Your non-depressing guide to Type 2 diabetes
First of all: don't panic! Your doctor says you have developed Type 2 diabetes (or you're heading that way), and you have heard a lot of scary things about that disease. But still: don't panic. Despite what you've heard, there are things you can do about this, and they actually work. You'll find more thoughts on why you shouldn't panic here.
A Guide to Recent blog posts
I've decided to provide a summary here of the issues I've covered in my blog posts, by date. I'm hoping this will make it easier for you to find subjects I've written about which might interest you. It will take me a while to develop this, but for now, I can provide you with a guide to posts from January 2015 to date. (Also: see check out this Google trick for finding information on this site.)
February 4, 2016 -- What is the real connection between: wedding costs and divorce, diabetes and autism, diabetes and tendinopathy, diabetes and cannabis? (Also: the problem of hidden sugar!)
January 28, 2016 -- Rain comes to California; better treatments for Type 1 diabetes (transplanting beta cells, and protecting them); vitamin D doesn't cure diabetes; healthy food costs more.
January 21, 2016 -- Moving into a new office at work. Also: diabetes patients have "smelling problems"! Also: is exercise more effective if you do it in brief, crazily intense bursts?
January 14, 2016 -- Potatoes cause gestational diabetes, and whole grains don't? Or should we take a closer look at that? And will an enzyme called G3PP allow you to eat candy all day?
January 7, 2016 --Dental issues and how they affect diabetes; Star Wars movies as a marker of progress through life; the effect of stress on how body fat is used; the effect of blood glucose on blood pressure.
December 17, 2015 -- Last blog post of 2015! My chilly but invigorating 9-mile trail-run. Also: old people who want to be president: is their health "astonishingly excellent"?
December 17, 2015 -- Is Type 2 diabetes an "amyloid" disease, and what does that mean? And what does it tell us about the role of insulin resistance in causing the disease?
December 10, 2015 -- Correlation and causation: how worried should you be when you hear that having diabetes correlates with a heightened risk of some horrible thing or other -- such as losing your teeth.
December 3, 2015 -- Dealing with an injury. Dealing with the threat of hummus. Research into two possible causes of diabetes. And: why there can't be a single "diabetic diet".
November 19, 2015 -- Insulin has to be injected -- it can't be taken orally. Or have researchers found a way around that problem?
November 12, 2015 -- Causes of death ranked, and risk factors for those causes of death ranked. Also: online tools for assessing your risk level!
November 5, 2015 -- Another study claims to show good glycemic control is bad, but really shows something else. Also: a rant about avant-garde music which turns out to be a rant about homeopathy.
October 29, 2015 -- A Canadian study says that brief "bursts" of high-intensity exercise do more for diabetes patients than a conventional workout would. Are they right, and is this practical?
October 22, 2015 -- Small studies had claimed sitting is bad for you even if you work out. Not true, says a big study! How should we react when things that are supposedly bad for us turn out not to be?
October 15, 2015 --What I found out when I tracked my blood sugar after a meal. Also: health benefits of wine, and why exercise feels harder if you have diabetes.
October 8, 2015 -- The world was supposed to end and didn't. What can the weakening market for doomsday predictions tell us about drug prices -- and about press coverage of drug breakthroughs?
October 1, 2015 -- Thoughts on the annual flu shot, and thoughts on the flu virus: is a virus a living thing, and why or why not? Also: the ICD-10 diagnostic codes, and why American doctors hate them.
September 24, 2015 -- Has the research community become so captured by the pharmaceutical industry that objective scientific judgment is no longer possible?
September 17, 2015 -- Hemoglobin A1c results: what is the actual relationship between results on this test and your risk of serious health problems? Let's put some numbers on this.
September 10, 2015 -- Weird statistics say gestational diabetes affects fathers somehow. Also: effectiveness of bariatric surgery; high prevalence of diabetes in the USA; the trouble with grinding fiber.
September 03, 2015 -- Setting the record straight: I'm not against science, I'm just against the sloppy or dishonest use of it. Also: smoking is bad for diabetes patients; try to act surprised.
August 27, 2015 -- The problem with assuming diabetes has "stages" -- illustrated by pointing out what's wrong with the "five stages of grief" meme.
August 20, 2015 -- A guide to figuring out how to interpret a baffling scientific explanation of a medical issue. Also: what Pluto's demotion to "dwarf planet" tells us about saturated fat.
