Confused About Diabetes

Most of us are confused about diabetes, even our doctors. The confusion is mostly about how to manage this chronic disease, rather than what we want to achieve.

Most of us want to live as normal a life as we can. We know our goal, but not the roadmap to get there.

Normal for those of us who have diabetes means having a normal blood sugar level as measured by an A1C test. That level is certainly below 6.0 as I wrote in “The Normal A1C Level” and probably 5.4 or below as I wrote later in “How You Can Reduce Your Risk of Heart Attacks.”

We all make some effort to get there. At least 95 percent of us take the easy way out, which is to passively do some or all of what our doctors recommend. Almost without exception our primary care physician or endocrinologist will tell us to take one pill or another.

When our levels are sky high or when we have type 1 diabetes, our doctors will, of course, prescribe insulin injections. Nothing works faster or better than insulin to bring blood sugar levels down to normal, so for people who have type 2 diabetes this is a sensible short-term strategy. Of course anyone who has type 1 diabetes will need to continue taking it.

But if our doctors tell us to take a pill, we have a problem. All pills have some side effects. We know what some of them are, but it can take years of testing with us as guinea pigs before we find if they will harm us.

We need to remember the wise words of former Secretary of Defense Donald Rumsfeld. While he is hardly someone I generally admire, these words make as much sense in our battle against disease as his battles against other people:

“There are known knowns. These are things we know that we know. There are known unknowns. That is to say, there are things that we know we don’t know. But there are also unknown unknowns. There are things we don’t know we don’t know.”

For our doctors to tell us to take a daily pill and to come back to the office in three months is easy. They usually will tell us to eat less and lose a little weight, but they often say that in an offhand way, as if they don’t expect you to be listening.

Why? Probably because they know better. If the doctor has any experience in trying to help people who have diabetes, he or she knows how hard it is for us to change the habits of a lifetime. So I don’t blame our doctors.

I do know that all of us who have type 2 diabetes have a safe alternative for managing our diabetes. After 14 years of daily pills and injections, in 2007 I stopped taking all of my diabetes medication and began to follow a very low-carb diet. The results please me and my doctors. For example, my A1C level today is 5.3 and my BMI is 19.5.

I don’t expect other people to believe that they can manage their diabetes just by minimizing the amount of carbohydrates they eat. With all the conflicting theories of diabetes management that you can read — everything from high-starch to raw, vegan, or vegetarian, to say nothing of ignoring diet altogether — you have to experience and test this for yourself.

The best teacher I ever had was a spiritual leader who said he was not a guru and he did not want me to believe what he taught. Just try to do what he suggested, he told me, and see if that worked. Experience is what counts.

When we become actively involved in managing our diabetes, we can make mistakes. I certainly did when I followed the high starch diet that a distinguished doctor wrote about.

We have the tools to see if we have an alternative to pills for managing our diabetes. We are lucky that we have objective measures of testing the results of our efforts. Fingersticks and A1C tests tell is on a short-term and long-term basis how close we are to our goals.

I’m not saying that following a very low-carb diet will be easy, particularly at first. I am saying that if you experience following this less-traveled route, you will be healthier and that it will make all the difference. Experience is the best cure for confusion.

This article is based on an earlier version of my article published by HealthCentral.