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Diabetes, The Bigger Concern: Glucose Levels or Heart Disease

Caroline Trap Pic.jpg

People with diabetes are concerned about blood glucose levels. However, a bigger concern is heart health. Heart disease, not diabetes, remains the leading cause of premature death in the U.S. Fortunately, the same whole food, high fiber, plant-based diet you’ve learned about through the Plant-Based Nutrition Support Group is very effective at lowering cholesterol and reducing this risk factor for heart disease.

 

Vegetarian, especially vegan, diets reduce cholesterol levels, according to a review and meta-analysis authored by Physician Committee for Responsible Medicine researchers and published in Nutrition Reviews. Researchers reviewed 49 observational and intervention studies that compared vegetarian and vegan diets with omnivorous diets and their effects on plasma lipids. Vegetarian diets lowered total cholesterol levels as well as LDL and HDL levels when compared to omnivorous diets. The greatest benefit on lipid levels was seen in those who followed vegan diets.

 

Plant-based diets typically reduce body weight and saturated fat intake, which may benefit cholesterol management. These findings support previous associations of decreased cholesterol levels and vegetarian, especially vegan, diets.

 

 

Yokoyama Y, Levin SM, Barnard ND. Association between plant-based diets and plasma lipids: a systematic review and meta-analysis. Nutr Rev. Published online August 21, 2017.

 

Caroline Trapp, DNP, ANP-BC, CDE, FAANP

Director of Diabetes Education and Care

Physicians Committee for Responsible Medicine

5100 Wisconsin Ave., NW. Suite 400

Washington, D.C. 20016

202-527-7349 (Direct)

and

Diabetes Nurse Practitioner

Premier Internists, A Division of Millennium Medical Group, P.C.

32255 Northwestern Hwy, Suite 180

Farmington Hills, MI 48334

248-355-0880 (Tuesdays Only)

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Plant Based Paul

If you are reading this, you are likely to have attended a Plant Based Nutrition Support Group program. If not, don’t wait any longer. We have a local treasure in PBNSG founder Paul Chatlin, whose heart, once compromised with fatty plaques that caused him pain and limited his mobility, now beats tirelessly to keep others from suffering the same fate.  In my work with the Physicians Committee for Responsible Medicine, I have the privilege of traveling around the country and interacting with many experts in the world of plant-based nutrition. Because of Paul, and the team of dedicated volunteers he has inspired, manyof those experts have come to speak at PBNSG meetings. That would be something by itself, but Paul’s visionary work has extended beyond our local community of people who want to get well, to the next generation of physicians. Paul has worked to bring plant-based nutrition education into medical schools! He believed that the 4 hours that most medical schools offer on the topic of nutrition was not sufficient, and he is right. Local medical school graduates will hopefully come to see nutrition in its proper role, as the primary intervention for disease prevention and treatment, and medication to be used only as a last resort, for the sickest of the sick.

 

Heart disease is our top killer, and it is the leading cause of death in people who have diabetes. We in the Metro Detroit are so fortunate to have Plant-Based Paul, who has been heard to say that he can’t sleep at night, worrying that there is someone who needs this information but does not have access to it. Don’t miss a meeting. And please, contribute your time or dollars to PBNSG. We all need Paul to get some sleep.

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“Pharmacy” vs “Farmacy”

Reprinted with permission of Dan Piraro

Reprinted with permission of Dan Piraro

 

“Pharmacy” vs“Farmacy” by Caroline Trapp

As a nurse practitioner specializing in the care of people with diabetes, I was educated to tell newly diagnose patients that at some point, they would probably need insulin injections. “Diabetes is a progressive disease,” I’d been taught to say. Eventually, the pancreas “stops making insulin,” and people should not be made to feel guilty. We want them to embrace insulin, not fear it.

Well, I’m older and wiser now, and basically, this is a bunch of hoo-hah promoted by insulin manufacturers, and the army of clinicians and educators they have influenced.  I say this because I’ve seen a number of people who were on 100 or more units of injected insulin daily, who had been diagnosed with diabetes 10 or more years earlier, reduce or even eliminate their need for insulin shots. Just today, I had a grateful call from a patient who previously had an A1c of over 14%,  and required multiple medications for diabetes, high blood pressure and high cholesterol. She wanted me to know that since switching to a plant-based diet, her A1c was now under 7% and her need for medications had been cut in half, and her blurred vision was completely resolved.

