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Type II Diabetes: Self Care and Self Treatment

There is good news in, at least in those whose bodies are still producing insulin. We are learning more each day about insulin resistance and how to reduce it. Although all forms of diabetes are thought to be degenerative, progressive, and incurable, there is more and more acknowledgment among those who work with diabetics that there is such a thing as remission, or a return to “normoglycemia” (that is, normal levels of glucose in the blood). Where remission is not achieved, insulin resistance can be improved or stabilized, and the progression of the disease can be slowed or halted, with the possibility of delaying or avoiding late-stage symptoms such as blindness, neuropathy, rotting of the extremities, and heart and kidney failure.

Disclaimer
If you are a Type I diabetic, and now take insulin, none of the advice that follows can be expected to change your need for it. It may be good advice for you and for most people—and perhaps for people with the rarer forms of diabetes—as well as for the Type II diabetics for whom it is designed. It will not produce insulin for you if your body is depleted and no longer doing so. There are on-going debates about this topic and they will no doubt continue as long as humans exist.

General Limitations
Any discussion of self-treatment for diabetes has to take the following into account:
• Although diabetes is an ancient disease, effective treatment of it is in its infancy
• Nutritional science is in its infancy
• Nutritional and diabetic research are most often funded by drug companies, who have their own agenda that determines the possible answers by determining the questions
• Government nutritional data on food is sound—in fact, it’s the gold standard—but its recommendations on diet are deeply flawed by subservience to American agribusinesses. The notorious pyramids are not promulgated by the National Institutes of Health or any other part of Health and Human Services, but by the Agriculture Department. (Harvard’s Nutrition Source provides evidence-based alternatives.)
• News on valid nutritional research is often badly reported—sometimes beginning with the conclusions drawn by the researchers themselves—and almost invariably picks up distortion by the press and/or by popular enthusiasms as it spreads
• Our limited knowledge about food is surrounded by a thick cloud of faddism, pseudoscience, and baseless belief

General Principles for Care and Treatment
Reach and/or maintain a healthy weight. Losing excess body fat is the single biggest harm-reduction and self-treatment step you can take. Weight loss of as little as 5-10% significantly reduces your risk for diabetes and heart disease; as a bonus, and of course assuming you’re losing fat and not starving yourself (we note in passing the usual disclaimers: not all diabetics are fat, not all fat people are diabetic, body types vary and so on), a 10% weight loss is the threshold at which people usually start noticing and telling you that you look great. For diabetics, the specific helpful mechanism is that reducing both body fat and dietary fat halts or reverses the progression of insulin resistance, meaning your body is better able to use the insulin it produces.

Work it! For diabetics, “use it or lose it” has a particularly literal pungency. You’ve already chosen, or are contemplating the choice, of self-reliance. That includes moving your body around to do your work in the world, and to play and rejoice in it. Activity—work, play, motion, some sweat now and then, some sprinting now and then—all will help with fat elimination and weight control, condition a healthier heart, and specifically and independently reduce insulin resistance, making for a healthier, livelier and yes, even sexier you.

Eat right. In what has become something of a cliché, food activist Michael Pollan distills human wisdom about diet into seven words: “Eat food. Not too much. Mostly plants.” He goes on to say, “A little meat won’t kill you, though it’s better approached as a side dish than as a main. And you’re much better off eating whole fresh foods than processed food products. That’s what I mean by [“Eat food”…There are lots of edible foodlike substances in the supermarket, often] in packages festooned with health claims, which brings me to a related rule of thumb: if you’re concerned about your health, you should probably avoid food products that make health claims. [A] health claim on a food product is a good indication that it’s not really food, and food is what you want to eat.”

For diabetics, “not too much” has a specific meaning. Your body does not respond to food, and particularly to easily soluble carbohydrates (sugars and starches), particularly in large quantities, in a normal way. High quantities of protein and fat together promote insulin resistance, and thus your diabetes. In short, you need to strike, pretty much at every meal and snack, an optimal balance of nutrients that is going to satisfy you and is not going to make you sicker. Complacency will kill you, most likely after it cripples you. You can just knock fifteen years off your life expectancy now, and apologize in advance to the people who will have to take care of you—or you can log and meter your eating for the rest of your life. Bonus tip: In study after study, keeping a complete record of everything that passes your lips throughout the day has been shown time and again to be the single most effective tool for weight loss.

