what can I expect

[Ladylaw]

Just under 4 years ago I was diagnosed with diabetes probably at its very onset. I dumped 25 lbs and reduced BG to about 120 but weight loss and BG's stalled at that point. I used portion control as the primary method and only had "sweets" about once a month. I kept the weight and BG there until last October. BG's worked its way up to 220 by this May. I could tell from diet consultation that ADA diet would be catistrophic for me. (Forgot to mention that in April my doctor gave me a 30 day trial of Actos which did not lower the readings at all.) I refuse to go on med unless or until I've tried all reasonable alternatives and have failed. Two weeks ago today, I started the Induction Phase of the Atkins diet. My BG's dropped to low 80's within 4 days and have stayed there. I dropped another 10 lbs in that time with 30 to go. So here's my question. What should I expect now?

Is it likely that BG's will shoot up again as I increase carbs the way suggested in Atkins for life. I'm ready for the first increase in carbs but concerned as to whether to take that step or stay on the induction phase.

Also, as you stay of LCD are you ever able to have the occassional piece of birthday cake and ice cream in small portions?

Finally, I love fruit. How do I factor that in without sending BG's sky-high?

Thanks for any insights.

[Lisa N]

Is it likely that BG's will shoot up again as I increase carbs the way suggested in Atkins for life.

Maybe or maybe not. You only increase by 5 gram increments, so any adverse affect would show up on your blood glucose meeter pretty quickly. On average for a non-insulin dependent diabetic, 5 grams of carb would raise your blood sugar 15-20 points following a meal. It would probably help if you spread that extra 5 grams throughout the day instead of adding them all to one meal or snack, as in add 1 more gram to your breakfast allowance and 2 more each to your lunch and dinner. Monitor carefully while you are raising your carb allowance and stop when you see that meeter starting to show higher readings than you'd like (or back it off 5 grams). This is called "eating to your meeter".

Also, as you stay of LCD are you ever able to have the occassional piece of birthday cake and ice cream in small portions?

Perhaps, but be prepared for a much higher reading at your 2 hour post prandial, even with a small portion. The test will be in how quickly those blood sugars come down and whether or not your fasting readings the next day are still elevated after such a treat; if they are, then it might be a good idea to abstain or find a lower carb substitute that you an enjoy while everyone else is eating their cake and ice cream. It all comes down to how high of a post prandial spike is acceptable to you. For me, I don't want to see anything over 150 at any point.

Finally, I love fruit. How do I factor that in without sending BG's sky-high?

Again, it really depends on you and what your body can handle. Dr. Bernstein (who I'd at least recommend that you read: Dr. Bernstein's Diabetes Solution Diet), does not recommend fruit in any shape or form, but I've found through testing that I can have small portions of the lower glycemic fruits such as melons or berries when they are in season. The rest of the year, I don't eat much fruit at all. Higer glycemic fruits such as bananas are out of the question for me.

HTH and congratulations on your success so far!

[rainne]

Lisa, you give such excellent answers to so many people.

Ladylaw, I started a thread here myself not too long ago with the same quesiton 'what can I expect?'. Does that make us some sort of soul-forum-sisters, I wonder.

I commend you for staying away from meds as long as possible. After about a year, I've just gone off meds and am trying to get things under control naturally. I understand that desire.

Richard K. Berstein's book really is worth the read. I really wish I had read it sooner.

[Ladylaw]

Thanks. It's off to the bookstore for me. I read of people who are "cured" which I know is like heading for Mars under your own steam. But I sure hope that as the extra weight comes off that I can reinsert fruit. I wonder if there are any out there who have been successful in that regard.

[c6h6o3]

I don't understand why diabetics will go to such lengths to avoid medication.

Properly administered, OHAs and insulin can salvage years of pancreatic function which would otherwise be lost to you. The notion that all allopathic medicine is bad for you has become a mantra. I don't believe it.

[rainne]

Good post, and good point, C6. May I call you C6?