If you or somebody you know has been told that they need insulin or some fancy new pill or injection for type 2 diabetes, please be aware that there may be an effective, safer, and more affordable alternative. When people in this situation make and sustain a switch to a whole food, plant-based diet, they are likely to see significant improvement in blood sugar levels. Uncontrolled diabetes is dangerous, so I’m not recommending foregoing necessary treatment, or stopping medication without support.  However, insulin injections can cause weight gain, and low blood sugar, and they are expensive. People taking insulin do not always report a better quality of life. There is no inexpensive, generic insulin, and none in the pipeline.  Everyone deserves to be fully informed about the potential down sides of insulin and other diabetes medications, and the power of plants. Injected insulin has been proven to lower A1c, but it does nothing to get at the root cause of the disease that leads to damaged blood vessels and organs. That’s why I choose to prescribe the “Farmacy,” available at your local grocery or garden market, over a visit to the Pharmacy. 

Dr. Caroline Trapp, DNP, ANP-BC, CDE, FAANP

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Tom Hanks - You Are Not an Idiot

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Tom Hanks - You Are Not an Idiot

Beloved actor Tom Hanks recently declared "I am an idiot" referring to how he caused his type 2 diabetes by allowing himself to gain weight. 

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To me that does not suggest someone lacks intelligence; after all two-thirds of all Americans are overweight. We are all at risk in a toxic environment where highly-palatable disease-promoting foods are lurking everywhere people gather.

In fact, I would suggest that Tom Hanks is pretty smart to recognize that lifestyle can play a role, and to commit to taking better care of himself. 

Now, peddling some expensive medication to treat a disease that is caused by the unhealthy Standard American Diet, is an entirely different story. Mr. Hanks - I urge you to do the right thing, and the smart thing if you care about your health and about helping others who have diabetes or are at risk of developing it. Resist the urge to accept a lucrative contract to promote the latest pharmaceutical intervention and instead adopt a whole food plant-based lifestyle. This is the one dietary approach that has been shown to not only reverse type 2 diabetes, as well as heart disease and some types of cancer, but has additional benefits of weight control and longer life.

My simple prescription for you:

  1. Watch Forks Over Knives.  (www.ForksOverKnives.com)
  2. To learn how to get started, watch the TEDx talk by Dr. Neal Barnard at www.PCRM.org/Diabetes
  3. Commit to a 21-day trial of the best dietary pattern (use the excellent, free program created by the Physicians Committee for Responsible Medicine at www.21DayKickstart.org).
  4. Find a community of people committed to health to help you continue this powerful lifestyle. Here in southeastern Michigan, we have the Plant Based Nutrition Support Group (PBNSG.org). Lots of great resources are available online.

Don't settle for "managing" diabetes. Get at the underlying problem. It's not rocket science. Anyone can do it. 

Dr. Caroline Trapp

Caroline Trapp, DNP, ANP-BC, CDE, FAANP

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Is it true that natural food starches can cause blood sugar imbalance, and spikes in my readings? How should I handle this?

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Is it true that natural food starches can cause blood sugar imbalance, and spikes in my readings? How should I handle this?

Q: Dear Dr. Trapp, 

Is it true that natural food starches can cause blood sugar imbalance, and spikes in my readings? How should I handle this?


A:   Dear Pauline,

Great question. The issue is how high, and for how long, and how often. I can't give you specific advice, but in general, for people 65 and younger, it is reasonable to aim for the ADA goal of 180 mg/DL of less, 1-2 hours after eating (The most current guidelines have relaxed the targets for older adults on medication, due to risk of hypoglycemia, a leading cause of hospitalizations). Another good tool is to look at your A1c, which provides a 3-month average. If your A1c is where you and your health care professional want it, than the spikes are probably not significant. 

Significant spikes after certain foods don't necessarily mean you need more insulin. In fact, more insulin might just make you hungrier, which can make you eat more, which can raise your blood sugar! You might try choosing lower glycemic index foods, such as sweet potatoes instead of Russet potatoes, or steel cut oats instead of instant oatmeal. You can also try going for a walk after the meal, a great way to naturally lower blood sugar. 

A great read is Dr. John McDougall's book, The Starch Solution. He provides ample reassurance that starchy vegetables and beans have sustained people for years, and are perfect for preventing and treating type 2 diabetes. 

