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Diabetes Diet

Diabetes without Drugs

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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  • ruslim at

    Thanks a lot David …. journey reversing diabetes is changing live experience .

    God Bless You ….


  • ruslim at

    Dear David , thanks for your inspiration , , I am Ruslim , 45 years old. I am free from diabetes drug for almost 2 years now . The last blood test my hbA1c is 5.7 . I manage this condition by low carb and high fat diet, fasting and exercise . And my doctor told me that there are type 5 diabetes which mean can be reverse (cure) by changing life style, do you have reference regarding this ?



    • David Mendosa at

      Congratulations, Ruslim! You are right on the cusp of the standard definition of “complete remission” of diabetes, which is “is a return to “normal” measures of glucose metabolism (A1C in the normal range, fasting glucose <100 mg/dl [5.6 mmol/l]) of at least 1 year's duration in the absence of active pharmacologic therapy or ongoing procedures."

      Besides the very low-carb diet that you and I follow with such success, I know of two other ways, as I wrote at:




  • Rhonda at

    I really miss cereal for breakfast and as a snack. Does anyone have a substitute?

    • David Mendosa at

      My favorite breakfasts are:

      1. Protein powder with unsweetened almond milk
      2. Any vegetarian omelette.

  • donna at

    Hi David. I have commented from time to time. I am at the point now with awful gastric issues, hair thinning, rashes, dry skin; am hypothyroid, fatty livered, have rosacea, and a fissured geographic tongue, and other gluten associated issues. In short order, I am having food allergy testing, gluten intolerance testing, and scoping of both ends with a small intestine biopsy to see if I am celiac or gluten sensitive/intolerant. I feel if this is on the money, I have been ill for 20 years unnecessarily, and following the ADA diet – whole grains – may have had the cumulative effect of bringing the “wheat issues” to the forefront, if indeed that it what is ailing me.

    Literally, I’ve grown scared to eat due to the afterwards bathroom issues, bloating and pain, but until the tests are done (by 5 weeks from now) I am to continue to eat wheat or it may not show in my test results. It may not show anyhow, but I plan on going gluten free regardless.

    Have you done any articles on diabetes type 2 and wheat and/or celiac? I am reading a correlation between type 1 and celiac but it makes sense it could tie into type 2 also.

    The fact that I have had a fissured geographic tongue for 20 years escaped every doctor; I’ve read there is a strong chance if your tongue villi are damaged, your small intestine looks the same.

    Can you point me in the direction of any advice on this? Thank you for all you do.

  • Karen Okamoto at

    I was diagnosed with an a1c of 7 about 9 or ten years ago. I was 59, very active,….slightly above the average weight level. (I was familiar with diabetes as my daughter got type 1 diabetes when she was 10 and 5 years ago her son, of 4 months old at that time, got type 1. )
    Ultimately I took metformin, and reduced my a1c to around 6.5. I eventually was unable to keep my numbers down without eating only salads!!! I asked to be put on insulin at that point. ( I actually was in a listserv group of Arturo Rollo, when my daughter was young and David was on this site as well. Because of Arturo I asked the hospital to put Linsey on an insulin pump. She was the first children put on a pump at Children’s Mercy hospital. They continued to put all their patients on pumps after that.)
    Then I began to read even more, and went to an all vegetarian diet developed by Esselstyn. My a1c went down to 6.1. The beans in the diet probably prevented me from going lower.
    Next I tried a 5-600 calorie diet to see if I could get off insulin. It helped my blood sugars a lot, and I lost weight, but was not able to get off insulin. Some meals I would only need 1 unit, but if I ate something with many carbs,…….up my blood sugar went.
    Then I began reading about Bernstein. With his diet I went down to 5.4. ( I often use recipes by Dana Carpendar. ) I have continued to use his ideas. I have remained low carb, though I eat too many nuts and too much cheese.

    I need to improve on things in Bernsteins book, like have 5 hours between meals,…..eat consistent meals from day to day, measure better, etc etc I am a type 2 diabetic, but I do not believe I could become nondiabetic. I have tried it all and get discouraged, though since following Bernstein I have remained low carb and will probably remain in the 5% club.

    I see one of the best eye doctors in the world…..Durrie …and he has yet to see evidence of any diabetes. He told me once it always effects the eyes and he has equipment that I believe can view at the molecular level, so it remains to be seen if my eyes will remain untouched!!!!

    • David Mendosa at

      Dear Karen,

      Twenty years ago yesterday a doctor first told me that I have diabetes. As soon as I could get an Internet connection I joined Arturo’s group. So your message brought back fond memories. One of them was meeting my late wife Catherine on that group. I am of course familiar with Dr. Bernstein and his work as well as with Dana Carpender’s books.

      Further, I have brought my A1C level down to the low 5s through a very low carb diet, just as you have done. I have had a small microanyurism in my left eye, but most recently my eye doctor said it is “only a ghost of its former life.”

      Anyway, thanks for your message and for sharing your journey along our mutual path.



