Doctor pressure

[jgallo]

I was diagnosed with Type 2 about a month ago. The doctor immediately started me on 2mg Amaryl. Ironically, I found out I was diabetic because I wanted to start the Atkins diet and thought I'd follow his recommendation to get a pre-diet blood test. When the results came back, the doc broke the bad news. I started the diet because I believed, and still do, that it was EXACTLY the kind of WOE I needed as a diabetic. As I read more and more about treatment, I was disturbed to learn that Amaryl stimulated my pancreas to constantly produce insulin (just GREAT for an overweight diabetic) and on my next appointment, asked to talk about changing my medication to metformin. Her response to me was that if I didn't like the medication she prescribed, I should stop taking it, leave the office and go see an endocrinologist. That was the best advice she'd given me since she diagnosed me. By chance, I discovered my local hospital has a Diabetes Care Center, and I made an appointment with an endocrinologist, but I can't get in to see her until Dec. 2. In the meantime, they suggested I take their Diabetes Self Management course, which I just took today. I received excellent information and answers to many of my questions. THEN came the second half of the course, with a nutritionist. Well, it will come as no surprise to many of you that they take the ADA approach to diet----45 grams of carbs PER MEAL. I was horrified! They're telling me that my protein and fat intake is putting a strain on my cardiovascular system, and I do understand that as a diabetic, I am at great risk for heart problems. Since I've only been on this WOE for a month (13lbs lost, BTW), I don't know if my lipids have changed. I understand that can take some months. I'm a little afraid of the pressure they're putting on me to change my evil ways, and if my numbers can't support my diet choice, how will I be able to argue? I was told that if my cholesterol is high (it was 234 a month ago), they would prescribe medication. Should I just have faith that this WOE will improve my lipid numbers? Has this been a common experience? They've got me afraid that I'll stroke out!

[Lisa N]

jgallo...

Take a deep breath and relax. :)
You don't mention how your blood sugars and blood pressure look. If your blood pressure is normal, it's very unlikely that you're going to have a stroke and you'd be in far more iminent danger from ucontrolled blood sugars than from a slightly elevated cholesterol. Low carbing helps with all of these by controlling insulin production and lowering insulin resistance.
If you haven't read it already, I'd suggest that you get a copy of Dr. Bernstein's Diabetes Solution; it's low carb specifically for diabetics.
It's not the protein and fat that put a strain on your cardiovascular system, it's the constant over-production of insulin and high blood sugars that does which cutting the carbs controls.
They're still coming from a high carb/low fat mindset (most dieticians are).
The best way to prevent being "scared into submission" is to educate yourself. Read Dr. Bernstein's book and you might also want to read The Schwarzbein Principle and Protein Power as well; they all do a very good job of explaining why this WOE is so beneficial for diabetics.

[Oldsalty]

You should also read this site before you take what is a potentially dangerous drug for a harmless condition.

The idea that too much animal fat and a high cholesterol is dangerous to your heart and vessels is nothing but a myth. Here are some astonishing and frightening facts.

See http://www.ravnskov.nu/cholesterol.htm

and then buy the book it will cost less than a month's supply of a drug that you will end up taking for the rest of your life if your doctor's advice is taken.

[jgallo]

Thanks for your kind responses. I bought Dr. Bernstein's book right after my diagnosis and am firmly convinced of the logic of his program and his personal and professional success. My BS is in the high normal range - avg. 107 without any meds. However, post-prandial (2 hours) goes as high as 116-118. This is good according to ADA, but Bernstein says the goal is to have no change, and this I am not managing even with my low carb level. I am consuming around 20 grams of carbs per day. Obviously, if I use the ADA diet, I won't be able to even maintain these BS levels without medication. I don't know what my blood pressure is today. The day of my diagnosis, I was 142/80, which is high for a diabetic. I have an appointment with a new doctor this week, and I'll see what that looks like after a little over a month low-carbing, weight loss and two weeks into my exercise program. I would so love to have a doctor's support, but so far the ones I've seen are using scare tactics and conservative mainstream methods. Thank God for all you folks ---- you really reinforce my resolve to hang in with what I'm doing. If I don't find someone locally soon to work with me on this program, I am seriously considering traveling the two hours to Dr. Bernstein's diabetes center. Insurance coverage may be an issue, but I would feel a lot better having some kind of medical support. This is all new to me, and I'm damn scared of the complications I'll face if I don't keep normal blood sugars on a consistent basis.