Kind regards,

Dr. Caroline Trapp

Caroline Trapp, DNP, ANP-BC, CDE, FAANP

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Can Diet Get My A1C Under 5.7?

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Can Diet Get My A1C Under 5.7?

Q:  Dear Dr. Trapp,

I have been pre-diabetic for about 3 years. My A1C has been 6.1, two years in a row now. Using diet, what could be my chances of getting it under 5.7?  I am planning to eat a strict WFPB diet for 6 months, and then re-test.  

Sincerely,  Maryann


Dear Maryann,

It is a great idea to use the no oil WFPB dietary approach (like we advocate here at PBNSG), to help lower your A1c. I have had many patients do this successfully, and research supports the effectiveness of this approach.  For a useful resource, check out www.21daykickstart.org - providing free meal plans, which are all vegan and oil free.  Also see the 18-minute TEDx Talk with Dr. Barnard at www.pcrm.org/diabetes

Wishing you good health,

Dr. Caroline Trapp, DNP, CDE

 

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Will my blood glucose numbers decrease as I lose weight?

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Will my blood glucose numbers decrease as I lose weight?

Dear Dr. Trapp,

My doctor has me on Metformin for now. I was wondering if my blood glucose numbers go down more when I lose more weight?  

- Debbie


Hi Debbie,

As you continue a pattern of healthful eating and more activity, you are likely to see the morning readings drop. Try to be patient and not be so overly fixated on that number or on weight. 

Behaviors and habits are more important than any single number or a specific reading on the scale. Focus on getting enough of the right foods and getting more physical activity, every day. Find and stick with healthy meals and activities you enjoy. Everything else will follow. 

Dr. Greger's Daily Dozen app (Nutritionfacts.org) can be very helpful in keeping you focused on the key behaviors, not the numbers. 

Make sure you take Vitamin B12 with a WFPB diet and with metformin to prevent deficiency. 

Applause to you - you are well on your way to turning diabetes around and preventing other medical issues!

Kind Regards,
Dr. Caroline Trapp, DNP, CDE

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IS IT HYPOGLYCEMIA (ALSO KNOWN AS LOW BLOOD SUGAR)?

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IS IT HYPOGLYCEMIA (ALSO KNOWN AS LOW BLOOD SUGAR)?

Here's a  special word to anyone who takes medication for diabetes that can cause low blood sugar. With a significant diet change, your medication may suddenly be too strong. This is true, even in people who have never had low blood sugar before. 
 
Know how to recognize low blood sugar! It's common with a "low" to get a headache, or feel shaky, sweaty, or lightheaded. On your meter, this would be any reading below 80, or whatever your health care professional suggests is too low for you (for some, it might be 100, or 120). Low blood sugar might occur when you've gone too long between meals, overnight, or on a day with increased activity or decreased food intake. If you take a medication that can cause low blood sugar, always be prepared with a treatment, in case you go too low. Carry glucose tablets or hard candies; about 80 calories or 15 carbohydrates worth and then follow up with a meal within 30 minutes. If you are low more than twice in a week or have a severe low that requires help from someone else, be in touch with your health care provider for an adjustment in medication. Low blood sugar is risky and can delay reflexes when driving or change your level of consciousness. It can also effect memory.
 
For those on blood pressure medication, your switch to a WFPB (that's "Whole Food Plant Based") way of eating can also make your blood pressure medications too strong. Watch for fatigue, or dizziness when you change position, such as from sitting to standing. 
 
If you get low blood sugar or low blood pressure from making the shift to plant-based, congratulations! You probably don't need so much medication! For some, it happens immediately; for others, it occurs after some weight loss, over time. Some medications, such as beta-blockers, should never be stopped suddenly. Be safe and work with your clinician.

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This I Know For Sure

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This I Know For Sure

Diabetes. What did you think when you were first told you were at risk for this disease? Or were told that you had it? Many think about family members or friends, who are consumed with balancing food and insulin, or who carry a meter and prick their fingers to monitor their blood sugar, or who struggle to afford their medications. Or they think of those they know who have suffered the complications of diabetes. And of course, everyone worries about how diabetes will impact their own life.
 
Diabetes can be an awful disease. But those who are involved in the Plant Based Nutrition Support Group know that it does not have to be. We know that there is reason for hope. A diagnosis of diabetes, or pre-diabetes, might be a wake-up call to get educated, and adopt some new habits. Members of this group learn to put taking care of our health before everything else. The group provides support in many forms. Through this group, you will meet people who will inspire you, and help lead the way.  
 