Let yourself get hungry. As a Type II diabetic, you may have forgotten what hunger feels like. That’s because once your blood glucose levels leave the normal range—whether they are chronically too high or periodically too low—you will crave food. You will feel “hungry” in the sense of feeling not-so-good-and-food-will-make-me-feel-better. You will be not just eager but literally anxious to eat. You will feel this pretty much most of the time. Real hunger is a different feeling—a kind of emptiness in the middle, sometimes accompanied by mild transitory pain: the “pangs” of hunger. Once you find the sweet spot for the content of an optimal meal, the false hunger abates. Something like four hours after eating, true hunger will probably appear. Oddly, its effect (and affect) will probably not be “MUST. HAVE. FOOD. NOW.” It will more likely be “Oh, I guess I should eat something.” Welcome this novel feeling, and nurture it by not eating too often.

There is no magical food. There is no diabolical food. That said, there are some very good foods, and some not so good. For diabetics, wild-caught fish is the animal protein of the gods. Vegetables are God’s gift to satiety. Olive oil protects the at-risk heart while hard animal fats stress it. Beans and legumes judiciously mixed with whole grains provide complete protein, without the fatty overhead of most meats. Various specific foods like bitter melon, nopal, buckwheat, possibly cinnamon, seem to reduce blood glucose. Excess salt raises blood pressure for most. Most important, no one food or combination of foods will have as much impact on blood sugar and general health as reaching and maintaining a healthy weight.

Do not starve yourself. There are various ways of starving yourself; almost all fad and crash diets depend on it. You want a diet—in the general sense of the totality of what you eat—that is sustainable. Whenever you consider a modification to your plan, you need to ask yourself: Can I continue to sustain this practice for the rest of my life? If the answer is no, then what’s the point?
Avoid food fads and pseudoscience. If an Internet search on a food topic—acidity and alkalinity of foods, say or glycemic index—produces a page of nearly identical language, claims of miracles cures, claims of suppression by the medical establishment, repeated appeals to the non-peer-reviewed “research” of someone who has a vague claim to the title “doctor”—run, do not walk, to the nearest exit. You are in food fad land and food faith land, and your brain as well as your health is in danger.

Be Kind To Your Feet. You’ll Miss Them When They’re Gone.
Inspect your feet. The standard recommendation in the U.S. is daily inspection. In the UK, the recommendation is twice daily—diabetics are instructed to work a foot inspection into their lunch break. Look for fungus, calluses, corns, any hardening of the skin or softening and swelling of the nails. Never ignore pain. You’re lucky you can still feel it.

Treat your feet. Study the structure of any abnormality—so you can trace its origin, and fix or replace any shoe or sock that causes you problems, and so you can properly attack hardened skin or softened nails with pumice stone and emery board. Consider fungus to be your mortal enemy—it’s at best opportunistic toward any other weakness or abnormality of the skin, and at worst, can actually cause potentially ulcerating wounds. Keep fungus from spreading to the nails if at all possible—once it takes root there it’s extremely difficult to dislodge. It could easily take another article this length to address treating nail fungus, but recent promising research tends to confirm the effectiveness of a widely-touted folk remedy you may already have in your medicine cabinet: Vicks VapoRub. (If you use a generic, check its “inert ingredients” for thymol, a thyme oil derivative that may actually be the strongest antifungal agent, although the camphor also has some effect.)

Protect your feet. If your feet are enclosed in shoes or work boots through most of the working day, you may need to develop the habit of regularly giving them some light and air. Consider washing them or wiping them down with a hand disinfectant as you change into slippers or sandals. Conversely, if your barefoot habits are contributing to foot problems, give them up as readily as you would an ill-fitting pair of shoes.

Use your feet. If you let foot problems limit your mobility, you’re headed down a slippery slope. Do your protection, treatment and maintenance so that you can keep those feet active and flexible—that’s protection and maintenance, too.

A Word of Encouragement
As a diabetic, dietary management may seem dauntingly complicated. On the other hand, a few simple principles go a long way:
• Eat lots of vegetables
• Avoid processed foods and high-glycemic carbs (the notorious “white foods”)
• Be moderate in your consumption of everything else

And although your biochemistry has changed, the physics of weight loss and weight maintenance has not changed:
• calories consumed < calories expended = weight loss
• calories consumed = calories expended = weight maintenance
• calories consumed > calories expended = weight gain

You do the math.

© 2008-2014 Off The Grid News

12 comments

  1. I have been a subscriber to your newsletter and site for several months and appreciate the information you and other provide. However, you are way off base on some of your recommendations above. I refer you to mercola.com for extensive articles on the subject of diet. You need to balance Mr. Pollen’s advice with some from Dr. Mercola. It is mostly, although not entirely, from his site I obtained the following information.

