What Every Person With Diabetes Must know About This Highly Manageable and Treatable Condition

Pharmacist George
By Pharmacist George Latest Reply 2013-01-23 23:52:37 -0600
Started 2012-10-07 17:08:30 -0500

A diagnosis with Type 2 diabetes is not the end of world and your life is still the same as you know it. You have the same chances of finding jobs, do anything you want and be involved in any hobby or any activity you choose just like before the diagnosis. You must also know that even if you have been diagnosed with Type 2 diabetes your lifespan has not been shortened and that you can still maintain the same quality of life as before the diagnosis.

What you must also know that having diabetes does not mean that you will have all the complications of diabetes such as blindness, leg amputations, heart disease, kidney failure so on and so forth. Facts are that you may not get any of them if you keep your diabetes under control meaning keeping your weight, blood sugar, blood pressure and blood cholesterol under control and avoid smoking.

You must also know that a diagnosis with Type 2 diabetes does not mean that you can’t eat anything sweet, any desert or any other food groups for the rest of your life. In fact nothing is off limit to you or anyone else with diabetes provided you consume it in balance and moderation and as part of a balanced and physically active lifestyle.

Having said all this, it is real important for you to understand that although diabetes is a controllable disease, if you don’t take it seriously and make favorable choices with regard to lifestyle changes or make inappropriate changes to your treatment without consulting with your doctor or pharmacist then you make yourself a magnet to all of the dire diabetes complications mentioned above and much more.

Most importantly you must claim responsibility for your health because primarily you must be in the driver seat by monitoring and keeping track of your vital parameters such as your blood sugar, blood pressure and blood cholesterol (your doctor will monitor it periodically).

In the book that I authored about diabetes I say this: “Diabetes is like a sword with 20 sharp edges but you have control over that sword. If you keep a tight grip on it then you live with diabetes happily everafter but if you let loose then the sword’s sharp edges will do great damage to your internal organs.

To help you achieve diabetes control, avoid complications and enjoy the best quality of life as stated above you have 4 friends along the way to help you achieve this very attainable goal: Weight management/loss, physical activity, raising fiber intake and Metformin.

The main problem with Type 2 is insulin resistance whereby insulin is being produced from your pancreas but when it gets to your muscles, liver or fat cells to help glucose (sugar) to be stored in those sites it is unable to. The result is sugar and insulin pooling in your blood and causing all sorts of problems to your internal organs.

For people with Type 2 the problem of resistance was caused by lifestyle choices and factors such as belly fat, physical inactivity, sitting for long hours, consuming excess calories coming from high fat, high sugar and high salt containing processed food, snacks and beverages, lack of adequate fiber content in the daily diet.

For people with Type 1 although the cause is not lifestyle related but those lifestyle factor mentioned in Type 2 become a problem and cause the same resistance for injected insulin thus raising the need for higher insulin doses. Higher insulin doses means higher insulin side effects such as weight gain, hypoglycemia and high triglyceride levels which worsen the resistance problem and the blood cholesterol profile.

The solution is to embrace those 4 friends mentioned above because all of them would improve or resolve insulin resistance and will make your body more sensitive to insulin and gradually resolve insulin resistance. You really don’t have to do a lot to improve insulin sensitivity but rather small and sustained actions will bring you priceless health benefits.

With regard to weight, studies have shown that a weight reduction of only 6 or 7 pounds would greatly improve blood sugar control, reduce your blood cholesterol and blood pressure. But more, sustained and gradual weight loss is even better and will do wonders to your diabetes control and improve blood cholesterol and pressure. In early Type 2 diagnosis and in the absence of organ damage with those favorable choices you may actually reverse diabetes and many not need to be on medications any longer. But any such decision would have to come from your doctor and you should never make any changes to your treatment without consulting with your doctor.

Metformin is a one of kind drug that works by sensitizing your muscles and liver to insulin and help them store your sugar and take it away from the blood. Most importantly, it promotes weight loss which in turn improves insulin resistance.
Physical activity and raising fiber in the diet play likewise a major role in making your body more sensitive to insulin and are indispensable arsenals to keep on your side in the fight against diabetes.

I have covered in detail in my book and in various articles on Living with Diabetes or through various posts on how to take the first step into making lifestyle changes and increase physical activity, increase fiber intake and lose weight without ever dieting again.

Here’s a 101 summarized approach on how you can start making those favorable lifestyle choices:

The first and foremost factor that promotes blood sugar stability is to have a balanced meal and snack structure throughout the day. Your body functions on regularity and a meal distribution that’s ideal for your blood sugar is to have 3 main meals and 2 snacks in between.