Hopefully, the first thoughts you had about diabetes will be replaced with optimism, as you learn that there is so much that you can do to turn diabetes around.  And I don't mean that you can "Ask your doctor if ___________ is right for you." Type 2 diabetes is not caused by a deficiency of an ingredient in any pill! 
 
I'm grateful to have a role in this group. As a nurse practitioner who has worked with people with diabetes for many years, I'm now happy to encourage my patients to get active in the growing PBNSG community. Its an easy and affordable way to access up-to-date and accurate information, and hopefully, to require less medical care. 

In addition to the great resources at WWW.PBNSG.ORG, if you'd like to listen to discussions with many diabetes experts, all of whom prescribe lifestyle for diabetes prevention and treatment, please check out an exciting new resource at www.diabetesperspectives.org. The series begins on Sept. 9th, and there is no cost for the introductory lectures. Speakers include Dr. Neal Barnard, Dr. Michael Greger, Brenda Davis, RD, Marty Davy, RD, Dr. Wes Youngberg, and others. I'm honored to be included, and hope you'll find it useful.
 
What I know for sure is that diabetes a treatable condition. I know that the PBNSG is an incredible resource for people living in southeastern Michigan, or for anyone who takes the time to explore the website. I know that you don't have to feel alone  - a friendly and helpful community exists. 
 

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Should I consider bariatric surgery?

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Should I consider bariatric surgery?

What can be said about bariatric surgery as a treatment for type 2 diabetes in people? After all, the American Diabetes Association has approved it as a treatment option in people who are obese. It works well in the short-term to promote weight loss (often because of the inability to eat as many calories; sometimes the weight loss is  because food won’t stay down – not a very pleasant outcome). We don’t have years of research to know the long-term effects with regards to safety and effectiveness. Nutritional deficiencies due to reduced absorption are one concern. 

It can also be said that bariatric surgery is a huge money-maker for hospitals and surgeons. The surgery itself is quick, and the pre-and post-group counseling is cheap for a hospital or health plan to provide. Caution about being on the receiving end of an elective procedure that has a huge profit margin seems reasonable.

Surgery is expensive, and risky, and unless there are significant, sustained lifestyle changes, the weight loss and diabetes reversal will not be sustained. I have known some people to do quite well with bariatric surgery. However, I have also had patients who have had complications and poor results, and who regret the decision. 

Looking at the adoption of another surgical procedure may be instructive. Surgery to implant a small wire stent to open up partially-blocked arteries in the heart has become the normal way to treat chest pain. Invasive and risky, and often ineffective at preventing future heart attacks, these surgeries continue to be performed. Drs. Ornish and Esselstyn have demonstrated the efficacy of lifestyle in reversing blocked arteries – no surgery required! 

Dr. Neal Barnard and his research team have demonstrated the safety and effectiveness of lifestyle to treat type 2 diabetes. I like Dr. Barnard’s recommendation: better to do “surgery” on what’s in the kitchen. “Cut” out the problem foods, the problem cookbooks, the problem meals out. 

If you’ve been told that you are a candidate for bariatric surgery, at the least, give an oil-free, whole foods, plant-based dietary pattern a try for a few weeks, and see if that does not make a difference. Gain support to make it stick through the Plant Based Nutrition Support Group. The benefits to this specific dietary approach go well beyond weight loss and diabetes control. 

What have you got to lose? 

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Do you take insulin? Read on!

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Do you take insulin? Read on!

Could a plant-based diet ever be risky?

Very rarely, but this letter I received on the PBNSG website about diabetes perfectly illustrates a real risk:

After suffering two strokes in late January 2015, my husband and I went on a plant-based, no oil vegan diet. He has lost some weight (with more to lose), but is having a really, really hard time with continuing episodes of low blood sugar. These are daily - sometimes multiple times per day. Often he needs assistance to get the sugar to him, and will wake me up when it happens at night to help him. He has some other health issues as well, from a vehicle accident suffered a few years ago. Our primary doctor, while sympathetic to our plant based diet, mostly follows a Mediterranean diet, and just leaves my husband to figure out his own insulin dosage. His diabetic doc also knows we are following this diet, but pretty much just continues care as usual.

