Diabetic Connect's Voices of Diabetes series gives members of the diabetes community the opportunity to share their personal challenges, insights, and life experiences with a larger audience. We hope these stories inspire and encourage you to find your own voice as a diabetes advocate. If you would like to share your story, contact us at firstname.lastname@example.org. Visit the Voices of Diabetes page on Diabetic Connect for more in the series.
After first being diagnosed with type 2 diabetes, Brian Buckley made a big lifestyle change and managed six years of excellent blood sugar control without any medications. But when his lifestyle slipped again and his BG's shot up, Brian's doctor started him on insulin.
It took him four years, but Brian is now back on the path of medicine-free diabetes management. When Brian's daughter had her second child and went on a slow-carb diet to shed her baby weight, Brian did it with her. He's lost 35 lbs, 10 inches off of his waist, and 13 percent body fat on the plan. But, best of all, Brian's BG control is better without insulin than it was with insulin.
Brian was so excited about managing again without insulin that he wanted to share what he's learned with others. His blog "BeatT2Diabetes.com" is his way to encourage others. Read on for Brian's take on the slow-carb diet, managing his diabetes without medication and tips for those who are newly diagnosed (or, we'd say, even "old hats" at the disease).
Q: Tell us how your diabetes story began. When were you diagnosed? How did you react?
I was diagnosed in January 2000. I had been working incredibly hard and was under a lot of stress. I didn’t even notice that I was eating like a horse, had an insatiable thirst, and couldn’t stop going to the bathroom. I lost 20 lbs in two weeks. Thankfully, my wife noticed what was going on and made an appointment for me to see my doctor. There was a fellow at work with type 2 diabetes. He used his meter to check my BG and it was sky high, so I was prepared for the same result at the doctor’s office.
I had mixed emotions to the diagnosis. On the one hand, it was good to know what was causing the emotional and physical changes in me that other people were noticing even more than I was. On the other hand, there was a lot of uncertainty. People were consoling me as if I’d just suffered a death in the family. It didn’t help that my diagnosis was made on a Friday afternoon, so my doctor sent me to the ER in order to ensure that we’d be able to get lab tests done. The ER doc told me that they were going to check me into the hospital and start insulin right away. Fortunately, a shift change happened. The new doctor had a lot of experience with type 2 and he told me that he had seen people like me manage with oral meds and weight loss. I got to go home that night without starting insulin. Once I had a plan to focus on, I felt a lot better about things.
Q: Why did you make the decision to blog about your diabetes? What are your hopes and goals for the blog?
I went through six years of excellent blood sugar control – off all meds and regular excellent A1C results. This was all accomplished through a big lifestyle change. Unfortunately in 2007 for various reasons my lifestyle slipped back and my BGs shot up again to the point that my doctor started me on insulin. When I finally found the way to manage again without insulin, I was so amazed and happy that I wanted to share it with others. My blog is my way to share what I have learned, as well as encourage anyone who may think they are facing an insurmountable obstacle.
Q: After more than four years of using insulin, you recently stopped insulin injections after adjusting to a slow carb diet. What was the trigger for this change?
It was a happy coincidence, one that I never really expected would have such an impact on my BG control. My daughter had delivered her second child. She is a big Tim Ferris fan from his book “The Four Hour Work Week.” She had read “The Four Hour Body” and was following the slow carb diet to shed her baby weight. I had gained about 30 lbs while on insulin, so I thought that this diet change was worth trying.
The first morning on the new diet I set my breakfast and lunches up to be the same number of carbs as I usually ate, so I injected my regular doses of insulin. Just before dinner, I had such a severe hypo event that I had to run to the fridge for a fruit juice freezie! I didn’t fully understand what was going on, but I knew enough to reduce my insulin dose. Over the next four weeks, I regularly reduced my insulin injections until they were so small that I just discontinued taking them completely.
Q: What results have you seen with your new treatment plan? What has been the hardest part of going off of insulin and using diet to manage your diabetes?
My BG control as measured by my quarterly A1c tests is better without insulin than it was with insulin. I have lost 35 lbs, 10 inches off of my waist, and 13 percent body fat. Another benefit is that I have fought with arthritic tendencies for years and years. On the new diet, my joints feel amazing. I hardly ever have any of the aches and pains that I used to suffer from.
There has been nothing hard about going off of insulin, period. No more injections, fewer BG tests, and huge financial savings because I am self-insured for health care.
In terms of the diet change, it does take a little bit of resolve to maintain the discipline of keeping starch out of your daily diet. That has been easier for me the longer I have stayed on the diet, and because everyone in my house is doing it, too. The most difficult part is dealing with what to do if I have to attend a function that doesn’t include food that is in my diet. It doesn’t happen very often, but conferences or celebrations can prove challenging.