July 30, 2015 -- Skipping breakfast sounds as if it might be a good move for diabetes patients, in terms of glycemic control. Turns out it's bad!
July 23, 2015 -- A new technology for testing glucose without using test strips. Also: why anti-inflammatory treatments for diabetes keep being discovered, forgotten, and rediscovered.
July 16, 2015 -- Thoughts on health insurers who don't want to pay for diabetes patients to test their glucose frequently.
July 9, 2015 -- Turns out three diseases are worse than one, and coffee isn't bad for you. Also: just 1% of drug researchers do 32% of all studies -- and guess what industry they work for?
July 02, 2015 -- Why diabetes patients need to operate as if they were scientists -- and why they need to be experimentalists, not theoreticians.
June 25, 2015 -- Diabetic men who take drugs for erectile dysfunction live longer, but why? (More reason to live, perhaps?) Also: an explanation of what might be causing for "diabetic heart".
June 18, 2015 -- Q&A (more of my attempts at answering questions implicitly raised by Google searches). As usual: lots of urine-focused questions.
June 11, 2015 -- Some potential flaws in the accuracy of the hemoglobin A1c test, explained with reference to the "Deflategate" football scandal. Don't blow things out of proportion, folks!
June 4, 2015 -- At last -- a disese (ALS) that's less common in Type 2 patients! Also, glycemic control, coronary risk, and the "not dying" thing.
May 28, 2015 -- High blood pressure is a big issue for many people with Type 2 diabetes. How do the possible treatments stack up against each other? Also: the false-correlation problem in research news.
May 21, 2015 -- Randall Munro's "Up Goer Five" described a Saturn V rocket using a restricted vocabulary (only the 1000 most common words!). Can the same be done for diabetes -- by me?
May 14, 2015 -- Jonathan the tortoise is thought to be over 180 years old. Why do these creatures live so long -- and can we learn anything from them? Also: the potential impact of anemia on hemoglobin A1c tests.
May 07, 2015 -- Thoughts on witnessing a helicopter-based rescue at the local state park. A comparison between the glycemic impact of dieting vs. exercise. And: why is screening for diabetes done so badly?
April 30, 2015 -- Q&A (more of my attempts at answering questions implicitly raised by Google searches). Lots of questions about the A1c test. Also: what normal glycemic control looks like!
April 22, 2015 -- Taking a closer look at the clinical guidelines I wrote about the previous week (April 16). More documentation had become available; the situation looked a little better (but not a lot better).
April 16, 2015 -- The American Association of Clinical Endocrinologists (AACE) and the American College of Endocrinology (ACE) updated their clinical guidelines for T2. Their focus: drugs. Exercise? Not mentioned.
April 9, 2015 -- Drugs that are used for years without scientists having any idea how they work. Also: intestinal inflammation as a cause of diabetes, and eating eggs to prevent diabetes.
April 2, 2015 -- The years-long battle over whether eggs are "healthy". Also: exercising with an injury.
March 26, 2015 -- Making sense of the statistics: why is the apparent prevalence of diabetes so strongly affected by local politics? And why is there more hypoglycemia going on than doctors think?
March 19, 2015 -- A US presidential candidate's highly questionable role in pushing a diabetes "cure". Also, questionable claims about "net carbs" in processed foods.
March 12, 2015 -- Retrospective thoughts on my fourteen years with diabetes -- inspired by the results of my annual physical, and the lab results I got (5.5% A1c!).
March 5, 2015 -- The possible drawbacks of the widespread use of statin drugs (apparently they increase diabetes risk substantially). Also: weird research on rats and mice.
February 26, 2015 -- The maddening unpredictability of individual responses to factors affecting blood glucose levels. Why can't this kind of thing follow simple, straightforward patterns in consistent way?
February 19, 2015 -- Sleep loss is known to promote diabetes -- but why? A possible explanation of the mechanism. Also: looking for the good aspects of dangerous climate change.
February 12, 2015 -- Can chemical engineers build a better version of the insulin molecule, and if they can do it, should they? Also: diabetes and hypertension tend to go together; what can be done about this?
February 5, 2015 -- The tortoise and the hare: is it true that "slow and steady wins the race"? Some researchers think so. Also: a newly-discovered chemical pathway may explain the liver's role in diabetes.
January 29, 2015 -- Diabetes is highly complicated, and people try to simplify it too much! People also talk too much about diabetes killing people. Also: why I don't use "data" as a plural.
