Diabetes: controlled or . . . cured?

Russ had a beer belly, a big protuberant, hanging-over-the belt-on-top-of-skinny-legs sort of beer belly. Except he didn't get it from beer (only). Yes, he did drink beer, up to 3 or 4 per day on weekends, rarely during the week.

Russ got his "beer belly" from snack foods, processed foods, and yes, wheat products.

He came to my office for consultation for unexplained breathlessness. His primary care physician was stumped and asked for an opinion.

So, part of Russ' evaluation included laboratory work. Russ proved to have a blood sugar (glucose) of 136 mg/dl, well into the diabetic range. His insulin level was 102 microunits/ml, way above the desirable range of <10. I interpreted this to mean that Russ had early diabetes but still maintained vigorous pancreatic function, since the pancreas is the abdominal organ responsible for insulin production. In pre-diabetes and early diabetes, insulin levels can be high, reflecting the revved up output of the pancreas. However, the pancreas eventually "burns out," unable to keep up with the demand to product enormous quantities of insulin. That's when blood sugar skyrockets.

Along with the blood sugar and insulin, Russ showed all the expected markers of this syndrome (the "metabolic syndrome"): low HDL of 34 mg/dl, high triglycerides of 257 mg/dl, severe small LDL (80% of total LDL), high c-reactive protein, and high blood pressure.

A heart scan showed a surprisingly small amount of coronary plaque with a score of only 4. Thus, Russ' symptoms were unlikely to represent a coronary issue ("ischemia"). Breathlessness was far more likely to be from 1) his obesity and protuberant abdomen, large enough to encroach on his chest and lung volume, and 2) high blood pressure (which can, in turn, lead to high heart pressure and breathlessness, often called "left ventricular diastolic dysfunction").

I persuaded Russ to eliminate his previously flagrant and abundant over-reliance on wheat products and snack foods. Two months later, 15 lbs lighter, and a modestly less protuberant beer belly, Russ' laboratory evealuation showed:

--Blood sugar 90 mg/dl--normal.

--Insulin 12 microunit/ml--darn near normal.

Blood pressure was down 20 points. Russ' breathlessness was now entirely gone. He has another 30-40 lbs to go, but he's off to a great start. He is now clearly, solidly, and confidently NON-diabetic.

I see experiences like this every day, as do committed diabetes fighters like Jenny at Diabetes Update.

Why isn't this common practice? If pre-diabetes and diabetes can be cured by such a simple approach, why isn't it more widely embraced? After all, what other devastating diseases can claim to have such a simple, straightforward way to achieve cure?

And why does the American Diabetes Association (ADA) actually condone the inclusion of abundant carbohydrates in diabetics? Their modified food pyramid shows the widest part of the pyramid filled with "breads, grains, and other starches."

How about this question taken from a Q&A on the ADA website:

Can I eat foods with sugar in them?

For almost every person with diabetes, the answer is yes! Eating a piece of cake made with sugar will raise your blood glucose level. So will eating corn on the cob, a tomato sandwich, or lima beans. The truth is that sugar has gotten a bad reputation. People with diabetes can and do eat sugar. In your body, it becomes glucose, but so do the other foods mentioned above. With sugary foods, the rule is moderation. Eat too much, and 1) you'll send your blood glucose level up higher than you expected; 2) you'll fill up but without the nutrients that come with vegetables and grains; and 3) you'll gain weight. So, don't pass up a slice of birthday cake. Instead, eat a little less bread or potato, and replace it with the cake. Taking a brisk walk to burn some calories is also always helpful.

The answer is simple. Just as the American Heart Association focuses on ways to deliver the message of palliation, so does the ADA. So ADA diet advice is designed to help diabetics maintain a stable blood sugar on their medication. It is definitely not intended to reverse or eliminate diabetes. My patient Russ would be deep into diabetes on the ADA diet, enjoying his rolls, whole wheat bread, breakfast cereals, and birthday cake.

Once again, another example of the growing irrelevance of the "official" arbiters of health information for those of us looking for reversal of disease.

Comments (37) -

  • vlm

    11/28/2007 1:47:00 AM |

    I wish there were good answers to you questions.

    When I controlled my newly diagnosed mild diabetes with elimination of grains, starch, sugar and processed foods from my diet, dropping 70 pounds along the way, my doctor was astounded but ultimately not interested in the details of how I did it.  Same with the diabetes nutritionist.

    When I began to explain how I accomplished blood sugar control and weight loss without medication (coming off high blood pressure meds at the same time), and that my methods contradicted the ADA recommendations (and their advice), I was met with 'well, most people can't stick to that'.  End of discussion.  They don't want to know - they really don't want to know.  It's very disappointing because positive personal experience seems to count for nothing with the very people who are tasked with helping.  They actually disapprove of the approach I've taken because it contradicts convential wisdom and advice.  It seems they'd rather write off my experience as 'one of those things' than consider that there are ways to achieve blood sugar and weight control.

  • Dr. Davis

    11/28/2007 2:34:00 AM |


    Thanks. I took a look at Jimmy Moore's blog post from today. It is an excellent update on the changing landscape in carbohydrate restriction.

    I do fear, however, a politically correct lukewarm (at best) endorsement of the concept, since there is a great financial stake in maintaining the status quo. The number one monetary contributor to the American Diabetes Association, for example, is Cadbury-Schweppes, the world's number one candy and soft drink manufacturer.

