Realities Created, Maintained and Destroyed, WHILE-U-WAIT!

Thursday, October 08, 2009

Defeating Diabetes

Jason asked this question in the comments section.

While mostly this blog is for fun, this is one of those really important topics, so I would be remiss in not moving it out of comments and addressing it here.


Jason Asks,

As Salaamu Alaikum Mushtaq,

All these posts on running have been very inspirational for me. One of the reasons I have been trying to run more often (other than for enjoyment) is that I am also diabetic. It is very inspiring for me to read that you control your blood sugar with diet and exercise alone. I take medication to help control my blood sugar but would like to control it with diet and exercise alone. I have found calorie restriction and exercise to be very helful in controlling blood sugar levels but there is a lot of confusing information on what to eat or not to eat. Would you mind sharing any tips or resources on what you do to maintain your blood sugar? Jazakallahu Khair.
Well, I can tell you what is working for me. I suspect that everyone will be a little different in how they respond.

My sense is that type 2 diabetes is reversible in most cases, but it requires serious work.

The first thing is that you need is to be utterly ruthless with yourself and develop complete self discipline. No excuses, no "falling off the wagon", no exceptions. Ever.

The second thing is to make sure that you have a Doctor who is willing to work with you. At some point you are going to have to go off your meds and you need a competent MD to help with monitoring you.

Make friends with your lancet. At first you may need to test your blood glucose as many as eight times a day. You need to know what eating a particular food is doing to you. You also need to know how much your blood sugar is reduced by any given exercise.

Make serious changes in your diet until your sugar normalizes.

For me this included giving up all processed foods, and building my diet around fresh fruit and vegetables. Processed foods are poison.

My diabetes is based in my genetics. The Native American side of my family suffers greatly from it. As a matter of fact type 2 diabetes is epidemic throughout the Native American population.

So what I did was to go back to a "pre-Columbian" diet. I built my eating habits around what my fore-bearers ate and thrived on. So my diet has a lot of squash and beans in it, and some corn, but only "heritage strains", lots of chia seed, and "wild meat". Where I live it is easy to access buffalo meat and venison, which is so much better than beef it ain't even funny. More on diet later.

You MUST exercise every day. Serious exercise. This is an essential key to the process. You need a way to get rid of excess blood glucose and that means burning calories.

You also MUST get your weight down. Determine what the lowest healthy weight is for your size and drop down to that. Make sure that your body fat percentage is under 15%, under 10% is better. You will have limited success until you normalize you weight and composition.

Find what motivates you and use it. You will be fighting a lifetime of bad habits, so you will need tools to counter them.

Get a copy of the book "The End of Overeating" by Dr David Kessler and read it multiple times. Better yet read it out loud to your wife. It helps to actually hear the material and having family support is essential. This is the single best book on "food addiction" in modern times I have run across. More than that, it will give you a deep understanding of Nafs al Amara.

Have "tools" in place to deal with temptations and addictive thoughts.

For me it is the memory of one of my favorite uncles. He was a wonderful person, deeply spiritual in the best sense of the word. He had lost both legs to diabetes and developed all the secondary diseases associated with diabetes.

The memory is of the last time I saw him alive. It was at an all night ceremony near his home. His son and I carried him to the place where he would sit (there is no real wheel chair access to a tepee) and even though he was in constant pain he sat there until sunrise. He was a powerful singer, one of the best. He sang all night long, praying for the health and prosperity of his people.

Near sunrise, it was again my turn to sing, and I did my best. After my turn was done and I had passed the staff and gourd to the next person, I saw my uncle lean over to my (adopted) father and I heard him whisper to him "Our son sure sings good". It was one of the high points of my young life.

Two days later he was dead.

So whenever I hear the voice of my nafs saying something like "Hey, one piece of frybread won't hurt you, go ahead" I have trained myself to remember my uncle, to see him in my mind's eye sitting there and singing, both legs cut off above the knee, and to remember that "one piece of frybread" took him away from all the people who needed him. It's a memory that has never failed me.

You will need to find something like that. Something that will override any excuses for breaking your discipline.

Make sure your environment supports your efforts to be healthy. I didn't start getting a handle on my blood glucose until I got out of a very toxic living situation and into a healthy one. I was living with two obese room mates, both of whom were quite dishonest about their own health and eating habits. You need complete control over what and when you eat and you need for the people around you to be supportive of your efforts. It also helps to be surrounding yourself with life affirming people just for the general well being it produces. From what you have mentioned of your wife, it sounds like you're off to a good start.

Back to diet.

What I did was this. I would test something, a food, a method of cooking, portion, whatever. If my glucose went down I held on to whatever it was for further testing. If it went up I threw it out and never went back to it. So I guess the rule would be. Change your behavior until you get the result you are looking for. Never be attached to any one modality.

