Is Diabetes Progressive?

9/28/07 12:22am

An eloquent expression of the empowerment I try to confer to others. I will refer both health care professionals and patients in need of a positive viewpoint to read this. Thank you David.

Mark Benjes

9/28/07 6:11am

David,

I think part of the problem is that society wants to have an easy magic pill solution for anything. Drug companies promote it, and often Doctors end up promoting it. Even though they mention diet and exercise will help, they want to instantly put people on medication to quickly get sugar levels right. The problem I have with this, is that your body adjusts to what is put in it, and putting medication in too soon may actually make diabetes worse.

I was just diagnosed June 22, had an A1c of 8 and resting glucose of 200. With diet and exercise, lab tests on 9/7 I had already dropped the A1c to 6.2 with a resting reading of 101, my meter showed 95 that morning.

I went on the simple carb counting method, in other words break things down to 15 grams of carbs, and eat 4 carb choices at my main meals. Used lettuce, celery, and carrot sticks to fill my tummy if I was still hungry. Still ate mostly lean beef, but didn't really do the " heart healthy " lowfat, but cholestral readings improved, and everything they checked was right in the middle range of what is considered normal.

Lower carb diets appear to be the key, but look at the controversy around the Atkins diet. If you read the diet, they basically want you to change to a carb choice counting diet after you get your metabolism changed. The " low fat is the only way to go " crowd has not come to grips that they are wrong. ( BTW, I usually eat eggs 1 or 2 times a week, and I use butter, not margerine ) I also eat cheese, and drink lots of milk ( although I use A2 milk which is available in my area. Most milk is the A1 protein, not the A2 protein )

Talking with the diabetes dietician and the nurse that showed me glucose meters and how to test, they seem almost surprised that I am getting along that well.

So either people don't follow diets very well, or I'm lucky that it was caught early and easy to get my metabilism working right.

Rob

9/28/07 12:50pm

Late last year after my second bout of retinopathy I started reading, including Bernstein. Against the advice of my Internist I concluded I was diabetic and started metering. "Eating to my meter" moved me from low to very low carbs, and two viral infections moved me over the next 9 months to the "official" diabetes territory in Fasting Blood Sugars. Dr. reluctantly Rx'd Metformin in very low doses. It didn't do much, I checked with other physicians who poo hooed my concerns. I got OTC Regular Insulin and a hundred needles at Walmart (less than $35), and very cautiously started using insulin, and found an Internist who would take me on as a patient who wanted to acheive normal glucose levels. I am letting those numbers creep down, and am about half way to where I want to be, readings from 80-110 most of the time.

Anil

9/28/07 1:14pm

I totally agree with what you say. I heard similar sentiment from folks when I got diagnosed. I resolved to not let diabetes bring me down and I kept fighting it without medication.

Recently due to life changes I cannot do enough exercise and so am staring Metfornin. But my hope is that as soon as I can get back onto the exercise schedule, I will be able to shake it off.

I am big fan of Dr Bernstein. His was one of the first diabetes book that I read. Wonderful inspirational book.

Thank you for blogging on this issue.

John Dodson

9/28/07 2:44pm

David, Thanks for your excellent article and your clear insights into managing diabetes. Rather than progressive I like to think that diabetes is responsive. It responds and reacts to our actions to move toward a healthy life. I believe my body is actually healthier now than before I had diabetes. Because my body has taught me it will respond positively to my actions and vice a versa I have gained new energy and life though following that lead. John

Anonymous

9/28/07 6:07pm

I am delighted to hear you say this!

Diabetes is certainly progressive if you continue to eat like a pig, lie around, and expect that if you take your medications that you are "doing all you can", or "struggling" or "trying sooo hard."

People who take action seem to fare much better than those who can't be bothered, so there must be something to this point of view that diabetes isn't (necessarily) progressive.

Those who can't be bothered to take care of themselves are probably headed for major problems down the road. Diabetes is relentless and doesn't care how hard we "try" only what we actually do gets results.