  • Dr. Davis

    11/28/2007 2:38:00 AM |


    What a spectacular result!

    I say stick with what works, regardless of the ignorance of those around us. But be sure to educate your friends, family, and neighbors, particularly when they ask why you've looking so good.

  • Don

    11/28/2007 4:16:00 AM |

    Not only is the ADA. AMA and AHA becoming irrelevant so are the doctors who follow these destructive advices. Look for a paradigm shift-Dr. Davis is on the cutting edge of that shift.

  • Neelesh

    11/28/2007 8:08:00 AM |

    Dr Davis,
       I am from South India and the primary diet is white rice. There is a wide spread notion in our region that rice adds up to your weight and wheat is the best alternative. After reading your articles about wheat, I have switched back to rice, but this time, to raw brown rice.
       Are your observations about wheat also applicable for rice and other grains?


  • Dr. Davis

    11/28/2007 12:34:00 PM |

    Yes, it does, though rices, particularly the cruder forms like brown, are less of a culprit.

    However, the need to make these changes depends on lipid patterns such as low HDL, high triglycerides, and small LDL. If these apply to you, then an across-the-board reduction in high glycemic index foods like wheat and rice improves these patterns. However, if you have none of these patterns, then such a change may not be all that necessary.

  • Regina Wilshire

    11/28/2007 2:27:00 PM |

    I do fear, however, a politically correct lukewarm (at best) endorsement of the concept, since there is a great financial stake in maintaining the status quo.

    That's exactly why I haven't included the rumor that the ADA is revising to include low-carb as an option in their upcoming position statement for 2008 - I'll believe it when I see it.

    Bravo on this post Dr. Davis!

  • vin

    11/28/2007 2:34:00 PM |

    Dr Davis : You show ADA food pyramid with grains at one end.  Do you have an example of a food pyramid that you would suggest for track your plaque followers.

  • Dr. Davis

    11/28/2007 3:10:00 PM |

    I've always found the whole idea of a food pyramid kind of goofy. But, just truncating the entire bottom of the pyramid is what I would suggest. There is indeed room for non-wheat grains, such as flax and oats, but I base it on individual lipoprotein patterns.

    The new Track Your Plaque diet is still in the works.

  • prairie mary

    11/28/2007 5:54:00 PM |

    Another testimony to this idea: I was diagnosed with diabetes 2 when my retinas hemorrhaged slightly.  (Flashers and floaters.)  My glucose was at 300 and the doctor prescribed strong meds.  It was just after Christmas and everyone had sent me chocolate which I enjoyed.  After this diagnosis, I threw out the chocolate, did not eat sugar, flour (except a little as a binder in muffins), corn syrup, or any processed foods.  I quickly dropped the fifty pounds I'd been trying to lose over the previous two decades.  

    The strong meds sent me down to the 60's in glucose scores.  This made my doctor and her nurse angry -- they are 80 miles from me and I made contact on the phone.   Figuring I was on my own, I dropped all meds, then added back one metformin in the morning.  This has given me an a1c of 6.1.  The doctor refused to believe my reports.  There is no diabetes specialist for hundreds of miles, not even a nurse/counselor -- yet rates are very high.  My experience is shared by at least three other women in this village of 300.

    It appears that diabetes is one of the political diseases.  To say nothing of deliberate corporate evil.

    Prairie Mary

  • Dr. Davis

    11/28/2007 6:19:00 PM |

    Wow, Prairie!

    What an interesting experience. I love hearing about non-pharmaceutical successes!

  • Alan

    11/28/2007 9:07:00 PM |

    Dr Davis, I have been reading your blog with interest since we first "met" in cyberspace. You may remember that I heartily agree with your views on the ADA and it's dietary advice. I wrote on it a while ago: http://loraldiabetes.blogspot.com/2006/11/diabetes-authorities.html

    You post some very valuable advice. However, I do find it hard to accept "He is now clearly, solidly, and confidently NON-diabetic."

    To the best of my knowledge, there is no cure presently. I would not apply this to you, but my usual advice to any diabetic dealing with a doctor who claims to cure diabetes would be to find a new doctor. To me, until a complete cure is discovered, it is a four-letter word in that context.

    "Russ" may now be a very well-controlled type 2 diabetic, but he would still be a diabetic. As a diabetic in a similar position of good control I only have to test my blood glucose after an unwise high-carb meal to remind myself that I am not cured, just well-controlled.

  • Dr. Davis

    11/28/2007 9:12:00 PM |

    Hi, Alan--

    I agree that there is tremendous variation in insulin and glucose responses.

    However, I have seen many people who exhibit entirely normal after-eating responses when diet has been modified and after weight loss. Of course, not everybody achieves this, but many do.

  • G

    11/28/2007 10:40:00 PM |

    Wow, Dr. D -- that was the most superfabulous exposition!!!

    you hit it right on the nail!again!!

    We all exist somewhere on the 'Metabolic spectrum' -- having the ability to convert glucose energy from any food source (ie, tree bark, vegetation stems & leaves, etc, the quintessential Paleo diet) was actually a survival mechanism. Most races are hard wired that way, and some more especially so (perhaps they lived in more rigorously harsh environments like the Pima American Indians which have the highest rates of T2DM).
    I believe you are curing people -- if they maintain non-diabetic glucose levels (without meds) for some time then I believe that is a cure in my book. The corporate world is not ready to lose profits, and therefore they will always be hardpressed to acknowledge 'cures'.  But we're ready for cures!  keep bringin 'em on!!!!

