Specifically, if type 2 diabetes is well managed with exercise and superior nutrition, there will be many benefits:
- No highs or lows in blood sugar
- Reduction of medications by an average of 50 percent in the first week, more in the first month, and most typically 100 percent within six months
- Need for insulin is eliminated, usually within the first week
- Normal, lean, and stable body weight
- Normal life span, without complications
- Reversal of diabetes and prevention of diabetes-related complications
The goal is to reverse diabetes to the point of becoming nondiabetic again, meaning ideally that your glucose levels run below 100 without medications. Be aware, though, that once you’ve been diabetic, the tendency to become diabetic again remains if you regain weight or go back to unhealthy eating. This is a new diet style and lifestyle forever.
You can anticipate your blood sugar falling with this diet and lifestyle plan. As discussed earlier, you will be able to reduce your medications. Err on the side of too little medication, not too much. Prevent the occurrence of hypoglycemic episodes with good communication with your physician and careful use of minimal medications.
If your blood glucose has been elevated for a while, even as your blood sugar approaches the normal range, you could feel somewhat ill as the body gets accustomed to experiencing normal blood glucose levels. Nevertheless, when on diabetic (glucose-lowering) medications, especially insulin and sulfonylureas—Amaryl (glimipiride), Diabenese (chlorpropamide), Glucotrol (glipizide), Diabeta, Glynase (glyburide), Actos (pioglitazone), Avandia (rosiglitazone)—it’s important to check your blood sugar frequently during the first week to make sure you are not being overmedicated. Glucophage (metformin) is a commonly used oral diabetes medication that does not cause the blood glucose to drop too low and does not cause weight gain, so this is the preferred medication to remain on, if one is needed.
Snacking to prevent a hypoglycemic reaction from the overuse of medication is poor medical management and should not happen. Medications should be reduced in time so this never occurs. I tell patients starting this program that if a blood sugar reading is below 120, it is time for the next round of medication reduction. It is better to be undermedicated slightly, to prevent the need to treat hypoglycemic events, than it is to be overmedicated. If the diabetic patient experiences hypoglycemic episodes and extra snacking is required to bring the glucose up, then the physician overmedicated the patient and did not do his job correctly.
The ADA diet uses the diabetic exchange list to help diabetics create what they call balanced meals. This exchange diet divides foods up into groups based on similarities in nutrient content and includes starches, fruits, milk, vegetables, meats, fats, sweets, and other carbohydrates. It looks to make meals that are based on a preconceived notion that balancing an equal amount of fat, carbohydrates, and protein at each meal is favorable. It then allows exchanges based on the amount of calories from that macronutrient. For example, in the starch group, one slice of toast can be exchanged for a half cup serving of cooked oatmeal.
Because the foods the diet is designed with are inherently poor in fiber, micronutrients, and resistant starch, they fuel an obsession with food because the dieter is never satisfied. This continual struggle with dieting and trying to maintain small portion sizes of foods that do not biologically fill you up rarely works. Even in controlled dietary studies in which calories are carefully monitored, the results are relatively poor simply because the American dietary standard is so poor and the ADA diet mimics this failed dietary pattern utilizing too much unhealthy, low-micronutrient food. Researchers have also frequently noted the difficulties involved in the ADA plan, particularly the requirements to dramatically restrict portion sizes that most individuals simply cannot comply with long term.
An ADA sample breakfast meal may include two slices of toast with one teaspoon of margarine, a scrambled egg, three-quarters of a cup of unsweetened ready-to-eat cereal with one cup of nonfat milk, and a small banana. Another breakfast choice on the 1,800-calorie ADA diet may include two four-inch whole wheat pancakes with two tablespoons of light pancake syrup, one teaspoon of margarine, one cup of sliced strawberries, one-quarter cup of low-fat cottage cheese, and one cup of nonfat milk. These sample meals are a formula for disaster for diabetics. In order to get the glucose controlled after consuming all those low-fiber carbohydrates, an excessive amount of diabetes medication will have to be prescribed, which will lead not only to highs and lows but also potentially to hypoglycemic episodes. Then diabetic patients are instructed to snack to prevent the low blood sugar results of the medication, further impeding their possibility of dropping the excess body fat. The additional side effects and weight gain from the medications just lead to a worsening of the diabetes. The focus with standard care is on the glucose level and maintaining the right amount of medication to optimally stabilize the glucose. It misses the boat, though, because it fails to focus on the health and weight of the person first, and the miraculous health and weight loss benefits of the right dietary pattern based on greens, beans, mushrooms, onions, tomatoes, peppers, berries, intact grains (not just whole grains), seeds, and nuts.
In contrast, type 2 diabetics can become nondiabetic, achieving complete wellness and even excellent health. They can be diabetes-free for life. In my twenty years of clinical experience with this program, I have experienced that more than 90 percent of type 2 diabetics who follow this diet and exercise lifestyle are able to discontinue insulin within the first month.