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. Read on.
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" (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 lot of 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 Im 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.