The other day, on Facebook, someone managed to find that particular button in me, and didn’t just press it...but started HAMMERING ON THE FUCKER!! My major pet peeve, my major PISS OFF...is people who act like they know jack shit about diabetes...WHEN THEY DO NOT LIVE WITH THIS BEAST!!
The militant Vegans are about the absolute worst in this regard...they seem to believe that a Vegan diet cures everything. It does not. And a Vegan/vegetarian diet is probably not a very good idea for a diabetic. And sorry, but it is NOT a natural human diet. We are omnivores. But that is another topic, and I do not wish to go off on that tangent here, so I digress.
Before I continue, I should point out a few things...a few things about diabetes, a few things about me...and a few things about what I am discussing in this Diary.
First, I AM NOT A DOCTOR!! Nothing I say here should be taken as any kind of medical advice, official or otherwise. Second, as I am a Type 2 diabetic...as 85-90 percent of all diabetics are...a lot of what I am discussing pertains to Type 2 diabetes specifically. Some of the things we do, as Type 2’s, to manage our condition, also work for Type 1’s...but the mechanics of Type 2 are very different from Type 1, which is actually an autoimmune disorder. So when I am speaking about the process of diabetes in one’s body, I am referring to Type 2.
In the simplest terms, Type 2 diabetes is a deficiency in carbohydrate metabolism. We do not process carbohydrates in the way normal, non-diabetic people do. We must limit our intake of carbohydrates. Some moreso than others, diabetes is NOT a one-size-fits-all condition...and neither should our treatment be. Certainly, a diet high in carbohydrate is not very good for anyone; this goes triple for diabetics. Some carbohydrates are better than others, but in the end, all carbohydrates affect us in deleterious ways. High blood sugar is only the SYMPTOM of the actual problem.
So when militant Vegans claim they can cure or reverse diabetes with a vegan diet...or when snake-oil salesmen like Mike Hucksterbee claim to have a “cure” for diabetes, one that you can buy for just 99 bucks...know that the only person that is going to benefit is the person who is peddling the “cure.” And it is INSULTING to a diabetic, to imply that you, a non-diabetic...know more about managing the condition...than those of us who live with it. And it is even worse, when you are a Type 2 yourself...one who should know better...and you’d rather turn a buck than give truthful information...like Mike Hucksterbee...or, more recently, Jerry Mathers (formerly The Beaver.) People like that give false hope, especially to newly-diagnosed diabetics, who will do themselves far more favors if they learn, and undertake, the lifestyle and dietary changes needed to manage this condition.
There are a lot of myths surrounding diabetes. The biggest of those myths is that diabetes is a “fat person’s disease.” It isn’t. But this myth which persists, leads to a stigma we diabetics must face, and it DOES affect the treatments that are available to us, and the treatment we tend to get...from doctors, from people we know, and from complete and total strangers. Including the aforementioned “geniuses” who tell US how we must eat and live in order to “reverse” or “cure” our diabetes. The main way in which this stigma affects us is that, because it is assumed, by the general public, that diabetes is a fat person’s disease...it is not a very far “logical” leap that we must have eaten our way to diabetes...and so we DESERVE all the suffering we now have.
We diabetics are seen as fat, lazy slobs, who...because we did not push our plates away, and because we were couch potatoes...we are somehow “failures” — and we brought it all on ourselves. So we do not deserve any sympathy (we get lots of pity, though) and we do not deserve any concentrated effort to get at the root of what is causing this epidemic. And we deserve it that the Big Pharma companies pick our pockets every day, making vast sums of money off our suffering. And then you have the snake-oil salesmen who want to turn a fast buck peddling bullshit “cures.” Let me say this: If diabetes could be CURED...then we could go back to what we had been doing before with no ill effects. We CAN’T. Not that those of us who have managed their diabetes as I have...would WANT to go back to the way we had been living, anyway.
As a non-diabetic person, you can scarf down three Krispy Kremes, and maybe get a high bloodsugar reading of about 150. If we tried it, we’d end up around 400! And I don’t care what miracle “cure” you followed, or for how long...this is what will happen if you go back to what you were doing. SO IT CANNOT BE CURED. It can be put into “remission,” it can be “managed” — you can have very tight control. And it is possible to live — and live well, with diabetes. BUT IT CANNOT BE CURED.
But what, actually IS diabetes, how does one get it? As I said, simply, diabetes is a malfunction of carbohydrate metabolism. Your body is literally tricked into working against you. It is a process that ramps up for years, undetected, in your body...because it takes a long time before the SYMPTOM, high blood sugar, actually shows up and begins causing problems that get noticed, and eventually get you diagnosed. Four out of five diagnosed diabetics are obese. But it is that process that causes the obesity...and not the obesity causing the diabetes! If obesity, by itself, got you diabetes...then why don’t ALL fat people get diabetes? Why do thin people get diabetes...even Type 2? Type 2 diabetes can be basically summed up as insulin insensitivity.
What is insulin, and what role does it play in diabetes...and in obesity? To explain that, I have to get to the basics. There are three basic macronutrients that all food (fuel) we consume consist of: fat, protein, and carbohydrate. Carbohydrate is the body’s first and preferred fuel, because it is broken down quickly, and is readily available to your body. Protein breaks down slower. Both cause your body to produce insulin. Fat, however, does not cause the production of insulin. And if you really want to manage Type 2 diabetes well, you do not want to increase your production of insulin. Which is also why I resist any treatment with insulin. It makes no sense to me. The problem is that your are not utilizing the insulin your body is already producing...so WHY would you want to put even more of it into your system?
