In 1986 I was told that I had diabetes. For me, Dr. Bernstein’s book, Diabetes Solution, was an eye opener. there were two different types of diabetes. …
About Me
In 1986 I was told that I had diabetes I lived for 10 years thinking that
this was really not a major problem At that time no one gave me any
advice, no instructions, or any warnings about complications It would have
been helpful if someone had asked me if I understood what I was dealing
with and if I knew how to deal with it I began a search for knowledge and
understanding of the disease For me, Dr Bernsteins book, Diabetes
Solution, was an eye opener The book presented information to me in a way
that I was able to finally understand what I was dealing with and what to
do about it - and I did just that At mid-year my HbA1c was 90; at year-
end it was down to 58 Since then, I have continued to read and learn all
I can about diabetes and how to manage it This article is written to share
with you what I have learned and what I did to manage my diabetes
About Diabetes
I knew that there were two different types of diabetes I knew that Type 1
diabetes usually starts early in life and requires insulin injections to
balance blood sugars since the pancreas is unable to produce it But I
knew little about Type 2 diabetes I have Type 2 diabetes Type 2
diabetes
usually starts later in life and is due to a genetic flaw that prevents
proper movement of glucose sugar from the blood stream into the muscle
cells This is known as resistance to insulin As the level of glucose
increases the pancreas compensates by secreting more insulin and eventually
starts to burn out When that burn out reaches a certain point, the level
of glucose increases to above normal levels and diabetes is diagnosed For
some years prior to diagnosis, there is excess glucose and excess insulin
in the blood stream The excess glucose leads to diabetes and the excess
insulin leads to Metabolic Syndrome or Syndrome X Both have serious health
consequences
In the book Diabetes Solution, Richard Bernstein describes in detail the
metabolism of glucose and the role of insulin I found this information to
be extremely helpful to me in understanding what I could do to help manage
my blood glucose levels As I understand it, insulin is used in two phases
Phase one insulin is produced and stored in the pancreas and is released
into the blood stream when, as a result of eating, glucose in the blood
increases This fast release of insulin prevents the glucose in the blood
from
rising to dangerous and harmful levels Phase two insulin is produced
and released into the blood stream, as the food is further digested In
Type 2 diabetes, the insulin that the pancreas produces is used up in the
digestive process and there is not enough left for storage and phase one
release Therefore, two people eating the same size piece of chocolate cake
may have very different levels of glucose in their blood The person whose
pancreas has stored phase one insulin will not have the rapid rise in blood
glucose that the individual with low stores will experience However that
does not mean you cant have chocolate cake You just cant have much The
important difference is that the healthy pancreas can produce a large
amount of insulin in a very short time whereas the pancreas of the person
with diabetes cannot do so
Eating Wisely
With diabetes, it is essential that you compensate for a shortage of
insulin by watching the amount of carbohydrate you eat This means taking
into account everything that you eat at one time Lets use the example of
a whole meal Start with two dinner rolls, go on to clam chowder, pasta
with some meat, garlic bread and topped off with cake and ice
cream and
coffee with sugar In this example, you are assaulting your system with
carbohydrates that convert to glucose, which your pancreas cant possibly
handle Meanwhile your dinner partner can handle it with ease You cant
eat this way any longer If you want to prevent great damage to your eyes,
heart, kidneys, feet and sexual function you must limit the amount and type
of carbohydrates in your meals
People with diabetes are encouraged to measure their blood glucose both
before and after meals to determine if the levels are within the acceptable
safe range To learn how to control the levels of glucose after meals, it
is important to measure after meals Generally measure one to two hours
after a meal When I started, I measured one hour after a meal that would
produce a lot of glucose and I set my goal at under 200 While I did not
push it this far very often, I soon learned where my limit was Two
hours after a meal the level should not exceed 140 In this way you will
learn how various foods and food amounts affect your blood glucose In
other words, you will over time, learn what foods in what quantities are
safe and which are not I did this for about three months and now do
so
only when I eat an unusual meal And remember that since you do not have
phase one insulin stored in your pancreas, the high blood glucose may last
for several hours
Good sense is essential at all times Start to know and understand the
effect of the foods you choose If you are out for dinner and you know a
special dessert is coming, eat lower quantities of any foods with sugar and
most foods with carbohydrates to save room in terms of glucose intake
for the dessert And then eat only a small portion
Reading Labels
Time spent in the grocery store reading labels is very worthwhile For
example, dietary fiber is important for a diabetic to eat While cereals a
common source of fiber with high carbohydrate content will increase blood
glucose, there are crispy type crackers with relatively low carbohydrate
content and high fiber content Wasa Fiber Rye Crispbread has 4 grams of
carbohydrate as compared to a slice of regular bread with 16 to 20 and 2