My question, since we are on the west side of the state (MI) is: can you refer us at all to someone who will help us monitor the draw down of needed insulin medications? These daily, repeated and severe low blood sugar reactions are scaring me a bit.
— Anonymous
Low blood sugar effects

Low blood sugar effects

The "side effects" of a plant based diet are good ones (weight loss, reversal of heart disease, etc.), except for this sort, when medication suddenly becomes too strong. Wise to be scared! Low blood sugar can be dangerous. It can cause confusion, or delayed reflexes - very dangerous, especially when driving - or weakness that can result in a fall. Frequent low blood sugars may cause memory problems, or loss of the warning signs that alert the person that blood sugar is falling. Severe low blood sugar can cause loss of consciousness, and requires emergency treatment with a glucagon injection (available by prescription) or by EMS.


When someone who takes insulin starts on a no-oil, whole foods, plant based diet, improvement in high blood sugar levels can come very quickly. Suddenly, someone who has never had a "low," finds they are low all the time. This is good news! But immediate action is required: continue with this healthy way of eating AND work with your health care provider to cut back on insulin! Some people may be able to eliminate the need for insulin shots and other medications completely.

Clinicians are guided in how to increase medications, but there is little guidance on how to reduce it.

Clinicians are guided in how to increase medications, but there is little guidance on how to reduce it.


Doctors, nurse practitioners (like me) and physicians assistants are taught a lot about how to adjust insulin doses to correct high blood sugar. After all, that is a frequent reason for medical office visits. Professional organizations such as the American Diabetes Association and the American Association of Clinical Endocrinologists publish guidelines on how to add medications or increase doses until clinical goals are met. Pharmaceutical reps provide handy charts on how to add a certain number of units at regular intervals until blood sugar hits a pre-determined target. However, I've never seen a guideline from these sources on how to reduce insulin. Neither, it seems, have the doctors responsible for the care of the spouse of this letter writer.

 
The writer did not ask me HOW to reduce the insulin, and since I'm not her husband's care provider, with his chart in front of me, I would not want to provide specific advice (Wish I could, but that is a limitation of this forum). There are lots of factors to consider in adjusting insulin doses: current blood sugar levels throughout the day, type(s) of insulin used, meal times, and meal content. I would want to know when the last A1c test was done, and the result. If it has been more than a few months, I'd repeat the A1c to get a baseline now. I would want to know if he takes other medications besides insulin that can cause low blood sugar, such as pills in a class called sulfonylureas, or any of the non-insulin injectables.

 
While I would ask a lot of questions, I would not hesitate for a second to cut down on the insulin dose if this patient was under my care
. In fact, I would rather err on the side of too little insulin than too much! Low blood sugar can cause immediate harm, whereas high blood sugar takes days, or often even weeks or months to cause problems. The insulin dose(s) should be reduced, and followed closely by the patient and clinician, as further corrections may be needed, especially with additional weight loss.

 
A plant-based diet for people with diabetes can be powerful medicine. So powerful in fact that medications can often be reduced, and perhaps even eliminated.

 
The other question that this letter raises is how do you handle a health care professioinal who does not seem supportive or knowledgeable about your no-oil, whole foods, plant-based diet? Suggestions? Please post them here.

Dr. Caroline

PBNSG Director - diabetes education 

P.S. For information on how to recognize and treat low blood sugar and low blood pressure in plant-basers who take medications for diabetes and/or hypertension, please go here and scroll down read 'IS IT HYPOGLYCEMIA (ALSO KNOWN AS LOW BLOOD SUGAR)?'

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Hope for Diabetes

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Hope for Diabetes

As a nursing student in the 1980s, diabetes always seemed overwhelming and hopeless to me. So much to know: so many parts of the body affected, so many potential acute complications, so much to teach patients about self-management. But my first job after graduation was working in a large teaching hospital with people with diabetes, and I loved becoming a specialist in a disease that many health care professionals found frustrating. Over the course of my career, new equipment and new medications came along. And for a while, I really thought that the secret to diabetes management was to get people on insulin, and aggressively adjust the doses to achieve good blood sugars.

Diabetes management is no longer my goal. Type 2 diabetes can be cured, and prevented from happening in the first place. People with type 1 diabetes can often reduce the total amount of insulin needed, and reduce wild swings in blood sugar and get on the road to good health.
— Dr. Trapp, PBNSG Director - Diabetes

As a nurse practitioner, I got really good at prescribing insulin, and helped a lot of people get good numbers. But it was disappointing, to say the least, to see that this did not always protect them from heart problems…

or nerve problems… 

or kidney problems, etc.