January 22, 2015 -- The health-hazards associated with siting too much, and my struggles to spend less time in chairs. Also: living in a world which wants to force a high-carb diet on you.
January 15, 2015 -- The importance of finding a nice local spot for outdoor exercise. Also: research linking inactivity with early death. Also: an asthma drug helps diabetes patients -- at least if they're mice.
January 8, 2015 -- Research on how to make mice thinner -- what's in it for us? Also: two articles on metformin, on saying we're underusing it, and one saying we're overusing it.
January 1, 2015 -- Resolution running -- people hitting the trails to make up for all those Christmas parties. Also: being poor is very bad for your health. This worries doctors: what if they get blamed?
Highlights from Previous Years (2014)
November 13, 2014 -- Nature's plan for us: when a physician and bio-ethecist declared that he didn't want to live past age 75, I had some thoughts to share on the subject.
October 9, 2014 -- Which foods are okay if you're diabetic? A ranking of common foods in terms of their carbohydrate and fiber content.
September 11, 2014 -- Does "diabetes" mean anything these days? The fascinating problem of how we define a complex and highly variable disease.
August 28, 2014 -- The Maillard reaction (also known as the "browning" reaction) -- what it is, and how it affects diabetes patients.
July 24, 2014 -- Are doctors turning against the concept of pre-diabetes? They might be, and maybe it's about time.
February 18, 2014 -- Cheating, being cheated, and wanting to be cheated: our eagerness to believe that a "low-carb" food really is low-carb.
(I'll add more highlights from previous years as I find time to do it.)
Searching this site
Another way to look for topics on my site is to enter a line formatted of this type in Google:
Replace "topic" with whatever subject you're looking for. For example, to look for information on the hemoglobin A1c test, enter site:notmedicatedyet.com A1c
This is one of those subjects I've written about pretty often, but the search results give you a pretty good idea of what you'll find on the indicated pages.
The usual, depressing message about diabetes is sometimes tactfully disguised, but anyone who has been diagnosed with the disease soon learns to decipher it. The message is: "Give up! Resistance is futile. You are now in the grip of mysterious, uncontrollable forces, and there's nothing you can do about it. Please resign yourself to a life of helplessness, drug-dependence, disability, and early death. Have a nice day!"
Oddly enough, this message generally fails to energize and inspire people. In fact, once people realize this is the future that has been mapped out for them, they tend to become depressed and apathetic. The result is that a lot of people who have been diagnosed with Type 2 diabetes fail to do any of the things that could improve the situation. They don't know, or don't believe, that there actually is anything they could do to improve the situation. And there might as well not be, if people don't try! A solution which people don't take advantage of is effectively the same as no solution. Therefore, there is an urgent need for patients to find out what they can do, and do it.
I emphasize patients because of an unusual aspect of Type 2 diabetes: it's a treatable disease, but it can't be treated by doctors. The practitioner who is going to be administering your diabetes treatment is you. Doctors can advise you, and they can give you legal permission to buy certain controlled substances, but (unless you happen to be in a coma), they can't treat your diabetes for you, any more than the GPS device which advises you to take the River Road exit can drive your car. Doctors simply aren't in the driver's seat, because they cannot live your life for you. Success or failure at getting healthy (and staying healthy) after a diabetes diagnosis will be determined mainly by what goes on during that part of your time which is not spent at the doctor's office or the pharmacy. Diabetes care involves a lot of things, and getting prescriptions filled is a pretty small part of the picture. (For me, so far, it's no part of the picture at all.)
Although the idea of solving your diabetes problem by taking pills (and doing nothing else) has a certain appeal, it's clear by now that this approach doesn't work very well. It's also clear by now that there is another, better approach available. Most doctors try to talk their patients into adopting it. Unfortunately, most of their patients would rather be given pills than advice on how to live. "Why change my habits when I can simply take prescription drugs?", they ask themselves. That would be a valid question, if the drugs were enough, by themselves, to keep diabetes patients healthy and safe. They aren't.
Peek behind the curtain of pharmaceutical-industry hype, and you'll find that the available medications for Type 2 diabetes scarcely deserve to be called wonder-drugs. They're costly, they produce unpleasant side effects, they can be a bit dangerous, and the benefits they provide are apt to be disappointing. At least, they are apt to disappoint a patient who assumes that taking the drugs is all it takes to be healthier and live longer. To cite a particularly stark example of what I mean, these drugs offer you little or no help with the biggest problem diabetes patients must solve: how to prevent "cardiovascular accidents" (that is, strokes and heart attacks). Call me fussy, but I see that as a flaw.
