When I got diagnosed with diabetes, on March 31, 2015, I thought my world had just about ended. I was crushed and devastated. I was fearful. That did not last long, though. I became angry and stayed angry. To this day, it is that anger which helps me to fight my diabetes. I fight it with everything I got, I fight it like the vermin it is. Diabetes is an unwelcome guest in my body. I will never be “normal” again.
That does not mean I have to accept the eventual complications that can result from diabetes…I can fight as hard as I can to prevent them. To that end, I began to seek out other diabetics, mostly on-line, in order to pick their brains, and to know what was working for them. I also assembled a healthcare team, which currently includes my PCP, an endocrinologist, and a dietician. At some point, I may need to add an opthalmologist and a podiatrist to the team.
The first thing I decided was that I was going to be the captain of my healthcare team…and I was going to do what I felt was best for me, given all the information I was able to obtain, and my own goals…taking into account my own aversions as well.
The first thing I decided was that I was NEVER going to do so much as a drop of insulin. I am incredibly needle-phobic, and I know that would be very hard, if not impossible, to overcome…for me. It’s one thing to do the finger-stick for testing – that is lightning-quick, and you don’t have to push anything in, and you don’t have to worry about air in a syringe or pen, and you don’t have to worry about hitting the right spot, etc. It’s bad enough when I go to donate blood, or get shots from the doctor, or get bloodwork drawn…but at least, with that…I can clench up and look away. I don’t see how you do that with giving yourself a shot of insulin, so I decided early on I was going to do everything possible to avoid EVER having any need for insulin.
Now, Type 1’s cannot avoid the need for insulin, but, as a Type 2, many of us do not need insulin, and it could be argued that none of us really NEEDS insulin. In fact, insulin could be precisely the wrong course of treatment for a Type 2. I will state here that I am not a doctor nor am I a dietician, and I am in no way qualified to give medical or dietary advice. I am, by trade, a medical biller/coder – therefore, as part of my job, I am familiar with medical terminology, disease processes, context, and contraindications. The schooling we get is fairly similar to what a transcriptionist would get. So I am not qualified to diagnose, nor to give any sort of medical or dietary advice. Any “advice” I give here should always be checked with your own healthcare team. I can only tell you what has worked for me…and has worked for the many diabetics I have talked to in developing my own plan of attack.
At diagnosis, five and a half months ago, I weighed 304.5 pounds, and I had a fasting blood glucose reading of 388, with an A1c of 13.2 – these numbers are HORRIBLE!! For perspective, a healthy person has a blood glucose (fasting) reading of 70-110, and an A1c of 6.0 or less. On September 14, I got new official numbers: I now weigh 229.2 pounds (75.3 pounds of weight loss!!) – my fasting blood glucose reading was 96, and my A1c was a fabulous 4.7!!
So, how did I achieve this, you ask? I will tell you what has worked FOR ME. I will also tell you that every diabetic is different…what works for me may work better for you, it may not work as well for you, and it may not work at all. In fact, some of what I am doing can be dangerous, if you have certain other conditions or risk factors, which is why it is essential that you check with your own doctors concerning anything I am doing, before doing it yourself. Just as an example, if you have, or are at risk for pancreatitis, fat is something that really needs to be watched in your diet. I, fortunately, do not have this problem.
So, let me start by telling you what my goals are/were:
- By June 1, 2016 (diagnosis plus fifteen months) I would be off all medications related to my diabetes…with numbers that would make any doctor happy.
- I would be below 200 pounds (a weight loss of 105 pounds…my eventual goal is a weight loss of 155 pounds, I would like to eventually be at 150)
- I would have fasting blood glucose readings in the healthy range, preferably below 90.
- I would be managing my diabetes with diet and exercise alone.
- I would have an A1c below 6.5 (ADA recommends diabetics to be below 7.0)
- I would never need so much as a drop of insulin to achieve this.
Pretty tall order, huh? So how have I done?
As of September 14, 2015, diagnosis plus nearly six months, I am nearing my weight-loss goal, and expect to achieve it far in advance of the June, 2016 deadline. I am down from 2000 mg of Metformin a day to 1500. I am off two out of three of the blood-pressure meds I was on, and my slep apnea has all but disappeared. My fasting blood glucose reading is in the healthy range, although it is slightly higher right now than my goal. The A1c is even better than I expected or hoped for, and I have never used a drop of insulin. So I am on target!
How am I achieving this? I have a several-pronged approach to diabetes management:
- Exercise! I get 2 – 2 1/2 hours A DAY, EVERY DAY, of walking. Prior to diagnosis, I could not have walked three blocks without being out of breath…today, I do 5-7 miles a day (I worked up to this level!!) I split my walking up and do three walks a day, the longest one in the morning, the shortest one at night.
- Low-carb diet. I try to get no more than 20 percent of my daily caloric intake from carbs, and try to avoid simple carbs altogether. The ideal ratio for me is 20 Carb, 35 Protein and 45 Fat. Fat is not the great big bugaboo we have been led to believe it is, although there are certain fats to avoid, I have written a separate article about this. My caloric limit is 1810 calories a day. I aim for 80-100 grams of carb per day as a maximum, and am even happier when I consume less.
- Vitamin supplement – I take a vitamin supplement every day, one that is specifically engineered for Diabetes support. There are certain trace minerals that are affected by the medications we take, and the vitamin I take helps to replenish those trace minerals.
- Brewer’s Yeast – I take brewer’s yeast with every meal. Brewer’s yeast has a compound in it which is also found in shitake and portabello mushrooms that acts to stabilize blood sugar. Because I cannot get past the basic fact that mushrooms are fungus long enough to get them down my throat, I use the brewer’s yeast.
