to cope with how to live with this disease for the rest of their lives.
I know this from personal experience. I was diagnosed a Type 2 in 1986 at age 44. An observant physician looked at my weight (300 pounds), and my blood pressure, and decided to check my fasting blood glucose (FBG). Although the FBG standard was higher in those days, he decided to treat me for Type 2 diabetes. I don’t have that lab report, or even remember that doctor’s name, but this guy was ahead of his time, and I am grateful. I was lucky because my doctor acted, proactively, on the clinical signs of Insulin Resistance. He did not take a “wait and see” attitude.
Neither do I recall what, if anything, he told me at the time about my weight, or my high blood pressure and elevated blood sugar. Whatever it was, I ignored it. I just filled the prescriptions and took the pills as directed.
Five years later I was in a new city, had a new job and a new doctor. At my first visit (on my 50th birthday), I was 310 pounds, my BP was improved but still too high, and my fasting blood sugar was “out of control.” My new doctor added a blood pressure med, upped my diabetes meds, and sent me to see his Registered Dietitian.
For the next 11 years his treatments for blood pressure and blood sugar had some salutary effects. In 2002, my blood pressure was 140/90 and my fasting blood sugar was 81, but my weight had ballooned to 375 pounds. All his efforts over those years to get me to lose weight were to no avail. His Registered Dietitian had advocated a restricted-calorie, “balanced diet” and regular exercise. What would you expect?! And that’s still the drill today.
Anyway, I don’t berate either of these doctors. They diagnosed and treated my hypertension and Type 2 diabetes. They did what they could. Losing weight was not something they could do for me. That was my responsibility. He had been telling me to lose weight for 11 years. He had done all he could do to get me to do it. He did tell me.
So, this is not a case of “My doctor never told me…” This is a case of my doctor didn’t know what to tell me. He didn’t know (or had forgotten) how human physiology works when a patient’s glucose metabolism is broken by Insulin Resistance. He didn’t understand that the patient is thereafter, forever I’m afraid, Carbohydrate Intolerant.
So, he just wanted me to lose weight. By increasing dosages of oral medications, he had my diabetes “under control,” he thought. But he had the thought, as he suggested one day in 2002 after reading a story in the New York Times, that, maybe if I lost weight by eating Very Low Carb (VLC), “it might even help your diabetes.”
Well, little did he know how right he was. Of course, eating VLC did make it easy to lose weight, and, in the first week virtually I eliminated the need for oral antidiabetic medications. And, as I adapted to this Way of Eating, my HDL doubled, my triglycerides dropped by two-thirds, and after I Iost a lot of weight, my blood pressure dropped.
Essentially, my Type 2 diabetes was put in clinical remission. How did all this happen? I took responsibility for my own weight. My doctor suggested VLC, even if for the “wrong” reason, but after I started it, he just sat back and watched…and smiled every time he saw me. He never again had to cajole or badger me to lose weight.
Occasionally he would ask me, “How do you do it?” And I would just smile and answer, “It’s easy, doc! You just stop eating carbs. After a few days, you never feel hungry again.” And that’s the truth. You switch from being a “sugar burner,” with constant cravings for sweets and snacks, to being a “fat burner.” You live off your stored body fat.
In 2012 (when this was originally posted), and maybe even today, your doctor may or may not approve of your eating VLC. Doctor’s aren’t trained in nutrition, so their dietary advice would likely be wrong anyway. But the bottom line for both you and your doctor is results. If you eat Very Low Carb, your results (weigh-ins and lab reports) will tell him or her that what you’re doing is right. And they’ll say, “Just keep on doing what you’re doing.”

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