The American Diabetes Association recommends the following macronutrient distributions per meal: 50 – 55% of calories would come from carbs (mostly complex), 30% from fat and about 20% from protein.

This can be simplified by using the plate method for meals which I recommend in my books “Lifestyle Makeover for Diabetics and Pre Diabetics” and “Lifestyle Makeover for Couch Potatoes”. The first lady Michelle Obama is now recommending this same method and named it “My Plate”.

It goes as follows: Divide an average size plate into three sections: one half and two quarters. Fill the half section with vegetables raw, cooked or as a salad, fill a quarter with either lean meat, lean chicken, lean pork or fish. Fill the remaining quarter with high fiber carbohydrates such as 2 slices of whole grain bread, or brown rice, or whole wheat pasta, or a medium baked potato with skin (you can add a smear of butter or sour cream if you like). Your main goal is to have a balanced meal that includes a variety of all the important elements of a sound nutrition without “dieting”, feeling hungry or being deprived of any food.

How to get the recommended daily fiber amount 35 grams:

Aim at raising your daily fiber intake up to 30 or 35 grams and I’ll show you how you can reach this amount with just a couple choices: 1) Start your morning with Fiber One bars by General Mills or Fiber Plus bars by Kellogg’s have each 9 grams of fiber, they are delicious and a great way to start your morning. 2) For Lunch or Dinner sandwiches use whole grain bread with high fiber content such as “Double Fiber” by Oroweat or by Nature’s Own brands contains 5 to 6 grams of fiber per slice.

You can create a delicious lunch sandwich with a couple slices of these breads smeared with mustard, include lean ham or any other choice of lean deli meat or poultry, a slice of cheese then loaded it up with lettuce and tomato slices. This sandwich will yield about 12 grams of fiber.

Then for dinner if you eat a salad, a different choice of protein than lunch, or a bowl of beans (of any kind) or peas then this is going to get you at least another 11 to 13 grams of fiber or more.

For snacks, including a couple fruit snacks along with a small amount of nuts or almonds in between meals daily will supply you between 3 to 5 grams of fiber per choice of fruits such as bananas, apples (with peel) or oranges (keep some of the white rind).

Physical Activity

Another crucial factor and one of the most arsenals available to you at no cost and with absolutely no side effects to reduce your blood sugar, maintain or lose weight, disease prevention, stress management and whole host of health benefits is daily physical activity. To include physical activity of about an hour or more daily as part of your lifestyle is to increase walking by as simple as standing up and walking a couple steps then sitting back down and repeating this cycle every 15 to 20 minutes. Try to make more frequent walking trips to perform most daily chores and stand instead of sitting to wait for anything.

Always keep in mind that your health is the sum of choices you make every day and that small sustained actions bring you a wealth of health benefits.

29 replies

CJ55 2013-01-23 23:52:37 -0600 Report

I had to stop taking Metformin because of my kidneys. Took Metformin for 7 years.. Gained weight from it as well.

Tony5657 2012-10-09 05:17:04 -0500 Report

Thanks George for taking the time to share all this valuable information. Are there any negative side effects associated with Metformin?

Pharmacist George
Pharmacist George 2012-10-09 23:58:50 -0500 Report

Hi Tony5657,
The most frequent side effects are gastrointestinal upset, including diarrhea, cramps, nausea, vomiting and increased flatulence. Those side effects generally occur in the first few weeks of starting the treatment. That’s why the doctor may want to start you off with a 500mg tablet daily and increase it by one tablet daily every week up to the maximum effective daily dose of 2 grams. Take Metformin with food to help minimize the abdominal side effects.

Metformin does not cause hypoglycemia unless combined with a drug that causes hypoglycemia such as Glyburide or Glipizide. Metformin contributes to weight loss which is a favorable side effect.

Metformin should be given with caution to people who have compromised kidney function and may be contraindicated for those who have severe kidney dysfunction or heart failure depending on the severity of their condition. However, Metformin itself does NOT cause any kidney dysfunction. Hope this was helpful Tony. Take care.