I love you guys!

Janet

[Lisa N]

Hi Janet!

If your 2 hours readings are only 10 points higher than your pre-meal readings after only a month and no medications and are generally below 120, I'd say you're doing fantastic. Even with the low amounts of carb that you take in, there is no biological way to prevent at least a small rise when you eat. On the average, 1 gram of carb will cause a 3 point rise in blood sugars for a type 2 diabetic so if you consume, say 12 grams of carb at a meal, you should expect your blood sugar to rise between 36 and 40 points before going back down again.
Give it another month or so and I'll bet that you'll consistantly be seeing numbers less than 100; insulin resistance doesn't disappear overnight. It takes some time to heal. Consider, too, that if your blood sugars were elevated for a while your body got used to that and taking them too low too quick is not going to feel comfortable for you so lowering them slowly isn't always a bad thing (Dr. Bernstein even says this in his book). Overall, though, I'd say you're doing great and should give yourself a well-deserved pat on the back.
I wish you success in finding a doctor who is willing to work with you as your partner in health, not a dictator. They're hard to find, but they are out there so keep looking.

[aebh]

Hi Janet,

You have gotten some great advice and I can only add that, if your new Dr. doesn't support you keep looking. I was diagnosed in June of this year and though skeptical my Dr agreed to letting me try blood sugar control with diet alone. When tested 2 months later all my readings were in normal ranges and chol. was below 200. Blood pressure down from 140/80 to 120/78. The added bonus was a 30 lb. weight loss.

You are doing well and my thoughts and best wishes will be with you. Take care.

aebh

[jgallo]

You can't imagine how much better your responses have made me feel. I suppose it's just a l-i-i-i-i-tle bit unrealistic to think I could be on the straight and narrow for a month and whoop---I'm better! Posting here has been just about the best medicine--and I'm so encouraged by your comments. I'm finding this WOE so satisfying and easy to follow, that part of me thinks it's too good to be true. Everything else is always a project, right? But I'm finding the "project" part is finding what you said, Lisa---a partner in healthcare, not a dictator. Oh well---time to stop being a weenie and stand up for myself.

Your good thoughts and wishes are powerful stuff, and I'll be around to let you know how I'm doing. Maybe I'll even be able to help somebody else the way you have helped me.

Janet

[Sheldon]

In addition to what Oldsalty suggests, read this article (http://www.redflagsweekly.com/features/2002_oct31.html). You'll see why you need not worry about cholesterol. LDL has no way to damage arteries. But stress does.

Considering that stress may be the real killer, please try not to stress yourself out over these things, especially not cholesterol and fat.

Sheldon

[Lisa N]

Janet...

This might make you feel a little more at ease. My doctor was concerned about coronary artery disease because I have several risk factors (in his estimation), so he sent me for a Thallium stress test. This is a test where they inject a radioactive substance (sestamibi) into your bloodstream and then take special images of your heart (both resting and after exercising on a treadmill) to see how the blood circulates. If there are any blockages or areas of your heart that are getting less blood, it will show up as dark spots on the images.
I had the test this morning. Result (after 18 months on a high fat/low carb diet)? Completely normal and no blockages or coronary artery disease to be seen anywhere!

[Sheldon]

Good news, Lisa!

[jgallo]

That's great news, Lisa! Who could have believed it ---- fat and protein and beautiful test results like yours! Nothing could be more motivating.

I have good news, too. I saw a new doctor yesterday, and after reviewing my blood tests, he seems to feel that I don't have full-blown diabetes, yet. He thinks I'm "just" insulin resistant at this stage. He said the facts that my blood sugar has gotten into the normal range so quickly and with no medication, an HbA1c of 7 a month after diagnosis, normal triglicerides and normal thyroid levels support his opinion that I have luckily caught this early. AND, he has no problem at all with my low-carb diet. He told me to keep doing what I'm doing, and retest fasting glucose and HbA1c in mid-December. I guess I found my new doctor! Even if I am diabetic, his encouragement and support (along with everyone's here) have made a tremendous difference. The whammy that the other doctors and the nutritionist have put on my head is gone.

Janet

[Oldsalty]

Congratulations on great results and you are a great example to all. Showing how to take control of your own health and working through all of the misinformation untill you got to the truth..