    Non-Diabetic Glucose Ranges:
    Pre-meal = and < 99
    1-2h post meal < 120-130
    I h-a-t-e that pyramid... as you are aware... it should be flipped around w/ veggies on the BOTTOM, then raw nuts, fish oils.

    That was entirely lovely...THANK YOU!

  • G

    11/28/2007 10:51:00 PM |

    Ok, I cannot refrain in sharing these older studies which relevantly showed that either high carb was bad or that low carb was VERY GOOD for lowering TGs and raising HDLs and lower small atherogenic LDLs... (i apologize if the links get chopped up)

    Am J Med. 1987 Feb;82(2):213-20. Links
    Deleterious metabolic effects of high-carbohydrate, sucrose-containing diets in patients with non-insulin-dependent diabetes mellitus.
    Coulston AM, Hollenbeck CB, Swislocki AL, Chen YD, Reaven GM.
    The effects of variations in dietary carbohydrate and fat intake on various aspects of carbohydrate and lipid metabolism were studied in patients with non-insulin-dependent diabetes mellitus (NIDDM). Two test diets were utilized, and they were consumed in random order over two 15-day periods. One diet was low in fat and high in carbohydrate, and corresponded closely to recent recommendations made by the American Diabetes Association (ADA), containing (as percent of total calories) 20 percent protein, 20 percent fat, and 60 percent carbohydrate, with 10 percent of total calories as sucrose. The other diet contained 20 percent protein, 40 percent fat, and 40 percent carbohydrate, with sucrose accounting for 3 percent of total calories. Although plasma fasting glucose and insulin concentrations were similar with both diets, incremental glucose and insulin responses from 8 a.m. to 4 p.m. were higher (p less than 0.01), and mean (+/- SEM) 24-hour urine glucose excretion was significantly greater (55 +/- 16 versus 26 +/- 4 g/24 hours p less than 0.02) in response to the low-fat, high-carbohydrate diet. In addition, fasting and postprandial triglyceride levels were increased (p less than 0.001 and p less than 0.05, respectively) and high-density lipoprotein (HDL) cholesterol concentrations were reduced (p less than 0.02) when patients with NIDDM ate the low-fat, high-carbohydrate diet. Finally, since low-density lipoprotein (LDL) concentrations did not change with diet, the HDL/LDL cholesterol ratio fell in response to the low-fat, high-carbohydrate diet. These results document that low-fat, high-carbohydrate diets, containing moderate amounts of sucrose, similar in composition to the recommendations of the ADA, have deleterious metabolic effects when consumed by patients with NIDDM for 15 days. Until it can be shown that these untoward effects are evanescent, and that long-term ingestion of similar diets will result in beneficial metabolic changes, it seems prudent to avoid the use of low-fat, high-carbohydrate diets containing moderate amounts of sucrose in patients with NIDDM.
    PMID: 3544839 [PubMed - indexed for MEDLINE]

  • G

    11/28/2007 10:52:00 PM |

    Am J Hypertens. 1990 Jul;3(7):527-32.
    Links Effect of low fat-high carbohydrate diets in hypertensive patients with non-insulin-dependent diabetes mellitus.
    Fuh MM, Lee MM, Jeng CY, Ma F, Chen YD, Reaven GM.
    Department of Medicine, Tri-Service General Hospital, Taipei, Republic of China.
    Effects of variations in dietary fat and carbohydrate content on various aspects of glucose, insulin, and lipoprotein metabolism were evaluated in 11 patients with hypertension, who also had non-insulin-dependent diabetes mellitus (NIDDM). All of these patients were being treated with sulfonylureas, thiazides, and beta-adrenergic receptor antagonists. The comparison diets contained either 40 or 60% of total calories as carbohydrate, with reciprocal changes in fat content from 40 to 20%. The diets were consumed in a random order for 15 days in a crossover experimental design. The ratio of polyunsaturated to saturated fat and total cholesterol intake were held constant in the two diets. Plasma glucose and insulin concentrations were significantly (P less than .001) elevated throughout the day when patients consumed the 60% carbohydrate diet. Fasting plasma total and very-low-density lipoprotein (VLDL) and triglyceride (TG) concentrations increased by 30% (P less than .001) after 15 days on the 60% carbohydrate diet. Total plasma cholesterol concentrations were similar on both diets, as were low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol concentrations.
    PMID: 2194509 [PubMed - indexed for MEDLINE]

