Diabetes 101

Hello all my diabetic friends out there.  Something to think about……

The goal of most primary care physicians (including myself for most of my career) is to manage your sugars.  Need to keep them below 110…. without going too low.  Too low is no fun at all.  “Here is a pill to take.  Keep a journal and report back to me in 3 months.  At that time I will order some labs to see if your meds are working”.   What about diet you ask?  “Don’t eat cake.  See you in three months”.  Wash, rinse, repeat.

Soon my practice was full of people managing their sugars.  It turns out I was good at managing this illness.  The few people who remained uncontrolled where usually noncompliant.   Your fault.  Not my fault.  I did notice that over time most of my patients required more meds to remain “well managed”.  Some even required insulin.  That’s when I really stepped up my game.  I became the Insulin Master.  I would use a combination of long acting and short acting insulins in combination with calorie counting to keep those sugars 110!!  I may have even said thing like “If you eat a desert, just make sure you take more insulin”……… gulp.

The problem is that I forgot something along the way.  Turns out it is kinda important.  Diabetes is a reversible illness…….

Yep, completely reversible in most cases.   How many had I cured?   One.   Interestingly, my very first patient in my resident clinic at Vanderbilt University Medical Center had actually cured his diabetes with a change in diet.  My first patient.  He told me that he did not like taking medications so he was going to eat better and lose weight.  Not only did he come off his diabetes meds, he was able to stop his blood pressure meds, heartburn meds, and gout meds too.  I viewed this case as the rare exception and not the rule.   Fast forward 15 years, and I score an “A” on managing sugars, yet get a zero on treating diabetes.

“But, diet is so hard and takes so long…..”  Nope.  Can happen in as little as 1-2 months.  And, you don’t have to cut calories.  You can always pick from foods that you like.  And, you don’t have to lose a bunch of weight for it to happen (although you will lose weight….. lots of it).

“If medicine wants to focus on prevention, there’s no better tool than nutrition.”  Dominic D’Agostino

by | Jul 9, 2018

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