Mixed Messages, Diabetes, Food, and Pharmaceuticals

Seven months after being diagnosed with Type 2 Diabetes, my A1C blood test number has gone from 8.6 to 6.8.  gty_sugar_jtm_130918_16x9_608

Thanks you.  Thank you very much.

And yes, this is a lot of improvement in a very short time — especially since it’s only diet and exercise that have changed to achieve this difference. I wanted so badly to NOT take diabetes medication (almost all of them have dangerous potential side-effects, and most have complications to respiratory systems — and I’ve already got enough problems with life-long asthma.)

I made a choice from the moment the doctor told me I had serious Type 2-D that I needed to fix this with diet and exercise if at all possible, or else resign myself to oxygen tanks and a life lived while wheezing and coughing and passing out from lack of oxygen.

From the beginning, I have read everything possible on diabetes and controlling it — I started with the Mayo Clinic’s excellent foundation book.  I read online.  I read blogs, discussion groups, Facebook pages and leaflets at my local doctor’s office.  I read cookbooks published by and with the approval of the American Diabetes Association.  I signed up for regular emails full of “tips and tricks.”

And I resisted loudly and frequently my physician’s urging to start using diabetes meds.  From the beginning, this was the “treatment of choice” as far as she was concerned.  Resisting drugs that could potentially save my life from the damage associated with high blood sugar was not something she was willing to let me do — at least not for very long.  And for most people, this is probably something completely necessary.  And this is in large part how I ended up with this person looking after my health.  I’m stubborn, and I believe I’m smart enough to handle almost anything that can be handled by brains and will — and she is willing to both listen, and argue me down if necessary when more than brains are required.

I convinced her to let me go for 3 months (the amount of time between one A1C test and the next).  She agreed to this, but only if I emailed her 4 daily blood sugar test numbers.

And after 3 months, my 8.6 had dropped to 8.0 — .6 is not a trivial lowering of this number.  The goal (and the numbers typical of those without any diabetes or pre-diabetes) is between 4 and 6.  Most people (according to several online discussion groups) lower their A1C between  .1 and .3 in a 3 month period — so my .6 looked good enough that I evaded the drugs for another 3 months.  Lowering from 8 to 6.8 is almost unheard of.  My doctor, her nurse, my dentist, and my dental hygenist all practically cheered and danced in the street.

😀

It also doesn’t hurt that I’ve lost over 35lbs, and lowered my blood pressure so much that I’ve cut my hypertension meds in half.

But I was seriously motivated.  I don’t want to live my life with any more medications or medical aparati apparatusses  — stuff — than I absolutely have to.  Thanks, but no thanks.

But aside from carefully pointing out the potential dangers of walking around with excessive sugar in my blood — and there are many — and giving me the time to change my evil ways, the only other thing the doctor did was refer me to a nutritionist.

And while I’m sure there are a lot of very qualified, helpful folks doing the works of trying to save people from their own terrible eating habits — I made most of the changes I chose based on reading and talking with my best friend who was a nurse for many years.

The doctor (who, thank heavens, listened and agreed to let me try/experiment on my own) — and the nutritionist (who didn’t know me or anything about my other health issues) — both saw the road ahead paved with pills, capsules, and injections.

And they said so.

Medication is the first and chosen point of attack.  Evidently.

Yes, diet and exercise can be effective means to controlling Type-2 Diabetes.  It’s just not expected to work most of the time.

Which leads me to my biggest question about all this tangle of information and treatments.

If someone who is gluten intolerant is expected to dodge gluten at every spoonful….  If someone who is lactose intolerant is expected to avoid dairy/lactose like it is a flaming bullet….  If someone with a peanut allergy can sue an airline if they so much as offer a 3.4oz packet of peanuts….

Why is it that half the emails I get with “tips & tricks” for controlling Type-2 Diabetes contain recipes full of sugars, fruit, flour, rice, and pasta?