  • G

    11/28/2007 10:53:00 PM |

    JAMA. 1994 May 11;271(18):1421-8.
    Effects of varying carbohydrate content of diet in patients with non-insulin-dependent diabetes mellitus.
    Garg A, Bantle JP, Henry RR, Coulston AM, Griver KA, Raatz SK, Brinkley L, Chen YD, Grundy SM, Huet BA, et al.
    Center for Human Nutrition, University of Texas Southwestern Medical Center at Dallas 75235-9052.
    OBJECTIVE--To study effects of variation in carbohydrate content of diet on glycemia and plasma lipoproteins in patients with non-insulin-dependent diabetes mellitus (NIDDM). DESIGN--A four-center randomized crossover trial. SETTING--Outpatient and inpatient evaluation in metabolic units. PATIENTS--Forty-two NIDDM patients receiving glipizide therapy. INTERVENTIONS--A high-carbohydrate diet containing 55% of the total energy as carbohydrates and 30% as fats was compared with a high-monounsaturated-fat diet containing 40% carbohydrates and 45% fats. The amounts of saturated fats, polyunsaturated fats, cholesterol, sucrose, and protein were similar. The study diets, prepared in metabolic kitchens, were provided as the sole nutrients to subjects for 6 weeks each. To assess longer-term effects, a subgroup of 21 patients continued the diet they received second for an additional 8 weeks. MAIN OUTCOME MEASURES--Fasting plasma glucose, insulin, lipoproteins, and glycosylated hemoglobin concentrations. Twenty-four-hour profiles of glucose, insulin, and triglyceride levels. RESULTS--The site of study as well as the diet order did not affect the results. Compared with the high-monounsaturated-fat diet, the high-carbohydrate diet increased fasting plasma triglyceride levels and very low-density lipoprotein cholesterol levels by 24% (P < .0001) and 23% (P = .0001), respectively, and increased daylong plasma triglyceride, glucose, and insulin values by 10% (P = .03), 12% (P < .0001), and 9% (P = .02), respectively. Plasma total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol levels remained unchanged. The effects of both diets on plasma glucose, insulin, and triglyceride levels persisted for 14 weeks. CONCLUSIONS--In NIDDM patients, high-carbohydrate diets compared with high-monounsaturated-fat diets caused persistent deterioration of glycemic control and accentuation of hyperinsulinemia, as well as increased plasma triglyceride and very-low-density lipoprotein cholesterol levels, which may not be desirable.
    PMID: 7848401 [PubMed - indexed for MEDLINE]

  • G

    11/28/2007 10:55:00 PM |

    N Engl J Med. 1988 Sep 29;319(13):829-34.
    Comparison of a high-carbohydrate diet with a high-monounsaturated-fat diet in patients with non-insulin-dependent diabetes mellitus.
    Garg A, Bonanome A, Grundy SM, Zhang ZJ, Unger RH.
    Center for Human Nutrition, University of Texas Southwestern Medical Center, Dallas 75235-9052.
    We compared a high-carbohydrate diet with a high-fat diet (specifically, a diet high in monounsaturated fatty acids) for effects on glycemic control and plasma lipoproteins in 10 patients with non-insulin-dependent diabetes mellitus (NIDDM) receiving insulin therapy. The patients were randomly assigned to receive first one diet and then the other, each for 28 days, in a metabolic ward. In the high-carbohydrate diet, 25 percent of the energy was in the form of fat and 60 percent in the form of carbohydrates (47 percent of the total energy was in the form of complex carbohydrates); the high-monounsaturated-fat diet was 50 percent fat (33 percent of the total energy in the form of monounsaturated fatty acids) and 35 percent carbohydrates. The two diets had the same amounts of simple carbohydrates and fiber. As compared with the high-carbohydrate diet, the high-monounsaturated-fat diet resulted in lower mean plasma glucose levels and reduced insulin requirements, lower levels of plasma triglycerides and very-low-density lipoprotein cholesterol (lower by 25 and 35 percent, respectively; P less than 0.01), and higher levels of high-density lipoprotein (HDL) cholesterol (higher by 13 percent; P less than 0.005). Levels of total cholesterol and low-density lipoprotein (LDL) cholesterol did not differ significantly in patients on the two diets. These preliminary results suggest that partial replacement of complex carbohydrates with monounsaturated fatty acids in the diets of patients with NIDDM does not increase the level of LDL cholesterol and may improve glycemic control and the levels of plasma triglycerides and HDL cholesterol.
    PMID: 3045553 [PubMed - indexed for MEDLINE]

  • Dr. Davis

    11/28/2007 10:58:00 PM |

    Hi, G--

    Thanks for all the wonderful references.

    Interestingly, the "low carbohydrate" arm in all the studies were actually high-carbohydrate by some standards. I suspect that even more pronounced differences would have been seen with a stricter reduction of carbohydrates.

  • Dr. Davis

    11/28/2007 11:07:00 PM |

    Is it any wonder that we now have a nation full of obese pre-diabetics and diabetics? All with accelerated heart disease and cancer risk?

    Yet the offical organizations cling to the old notions.

  • BarbaraW

    11/29/2007 5:53:00 PM |

    Dr. Davis,
    This isn't related to this post, but I am wondering about fish oil supplementation for people on Warfarin.  There's an "ask your healthcare professional" notice on our bottle of fish oil.  What does this mean?

  • jpatti

    11/30/2007 4:53:00 AM |

    Dr. Davis, you said... "However, I have seen many people who exhibit entirely normal after-eating responses when diet has been modified and after weight loss. Of course, not everybody achieves this, but many do."

    This remains as long as they stick to the diet that achieved this for them; however, if they eat crap again, their postprandials rise to diabetic levels again which is *not* the case for nondiabetics.  Thus they are a very well-controlled diabetic, not a cured diabetic.