I believe strongly that *if* achieving normal blood sugars is possible without meds, that's the smartest way to go. Especially for those in my boat, where the safest class of drugs (metformin) is not available as the docs insist on prescribing sulfonylureas.

I don't believe living with high bg is preferable to meds.



I find it fascinating that metformin will soon (or is now) unpatented, and as such, no doubt, my doctor is being strongly lobbied by the drug companies to prescribe something newer, and of course, more profitable.

[c6h6o3]

C6 sounds too much like a high tech explosive.

[c6h6o3]

Originally posted by rainne
I find it fascinating that metformin will soon (or is now) unpatented, and as such, no doubt, my doctor is being strongly lobbied by the drug companies to prescribe something newer, and of course, more profitable.

I find it disgusting. People are literally being sacrificed upon the altar of drug company profits. Many more who don't die suffer needlessly.

[Ladylaw]

Although I can't speak for others, I will answer why I do not want to go on meds:

1. Diabetes (type 2) is a lifestyle disease. That means I need to change my lifestyle back to a healthy one. When I observed good nutrition and healthy habits I didn't have a problem.

2. Most diabetics I personally know want to rely on a "pill" to fix a problem that they are in part, or wholly, responsible for causing.

3. Modern pharmacology is only dates from WWII and penicillin. That's not very long really to know what the lasting effects of some of tose "wonders" are. Need I remind anyone of thalidimide etc.

4. As a practicing attorney, I don't truly trust the present licensing and/or approvals system either for drugs or food products. Look at the reports on aspartame to see what I mean.

Because I do not want to be blind, on dialysis, or an amputee, if I am unable to exercise sufficient restraint to cure the symptons, I will resort to the meds. But as one who really reads the drug company inserts, so far the risks associated with each aren't worth it if I can fix my habits.

[rainne]

Is diabetes a 'lifestyle disease?'

I think that is harsh at best and unfair at worst.

I've always taken better care of myself than my husband takes of himself. I'm diabetic, he's not simply because it's in my family, not his.

[c6h6o3]

I ate an everything bagel with butter and cream cheese every morning for about ten years. Before that I was into low fat eating. This supposedly "healthy lifestyle" got me 35 extra lbs. and diabetes. As soon as I adopted a low carb lifestyle, guess what? I'm at my ideal weight, all my diabetic complications are reversed and my lipid numbers are better than most non-diabetics. The good news is that this lifestyle sword cuts both ways.

[kjturner]

Well, yes, it IS a lifestyle disease. As to 'running in the family', well lifestyles are learned from those who teach you. If your distant ancestors survived and evolved by living mostly near glaciers where for thousands of years they would have eaten mostly animal proteins and very very little fruit or veggies, where plant based sugars were rare, then you developed a body type that requires very little plant sugars to live. It takes thousands of years for body types to change, and we've only had an agriculture based lifestyle for a few hundred years and highly refined foods for less than 100 years. So your plant sugar-sparing metabolism now is glutted upon readily available plant sugars, that you don't even have to really digest as the refinery does that for you by removing the fiber. And especially in the past 25-30 years it's been even worse as the fast food industry really took off. It's no wonder our kids are now becoming type two diabetics at age 11--and myopic as well. (Too much sugar given to an infant at an early age causes the eyeball to grow at the wrong rate which results in nearsightedness). So yes, it is a lifestyle problem, which most of us are trying to correct as we 'feel' our way along the blind trail of nutrition. (Yes, I consider it a blind trail as the AMA/ADA has been posting incorrect signposts in my opinion) If you have a good of idea of where your ancestors came from it'll help. If you know you're of tropical origin then you'll probably do better eating lots of seafoods and tropical originated veggies, roots and fruits. If your ancestors came from deepest Africa, then probably game meats, seeds and roots with only occasional fruit would be better. If your ancestors were herding nomadics, then you would have quite a variety of foods available, probably including milk products. You get the picture.
So, yeah, lifestyle change is needed. Don't get defensive--how you got into this mess didn't start with you, but it IS a disease that developed along with recent modern civilization. However, it can STOP with you as you learn and pass what you learn along to the next generation.
Sorry about the 'soapbox' thing but diabetes does NOT run in my family and I BECAME diabetic eating 'healthy'--Lots of complex carbs, adequate protein/fat, avoiding red meats, lots of fruits. I now know I have a protein-based body type (oh, I am also apparently a rare "O-like" A blood type). So my food journey has been REAL interesting as I try to figure out what works best for me.