What I had to do was drop all grain from my diet as well as potatos. The only exception to this is corn in moderation, and only "heritage" strains like blue corn, no sweet corn, no dent corn, only flint corn from non GMO strains that were here before the White-Eyes showed up.

Memorize the glycemic index and glycemic load for every food you are likely to encounter and pay attention to it. Don't ever eat anything with an index over 50 or a load over 8 or 9. Less is better.

Take your vitamins!

Most diabetics are way low on Vitamin D, I sure was, and it showed. My liver got very confused. It thought that I was starving at night. I would go to bed with a blood glucose of 110 and wake up with one of 200 because my liver was dumping glycogens int my blood all night to make up for the "starvation" it was sensing. I now get lots of sunlight and take 2000 units of D a day. Now I go to bed with a blood sugar of 90 and wake up with one of 98. The problem is still there, but not to the extent that it will do damage. (for anyone who doesn't know, "normal" blood glucose is around 100, and should be between 70 and 90 when you wake up)

I have found other supplements to be useful as well, but that's going to need to be a separate post.

Make clear, incremental, attainable goals for yourself. Things like "I will drop three pounds in weight and two percent body fat in the next month". Write these goals down and read them to yourself out loud daily. If you fail at a goal (and you most likely will from time t time) don't beat yourself up, just go into trouble-shooting mode, discover the problem areas and modify your behavior until you achieve the goal. Never accept failure! Turn failure into feedback and learn from it. The only way to really fail is to die. As long as you are alive you have the means to win.

Restrict your calories. I found this to be essential.

There are a number of ways to do this. The way that works for me is intermittent fasting. I fast from all food on Mondays, Wednesdays and Fridays. On days when I eat, I do so as intelligently as possible and I don't over indulge. I allow myself as much zero calorie liquids as I want, mostly mineralized water and herb tea. After a few weeks I found doing this to be no problem at all. My energy is good on fast days and I rarely feel hungry. I can do a 30 mile bike ride while fasting as easily as on days when I eat.

There is much more to the process, but this will give you an idea of how I go about it. My blood glucose is normal these days I haven't gone above normal levels in months now. I do miss some foods, but contrary to the old saying, I have never eaten something I am willing to die for.

If this is of interest to people I will write more on it.

And here is some music, a prayer really, for my uncle, my (adopted)father my cousins and friends, all those who lost their lives to diabetes.

14 comments:

sabiwabi said...

Oh, please! Write more, write more, write more! I love the advice in this post and it is good for everyone, not just diabetics! I was considered "pre-diabetic" during all 3 of my pregnancies and it finally was enough to scare me into waaay better health habits. Thank God.

BTW, fry bread IS evil, isn't it? My best friend is Menominee and whenever we go out to the Pow-wows that's the thing that always makes me wince....fry bread consumption on a massive scale! Owww!

Mushtaq Ali said...

The worst thing about frybread is that it is SOOOOOOOO good. An incredibly seductive food.

The sad thing is that frybread came about because all Natives were given to eat on the Rez was some white flour, lard and a little salt.

jasonencke said...

Thank you so much Mustaq! This is valuable information. I really appreciate your help especially with something of such a personal nature. I’d be grateful for more information and I hope others enjoy your posts as much as I do. I've felt as if there was no hope for getting off medication for a while now. This is going to require hard work and discipline but I feel like it can be done. My wife and I ordered the book you recommended and we’re getting to work. I’m sure the book can benefit the whole family as well, not just me. I think the emotional aspect of eating is something I’ve overlooked.

I like your idea of a pre-Columbian diet based on your heritage. I’ve thought about the same thing for myself. Since I’m of German/Dutch ancestry on my Dad’s side my wife joked that we can’t really eat pork sausage and sauerkraut since we’re Muslim, lol. But I definitely like sauerkraut and some of the healthier German dishes my grandmother made when I was growing up; I just need to substitute the pork in some of them.

Dan Gambiera said...

One word of deadly serious advice:

Every case of diabetes is different. Some will respond to Mushtaq's regime. In fact, it's exactly what doctor's have been recommending for longer than any two of us have been alive.

But if it doesn't work or your situation does not allow you to live the life that would make it work, then for the love of G-d get back on medication. This is a matter of biochemistry, not moral superiority. If the you're healthiest with meds in addition to the diet and exercise there's no shame in it.

As the man said, you'll need constant monitoring and very close work with a doctor. Not all Type II diabetes is reversible; once enough of the Islet cells have gone tits up nothing will bring them back. Not all of it can be controlled by lifestyle alone.

Salma said...