    I am diabetic, but my husband is not.  I have tested his postprandial bg after eating 1/8th of a double layer chocolate cake and it is in the 70s.  Not that chocolate cake is healthy for him either, but no matter how long I am well-controlled or how much weight I lose, I will never be able to eat that without my postprandial bg going to diabetic levels.

    Type 2 diabetes is primarily about insulin resistance (IR).  Diet, exercise and weight loss can greatly improve insulin sensitivity and thus improve the disease condition so that bg control is easier and postprandial excursions less extreme.  One can improve the disease to the degree that one can achieve nondiabetic numbers, and if IR improves, do so even while eating more carb than could be handled while gaining control.  Diabetes can *certainly* be improved; it does not *have* to be a progressive disease.

    But by the time one is diagnosed with T2, there have usually been very high serum insulin levels for years as well as pancreatic damage reducing if not entirely eliminating the phase 1 insulin response.  Being in good control does not heal the pancreas, reduce serum insulin to normal levels, nor remove IAPP plaques, etc. And it does not mean you can have nondiabetic postprandial response to eating crap.

    I completely agree with your post overall.  These types of results are great and good patients achieve them.  I only disagree in the same place Alan disagreed; the word "cure" implies something more than can currently be achieved.  Diabetics can have good control, even very good control and nondiabetic numbers, but we are not cured.  

    But you absolutely have the right approach as opposed to the ADA; to them I say, "let them eat cake."

  • Dr. Davis

    11/30/2007 12:33:00 PM |

    I see what your trying to say. Yes, I would agree that's true for the majority of former pre-diabetics and diabetics.

  • chickadeenorth

    12/1/2007 3:52:00 AM |

    I too am a type II who was "cured" by doing Atkins. I was on tons of insulin, metphormin, cozaar,lipitor and within 32 hr of starting Atkins had to quit insulin. I have low carbed for 4 yrs and fell off the wagon a yr ago.Back on now after a hard lesson learned.

    My A1C were 5.5 without insulin or meds and eating Atkins.I allowed my doc to persuade me I needed grains and fiber and I went on some and it completely threw me off and the cravings were like a drug addict wanting more drugs.

    I lost control of my appetite, my cravings and my blood glucose levels.

    I asked my doc why they pushed grains and was told the CDA is sponsored by the Cdn wheat board.
    Duh...it made me angry but it motivated me to go back on insulin to get bg down again and go low carb and within 2 weeks I no longer needed insulin once again.

    I was so good with bg control for several yrs I thought I was "cured", but would have some healthy grians like cooked oat bran with large old fashioned oatmeal flakes and whamoooooo
    and my bg would bounce right back up there.

    However, I am not on insulin anymore, I use some Glucophage(and only use brand name Glucophage as yes it does work better than metphormin for me and for almost all of Dr Bernstein's patients it works better as well....go figure...).
    All druggists and Dr told me its exactly the same but it is not and once you learn how the FDA allows for differences in brand and generic names it will blow your sox off.

    I am skeptical of all who tell me now I need wheat, starch and grains and can have some sugars....they don't live in my body, they don't know the demons of craving I suffer when I go off my low carb program and if I follow their advice I wont live to be an old lady.

    I will never be "cured", the beast will rear its ugly head and harm me every time I eat something with grains, wheat, starch or yes crap.....but even when I eat "good grains"...my body just cant do it anymore.

    I am 57 and had yrs of overloading, I am in better shape now than ever in my life and I wish I was "cured" but I am not.

    I am aiming for an A1C of a non diabetic of 4.2 to 4.5 and slowly will get there.

    But in doing so I butt heads with all of the medical community yet they see me and exclaim how wonderful I look, how much weight I have lost, thnx to people who think outside the box like Dr. Atkins,( he made some boos boos in his new stuff which I think was from peer pressure, he should never have encouraged grains, fruits back into the prgram as it made bg go up for diabetics,causing cravings and high bg, he changed his original program) Dr. Bernstien,( he is strciter than Atkins and says you are diabetic, your body no longer tolerates grains, starches, sugars so get over it, if you want to live long)Dr. Davis and Dr.Blancehtt( from what I read here)are now treating the other side of evil us diabetics live with....heart disease.

    Now I know there are some well educated medical people who are looking outside the box, listening to their patients stories and treating us like we have some gray matter between our ears and trying to find out how to diagnsoe and treat us, I finally feel some element of security and safety.

    My blood tests don't lie although I have been treated by many Dr as though I am lying when I say what my blood meter shows and then they see their own lab results and are wowed.

    One other aspect I ahve noticed here, if anyone writes a differeing of opinion than Dr D he doesnt shut us up and hears us and often comments that is somethign frutehr he will explore or look into.

    I appreciate that we have your intelligent brain, yrs of medical practices and ability to think without getting defensive,

    Dr like you should have a Nobel prize as in a few decades this will hopefully all be commonplace treatment for heart issues and diabetes.

  • Dr. Davis

    12/1/2007 1:44:00 PM |

    Thanks for sharing your insightful experience, Chickadee.

    I personally have a similar pattern to yours, but have managed to keep off all meds once I dropped all wheat, along with processed carbohydrates. While we have to be careful in too broadly generalizing our experiences, I would estimate that this pattern is shared by 70% of people to various degrees.

  • jpatti

    12/1/2007 3:18:00 PM |

    I just want to add I agree with Chickadee.  It's Dr. D's blog, he doesn't have post comments from those who disagree; but part of why I participate here is because I saw that he did that.  