It's not harsh, or unfair in the least--it's just a matter of ancestry. In my ancestry (on both sides) Diabetes didn't show up until my generation. I have one other cousin on my mother's side who is diabetic and one on my Dad's side. None of my Aunts or Uncles who are blood related have it. I know my most immediate relatives came from Germanic/Scottish origin. I can trace back less than 200 years. So starting from there I assume my more distant relatives came from roughly Northern/Middle Europe and were probably not nomadic, but probably not from a high agriculture area either. So I try to go for more of a meat/seeds/nuts/greens/squash/berries kind of eating. So far so good, I experiment and learn.....

[CarolynC]

Diabetes runs on both sides of my family. My father is type II, as was his father who lost both feet to the disease. On my mother's side of the family even thin people have been known to become type II in their 40s. So, it's no surprise that I was diagnosed as a type II diabetic at the age of 39. My WOE up to that point wouldn't have made most people diabetic, but it did help me along to diabetes. However, changing my WOE and exercise level has lowered my blood sugar tremendously. Therefore, I do see diabetes as a "lifestyle disease" in that changing lifestyle can greatly improve the condition. Fortunately, at least for me, the lifestyle change hasn't been hard and the improvement in my health has been well worth giving up things like French fries and cake.

[rainne]

Good posts, kj and Carolyn. Every word you write is true. Even truer would be to call it a lifestyle *influenced* disease.


Of course, it would be equally true to say diabetes is an insulin resistance disease. Or a cellular glucose usage disease. Or a carbohydrate-hypersensitivy disease.


I still think 'lifestyle disease' is harsh. Not wrong - just harsh.

[c6h6o3]

Originally posted by rainne
Of course, it would be equally true to say diabetes is an insulin resistance disease. Or a cellular glucose usage disease. Or a carbohydrate-hypersensitivy disease.

Not always. Type I's often are diagnosed before an insulin resistance problem develops. Type IIs who achieve good control no longer have an insulin resistance problem, but still have diabetes.

[rainne]

I don't often hear Type I being called a lifestyle disease, either.

My point was that there is more than one way to label diabetes. I won't be using the 'lifestyle disease' label myself.

[c6h6o3]

I've thought about this a lot. The only attribute I can think of which accurately describes the condition in all cases is: "impaired insulin usage". This can either be because you don't produce it in sufficient quantity or because you are resistant to that insulin which you do produce.

I believe the term "impaired glucose tolerance" to be a misnomer, at least in the early stages of diabetes. In the beginning, the process at work is actually enhanced glucose tolerance, as the excess insulin produced by an overstimulated pancreas enables a person to tolerate much higher levels of sugar in the blood.

[Lisa N]

I don't often hear Type I being called a lifestyle disease, either.