- Intermittent Fasting – I have taken the principles of Intermittent Fasting, as described by Dr. Jason Fung, and put them to use. I do two 24-hour fasts every week. When I fast, I go from dinner of one night until dinner the next night without eating. I am still allowed all the water and iced tea I want, plus my morning coffee, because I am a bear if I do not get it. I do my fasting on Mondays and Thursdays. It is a good idea to have a routine to this, so that it becomes a habit.
The principle behind Intermittent Fasting addresses the very process that is going on in a Type 2 diabetic. It treats the underlying problem, rather than just treating the symptom (the symptom being the high blood sugar.) And the following I am about to write comes from Dr. Fung, and it is why I said earlier that insulin might be precisely the wrong treatment for a Type 2 diabetic.
The idea behind Intermittent Fasting is to lower that amount of insulin in your body for a period of time, in order to decrease your insulin resistance. Insulin resistance is the problem that a Type 2 diabetic has. Type 1’s do not manufacture enough, or any insulin at all, and this is why they need insulin. Type 2’s manufacture enough insulin, but our bodies do not utilize it properly, because we are resistant to it.
What, exactly is insulin, and what does it do? Simply, insulin is a “key” that helps to “unlock” cells to allow glucose to move from your bloodstream, into cells, providing your cells energy. Type 1’s produce little or no insulin, and therefore require insulin. This is not the problem a Type 2 has. In Type 2 diabetics, the insulin is not utilized properly by the body, the cells are not getting enough glucose energy, and the glucose stays in your bloodstream, causing all kinds of damage to your blood vessels, which lead to the myriad of complications diabetics can face. To top it off, you have all this unused insulin also floating around in your bloodstream. And so now you’re gonna push even MORE insulin into your system?? How is this a good idea?
Diabetes in a Type 2 is a really nasty process! Your body literally turns traitor. Your body is TRYING to do the right thing to deal with the problem going on in your body…but what it does turns out to be exactly the wrong thing! And it is a vicious cycle. Here is the vicious cycle:
- Insulin resistance causes your cells to not get enough energy. This causes your cells to issue a false “hungry” alert, causing your liver to release EVEN MORE GLUCOSE into your bloodstream.
- Because you are not properly utilizing the insulin your body makes, you have all this extra insulin floating around in your system. When you have extra insulin floating around in your system, your body believes you have more fuel than you need, and this triggers your body to go into fat-storing mode. (You did not eat your way to diabetes…the process that is diabetes CAUSED your obesity, not the other way around!!)
- As you gain weight and have more fat cells, you become even more insulin resistant. Return to Step 1.
So there is the vicious cycle for you. And Intermittent Fasting is designed to break that cycle. As is the low-carb diet. The body’s FIRST CHOICE for energy is carbohydrates. This is because it is the easiest, most-accessible fuel source for your body. It digests easiest, is broken down quickly, and is bio-available much sooner than proteins or fats. This is also why high-carb meals often do not stick with you long, and you feel hungry again. By drastically reducing your carb intake, you force your body into burning your stored fat…which it totally does not want to do. If you are on low enough carbohydrates, you force your body into ketosis, whereby fat is turned into ketones for energy – instead of getting energy from glucose, now you are getting it from ketones.
Ketosis should not be confused with ketoacidosis. Ketoacidsosis is a risk for diabetics, and it is where ketones are not being used by your body for fuel and are building up in your system. This can be deadly. In ketosis, your body IS using the ketones for fuel. Ketosis is the principle used by the Atkins Diet and other low-carb variations, such as South Beach, and other Low Glycemic Diets. By the way, a sweet, fruity taste in your mouth, or smell to your breath, can be an indication of ketoacidosis.
Because proteins and fats are broken down more slowly by your body (they do not digest as easily, and are thus not as readily bio-available) they stick with you longer, keeping you feeling full and satisfied longer. So there is an extra benefit! Also, because these are not broken down as easily or quickly, you minimize bloodsugar spikes…which is a concern for diabetics.
Some of us, myself included, need to take a fiber supplement when following a low-carb diet. Fiber is one of those okay…complex carbohydrates…and is the only carbohydrates that I purposefully ingest. Obviously all fruits and vegetables have carbs, but fiber supplement is me deliberately ingesting pure carbohydrate. But I never touch sugar. And the carbs in vegetables and fruits are more complex carbs…they do not break down and become bio-available as quickly as a spoonful of white sugar does. Just to illustrate this, place a few bran flakes into a glass of water. Into a different glass of water, place a spoonful of sugar. Which one dissolves quicker?
Anyway, as you lose weight, and as you lower the amount of insulin running around unused in your body, you begin to become more sensitive to insulin, and your body better utilizes the insulin it produces, which begins to reverse the vicious cycle that is the process of Type 2 diabetes.
Don’t take my word for it, my numbers do the talking for me! And everything I have said here can be cross-referenced in peer-reviewed medical articles available on the Internet from sources like JAMA.
One other thing I will say here, and I have said it elsewhere, but it bears repeating: The further away from your plate your food starts, the worse it will be for you. That is because of all the added sugar and added sodium used to help keep the food fresh for long-distance transportation. The closer to your plate your food starts, the healthier it will be for you.
A can of green beans, grown in California, and put on your plate in North Carolina…will not be as healthy for you as the green beans you buy fresh from your local Farmer’s Market. I cannot stress this enough. Buy local wherever possible, or better yet, grow your own! The closer to your plate your food starts, the healthier it will be for you. And try to have your vegetables RAW. Cooking them causes then to be softer, more easily digestible, and therefore bio-available to your body sooner…which can lead to bloodsugar spikes. Carrots are a great vegetable, as is broccoli…but eat them raw, or at least very lightly steamed and still crisp.
Until next time!!