    I also personally appreciate that he changes his mind (the info on this blog is different in some aspects than the info in the TYP book).  It's obvious he is still learning; too many people are dogmatic about their opinions.  

    Research progresses; so what we know changes.  I want my own choices to be based on the best current knowledge, not someone's near-religious beliefs.

  • chickadeenorth

    12/2/2007 10:49:00 PM |

    Yes patti, metoo!!!

  • g

    12/2/2007 10:50:00 PM |

    Chickadee (vlm and Praire Mary), Your experience is truly amazing.  You're preservering by faithfully following what you know to be true, in the face of the current medical establishment. You must be a beacon of motivation for a lot of  your friends and family (and you must appear hot and amazing as well!)...  I have to check out IAPP plaque -- luv learning stuff here!! I believe T2 parallels other chronic conditions like CAD -- if the destruction of cells is not irreparable (like CAD, if imminent myocardium death from obstruction and oxygen deprivation exists, then stents/bypasses are crucial and life-preserving), then a 'cure' is possible because our body has the capacity to repair and recover.  However as you discussed, if enough destruction of beta-islet pancreatic cells has already occurred, then recovery may not be possible to maintain normal 1 to 2h-pp glucose after a large glycemic load.  Unfortunately, 50% of islet cells are usually GONE at diagnosis for most T2DMs and progressively decline annually unless dramatic changes happen. Imperative changes like those encouraged and emphasized by the TYP plan. Even more important is to stop the destruction before we become older. I believe TYP should be taught to all children. as soon as possible.
    Pregnancy (progesterone-dominant) and certain drugs (prednisone) cause transient diabetes -- however when the triggers are gone (ie, give birth and resume exercise or stop the offending agent Prednisone) -- normal glycemic indices will often resume.
    My children only get 2 hrs of physical ed now per week in school, as a result (my understanding) of Bush's 'leave no child behind policy' which they claim is to bolster academics. Most unfortunate for the physical and endocrin/cardiovasc health of all Americans (hopefully Canadians are better off! well, you are... you don't have Bush... and soon neither will we). Remember, as kids we had ONE HOUR of PE e-v-e-r-y-d-a-y? Plus, playing outdoors until the sun went down!? Gone are those days esp in the decade of video games (and internet *sigh* -- look at me what a hypocrit)... surburban concrete and indoor malls...
    Most clinical studies are suspect because only the drug companies can afford them.  Big companies have lobbyists and choke-holds on all the major 'public health' sources (including ALL the major med schools and universities also... JAMA and most publications).
    Only vigilant far-reaching visionaries like Dr. D go far and beyond the call of duty to do the thankless job of educating and propagating  solutions for the #1 killer of women and men -- heart disease (AND #2 killer cancer arguably as well, and obesity and T2DM and most autoimmune disorders too).  THANK YOU DR. D!!!!
    Many of the strategies for CAD reversal are applicable to T2DM glycemic control optimization (I've personally lived it b4 I read the book/blog and see it in the diab patients that follow it). Getting enough vitamin D (esp you're Canadian and get absolutely no UVB above the 37th latitude) is key. In fact Vit D is more effective at insulin sensitization than metformin and other drugs (again, if there are enough remaining beta islet cells to sensitize).
    Exercising and therefore consuming minimum 350 calories daily (or 5,000 to 10,000 steps) via a pedometer as Dr. D prescribes in the TYP plan is imperative for insulin sensitization. Use it or lose it.
    'Bad' carb elimination, good carb restriction. Sufficient protein and good oils.
    Keeping your estrogen levels 'normal' arguable > 50 for most women (pre- or post menopausal -- if you have no breast CA in your family history)... Testosterone, in men, the corollary (and women too).
    Strength training -- lifting 3 x week all the major muscle groups -- 3 sets of 10 reps -- will achieve significantly improved IR as well (and a higher sense of mood and prevent spinal osteoporosis). Lean body mass, or MUSCLE, effectively metabolizes even at rest (for example, when our b**tts are atrophying in front of the computer). The more muscle, the more metabolism!
    Stress reduction, lowering cortisol through yoga/tai chi, being 'happy', optimizing your vitamin 'O' (the intangible optimism -- as Dr. D  puts it!!)...  the more love we give, the more we get! Lovingkindness -- it all works! The added benefit with less cortisol is less visceral fat deposition on the belly... as well as the liver, heart, coronary vasculature -- don't need those love-handles to LOVE!

    You're awesome -- keep it up!

  • g

    12/2/2007 11:02:00 PM |

    btw, make sure the TSH is 0.2 to 3.0! adequate thyroid function affects IR, lipoprotein patterns, heart hypertrophic changes, etc. guess what yoga poses do? cobra-pose for instance helps 'massage' the thyroid and parathyroid glands to remove toxins and allow an influx of fresh oxygenated blood! the deep nasal breathing allows the adrenal nervous system to shut off (which shunts blood from vital organs like the liver/kidney in order to oxygenate the muscles for 'fight-flight'), yoga turns on the cholinergic NS to promote rejuvenation and restoration including improved blood flow to the heart, kidneys/adrenals, and liver, etc.

  • Dr. Davis

    12/3/2007 12:44:00 AM |

    Thanks, as always, G, for your delightful commentary.

    I love your "vitamin O" idea!