    There are three types of nutrients provided by food — carbohydrates, proteins and fats. We require proteins and fats for survival, but we do not require carbohydrates. Contrary to what you wrote, it is carbohydrates — primarily grains and sugars — that are responsible for insulin resistance. Diabetics need to minimize their intake of all carbs, not just processed white flour. Whole wheat flour takes a little longer than white flour to break down into sugars but has the same effect of raising the blood glucose level.

    You have implied that we need to minimize our intake of dietary fat, but too low a level would be disasterous. Of course everyone knows there are good fats and bad fats. We definitely need to eliminate trans fats and vegetable oils from our diet. Margarine, corn oil, canola oil and most other vegetable oils, claimed to be healthy, are actually responsible for a lot of cancers and heart disease. Olive oil and coconut oil are much healthier, as is butter. Saturated fat has gotten a bad rap, but undeservedly so. We can’t have good health without it.

    There is absolutely NO evidence that salt is responsible for raising blood pressure. That is another one of those old fables. There IS evidence that sea salt is much better for the human body than ordinary table salt. But unless you’re allergic to salt, it does nothing to harm you in any way. Any excess is simply excreted from the body.

    It’s amazing that most doctors, including heart doctors, still cling to these disproven theories. You can’t trust your doctor to know what’s best for you when it comes to diet. They are mostly ignorant of the truth. You have to do the research and be responsible for your own health.

    Yes, we should eat in moderation, but the advice from the health and medical communities over the last 40 years is singularly responsible for the epidemics we now see of diabetes, cancer and heart disease. As you mentioned, the published “food pyramid” is just plain wrong — in fact, it is very nearly up-side-down for achieving and maintaining good heath.

    I have recently been on three diabetes medications and my doctor wanted to put me on a fourth. I refused and decided to reduce carbs instead. I immediately eliminated one of the three medications and reduced the other two by half. After two months, my blood glucose levels are about half of what there were when I got serious about my diet. It’s very difficult to eat a low-carb or no-carb diet. That means I have had to increase my intake of protein and fats — exactly what you warned against. This is what works! With a little more progress, I hope to eliminate all the medicine.

    • Don, your assertion that we do not need carbs is flawed. We can get too many carbs, but if you will go to mercola.com and type in carbohydrates in the search bar, you will find out his recommendations on that subject. We cannot survive without carbohydrates for a long period. Of course Dr Adkins’ diet would suggest otherwise, when we feed the body only proteins, the body goes into a state of ketosis and starts feeding off itself. This is how people lose weight on the diet. However, over a prolonged period, one might end up as Adkins did before he, overweight at the time, fell and hit his head and ended up dying.

      • Billy, You are misquoting the Atkins diet. The extreme low carb intake is only recommended for a short period (two weeks if memory serves) to get your body in the proper mode. As I mention below, there are carbs in meats, too. There is no such thing as a “no” carb diet. Read the book, you will be impressed.

      • Billy, you are right on with your carb comments. My mother had a fasting glucose level of almost 400 when she was diagnosed with diabetes. Five doctors told her it would be impossible for her to manage without drugs. She chose to go an alternative route (something most doctors think is pure folly). Today, 2 years later, she has never taken the diabetes drugs, and her blood sugar is consistently around 100. That would be considered excellent control for a diabetic who takes the drugs. It has been a hard road for her requiring a lot of committment, but it is worth it in the end not to be dependent on pharmaceuticals that can cause as much harm as they do help. Anyone seen the recent lawsuits over the diabetes drug Avandia? The cure was worse than the disease! The foundation of her program is very similar to what is outlined above. Limiting carb intake is very important. Not because we are advocating an Atkins diet, but because a diabetics body cannot handle them any more than an alcoholics body can physically handle alcohol. The bulk of her diet is plant based, but meat quantities are limited as a diabetics kidneys cannot process excess amounts of animal protein well. She exercises on the treadmil most days of the week, takes Vanadyl sulfate 30 minutes prior to eating each meal and starts the day off with fresh prickly pear cactus. Prickly pear is excellent for normalizing glucose levels and can be found in most international food markets. Take 1 small cactus pad, very carefully use a knife to scrape the spines off (very important to get them all), toss the pad skin and all into a blender or pulse cuisinart, add the juice of 1/2 a lemon and some water. Drink. My mother is living proof that contrary to popular conventional medicine belief, diabetes can be managed effectively without “big Pharma”.