grams of dietary fiber, which is about 10 percent of the recommended daily
amount And they taste pretty good These can be substituted for bread for
sandwiches and make a good in between meal snack Special lower
carbohydrate breads
are also available
There are several reasons to be careful when selecting bottled, canned,
packaged and fast food Carbohydrates and sugar will increase the glucose
your body must process and sodium salt may increase your blood pressure
Many bottled and canned drinks have very high levels of carbohydrates Look
before you drink Remember when reading labels that the Nutrition Facts
Label indicates fat, sodium, fiber and sugar Campbells Tomato Soup has
25 servings per can and each serving has 20 total grams of carbohydrates,
12 grams from sugar and 710 mg of sodium So each can has 50 grams of
carbohydrates, with 30 grams from sugar, and a whopping 1775 mg of sodium
Recommended daily allowance of sodium is 2400 mg per day I really like
Campbells Tomato Soup and have often had a whole can for lunch I do not
do that any more Its not worth it
It seems that companies who package food often say there are more servings
in a container than I think reasonable For example one can of Snows Clam
Chowder has 35 servings and 760 mg of sodium per serving If you eat the
whole can you get 2660 mg of sodium, more than an entire days recommended
allowance I recently asked about the sodium
content of sliced turkey at
the deli counter and was amazed that the amount for one sandwich was over
500 mg Also I recently saw the sodium content for super market made soup
and it was over 1200 mg per serving Fast food restaurants have Nutrition
Facts available for those who ask Ask what is in that cheeseburger and
fries next time you order Seventy seven percent of the sodium that the
average person eats comes from processed food such as those mentioned It
is wise to become a label reader and a ingredients asker and select
foods accordingly
Other Things
Another way to keep blood glucose at lower levels is to spread out your
meals For instance, if your dessert is a piece of fruit, eat this an hour
or more after your meal to minimize the amount of glucose your system must
process at any one time Also, since physical activity burns glucose, you
may want to experiment with eating the little bit of sugar that you crave
in the form of candy just before exercise
Above all, monitor your blood glucose; measure, measure and measure some
more If necessary, take readings up to ten times a day to find out the
effect of what you choose to eat When your blood glucose is
increasing, it
is best to use your fingertips That is a lot of finger sticking, but it
is worth it Soon you will know what, how much and what combination of
foods drive up your blood glucose, and what does not Since diabetics are
of different weight, different metabolism and have a pancreas that produces
different levels of insulin, you should make this determination for
yourself and not rely on general guidelines When you have this base of
experience and skill firmly in mind, you can measure less often, making use
of the knowledge you have gained I generally measure only once a day
Increasing the muscle mass in your body, and using your muscles more often
will better use up the glucose in the blood and cause your body to be more
sensitive to the effect of insulin For this reason, it is essential that
you exercise each day Strength training three days a week can effectively
build muscle Research shows that muscles exercised have improved
absorption of glucose that lasts for up to three days So the best
exercise is fairly high intensity strength training exercise of the large
muscles of the torso and legs On all days do aerobic exercise such as
walking, biking, running,
swimming or another activity that increases your
heart rate Ask your doctor to specify what your safe heart rate level
during exercise is As I am still overweight I work extra hard at intense
resistance exercise of all major muscles And the result is that my
average A1c over the last five years is 63 I consider exercise as the
most important thing I do to manage my diabetes
There are also some other conditions that must be controlled because they
can negatively impact the complications of diabetes by damaging the blood
vessels If you smoke you must stop Your doctor can help you with this
You need to know what your blood pressure is, and if you have high blood
pressure, it must be controlled A safe level is a blood pressure of 130/80
or less And intake of sodium has a substantial effect on blood pressure
Current recommended intake is less than 2400 mg per day
Finally, I have learned much from the use of search engines on the web
There are a number of web sites listed under Community Resources in this
notebook Use the terms in this paper to search the web for articles that
report new research and other developments The best book I have seen is
Bernsteins Diabetes Solution
In Summary
The five pillars of living a long and healthy life for a person with Type 2
diabetes are:
1 Eat only what your body can process without raising glucose in the
blood to dangerous levels
2 Exercise daily to better absorb the glucose in your blood, and
become more sensitive to the affect of insulin in your body
3 Achieve and maintain a normal weight
4 Control your blood pressure and do not smoke or use tobacco in any
form
5 Carefully use medication when needed to maintain normal blood
glucose The better you do with the first four pillars, the less
you will need drugs to maintain your blood glucose at normal levels
You cant cure your diabetes, but you can control your blood glucose This
will prevent the complications associated with high blood glucose You can
continue to enjoy a healthy body and a long life Good luck in your effort
By Harold M Petersen
A Patient with Type 2 Diabetes
Source:patientpowered.org