  • chickadeenorth

    12/3/2007 6:22:00 AM |

    Thnx for encouragement g as sometimes it feels like I do my health program in isolation if I didn’t have access to these forums etc.

    When I ask for tests I am often treated like I am “neurotic” for one Dr told me I am a double double Type A for being so careful with my diabetes as only 50% of diabetics can achieve an A1C of under 8.

    I thought oh great, glad I am or I would still be 80 pounds overweight if I kept eating the Cdn Diabetic program and still  injecting about 150 units of insulin a day!!!
    Bring on the Type A,,,, is that kind of like the Vitamin O…lol.

    I told him I believed diabetics couldn’t achieve under an 8 for A1c was due in part that they were told to eat low fat, high carbs. Diabetics feel great shame in following a program yet gaining weight and still having a high A1C. This shame is left in a shroud and never dealt with.

    I wish I had this info a few decades ago when I used to have GP’s refer me their diabetic patients to learn coping strategies and we taught relaxation techniques etc and behavior mod, if only I understood how hungry a diabetic is with BG dropping and rising. My hunger has not been an issue since I started low carb, it did when I fell off the wagon. I now use duct tape and stay securely in!!!

    I believe I still have some beta cells as there are days I can go without using glucophage at all, particularly on a very physically active day. …or if I am at a wedding or a dance and I have a few glasses of wine, my BG drops a lot and I don’t use meds. I only drink a few times a year though and have tried to learn to drink red wine nightly but don’t enjoy it and would end up with another bad habit I am sure.

    In winter when I am more sedentary I can see right away I need to use 500mg of Gluco TID.Man I will be happy if high doses of Vit D 3 help me with my A1C’s!!!!

    See Dr Bernstein and Atkins both said as soon as a type II is diagnosed they should go on small amts of fast acting insulin and preserve what beta cells they have left. Yet it is used as a last resort.

    I wish more Dr would read Dr Bernstein and Davis. Bernstein is offering a cruise for Dr to go on and get educational hours and he will train them his technique, its all a business write off but last I heard he had trouble filling the 100 needed for the cruise.
    Info is at www.diabetesincontrol.com

    In my mind I believe for me that eating low carb meant I only ate nutrient dense foods thus my body healed itself and began to slowly allow the beta cells to resurface and do their work. Grains are not nutrient dense for me.

    Low carbing offered me this:
    -I got off $1000 a yr of Imitrax as my migraines stopped.
    -My hot flushes stopped.
    - I had severe arthritis and used a ton of vioxx, my arthritis went away a few weeks after low carbing and I have not had treatment for it since 03. I have no pain at all.
    -My blood pressure dropped but I take cozzaar still as want an Ace inhibitor to protect my kidneys as well but BP is normally about 111/62, I am 57 and am still overweight about 20 pounds but have lost 80 pounds.

    So see I did this basically all against medical advice but once my long term GP( she moved after 21 yrs) saw the blood work she began to soften in her approach and support me and did allot of blood work as I was scared starting to eat more protein and using some fats.
    I had been so brain washed.
    Its hard to eat much protein after decades of eating protein to the size of a deck of cards and using heart smart margarines instead of butter but I watched my blood work carefully and all my lipids came way down, especially my trig. Broccolli is even better with a tad of butter. A cup of coffee with a bit of cream doesn’t make my BG go up, but using the skim milk in coffee made my BG rise.

    I didn’t know about the Vit D until TYP blog and forum and am gonna flood this new young doc I have with all this info but have only seen her once and don’t want to turn her off. So will slowly plod along.

    She is a real smart wise young woman, I can tell, and she is very open minded. She has already read Bernstein’s book and I am going to buy her TYP as a gift. She kind of wondered about me going for another calcium score and didn’t know anything about the advanced lipid profiling but she ordered it anyhow.

    I know doc have allot of reading and work to do and its impossible to be the expert on everything but I see she is wise and confident enough to have an open mind.

    One more tidbit you doc's here may be interested in knowing about.

    Dr Westman from the Duke did a project up in a Native reservation in northern Canada called Alert Bay. It was rampant with diabetics. He trained a Dr from Edtmn and his wife who was a nurse pract and Health Canada sponsored them. The whole village was taught to go back to their way of living from before they were influenced by white man and to eat more fish, meat, seeds, berries, basically almost an Atkins type program and it was a huge success.

    Dr Westman is very approachable and if you wanted I would ask him if I could give you his email in a private email as he has a head full of great ideas too about treating type II diabetes.

    In some ways to me it seems like all you wise docs are working in isolation around the world and you need a forum or a gathering place to host all these wonderful ideas so you can educate your colleagues

    How could we make this happen.???

    A conference in the Canadian Rockies!!!.

    I'll help organize it, not in winter though as the suns rays are so low and it is minus 29 degrees as I sit and type, but oh so pretty with all the snow covered mtns.

    This blog is more informative to me than anything I have had access to on the net and I have read and researched for ys to help my health improve.

    I feel so privileged to have found you folks and have learned so much in the past few weeks.

    I only wish the muscles I have built in my fingers typing could be transplanted into the lazy parts of my body.

  • Dr. Davis

    12/3/2007 1:34:00 PM |

    Hi, Chickadee--

    Thanks always for telling us your fascinating story. It's wonderful to know that we are having such an impact on lives, even in the "wilderness."

