My buddy has been suffering from type II diabetes and had a kidney transplant almost 2 years ago. Trouble is, he is really ballooning up, eating tons of sweet stuff, especially high glycemic fruit now that it is summer.

He is interested in low carbing to get him "back in control" but I'm concerned about too much protein intake. I know that the Atkins induction worked to kick my sweets habit but I would hate for him to eat so much meat. Does the Bernstein book address this issue at all?

Also, my other diabetic friend is 63 years old and is wasting away - does the book address this problem for diabetics (type II also)??

All their doctors half-heartedly recommend is the ADA diet - high carb, low fat, lotsa meds...

Thanks so much for any assitance you can offer.

JInx

It's really difficult to offer medical advice in cases like these (or over the internet at all for that matter) because we have such limited information.
With a kidney transplant, low carbing shouldn't pose a problem as it's really a high fat way of eating, not a high protein one and one would hope that they transplanted a healthy kidney that is functioning as it should. I honestly believe that they are putting that new kidney in more danger from eating all that high glycemic food than they would be from eating a little more protein and Dr. Bernstein does address the process of how uncontrolled blood sugars cause kidney damage.
Your friend who is "wasting" may also have very high blood sugars and because of the lack of insulin to move those blood sugars into the cells, their body is burning fat instead of glucose. This is also a very dangerous situation as they are setting themselves up for diabetic ketoacidosis in the very near future if those blood sugars are high and this is what is really happening. One of the symptoms of very high blood sugars is sudden weight loss.
Have either one of them been to an endocrinologist? If not, I would highly recommend that each of them do so to see what can be done with diet and medication together to get those blood sugars better controlled. I think we all know that the standard ADA diet isn't going to do the job.

First of all, thanks so much for your reply.

My friend who is wasting is on medicare - not the best care in the world, to be sure. His doctor told him that as long as his sugar doesn't get over 250 that that's fine and good!

The other has lost his job, will soon lose his insurance and no doctor has ever suggested either see an endocronologist. Like I said, the medical community is really lagging behind on this issue. I've been to countless appointments with both of them and have been a first-hand witness to the insance advice given by medical "professionals."

My one friend with the transplant drinks literally a gallon plus of diet coke per day - has for YEARS. Even with the transplant and severe anemia, no one really addresses his diet. The docs told him he could see an ADA certified dietician IF HE WANTED TO but we already know how that goes. The anemia has cleared up apparently, which is great. However, he is still eating things like Krispy Kreme donuts (there were a dozen at his place this morning, only he and his cousin live there) and then treating himself with shots and medication to "regulate" his sugar. He is seriously the type to listen to the medical establishment in regards to his lifestyle - but it's difficult for him to believe it will make a difference since none of his doctors talk to him about it. Very frustrating!!

He does address this issue quite well in his book. There's an extensive discussion of kidney function and protein in Appendix A. He does say that while high protein intake does not cause kidney damage, it can aggravate severe kidney problems if they're already present. If your buddy had enough damage to warrant a transplant, he needs to be in the hands of someone who really knows what he/she is doing. The protein could be a big problem for his other kidney if he's running a high GFR. He might want to call the Diabetes Center at 914-698-7525 and see if they can recommend someone in his area.

MsJinx...I agree that the advice that they are receiving is truly frightening, but did you know that on Medicare you can still choose which physicians you see? Most doctors do accept assignment from Medicare, meaning that they will accept Medicare's payment as payment in full and the patient is only liable for things that are not covered as well as their copays and deductibles. I'd strongly encourage them to seek a consultation with an endocrinologist.
When all is said and done, you can only suggest changes and actions for your two friends. They are the ones who will have to do the follow up and change their ways. You can't do that for them as much as you would like to. Nobody likes to see their friends and loved ones degenerate slowly when changing something as simple as what they eat on a daily basis could prevent it but when it comes to actually doing what needs to be done, we can only do that for ourselves until such time as we are no longer capable of making our own choices and then we are at the mercy of those whose responsibility it is to choose for us.
Another good reason for a living will; to make your wishes known while you're still capable of doing so.

I agree totally. I will suggest an endocronologist to them both.

As a side note, I was with my one friend before his transplant and had him fill out a living will. I was with my other friend before his 2 amputation surgeries and had him do the same thing. And, of course, I have one on file for myself and my fella. I would hate to put someone in the position of wondering what any of us would want if the worst were to happen.

Jinx