Sitting next
to a good friend – waiting for a memorial service to begin – I asked her if she
was pre-diabetic. Huffily she replied that she was not! Her fasting blood
sugars were all in the “low hundreds,” she said, which her doctor told her was
okay. She’s happy because she thinks
she’s avoided the dreaded T2 diagnosis and the drugs. But she’s “a little”
overweight, like most of us, so I supposed she might also be a little Insulin
Resistant. And, of course, she was pre-diabetic.
Tragically,
this is how the Medical Treatment
Paradigm for Type 2 Diabetes works, historically and for the most part
as it exists today. The doctor might
have told a patient with a blood sugar in the “low hundreds” to “lose weight
and move more.” But my friend is in her mid-eighties, still working hard, and
no doubt very glad to be alive and declared “well.” A good doctor
might also have counseled my friend to take Metformin and eat fewer carbs,
but given her age and the new, very
lax ADA Standards of Medical Practice for older people, she probably didn’t.
Doctors are
taught to diagnose disease and treat symptoms by prescribing medicine. But almost
all of us are “a little” overweight, and everyone is getting older, so
what’s a doctor to do? Prescribe Metformin for every one? Ironically, that’s
not a rhetorical question. There’s evidence that Metformin extends
longevity even in a non-insulin resistant population. It's been suggested in this peer-reviewed article
that maybe everyone should
take Metformin. It’s cheap and, except for brief intestinal distress in about
20% of those who start on it, it has no other side effects.
But even in
the best of circumstances, in our 40s
when we start to develop Insulin Resistance and put on a few pounds, a doctor
today would still just counsel “diet and exercise,” and when that fails
– as it invariably does – initiate drug
therapy. And Metformin is the
first line of pharmacotherapy recommended almost universally. In the
clinical world the debate these days is what should be the 2nd and 3rd course of oral medications, before the doctor begins a more advanced drug like an injectable GLP-1
incretin mimetic, or an SGLT-2, and finally, insulin therapy.
This is how
the Medical
Paradigm dominates the treatment of Type 2 Diabetes. We all wait
too long to start taking it seriously, and consider treating Type 2 Diabetes) as something doctors do.
Ironically, it is totally lost on us (and the doctors) that the reason we gained weight was a due
to a medical
condition called Insulin Resistance, whose best MEDICAL treatment
is a Lifestyle Change: a change in our DIET. Weight gain and Type 2
Diabetes both arose because for years we ate way too many refined carbohydrates
and simple sugars. That’s why we got fat and sick.
The Dietary Treatment Paradigm for
Type 2 Diabetes is rarely suggested in the doctor’s office. There are many
reasons for this, but suffice it to say it is both “safe and effective.” And so
long as YOU follow this dietary “treatment” (eating Very Low Carb), you will lose weight (a lot
of it, if you want) and your blood
sugars (e.g, your A1c) will get much better. Many people report
A1c’s below the pre-diabetic threshold (5.7%). My first A1c, taken by an
endocrinologist more than 25 years ago, was 8.9%. Last December it was 5.0%, rock
solid normal…and clinically, non-diabetic.
So, the
question arises: What will it take to bring about a revolution in the basic
principles and practices of medicine to make this Paradigm Shift, a
shift from the Medical to the
Dietary Treatment for Type 2 Diabetes? It does not require a shift in all
the “principles and practices of medicine.” It is only because TYPE
2 DIABETES IS A DIETARY DISEASE that a change
of diet is needed. Until doctors make this shift, patients
must learn that TYPE 2 DIABETES IS “REVERSIBLE” THROUGH DIET and then take
responsibility for their own health at every meal. Treating an elevated blood
sugar with drugs, because “that is
something doctors do,” is “old school.” Until that day comes, the protocol for
diagnosing Type 2 Diabetes and treating it with drugs will continue to be the Medical
model.
Doctors likewise need to be reminded that Hippocrates,
the Father of Medicine, said, “Let food be thy medicine and medicine be thy
food.” If you have fasting blood sugars in the “low hundreds,” you have
Insulin Resistance. You’re “Pre-diabetic.” And if you want to avoid the clinical diagnosis,
and the complications, now is the time to change
what you eat. Don’t wait before you graduate to finger sticks and a cocktail of drugs…and
worse.
No comments:
Post a Comment