Because diabetes drugs alone are not going to protect you, even if you are taking pills by the handful you will still need to do a few other things about your diabetes in order to be healthy. Because those other things provide benefits that the pills do not, and often outperform the pills in the areas where the pills do work, it's often possible (and preferable) to get by without taking diabetes drugs at all. Most patients never really explore that option, probably because they don't understand that the option is open to them. Sadly, they also seem not to understand that taking diabetes drugs, while doing nothing else about the disease, is a losing game.
And so, the drugs-and-nothing-but-drugs approach to diabetes treatment is the one that vast numbers of patients are getting. Their doctors know how unsuccessful this approach tends to be, but are unable to talk them into trying something better. This is a ridiculous situation, and it needs to change. This web site aims to help change it.
If you have been diagnosed with Type 2, and you are interested in finding a way to control the disease (instead of letting the disease control you),then you have come to the right place. Despite what you may have heard or assumed, it very often can be done. It just usually isn't.
But first: check with your doctor
Please bear in mind that I am not your doctor. In fact... well, don't tell anyone,but I'm not a doctor at all. The only reason you have for taking my advice seriously is that I have been very successful in managing my own diabetes without medication. This suggests that I am doing something right, but it really doesn't prove that I know what I'm talking about, does it?
Therefore, if you decide to take my my advice, I'm honored, but I want you to discuss it with your doctor, too. Or perhaps I ought to say that you should discuss it with your "health care team". This phrase turns up often in diabetes literature, to my puzzlement. Does everyone but me have a team? I have a doctor, but he works solo. Perhaps the other members of my team were benched for some infraction of the rules.
Anyway, see what your doctor, or squadron of doctors, has to say about all this. There might be circumstances in your life, or in your medical history, which make my advice inappropriate in your case. For example, your doctor might think that, given your present condition, the exercise program I'm recommending would do more to increase your cardiac risk than to reduce it. (I wouldn't count on it, if I were you, but conceivably he could think that, and if he does, you need to find it out now.)
Generally speaking, when you have type 2 diabetes you are in charge of your own treatment, and you have to make a lot of significant health decisions on a routine basis. But for the really big decisions, you need to seek guidance from a doctor who knows the particulars of your case. When you are thinking of adopting a new health regimen, no matter who recommends it, and no matter how much it may have helped someone else, you need to verify with your doctor that it is safe for you to give it a try. I want you to do this in regard to the recommendations I am giving here.
Feedback & Questions:
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If you're newly diagnosed with Type 2 diabetes, start with the Q&A section, which (I hope) gives useful answers to most of the questions you are likely to have about the disease and how to deal with it. (For a much shorter introduction, see Type 2 Diabetes in a Nutshell, in the Notes section.)
The Blog section is my daily report on what I'm doing, what kind of test results I'm getting, and what I think the connection between those things is.
The Notes section includes more in-depth essays on various topics that are important to diabetes management.
The Journey section includes essays about the experiences and changes that you are likely to go through as a result of being diagnosed with type 2 diabetes (particularly if you are going to have a go at controlling it without medications).
The Resources section includes links to other web sites that may prove useful to you.
The Author section tells you a just barely enough about me to make you think I'm probably a real person. Should you want to send me a question or comment, there is an e-mail link you can use at the bottom of this and other pages.
Why that title?
This web site owes its title
optometrist, who once asked me, "Are you still controlling your
diabetes with diet and exercise? You're not medicated yet?".
I winced and said "Now, don't say yet!". He winced too, as he realized how this had come across. He wouldn't ask me "How's your job going? You're not fired yet?", but it was only natural for him to talk that way about Type 2 diabetes. Everyone does.
Most people assume that, if you have Type 2 diabetes, the only thing that can help you is prescription medication; you might as well face that fact, and get with the program, because any attempt at managing diabetes without medication is bound to fail.
This assumption is based on what most patients actually do, not on what most patients can do. As an assessment of what's wrong with the world, it may be on target, but as an assessment of what is possible and desirable, it is simply wrong. Someone needs to be pointing that out. I guess it might as well be me.
If, as some people imagine, lifestyle adjustment as a therapy for diabetes is only a delaying tactic -- a stopgap treatment which sort of works, for a little while, and then fails -- I can only say that I've been using it for several years and it's still working just fine. Maybe Mother Nature is planning to make a liar out of me soon, but it hasn't happened yet.