Lee777 2012-10-09 02:56:45 -0500 Report

I posted this on your wall. I hope you can help me with this. Thanks! "Hello George! Thank you so much for your posts. Having been recently diagnosed with T2 DM at 23, it's really difficult to know how to start. But through your posts (as well as the others') I am greatly relieved that this condition is highly reversible if managed well. Thanks a lot!
I also have subclinical hypothyroidism. My initial TSH was 4.3 and the upper lab limit was 4.2 and normal T4. My internist started me on levothyroxine 100mcg OD. After 6 weeks my TSH was down to 0.8 and my dose was halved. I now have a euthyroid. But I just want to ask can levothyroxine cause hypocalcemia? Also, I was taking Reliv drink which has soya. Do you think it was the one that caused my TSH to rise? Prior to to that though, I already have a low serum ionized calcium but it was treated with calcium supplements.
I know my post is a bit rambled but I hope you will address my concern. Thank you so much. God bless you. :)"

Pharmacist George
Pharmacist George 2012-10-09 23:09:47 -0500 Report

Hi Lee777,
Levothyroxine does not affect calcium levels but possibly soy may have been behind the rise of your TSH levels depending on how much daily soy you. At any rate soy intake has been controvertial and blamed for causing a rise in cancer incidences in women when consumed in excessive amount. So if I were you I would cut back on soy consumption. As for levothyroxine take it in the morning on empty stomach with a full glass of water and don't combine other medications within a hour of it. Hope this is helpful. God bless you too. Take care.

Lee777 2012-10-10 02:50:18 -0500 Report

Hi George! You have been really helpful to me. I asked my doctor if soy increases TSH and she said no but at the back of my mind I knew she was misinformed. I've read from articles that it is goitrogenic and from you as well. So, I guess, it might've really caused the rise in my tsh level. Well, we'll see how the treatment goes after 3 months. I'm taking my levothyroxine with Essentiale, it is a phospholipid-containing supplement for the liver. :) Anyway, thanks really for the help. You are blessing in this site along with the others who are really approachable and very accommodating. TC!

Pharmacist George
Pharmacist George 2012-10-08 13:46:39 -0500 Report


Nowhere in my article there was blame to anyone or the mention that eating sugar causes diabetes. What I have stated are medical facts supported by all health organizations including the American Diabetes Association, the Centers for Disease Control (CDC) and may others. I gave tips and suggestions that are evidence based and that concur with the recommendations of those professional and respectable organizations I just cited.

It is true that some people who get diagnosed with Type 2 don’t have the lifestyle factors that generally contribute to Type 2 in the overwhelming number of people but even then maintaining favorable lifestyle choices will do a lot good in managing the condition.

I have great and unconditional respect for people especially those who have served and currently are serving in any branch of our great military force including you. I thank you and everyone else in our military for your service and sacrifices to our great country.

This is also a respectable and professional community and I appreciate any comment or criticism but without the use of offensive or disrespectful terms. Best of luck to you.

arsmithsr 2012-10-08 15:18:29 -0500 Report

For people with Type 2 the problem of resistance was caused by lifestyle choices and factors such as belly fat, physical inactivity, sitting for long hours, consuming excess calories coming from high fat, high sugar and high salt containing processed food, snacks and beverages, lack of adequate fiber content in the daily diet.

For people with Type 2 the problem of resistance was caused by lifestyle choices and factors such as belly fat, physical inactivity, sitting for long hours, consuming excess calories coming from high fat, high sugar and high salt containing processed food, snacks and beverages, lack of adequate fiber content in the daily diet.

you did in the above quote say they caused it themselves. That is not supported by any medical association.

Pharmacist George
Pharmacist George 2012-10-08 22:44:34 -0500 Report

I respectfully disagree and say that those claims a very well established and proven otherwise I wouldn't use. I will stick by my post and my reply.

arsmithsr 2012-10-08 11:39:12 -0500 Report

Ah another it's all your fault articles. Well I think you are full of BS. There are many studies that show we don't know what causes Diabeties take my case. I am not over wieght never have been. My Blood pressure is normal always has been. My Cholesterol is normal always has been. But I have Diabeties. I am also a Veteran of both the Navy and National guard so I have excercised. So according to you I should not be a diabetic but I am. I maintain control of my Diabeties through diet. My current A1C is 5.6 from 7.7 a year ago. I find it very frustrating when some stuffed shirt like you gets all pompouse and blames this on the people that have it. Most research says you can increase your chances of getting it from your above stated causes BUT EATING SUGAR DOES NOT CAUSE DIABETIES. You do no one any good by blaming them for their illness. And yes people like you piss me off.

granniesophie 2012-10-08 03:42:36 -0500 Report

Now please address those that cannot take Metformin, are gluten free, can't eat fruit because it causes major BS spikes, cannot tolerate large amounts of fiber, can't eat white potaotes because of high BS spikes, can't eat nuts, etc.
You article is one size fits all, and as as we all know, no body is one size fits all. How do those individuals manage their Diabetes according to you and your book??