Way to go

[Lisa N]

Janet...that is wonderful news! It's great when you have a doctor who is supportive and willing to work with you instead of dictate to you what must be done. Now, granted, some people find it easier to just let the doctor tell them what to do and then just follow that advice without any thought or research of their own. My in-laws were good examples of that...doctors in their opinion were second only to God and to question what one said was like committing heresy.
Some doctors, on the other hand, seem to hold that belief themselves and get rather irritated (as you found out) when you question their advice or judgment. IMHO if a doctor gets irritated or just plain blows you off when you ask "why?" instead of answering your question reasonably or downplays your concerns when you express them, it's time to fire your doctor and find a new one. Good for you for doing just that!! :thup:

OldSalty...coming from you, that is high praise indeed! Thankyou for the compliment! :D

[Elaine25]

:q: Hi jgallo,

I too joined a diabetes management class. When I was given the diet, containing 45 grams of carb per meal, three times a day, and 30 grams in one snack per day, I knew I was in trouble. Sure enough...I started the diet and monitored my sugar several times a day for a week. My sugars were running in the high 100's to mid 200's. I did manage to loose 5 pounds that week. However...I was afraid with my sugars running high and decided that I needed to get on a lower carb diet. At this point it is scary to have to pick weight loss or sugar control. I am just going one day at a time. But have definately opted for lower carbohydrate eating. It just makes sense. Hope you get things together. :)

Elaine25

[Lisa N]

Hi Elaine!

You don't necessarily have to chose weight loss over blood sugar control. You can have both . Low carbing will help get your blood sugars under control and will also help you lose weight.
As I said to Janet up above, knowledge is your best defense in this. Read and research as much as you can.

[jgallo]

Hi Elaine:

Lisa is right. I've been low-carbing since my diagnosis and lost 17lbs (in almost two months now). Plus, my BS is pretty good, too around 98-107 before meals and under 125 two hours after. Only thing that is irking me is my morning readings, which are often between 115-121. However, my new doctor didn't put me on medication, and said that my readings will improve as I lose more weight and keep up with my exercise (which I do faithfully). There's no way I could follow the ADA carb recommendation and control BS without medication, at least at this point in time. I truly believe low-carbing is exactly the eating plan I need to be following (permanently). I recommend that you read the book, Dr. Bernstein's Diabetes Solution. Look up the title on Amazon and read the customer reviews for starters.

Most doctors won't like the low-carb approach --- they keep saying you need a diet that protects your heart. However, the people who post in these forums are exclaiming improved cholesterol, tryglicerides and blood pressure -- and many of us are enjoying plenty of the "bad" foods we've been warned to stay away from.

What Lisa said --- read and research and hang around here, you'll learn A LOT! All the best to you, too!!

Janet

[kjturner]

Yeah, Elaine, and Dr. Bernstein's website has a place where you can download several chapters of his book to read before you buy it, that's how I got sold on it. He's also got a forum like this, but it's not as active as this one is. I post there also. I basically follow Dr B's basic advice, but I go to Dr Atkins for the 'details', plus I modify what I eat by following 'Blood Type' basic guidlines tempered by low-carb rules. (I'm a blood type A)
see:
http://www.diabetes-normalsugars.com

[lee]

Hey, Sheldon, thanks a lot for that URL!

http://www.redflagsweekly.com/index.html

[Sheldon]

Lee--

You're welcome. Check for Dr. Kendrick's regular column on redflagsweekly.com. He's doing great stuff to blast the cholesterol thesis to bits.

Sheldon

[Elaine25]

:) Hi Lisa, I wanted to thank you for your remarks. And wanted you to know that I finally started my low carb eating in earnest yesterday. I will be seeing a new doctor in two weeks. I decided to ditch the doctor that recommended that I keep up-ing my insulin. I was miserable, bloated, and it had put 15 pounds on me in two months. I know it is just two days into the low carb eating, but I already feel great because I have taken control of my life and not just wandered around in most doctors medications and high carb diets. I say enough is enough!! I plan to keep reading remarks in this forum, because I am encouraged by what others have been able to accomplish...this morning I was 239 blood sugar, no insulin...and 177 pounds. I am finally on my way, praise God! Thanks again!! Elaine25

ps, forgive me if I had responded to you before, but in any case, you just had to hear THIS good news!!

[Lisa N]

Elaine...