Insulin is a hormone, produced by the beta cells in your pancreas..and it allows glucose (your body’s basic fuel) to move from your blood into your cells. Those of us who are insensitive to insulin...the transfer of glucose from blood to cells is impaired, and so our own bodies produce even more insulin...to counteract the higher level of available fuel in our blood. Meanwhile, we are starving on a cellular level. Our cells are not getting the fuel they need, and the glucose stays in your bloodstream...leading to the higher bloodsugar which is only the symptom, and not the actual problem.
Insulin is also the “fat-storing hormone.” If you have excess insulin floating around in your bloodstream, your body assumes you have enough fuel, and do not need more...and this sends fat-storage into overdrive, leading to the weight gain and obesity. So now we are obese...and we are also starving! And this is why carbohydrates are not good for a diabetic, and why a vegan/vegetarian diet, consisting of mainly carbohydrate...is not good. Carbohydrate breaks down quickest...therefore is more bio-available to your body quicker...which leads to a spike in the bloodsugar level...and an attendant quick release by your body of insulin. Protein, which breaks down slower, does not cause this spike. Fat, which does not cause insulin production at all...well, you can do the math on this. This is why many of us well-controlled diabetics follow a low-carb/high-fat diet. If your carbohydrate consumption is low enough, you force your body into a state known as nutritional ketosis. This is a process where your body is now fueled by ketones, rather than by glucose.
Nutritional ketosis should not be confused with Diabetic Ketoacidosis, a life-threatening condition. Insulin itself, serves as a feedback loop to stop the production of ketones. If glucose is available to your system, you produce insulin, which shuts down the production of ketones...the body is actually pretty smart! For a Type 1, however, who does not produce their own insulin...the ketone production is NOT shut down. So now they have high glucose not being used in their system...and high levels of ketones...and this is diabetic ketoacidosis. It is not impossible...but it is VERY difficult, for a Type 2 to experience diabetic ketoacidosis.
Nutritional ketosis is the concept behind the Atkins Diet. My own diet is actually of my own creation, and incorporates elements of Atkins, as well as The Zone. I developed my own plan of treatment through talking with many diabetics, online...and picking their brains...finding out what was working best for them. And they were able to turn me on to medical studies and reports, from which I gleaned much useful information...and from which, in conjunction with my own medical team, I developed my treatment plan. My team consists of my primary care physician, a dietician, and an endocrinologist. But the best ally I have in my own management is my glucometer.
And this is why everything I have said to this point is so important: If I have a choice between listening to YOU (whoever you may be) or listening to my glucometer...I AM LISTENING TO MY GLUCOMETER...thank you very much! And you insult me when you act as if you know something about managing or curing diabetes...when YOU do not live with this beast! You insult me because you imply...even with the best of intentions...you imply that I do not know how to manage my own condition...and that YOU know better than me, better than my doctors, better than my glucometer! And you don’t.
So...this is my treatment plan:
1. Limit of 1810 calories a day (this level was determined by having a full metabolic workup by my dietician)
2. Limiting my carbohydrate intake to no more than 60-90 grams a day (about 20% of my daily calories come from carbohydrate, when I am on target.) This level was arrived at through trial and error, by listening to my glucometer...and finding out how many carbohydrates I can consume before I reach, for me, unacceptable levels.
3. Intermittent Fasting, as described by Dr. Jason Fung. The concept behind Intermittent Fasting (IF) is to lower the level of insulin in your body...thus improving your sensitivity to insulin. I undertake 2 24-hour fasts every week. This is far different that the ADA-recommended 3 meals and two snacks every day...which leads to your body never having any break from having tons of insulin swilling around in your bloodstream!
4. Metformin, 1500 mg a day, taken 500mg three times a day.
5. Brewer’s Yeast — there is a compound in brewer’s yeast which regulates bloodsugar. This same compound can be found naturally in portabello and shittake mushrooms, if you like mushrooms (I don’t, hence the brewer’s yeast.)
6. Diabetic-specific multivitamin. This multivitamin is formulated specifically for diabetics, and has higher concentrations of certain trace minerals that our bodies have a harder time absorbing (the medications we take often interfere with the absorption of these trace minerals.)
7. Vitamin D3 supplement, as cholecalciferol, 1,000 IU once per day.
8. Intensive exercise routine. I now walk 8-9 miles a day...I am active about three hours a day. This is essential, because exercise FORCES glucose into your muscle cells, and out of your bloodstream, even without insulin.
You will notice there is no insulin in my treatment regime. I have never taken so much as a drop of insulin, never given myself a single insulin shot and I intend never to have to.
So, how is it working?
I was diagnosed just over nine months ago, with a fasting blood glucose of 388, an A1C of 13.2 and I weighed 304.5 pounds, with a BMI of 42.5 In nine months, I have lost 118 pounds, my weight is now 186.4 pounds, I have a BMI in the 28-29 range at the moment. My fasting glucose tends to run 85-95 My A1C is down to 4.7 — most healthy, non-diabetic people have higher A1C’s than I do at the moment. So do you see why it is a MAJOR PISS OFF for me, when people who do not live with this beast act like they know the first thing about how to manage this condition...and that, by extension, I don’t? You do not achieve the results I have achieved without knowing a thing or two...and without doing a lot of the right things!