      • Billy, I quote Ron Rosedale on page 76 of “The Rosedale Diet”: “All carbohydrates are non-essential nutrients, that is, we don’t need to eat them. Although our bodies do require some sugar, we can make all the sugar we need from other nutrients. That means that you could be perfectly healthy if you never had an ounce of carbohydrate in your entire life.”

  2. Well, I am a physician, and neither one of you are completely correct, although both of you make excellent points, and I really loved this article! I am a fan of Jim Mercola as well. Here is my advice:

    1. Decrease carbs significantly, especially sugars. You do not need carbs! Eliminate grains from your diet, especially wheat. This one is often a surprise to people. This includes whole wheat. Grains, especially wheat, are not easily digested by anyone. If you eliminate grains, you will be amazed at how much better you feel in just a few weeks.

    2. Eat lots of above ground vegetables. In other words, greens, not root vegetables, which are high in carbohydrates.

    3. Protein and fat should be eaten in moderation.

    Atkins was very misunderstood, as is his diet. Anyone who has successfully lost weight on Atkins can tell you that when they eat too many carbs, their entire system changes after just one meal, and they begin to crave carbs again. The insulin resistant person, especially one with diabetes, enjoys carbs almost like they are drugs. That is why they can eat a giant bowl of ice cream and then crave another. That is why finding your critical carb level is so useful — it can make you have about the same interest in food as a “normal” person.

    My two cents.

    • Thank you, Thank you, Thank you! I have been telling people this for 40 years, but the rarely believe a “layman”. I was a “reactional hypoglycemic” in the 70’s. I had to eat no sugar/low carb to control it. Folks, there are carbs in everything we eat, including meats and cheeses. I still eat very few carbs and no sugars and I am NOT diabetic.

      One of the biggest causes of insulin resistance is your thyroid production. Have you ever been told your thyroid is a little low, but within the “normal range”? If so, they have discovered in the last decade that thyroid production in the “low normal range” is a killer. It nearly killed me. It’s referred to as “Covert Hypothyroidism”. That number range is absolutely necessary for regulating thyroid medication, but worthless as a diagnostic tool if it conflicts with the more important symptoms. Long term Covert Hypothyroidism will also cause a coating on the inside of blood vessels that inhibit transfer to the cells. If you have been told your thyroid is “a little low”, please get a book called “The Thyroid Solution” by Ridha Arem, M.D. He is the leading authority on the thyroid and editor in chief for fourteen years of the American Thyroid Association’s newsletter that all our physicians depend on to stay updated. It’s written in “layman” for the patient.

      Remember your history! Governments encourage grain consumption because they can control the grain and thereby control the hungry people. Hunter/gatherers are much more independent and difficult to control. Unfortunately, they can control our wild game and fish by not issuing licenses and allowing our wildlife to starve to death. We cannot allow our votes to be wasted. There are too many things bad guys in power can do.

      • Another thing that might help some people is Biotin (a vitiamin), and the herb, Stevia (use to replace sugar).
        For thyroid: Sea kelp helps. Worked for my husband. Be sure to have your doctor monitor your levels tho.

  3. Well, as the wife of a Type 2, I feel the need to chime in on paleolithic diet, i.e eating like our ancestors.

    Plentiful vegetables, in season; some nuts, some dairy, some meat and fish, some fruit, minimal grains and sweets. NOTHING processed other than what you do in your own kitchen. Folks lived on diets like this in rural areas well into the 1940s and 50s in this country, and life expectancies were pretty darn long (if you avoided childhood deaths and accidents). Combine that with significant manual labor/exercize (instead of sitting on your can typing into a computer) and you optimize your genetic potential for health.

  4. I see nobody here even considering the value to type2 diabetics in Vitamin E! I take 1000 IU of vitamine E and it helps me control my levels very well. It makes as much as a 20% difference in my levels as I have stopped taking it a few times to check. It also helps me keep consistant levels as well. My levels don’t jump all over the spectrum! I started this when my pharmacist gave me a copy of a study done many years ago and they had very good success with it. I should add, I am type 2 from exposure to defoliants, Agent Orange. There is no history of the disease in my family other than myself.

  5. I am so happy i found off the grid again and so very happy I found this article. I was feeling lost and alone.
    Now I feel inspired again. I take so many supplements but, now I know I must stop eating all those carbs
    they are not doing me any good. But what about Alpha Lipoic Acid I take 400 to 600 mg a day for nerve pain
    and it just goes away. It also helps my eyes and my feet are doing so much better too. Thank you all for all the great advice. I will be back for more.

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