Cheers

Anonymous

9/29/07 2:15pm

I was diagnosed type 2 in 2003 following a stroke. I'd had no previous symptoms. In the hospital stroke unit, my blood glucose was monitored and

I was given the so-called "diabetic" menu for meals. My levels stayed up. They gave me Metformin and they moved down marginally. Then they had a think and added gliclazide and they moved down a little more, but were still far too high. Now 4 years later I have learned better. I follow a much lower carbohydrate diet,having Read richard Bernstein's book and do my 10,000 steps a day walking. I do 2 sessions a week of water exercises and 2 long walks.( 2 miles +) I'm down to 2x 500mg metformin daily. no gliclazide and I've persuaded my GP to let me have Starlix, 60s I have one with each main meal. My mobility is almost normal, but I can't run, so exercise is determined by what I can do. I'm gradually convincing my doctor that low carb is the way to go. Even though it's not what NICE recommends. In addition I cannot get as many test strips as I would like, beccause NICE doesn't think type 2s need them

Kevin

9/29/07 4:48pm

I agree with the sentiments in this thread. However, I also believe that more physicians need to understand the progressive nature of unmanaged diabetes. Just because you have a person with an A1c or fasting glucose that is not above 6 or 7 in some cases, doesn't mean that you can ignore the elevated blood sugar condition as so many physicians do and simply wait for the patient's condition to worsen before taking action to arrest the condition.

If we can get physicians to understand that aggressive self-care including lifestyle changes are indicated for anyone with even slightly elevated blood sugars is critical. Otherwise, the 'progressive' nature of diabetes will accelerate the decline. We also know that the longer you live with elevated blood sugars the more difficult it is to reverse complications.

Maybe we need to caveat this thread with a recognition that unmanaged elevated blood sugars in both pre-diabetes and diagnosed diabetes will lead to a 'progressive' decline in the health of the person.

Anne

10/ 2/07 12:10pm

Aren't you special? You are all so controlled and safe. What a good place to be. Good for you! You'll never have anything to fear. Don't even bother for a cure, you are in full control. Nobody can hold a candle to your diabetes management. You are perfect. What a happy story, so uplifting, so encouraging, so full of inspiration and empathy. I didn't realize that diabetes control had a complication. Arrogance!

Jan

10/ 7/07 7:34pm

I have type 2 diabetes discovered incidentally when visiting an A&E department with a very high temperature.

Until I started accepting the theory propounded by David (then Rick) Mendosa, I assumed that advice from my country's diabetic association was correct. Gradually I thought that I might try the different way of eating and started on the glycaemic diet. Two or three years later my Hb1ac is around 5.4 and I have become actually slim, as opposed to slightly overweight.

It isn't at all difficult and really, Anne, don't be so dismissive. It works and while waiting for a cure to be discovered you might give it a try.

Jan

10/ 7/07 8:00pm

Sorry, Hba1c!

Bernard Farrell

10/16/07 5:22am

David

Thanks for a wonderful and inspiring post.

Diabetes management is hard and requires real effort. But the alternative is to ignore it and suffer the consequences.

I truly believe that if I didn't get diabetes over 35 years ago I'd be a lot less healthy today.

Bernard

http://blog.bernardfarrell.com

Dan Hunter

4/ 3/09 12:33pm

To me, this article rings a clarion call of wisdom and truth....pretty much "the law and the prophets" of diabetes control and remission. Thank you David, I have printed it out and it's on the wall in my kitchen. It sustains me when I get a tiny bit depressed with the disease.

april

6/30/10 4:57pm

Well I've been diabetic going on 10 years and let me say it's not as easy as some people will have you believe. I watch my diet, exercise 5x a week, and take my medications as prescribed and still have fasting sugars in the mid 200's.

I, like many of you, had no problems with my diabetes for the first few years that I was diagnosed and enjoyed a1c levels in the 5-7% range. As i have gotten older, however, it has become harder to control. So before you all judge other diabetics who are having a hard time controlling their sugars as lazy or pigging out, please consider other circumstances which are not as clear as yours were. Stop judging others and be grateful you are not in the same situation

Sibylla

9/11/10 5:15pm

Dear April,

Perhaps you should talk to your diabetes team about going on insulin? It does work and you very quickly get used to all the kit.

april

9/14/10 12:52pm

Thank you, I've been on insulin for several years now. I take Lantus and more recently have added a sliding scale Humalog prior to meals which does offer better control. My morning numbers are still high though. But thank you for your suggestion.

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