Q: You have a diet “cheat day” once a week. How do you keep your sugars from going out of control on these days? Why is having this day important to you?
That was tricky at first and occasionally still can be challenging. The best way to explain the approach is that I like to treat the cheat day as an opportunity to experience the foods that I don’t normally eat, not to go crazy on quantity. Drinking lots of water and getting some exercise in on that day helps, too. Increasing BG testing and making your eating decisions based on those tests helps, too. I wrote a blog post to help people with diabetes get through a 4HB cheat day.
I like to think of the “cheat day” as an opportunity for my body to respond to faster carbs once a week and see how it is doing. Better post-meal BGs on “cheat day” mean that my body’s insulin response and/or sensitivity are improving. Psychologically, the “cheat day” helps keep me on track for the other six days of the week. After a year on the diet, I can honestly say that I no longer have cravings that drive me to blow off my program.
Q: You’ve written before about the three areas – control, nutrition, and fitness – you think are necessary for diabetes management. Can you tell our readers more about your philosophy for each of these and why you think they’re important?
I think it’s easier to think in threes. Someone can make a simple plan if they can relate something they need to do to one of three components of a plan. So in managing your diabetes, try to make sure that everything that you do fits into one of these three pillars.
Control is important because it is so hard to get anything leveled out that is out of control. Everyone can identify with this whether it’s relative to weight loss or gain, our financial challenges, driving on a windy road, whatever. For someone with diabetes the yo-yo BGs are one of the first things that must be eliminated. This can be way more challenging for someone who uses insulin. The tendency is to respond to lows by over-eating and respond to highs by over-medicating. Too much of this will start to result in weight gain. As we gain weight our bodies tend to be less sensitive to insulin, so the cycle gets bigger. Get in control and keep in control to eliminate this as a factor. Newly diagnosed people may need to test more frequently than normal until they understand what is going on with their bodies and gain control.
Nutrition may be the biggest factor in maintaining control for most people. Eat a healthy diet that provides the energy that you need to get through your day and gives you’re the nutrients that you need every day. Pay attention to the kind of carbs that you are eating and what happens to your BG when you eat these foods. We all need some fat, and fat gives food flavor. Fat is also the enemy of insulin sensitivity, so be careful not to over-do the fat. My experience changing to a slow carb diet was the most dramatic change I have ever made. In my opinion, what you put into your body has the most impact on your diabetes management.
Fitness has both long and short term implications. I was taught when I was first diagnosed that increasing my heart rate to 50 percent of maximum for 20 minutes helps control BG for the next 24 to 36 hours. To me, this is the short term effect fitness has on diabetes management. If you don’t think this is true take the Big Blue Challenge: Test your BG, exercise for fifteen minutes, test your BG again. I’ve never seen it fail. You’ll see the change in your BG the next day if you do this regularly.
Longer term, good fitness improves your body’s overall management of diabetes by improving your insulin sensitivity and by converting body fat, which does not burn sugar, to muscle which does. The other important reason to improve fitness is to be heart healthy. Diabetes is the number one cause of heart disease. Get your heart in shape and you can beat those odds and live a long life.
Q: What advice would you give someone who has just been diagnosed with diabetes?
- Get all of the emotional stuff out of the way as quickly as you can. Having diabetes does not need to be a death sentence, but it can be if you don’t get yourself into a head-space that will allow you to deal with it effectively.
- Become a sponge for information. I joked that if I had waited for my public health “diabetes training” before I started to learn I would have died. Probably not literally true, but there was a four month delay in my case, and I think it is much longer now. Many people won’t have this option either, depending on where they live. There are tons of books, websites, and blogs around that can offer basic information to get you started.
- Tell all of your friends, people you work with, and family all about your diabetes and how they can help you if they see certain symptoms in you. This important information that they need to know, and it’s not well-known. A lot of people have things backwards. There was a recent episode of the TV show Touch where Kiefer Sutherland’s character came across a person who was unconscious. The man’s friend told Sutherland’s character to give him an insulin injection, which promptly woke him up. People, this is not what you want your friends doing for you in real life – it just doesn’t work that way!
- Take control of your own diabetes. Your doctors, nurses, friends, and people like me are all resources for you to use. None of us have as much as stake as you do.
- Take the set-backs in stride. We all make mistakes or have challenging times. Learn from them and you will be even stronger and better.
Q: Parting words:
I want everyone to know that type 2 diabetes is something that you can manage and continue to live normally. Twelve years after being diagnosed there has been no detectable blood vessel or neurological damage, despite having a couple of pretty serious set-backs. You can be active, have a normal career, and love your life. Since my diagnosis, I ran six marathons, became scuba diver certified, and started my own business which continues to thrive. Last fall, I set a new goal to qualify for and run the Boston Marathon before I turn 65.
I’m living and loving my life and you can, too!