Type 1 couldn't be classified as a lifestyle disease because its cause is very different from that of type 2. Type 1 is caused when something (usually a virus or autoimmune type disorder) destroys the insulin producing cells in the pancreas and type 1 diabetics produce no insulin at all or very little if they do. It is also not caused by anything that the person does or does not do; it's a matter of chance.
Type 2, OTOH, could fit the definition of a "lifestyle" disease because more often than not, it develops because of unhealthy lifestyle choices (too many high glycemic carbs/sugars, too little excercise) which cause the beta cells that produce insulin to simply wear out and stop producing insulin or the cells of the body become immune to the effects of insulin (insulin resistance) or both. Most of the time and depending on how soon you are diagnosed, type 2 diabetics are still capable of producing a lot more insulin than type 1 diabetics. Beta cells don't all burn out at the same time; it's a gradual loss which is why it can take so long to lose enough pancreatic function for symptoms to appear.
I may have inherited the genetic tendency that makes me more susceptible to diabetes than other people (ie more likely to develop it) but that didn't necessarily mean that I was doomed to develop it. My dietary choices in my teens and twenties practically ensured that I did develop it whereas if I had started a low carb lifestyle sooner, I may have been able to avoid it completely or certainly delay its onset for a couple more decades at least.
In that sense, I am just as responsible for my condition as the genes that were passed on to me that made me susceptible to it; it was my dietary choices (my dietary lifestyle) that hastened its onset.
But before we go placing the "blame" (if indeed there is any blame to be placed here) squarely on our shoulders, how many of us developed diabetes while following what we believed to be sound medical advice? That advice being that potatoes, rice, and pasta were good for us as long as they were low in fat. Desserts? Not a problem as long as they were low in fat. Breads and bagels? Absolutely! Just skip the butter and choose low fat cream cheese or margarine instead of that evil butter. Even for 10 years after developing diabetes I continued to follow this advice until I finally realized that it wasn't working and that I was getting worse and not better. I wasn't willing to accept the opinion of the doctor that it was simply the unavoidable progression of my disease and decided to chart a new course which brought me to where I am today...medication free and well controlled as well as a lot lighter than I was 2 years ago. Just as it was lifestyle choices that brought me to the place of having diabetes in the first place, it was also lifestyle choices that allowed me to bring it under control again.
So, for me, it is indeed a lifestyle disease; one that can either be worsened or controlled by the choices that I make.

[funpist]

I think that for the most part, Type 2 diabetes is a "lifestyle disease." (For the lack of a better term.) A disease that is the result of the lifestyles that many of us share.

Like many others, I bought into the whole low-fat diet dogma. I tried the low-fat diets. They did work for a short time period, but I blew it every time because I felt like I was starving. I was eating rice, potatoes, breads, pastas, etc. I would only feel full after going back 2 or 3 times for extra servings. An hour later, I was hungry again.

I was diagnosed last September with diabetes. To be honest, it didn't come as a shock. I was loading the carbs, hardly got any exercise, etc. I pretty much knew I already had the condition before I went to the doctor. The odd thing is, a little over a year earlier, my fasting BG was 110. My doctor said absolutely nothing. At one of my last doctor visits, I asked about doing Atkins. The nurse practitioner said absolutely not, because it could cause kidney problems. I blew off the idea and continued the typical drug regimen.

I came across Dr. Bernstein's site while surfing the net one day. Since it was a low carb plan, I also bought the Atkins book at the same time. (Atkins was nothing new to me, but I wanted to have the book anyway.) Within a month, I dropped approx. 40 lbs and my BG has been in the normal range. I quit taking the various drugs I was on. I am drug free and have never felt better! I hit a small road bump the last 2 weeks or so while I experimented with various foods, but I am back on track.

For a great portion of my life, I had to buy clothes from the big & tall stores. Now I can go to any store and find something. It was one of the happiest moments of my life when I bought clothes from a regular department store (Kohl's) a few weeks ago. I went to my doctor to just have my BP checked (they do it for free), and my nurse practitioner was amazed when she saw me. She told me to stick with it. I think her opinion of LC and diabetics has changed significantly. On one hand, I can't really blame the doctors, because I believed in the diet dogma myself. It's only when a doctor doesn't change his/her opinion when shown evidence that they need to be smacked with a clue-by-four.

I'm not really sure if this will help anyone, but I do know that LC is the way to go. Since I was extremely obese, I am dropping the weight faster than most. It is really helpful that many people at work are on the same plan along with me. We share tips, recipes, etc. My mom just started Atkins, and she is also feeling better (she's also a "borderline" diabetic).

Wayne