They usually start out talking about “25 Best 100 Calorie Snacks” or “Quick Diabetic Dinners” or “Your Slow-Cooker is Your Best Friend” headlines.  But they quickly degenerate into “Nearly-Cajun Red Beans & Rice” “Almost Enchiladas”, or “Faux Mac & Cheese.”

Right.  Yum.

So if it’s true that T-2-D can be thought of as an acute sensitivity or resistance to sugar-carbs (there are 3 types of cabs — fiber-carbs, sugar-carbs, and all other carbs) — then why isn’t every effort made by the medical community to steer diabetics away from all sugar carbs?

I know the “resistance” and “extreme sensitivity” or “intolerance” phrases are an over-simplification of a complex physical problem, but for the purpose of this question, it’s close enough.  It behaves like an intolerance.

For reference purposes,

  • a 20oz bottle of regular Coke contains 53 grams of sugar-carbs,
  • A medium Roma apple has 5g of fiber-carbs, and 17g of sugar-carbs.
  • 4 oz of Treetop apple juice has 36 total grams of carbs — 33 of them are sugar-carbs, and 0g of fiber-carbs.

When I finally got through all the reading and sorting and experimenting with my diet — my maximum sugar-carb number is 40/day, my maximum total carb number is 190 grams, and I eat between 90 and 110 grams of fiber every day (mixed between soluble and insoluble fiber, but mostly soluble — more on that later.)

It’s almost impossible to eat real food and not get a few grams of sugar-carbs.  That doesn’t mean I’m adding sugar to my coffee — it just means that tomatoes and carrots and onions and corn have a lot of natural sugar in them.  Milk products have lactose — which is a sugar-carb.  ALL my sugar-carbs are coming from whole foods that are naturally sweet.

And the fiber is not there to promote regularity.  (though it pretty much takes care of any potential problem as a side-affect.)  The purpose of the fiber is to SLOW DOWN the digestion process that converts food into useable energy (sugar).  Soluble fiber (like the middle of a green pea) keeps dietary sugars from hitting your bloodstream too fast.  And insoluble fiber (like the outside “skin” of the green pea) speeds the digestive track so that foods are flushed out of  your system before that slowed conversion can effect your blood sugar.

I didn’t hit that high fiber number overnight.  Every 2 weeks for 3 months I increased my daily number by 10 grams.

DO NOT MAKE A CHANGE OF MORE THAN 10G/DAY.

I promise you will regret it.

I also added a daily dose of probiotic to my diet.  Because it is unanimously seen as a good idea.

But again, don’t add too much at a time.

You’ll regret that, too.

I speak from experience.

———-

But as far as I can tell — nobody out there is saying all this to people who have been diagnosed with Type-2 Diabetes.  At least nobody said it to me.

And they should have.

Not everybody diagnosed with T-2D is as motivated as I was to avoid medication.

But they should be.   Doctors should be.  The ADA should be.  The FDA should be.  Homeland Security should be.

There’s a whole encyclopedia of reasons why everybody, diabetic or not, should cut down the number of sugar-carbs they’re eating/drinking.  Sugar is a natural inflammatory — sugar, fuel, burning — see the pattern?  So everything connected to inflammation from heart disease to migraine headaches is chemically tied to the amount of sugars we consume and the way we process them.  That’s the reason athletes load up on carbs (not fiber-carbs) before an event or contest.  There’s a reason kids need carbs to function and grow.  There’s a reason northern peoples stock up on carbs to forestall hunger through the lean winter months.

And there’s a reason to exercise if you’re Type-2 Diabetic — the exercise burns the sugar out of your system because it uses it as fuel.

But I didn’t hear that from my doctor or from the nutritionist I was referred to.

THIS IS COMPLICATED AND INFORMATION-HEAVY STUFF.  I know that.

And I know that Average Joe and Average Jane probably don’t read as much as I do.

So when Average Joe & Jane turn up with T-2 D, they’re not going to know this stuff.   And they’re not going to be told (evidently) by their doctor or their nutritionist.  And they’re not going to read it for themselves.

SO WHY THE HELL NOT?

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