    We can always be reached through the contact@trackyourplaque.com e-mail, of course, or through our Forum (when repaired--I believe it's almost there). I'd love to start a conversation with Dr. Westman. I didn't know that such a real-world "experiment" had been conducted. It would provide priceless information.

    We have some ideas in the works for better delivery of this message to the broader public, but it all takes time. But it will be fun and yield some interesting opportunities!

  • Anonymous

    12/4/2007 7:37:00 PM |

    This just came through one of my shared links sites: How low-carb diets help metabolize fats better: http://www.healthcentral.com/diabetes/c/17/17226/eat-fat-grow-thin/pf/

    "The beta oxidation (or “burning”) of fat by the body requires the action of an enzyme called insulin-sensitive lipase. This enzyme is turned off by insulin. Eating carbohydrate obliges the body of a nondiabetic to make insulin in proportion to the amount consumed and obliges many diabetics to inject insulin to prevent blood sugar elevation. When insulin levels go up, fat oxidation therefore goes down, and since insulin is also the fat-storage hormone, dietary fat is stored. Furthermore, insulin signals the liver to convert the carbon backbone of carbohydrates (glucose) to saturated fat, which then appears in the blood as triglycerides, which are subsequently stored. So calories of fat are handled much differently on a low-carbohydrate diet than on a high-carbohydrate diet. Recent studies on humans eating equivalent amounts of fat show that those eating more carbs store more fat."
    - Dr. Bernstein


  • g

    12/4/2007 8:17:00 PM |

    I'm not sure if I could survive the Rockies... but that cruise sure sounds enticing!!  thanks for all your info Chickadee -- I'm so grateful for forums like this!  You are doing a stupendous job on your body! Man, a1c < 5%!  So you teach mind body philosophies, eh?  Your MH is definitely strong. I consult on migraines and T2DM issues. It's funny how all these conditions are linked... along with IBS, Alzheim, UC, Crohn's, and other inflammatory conditions (even colon CA)...
    I do really believe that our bodies have the capacity to heal and be whole (mentally and physically) but we really need to be educated...  and have the proper tools at our disposal... that's so hard! you're totally right!  And now people no longer need to experiment and fool around.. the solutions already EXIST!!!

    I'd echo your same concerns -- after Dr. D receives a Nobel prize (which is just a matter of time) -- will he lack the time for the plebs and peons on the blog?  *chuckle* maybe he'll have trained enough protege's like yourself to outsource... *ha haaa haa*

    Perhaps Dr. Barry Marshall (who discovered HP as causing ulcers and gastric cancer) would've received a Nobel 10-20 yrs sooner if he had a blog and layman-oriented publications!  ;)

  • chickadeenorth

    12/5/2007 3:29:00 AM |

    Yes the net certainly makes us all closer and wiser and ideas catch on quicker, it is actually amazing. Bill Gates didn't know what he did for health when he developed some of his software ey.

    I never knew back when I was in the field about diabetes, OCPD, migraines, belly fat,hunger, all those dynamics that now make me get red flags.I had them all, many of us did,thought it was from the work we did not the starch and sugar we ate really as we were all low low fat eating people.

    Man I can walk thru Wal Mart and tell who is diabetic or pre diabetic if there is such thing...you know like being pre pregnant...LOL

    You could survive the Rockies, our winters can be harsh, cold and beautiful( I went north two weeks ago to see the polar bears in Churchill....amazing) but our summers are awesome. I live right by Jasper national park and it is one of the Seven Wonders of the World.

    You know.... about Dr Eric Westman, he has done low carb Atkins like program for diabetes since about 2002 or so. He sent me tons of scientific research about chol studies and ldl numbers not being all what they are cracked up to be and to watch for lipo (a) etc way back ys ago.Thats why I had mine tested and it always came back low under the range but I didn't know much else about it until I read TYP.

    Anyhow Westman has been onto low carb and diabetes and obesity and the Duke is known all over as being experts in field of obesity and diabetes.

    I think cause the media slammed Atkins so bad and there were allot of mytths surrounding him some of these doc's hung low.

    Recall the history of Freud, when he first heard about incest he got boo'd as he was going to present it at an international conference and his peers jeered him so he changed it all and we ended up with these anal and odephial(sp) complexes and it took a hundred plus ys to remove those myths.

    Well I think it is the same with low carb, even sat fats not being the devil. In 1oo yr it will be the norm, like in Taubes research he demonstrates that in 1862 Dr were telling diabetics and obese people to eat meat, dairy and a bit of fruit and veg and it worked.No starch, no sugars.

    Oh well, someday, this will be common place, we will get a heart scan like we line up for the flu shot and we'll all know our numbers and talk about it as we play bridge.Smile

    It will beocme a household word, in the mean time I am trying to learn so much lately my mind and body feels overwhwlmd but I feel joyous at knowing I can do something about my plague.I only wish I knew about Vit d and fish oil sooner.

    We are all so fortunate we can read and share and ask questions here and it is not open for just medical doctors as I think we can all learn from each other.

  • buy jeans

    11/2/2010 9:26:48 PM |

    Why isn't this common practice? If pre-diabetes and diabetes can be cured by such a simple approach, why isn't it more widely embraced? After all, what other devastating diseases can claim to have such a simple, straightforward way to achieve cure?