If you have type 2 diabetes, you can manage it well without any drugs — without any oral medications and without insulin. If you have type 1 diabetes, you will always have to take insulin injections, but you can likely use less than you do now.
To manage diabetes well means keeping your blood sugar level down in the same range as that of people who don’t have diabetes. The way we check this level is the A1C (sometimes called glycated hemoglobin, hemoglobin A1c, or HbA1c). This test tells you what your average blood sugar level was during the previous two or three months by using a drop of blood about as small as that you use on your regular fingerstick tests that tells you what your level is right then.
When you manage your diabetes well, it is well controlled. It is normal. We know that the normal A1C level is 6.0 or below. See “The Normal A1C Level.”
An A1C level of 6.0 or below means that your diabetes is in remission. It does not mean that you have cured it. If you relax your vigilance, your A1C level will go above 6.0 again, and you will again put yourself at risk of the terrible complications of uncontrolled diabetes.
You can use drugs to bring your A1C level down to normal. That’s a good thing. But this strategy does have its costs, and those costs aren’t just money out of your pocket or your checkbook. The worst of those costs are the potential side effects of the drugs.
All drugs can have side effects. The systems and the organs of our bodies are so interconnected that no drug can target just one part of it without having some effect elsewhere. Sometimes we find that the side effects are helpful, but we can also find that they are harmful. Sometimes they are subtle and affect only a few people, but sometimes they are serious.
All of the drugs that we take to manage our diabetes are known to or are suspected of having some serious side effects in some people. That’s the price most of us are willing to pay.
But some of us think we have a safer strategy of managing our diabetes without drugs. Back in 2007 I joined this group with the encouragement of a good friend of mine who is a Certified Diabetes Educator. Before that, I had 14 years of experience taking a wide range of diabetes drugs, including two different sulfonylureas (Diaßeta and Amyrl), Glucophage (metformin), and Byetta. For the past six years I haven’t taking any diabetes drugs, and yet I keep my diabetes in control with an A1C level usually about 5.4.
I had to make three big changes in my life when I went off the diabetes drugs, and they are hard at first. But now they are a routine part of my life, and I would never go back to my old ways. The changes that I had to make are those that almost everyone who has diabetes has to make. In order of importance, I had (1) to lose weight, (2) eat fewer carbohydrates, and (3) exercise more.
Any lifestyle changes this fundamental are difficult, first because a body at rest tends to remain at rest, as Sir Isaac Newton proved more than 300 years ago. I wrote here about both the down side and the up side of “Overcoming Exercise Inertia,” but inertia is just as big a factor in losing weight and in eating wisely.
But we have another difficulty at first when we shift our metabolism from getting our energy from carbohydrates to getting it from fats, the only choice we have. A very low-carb diet necessarily means a high-fat diet, and the transition from carb-burning to fat-burning for energy can make us feel weak for a couple of weeks, as I wrote in “It’s Low-Carb Weak.”
Those are hurdles we all have to cross in making the transition to managing our diabetes without drugs. Is it worth the effort?
For me, my answer is an unequivocal yes, and I feel confident that it will be for you, if you are not managing your diabetes well or even if you are managing it well while using a diabetes drug or two or three. The systems of our bodies are so interrelated that when we manage our diabetes well, we get a positive side effect that spills over into our general well-being.
This article is based on an earlier version of my article published by HealthCentral.
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