  • Mercabrio at

    Hi. Iam new here and want to share my progress with type 2. Iam 45 years old and was diagnosed type 2 in March 2012 with 400 on the blood glucose test, Hba1c 7 and very high cholesterol but normal high blood pressure.

    Within one year my tests revealed Hba1c 5.5, normal cholesterol level and fasting glucose of between 120 and 140. I did all this with exercise just walking, diet and Metformin 1000mg twice a day as the only medicine.

    I initially did a lot of research on type 2 in a panic and gathered a lot of info. One thing I discovered that I needed was Metformin. The benefits of this drug outweigh any other thing you can do about your diabetes. It is well tested over many decades. Studies have shown it has no serious long term side effect except vitamin B12 deficiency and also protects against cancers and weight gain. I was prescribed the statins for cholesterol and I flatly refused to use them because of the obvious side-effects which many people have reported. There was also another drug I should take before eating which also had very bad reviews on their long tern use. This is where I decided I have to disagree with my doctor and decided to go the diet way especially on the cholesterol problem. There was a risk but been well informed on the dangers of the statins there is no way I would have taken them.

    I do not want to tell others to do it my way but please research and evaluate yourself and make an informed decision.

    This is what i did. I consulted and worked with a Diabetic Nutritionist to arrive at the most effective diet to lower my cholesterol and also assist moderate my sugar levels. I bought a glucose tester and kept checking my sugar levels.

    My diet – No sugar (obviously). No alcohol. no juices (I instead eat whole fruits Apples or Oranges only). no whole milk – ( I use skimmed milk always). no red meat (occasionally I do treat myself). Eggs – 2 only once a week. Cooking – only sunflower oil. Salad – with a generous dose of olive oil BEFORE every meal.

    My size and composition of the Carbs have not changed. This is because my servings even before I was diagnosed have always been moderate. I still eat white rice (brown is ideal but not always available), brown bread, whole wheat chapatis, potatoes etc.

    My ever present salad bowl ALWAYS taken BEFORE meals. I take a big salad before ALL my meals even before breakfast. I consider this to be my best diet habit which is helping me live with my disease. I also decided to make my salad simple so that I can be able to make it and have it every time. When Iam out of lettuce (which have short shelf life) I just make my salad by slicing 2 medium size tomatoes, half onion, half cucumber, one carrot drenched in olive oil and Iam good for salad.

    Metformin 1000mg x2 – This is a drug I can live with it as long as I will need it. But remember use the Glucophage brand type of Metformin and not the generic one. The generic one also works but it will have a slightly different effect on your stomach. I know that because I have tested both. The best way to take Metformin is to let it sit between the food you have eaten. Before I start my meal I put my tablet with a glass of water next to my food and take it halfway thru my eating. For breakfast if Iam taking 2 slices of brown bread I take one slice then take Metformin and then take the other slice after. This looks like a small thing but it helps a lot for the stomach to cope with the drug. My doctor was surprised that I did not take the statins and yet my cholesterol is normal. He told whatever Iam doing is good and it is working. I asked whether I should continue with Metformin or reduce but he told me to continue for six months and see him mid-year for evaluation. One thing he told me is that doctors are discovering more and more linked benefits of Metformin even for high cholesterol and high blood pressure.

    Vitamin B12 tablet – every morning.

    Baby Aspirin powder sachet 100mg – every night.

    My best wishes to you all.

    • David Mendosa at

      Dear Mercabrio,

      Great A1C level! Congratulations and thanks for sharing your story.



  • Helen O'Neill at

    Thank you David for sharing all this personal info about what you eat. A lot of your readers probably feel as I do, that we know you as a friend and you are well informed and generous with good information. Your success gives me hope, once again, as I attempt to cut the carbs out of my diet. At the age of 70 I’ve been very disheartened lately about the fact that I’m still battling weight at this time of my life. The feeling of “why bother” keeps coming to my mind. On the other hand – what if I should live another 10 or 15 years? Wouldn’t it be nice to be more healthy than fat and sick? So I will continue to read your encouraging posts and attempt to make this the year that I get control of the carbs in my life. Thanks for listening.
    Helen O’Neill

  • deVries at

    Mendosa wrote: “Not a bad diet at all! In fact, it’s quite like mine!”

    Hi David, please share your current diet with us, and/or a list of the all foods you eat.

    Back in 2007/2008 I’m guessing you ate more carbs and foods you never eat now. Could you share what foods you ate then that you don’t eat now.

    I may eventually have to restrict my carbs to a very low level, but I’m experimenting cooking & baking foods myself to lower the GI/BG responses to hopefully not have to be as restrictive now that you seem to “have to” or want to be now.

    Do you think Byetta is still a fantastic wonder drug that you did back in 2008? Now that its been in wide use for 6+ years I’m just wondering if anything else has surpassed it in terms of its weight loss effects too? Would you consider it a very safe drug now that its been out and in use for several years?

    Would you have lost all the weight you did if you were able to just follow Dr. Bernstein’s diet back in 2008, or did you really need Byetta to do the big drop before being able to maintain his diet and keep the weight off too?