Pharmacist George
Pharmacist George 2012-10-08 23:02:14 -0500 Report

When I don't know any specifics about the condition details of a person I would have to address the topiic in a general way. If any individual can not tolerate a certain drug then doctor will choose from a whole host of other drugs available. If someone has any specific dietary requirements that their doctor recommends then I would stick with those recommendations. But for the vast majority of people then yes the recomendations here and those in my book are at the heart of diabetes control. My recommendations during a 26 year spotless pharmacy career, five professional fields of expertise in disease management and fitness and the prolific and diverse information in the five books I authored have actually helped tens of thousands regain control of their chonic diseases.

Lee777 2012-10-07 20:48:09 -0500 Report

This is really helpful. Thank you so much George. I have a few questions though. Most of the products that you mentioned are not not available here in the Philippines. Could you suggest some alternatives to them?

Pharmacist George
Pharmacist George 2012-10-08 23:35:35 -0500 Report

Hi Lee777,

If you don't have any of those products in the Philippines don't worry there are a ton of other dietary products available to you. All vegetables are loaded with fiber and this makes broccoli, cauliflower or celery a great snack or you can eat vegetables in salads, in any recipe of your choice. Any grain product such as lentils, chickpeas or any member of the bean family or peas are excellent sources of fiber but also a great source of vitamin B complex, protein and complex carbs. Also, switch from white bread to whole grain, white rice to brown rice and from white pasta or noodles to the brown or whole grain version of it.

A medium baked potato with skin (because skin adds fiber) is also a good source of fiber and complex carbs. Watch for portion sizes though and try to use the plate model I described in the discussion. The plate method is an excellent and simple way to balance portion sizes and the nutrients that your body needs daily.

Moreover, many tropical fruits that you might have in Philippines such as Guava, Mangosteen or Durian (although stinky) are rich in fiber, antioxidants and vitamins. Also, watch portion sizes and I would limit fruit intake to a balanced portion about twice daily. But for vegetables you can have 3 or 4 servings daily or more provided a small amount of canola or olive oil if at all is used to cook the vegetables. I hope this was helpful Lee777. Let me know if you have further questions. Take care.

Lee777 2012-10-09 02:54:50 -0500 Report

Thank you so much George. I really learned a lot from your post and from your reply. After reading your post, I now use a plate with division to have the right proportion of food. As of now, I cannot determine how the method affects my blood glucose because I don't have a meter yet. But I am feeling better compared when I was eating anything in large portions. How I wish I was living in US so that I could have more food options than here. lol. Anyhow, thank you so much for addressing my concern. More power to you and to your career. :)

Pharmacist George
Pharmacist George 2012-10-09 23:12:16 -0500 Report

Thanks Lee777 for your kind words and more power to you as well in controlling diabetes and not letting it control you or your life.

Nick1962 2012-10-09 11:26:55 -0500 Report

Lee, this is off topic (sorry Pharmacist George), but I think many of us would like to know what your meals are like in the Philippines. I know culturally the influences are Spanish, Chinese and Malaysian, a lot of it is seafood and vegetables, and meal times for you are seen as more important than us westerners, but I think it would be educational if you could start a post about what food and meals are like for you and your family. Maybe even a recipe or two.
And no, be glad you’re not here in the states with all the food choices we have. Those choices are what got most of us into trouble in the first place.

Pharmacist George
Pharmacist George 2012-10-09 22:28:03 -0500 Report

Hi Nick1962,

Great inquiry Nick and right on target with regard the Western food choices. It's a great idea to have Lee777 tell us about some of their foods and recipes. I've tried philliipines food and I enjoyed it.

Nick1962 2012-10-10 08:10:45 -0500 Report

I always liked finding about other culture’s foods. Many, even though they may be rice heavy, seem to be so much healthier than our own. There is a quite obvious link between the western diet and diabetes. If one looks at countries/regions where the western diet has spread, diabetes incidence seems to follow.

Lee777 2012-10-09 17:46:05 -0500 Report

Why is this off topic Nick? :) Yes you are right. There are Spanish and Asian influences as well as American. I will start a post about it and share it with you guys. I hope you would learn from it too. :)

Nick1962 2012-10-09 18:03:56 -0500 Report

Great! Thanks! I look forward to it. I know a lot of us here need a few ideas to switch up our diets a little, and it's always cool to learn about how things work in a place 8000 miles from me.