It's great that you've decided to take control of your own health and are already feeling better, but please don't just stop taking your insulin without a doctor's supervision. :eek:
While it's quite likely that you will be able to get off insulin and perhaps all medications for diabetes with low carbing, this should really be done with a doctor's supervision with the idea of keeping your blood sugars in the normal range with or without medications until you no longer need them. I didn't quit taking medication the day I began low carb; I used them as a tool to help me get and keep my blood sugars into the normal range and then decreased them with my doctor's supervision until I no longer needed them which took a couple of months on low carb. This is a great place for information and support, but we can't replace the supervision of a medical professional.
Please be careful!

[freydis]

When I first got off of the glipizide (after beginning Atkins), I tried to maintain good blood glucose levels with diet alone. It didn't work. I was consistently running around 200 and, though it never went higher, that wasn't a good place to be long-term. I kept hoping it would lower, with weight loss and a strict regimen, but it didn't.

Finally, I agreed to take Glucophage until my body can readjust and do the job on its own (please!). I think that being at 200 for so long did some damage, though. So, my long-winded recommendation is to go back and get something that won't destroy your islets, but will help you control blood sugars (like Glucophage that helps your islets produce more efficiently).

[Lisa N]

Freydis...

Glucophage, also known as metformin, is one of the better oral medications for diabetes out there. It works by making your tissues more sensitive to insulin, either your own or injected insulin, instead of forcing your pancreas to produce more.
You were right to be concerned with your blood sugars running so high; damage usually begins when blood sugars run consistenly over 150.
The good news is that by getting your blood sugars under control and keeping them there either with low carb or low carb in combination with medication, diabetic complications can often be reversed. Keep at it!

[TomX]

Hi Elaine,

I'm am new to diabetes myself, but I would strongly advise you to stay on your meds and slowly test things out. In my experience, I've had small successes by making gradual moves in the direction I wanted to go. I didn't start induction immediately. I moved toward induction by gradually cutting my carbs. I watched how it changed my blood sugar levels and how my body felt. It worked great and I felt much better. So I moved closer to the 20 grams of carbs. Things improved more. Then I looked for more information and I found this board. So now I'm moving into induction, using Fitday.com, and fine tuning. Nevertheless, in spite of the great success stories here, I listen to what my body is telling me. If my body is telling my 239 BS, I'm reaching for the insulin without a second thought. That's just too high in my opinion. Anyway, when it comes to treating your BSs I would stick to your meds and your insulin until you're sure the diet is dramatically improving things to the extent where your doctor agrees that you can stop a med. Just my two cents.

Tom

[jgallo]

It's been a little over a month since I started this thread and here's what's up. I have recently seen an endocrinologist who told me she was glad I was off the Amaryl, since the last thing I need in my body is more insulin. We discussed Glucophage, but agreed to hold off for a couple of months because my readings were improving. Since my appointment, I have had consistent morning readings of 105 and under (they were 120) and pre- and post-prandial readings between 87 and 95. Hot damn!! Weight loss has most definitely contributed to this improvement, but I think exercise has made the most dramatic difference. My weight loss has been very slow these past three weeks (even though I haven't cheated even once!), but I've been diligent with my exercise program, and after only a month, I'm doing beautifully blood-sugar wise. I always think these things work for OTHER PEOPLE, but have this nagging suspicion that there's something "different" about me.

Lisa, you predicted that this would happen. Got any lottery numbers for me?

[Lisa N]

Originally posted by jgallo
Lisa, you predicted that this would happen. Got any lottery numbers for me?

ROFL! I wish!
Seriously...I'm glad to hear that my "predictions" were accurate and that your blood sugar readings are now consistenly normal. Be patient with the weight loss. Many people find it difficult to lose weight during the winter months (including me) and it's very normal for rates of loss to vary from week to week or even from month to month. The important thing is to keep those blood sugars as stable as possible, keep up with the exercise and let the weight loss worry about itself. :thup:

[lee]

Hi jgallo, Glad to hear you are doing well!

I was thinking about what you said:

"Weight loss has most definitely contributed to this improvement,..."

I'm wondering whether, instead, the improvement contributed to the weight loss, or whether the improved sugar level and the weight loss are both symptoms of the underlying changes. Because it seems to me that we put on weight due to too many carbs, and then we put on more weight because we get diabetes, and not the other way around. Anyone with better knowledge than my guesses?? Interesting.