    Thanks, and Happy New Year! 🙂

    • David Mendosa at

      Dear Dean,

      You are absolutely right that I have reduced the amount of carbs in my diet, although I have been following a very low-carb diet since 2007.

      Before that, I took Byetta for almost two years, during which time I did also quite naturally reduce my carb intake somewhat. I still think that it is a fantastic drug and little has changed since I wrote my second book about it. The only real change has been the development of Bydureon and Victoza, two more recent drugs in the same class, GLP-1 agonists. Bydureon is actually the same as Byetta except that it comes with something that lets people take just one shot a week instead of two shots per day. Victoza is a somewhat different form of GLP-1 that you need to take only once a day. Both Bydureon and Victoza are therefore better than Byetta.

      Interesting question about whether I consider it “very safe.” I would not go so far! There is still some question — actually mostly disposed of — that any of these GLP-1 agonists might cause pancreatic cancer. I don’t think so and recent studies don’t show that they do, but I would never go so far as to say that ANY drugs is “very safe.” That is why I much prefer to manage my diabetes without drugs.

      Your last question is a great one! So great that I had already thought a lot about it and came to no conclusion.

      Now, here is what I currently eat:

      The question that people ask me the most often when they learn that since 2007 I have been following a very low-carb diet to manage my diabetes and my weight, is “What can you possibly find that you really like to eat?”

      That’s a good question, but one for which I have an equally good answer: “I eat so much healthy and delicious food that I have a hard time stopping myself.”

      In my continuing quest for these fine foods, I eat some old standbys, but have also discovered many foods that aren’t common in this country yet. I still keep discovering great additions to my diet and keep on writing about these foods here.

      Essentially, my diet is to eat no more than about 50 or 60 grams of total (not net) carbohydrate per day. My typical meals keep changing. But lately this is what I generally eat when I am at home:

      Breakfast: Two poached or hard-boiled eggs. I usually eat a little kimchi too. Sometimes I add 4 oz. of smoked wild or canned salmon with capers and a drizzling of olive oil.

      Lunch: A large salad consisting of greens (often spinach, arugula, dandelion greens, boy choy, and/or kale) broccoli, green onions especially including the green part, radishes, and cucumber. For salad dressing I use apple cider vinegar and raw extra virgin coconut oil or extra virgin olive oil. Sometimes the salad will also have green peppers, a small avocado, a can of sardines, mackerel, abalone, or salmon (each from VitalChoice.com), a little hard cheese, a little summer squash, or a few pitted green olives. I always add a sprinkling of chia seeds.

      Dinner: This is the meal that varies more than breakfast or lunch. Sometimes it’s just a bowl of plain whole yogurt with a few wild blueberries and a sprinkling of chia or sacha inchi seeds. Sometimes it’s just a bowl of the delicious soup that Whole Foods sells. Often instead it is a quarter pound of fish; wild ahi tuna is my favorite, but I also love wild salmon, which is the healthiest, because of its high omega-3 level. I never eat farmed fish and no longer eat meat or poultry.

      Snacks: I don’t snack much, but when I do it’s a handful of almonds or macadamia nuts, a bit of hard cheese, or no more than five Brazil nuts, or some olives.

      Intermittent Fasting: I make sure to eat dinner at least three hours before lying down for the night. I never have anything to eat after dinner. I skip dinner entirely if my weight is up and it’s above my goal weight.

      For me this is easy, because I have never been a good cook and never baked anything. And this probably doesn’t seem like enough for most folks. But in fact I am never hungry. I never need more. That’s because as I brought my weight down into the low normal range, I don’t need as much food. I no longer need to feed all that fat!

      Namaste and Happy New Year,


  • Ronald Stonis at

    Even “Oil pulling” by Dr. Bruce Fife has cured folks of dieabetes! The book is very informative. “Eat Fats, Lose Fats” by Mary Enig/Fallon is also a very good book. There is some recipes I do not use as the carbs are a bit too high. Diabetes is a “sugar disease” and all carbs turn to sugar as you know.

  • Ronald Stonis at

    I am 72 years old and now having type 2 diabetes for a year and a half. I tried all kinds of diets to avoid drugs, but none worked enough to get my sugar down. I came across a book: “Reversing Heart Disease and Preventing Diabetes” by Kent Rieske (amazon). He advocated a strictly high fat diet and very low carbs. I went for it and in one year, here are my numbers: Triglicerides down from 1100 to 55; cholesterol down to 148. blood pressure: 110/73. My a1c is down from 7.0 to 6.1. I lost a lot of weight and now feel great. No retinopathy or other complications. I recommend this book to everyone along with Dr. Bernsteins book too.
    If anyone wants to lose weight, a high fat and low carb diet is the way to go. I eat steaks, pork chops, lots of eggs, coconut oil, fish, some bacon and lots of salads with hard cheeses. Not a bad diet!

    • David Mendosa at

      Dear Ronald,

      You and I are on exactly the same path! Thank you so much for sharing your inspiring success story. Not a bad diet at all! In fact, it’s quite like mine!