Dear Mushtaq,
Thank you for being a good example and for sharing your strength and determination. It is very easy for me to neglect myself, though I tend to go to the opposite end of the spectrum. Instead of eating too much, I don't eat when I should and not enough. Hypoglycemia is as much of a battle as diabetes, although it does not enjoy the prestige of being a "real" disease as far as the medical community sees it, it seems. Nonetheless, it requires diligence and discipline to eat the right things every two hours, and I must admit, I get sick of it. So, I am thankful for the times when seemingly random people see me "zoning out" and remind me to eat. A support system is truly a Godsend, but not everyone is blessed with one. Those souls must be extra caring of themselves. Not easy to do. So, keep up the good work!!! Also, your prayer is beautiful...... S

Mo'in said...

Dear Mushtaq,

Thank you for this most informative and inspiring post!

You wrote: "You MUST exercise every day. Serious exercise. This is an essential key to the process."

At your convenience, could you elaborate on what your experience has shown to you as serious exercise? I am admittedly highly critical of much of modern exercise advice. In the last few years, I have embraced a very different, and far more intense, form of exercising popular in many combat athletic circles.

It's the kind one sees in the Crossfit community - www.crossfit.com - Ross Enamait sytle - www.rosstraining.com - etc.

Thanks!

All good wishes,

mo'in

Mushtaq Ali said...

Todd,

You are confusing type 1 and type 2.

In type 1 the islet cells stop producing insulin, in type 2 you become insulin resistant. Your pancreas can be producing all the insulin you need, often way more than you need. Type 2 diabetes is, in my experience, and there is more and more evidence to back me on this, almost always reversible if one is willing to do the work.

The problem is that many people are not willing. I have seen people give up and go back to eating at MacDonald's even though they had gotten their glucose levels back to normal without drugs just because it was "too hard" to keep up the regime.

It is hard, but the drugs for type 2 don't really keep you alive, they just slow down the dying some. It's better than dying quick, but it is not as good as being healthy.

jasonencke said...

For anyone interested in the Glycemic Index or Glycemic Load of a certain food there is a free database at this link http://www.glycemicindex.com/

Just click on the GI Database tab on the left column.

Mushtaq Ali said...

Salaams Jason,

I am also quite fond of
http://www.nutritiondata.com/
for really good data including glycemic load numbers

Dan Gambiera said...

Mushtaq,
You are, of course, mostly correct on my confusion of Type I and Type II. There is a large number of cases where the insulin resistance comes with insulin deficiency. You get the Devil and the Deep Blue Sea.

The research on treatment outcomes has gone through the ten, twenty and even fifty year trials. Many studies. Many methodologies. Large samples. The works.

What did they conclude?

Uncontrolled is very, very bad.

Chemical only with no significant changes in lifestyle is better by about the width of a flea's pecker.

The strict lifestyle school - only diet, exercise and monitoring - does quite well.

The moderate clinical school - appropriate medication with significant but less drastic changes in lifestyle - does no worse. Not in terms of mortality. Not in terms of morbidity. Not in terms of any clinical side-effects which can be measured. If it's just a matter of "dying more slowly" it's not something which we can measure.

Let me emphasize it again. This approach requires regular vigorous exercise and the sorts of change in diet which the ADA has been preaching for about sixty years. But it takes a rational view of medication as part of the program.

The only problem with lifestyle-only is that many or most cannot or will not abide by it as consistently and rigorously as the approach requires. There is a well-documented tendency to let things slide and then starve and work oneself down to the correct range a few weeks before visiting the endocrinologist. It's the worst of all worlds.

As they used to say "There are three sorts of people who are 100% unreliable - drunks, drug addicts and diabetics. The rest of us are 90% unreliable."

Salma said...

Dear Mushtaq,
Another thought. Maybe there is a correlation between my Hypoglycemia and my Saami heritage just as your diabetes is to your Native American heritage. Maybe I need to look at my problem from this angle. Hmmm...... S

Sun Bear said...

Research cited by the folks at Native Seeds/SEARCH supports your returning to a pre-Columbian diet to help control your blood sugar. If you are unfamiliar with them, they also are a great source of traditional American seed crops. Check 'em out.

Similarly, a traditional African diet was found to be beneficial with sickle cell anemia in an older book called "Appetites of Man", where they studied a Ugandan tribe's diet(along with Hunzas, Tuaregs, Inuit, California Indians, and several others).

Sun Bear said...

Oh...and, YES, fry bread is addictive! My father worked for the BIA when I was young, and we once had a Havaho teenager stay with us for a summer. My father said he made the best fry bread he'd ever had (and working at one of the boarding high schools - Sherman, in Riverside, CA - he'd had plenty of chances to try it. We probably make it about once a year. Its just too addictive, otherwise.

Sun Bear said...

Oops...sorry about the typo...Navaho. I hadn't even had my morning tea, yet...*sigh*