And, people on insulin usually gain weight, and have to worry about preventing and treating low blood sugar, and deal with the expense of insulin. Don’t get me wrong – insulin is an effective medication, and sometimes is necessary for type 2 diabetes, and always for type 1. But my patients had to deal with a lot of unwanted side effects and without any guarantee of good health or longer life – so it seemed to me that I had not yet really found the best way to help people.

 

Dr. Neal Barnard

Dr. Neal Barnard

In 2006, I was fortunate to stumble upon the work of Neal Barnard, MD, and research conducted by his team at the Physicians Committee for Responsible Medicine. He was kind to share with me data from a new study that was about to be published, which compared a low-fat vegan diet to a reduced-fat, restricted carbohydrate, portion-control diet based on the dietary recommendations of the American Diabetes Association at that time. His research showed that the people in the plant-based group lost twice as much weight if overweight, and their A1c (a blood test that measures diabetes control) dropped three times as much as those following the conventional diabetes dietary approach. Many people in the plant-based group were able to reduce or even eliminate some or all of their medications, and LDL cholesterol and kidney function also improved. And, after an initial period of adjustment, people liked the plant-based approach, and most found that they were able to stick with it.

So ok, this worked in a research study in Washington, D.C., but would my patients in Southfield be willing to go on a low-fat, vegan (plant-based) diet? Many of the physicians I worked with were pretty skeptical, understandably (“I can’t get my patients to go for a walk; you expect them to stop eating cheese burgers and Coney Dogs?”). But my husband Bill and I had been eating plant-based at that point for several months, and had seen our own health improvements, so it seemed to me that the right thing to do was to at least offer the option to the people who trusted me to help them manage their diabetes.

PCRM Power Plate

PCRM Power Plate

Fast forward 9 years. There are now many studies that support a plant-based dietary pattern for diabetes and the other chronic conditions that are epidemic in Michigan and across the U.S. The ADA now includes a plant-based diet in their clinical practice recommendations and provide some practical advice on their website – very encouraging! - and the USDA has identified a plant-based dietary pattern as among the best for all Americans. Most clinicians agree that this approach works, but many don’t think their patients can or will follow it. However, I’ve been offering this approach in my clinical practice for years, and time and time again, I’ve seen many are willing and able: people lose weight, people are able to reduce medications, other health problems resolve – it’s all good. To be sure, there is a learning curve, and it helps to have support of others. Over the months ahead, I’ll share some of the most important research studies with you, and allow you to peek into the lives of my patients (with their permission, of course) and share in their successes. We will explore the best-of-the-best tools and resources.


Diabetes management is no longer my goal. Type 2 diabetes can be cured, and prevented from happening in the first place. People with type 1 diabetes can often reduce the total amount of insulin needed, and reduce wild swings in blood sugar and get on the road to good health. 


Join me in this space to make it happen for you.

Dr. Caroline Trapp
PBNSG Director - Diabetes education

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Can I eat a lot of carbs?

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Can I eat a lot of carbs?

Dear Dr. caroline, 
 
I'm concerned that all of the fruit, potatoes, corn, rice and other carbohydrates will make my blood sugar go up. In fact, when I had a big bowl of oatmeal the other morning, my blood sugar was high at lunch time. I'm not sure this approach is right for me. 

Signed, 
Carbophobia


Dear Carbophobia, 
What a great name you've chosen - Check out the book by that name written by Dr. Michael Greger, or read The Starch Solution by Dr. John McDougall. Both provide plenty of reassurance that yes, high-carb, or starch-based dietary patterns are safe and very healthy, even and especially for people with diabetes, with one caveat. At the same time as you fill up on fruits, whole grains, beans, and tubers, it is important to  cut down, way down, on the intake of dietary fat from animal products and oils. Both making these changes together, you'll eliminate the dietary fat that promotes insulin resistance, which allows your body to process those healthful carbohydrates effectively.

As  a nurse practitioner who has worked with people with diabetes for more than 20 years, I can attest that most people who make this change see their blood sugars improve right away. For others, it may take a little longer, perhaps a few weeks. In general, I would not get too worried about a few high readings at first, unless it persists. Be sure to drink plenty of water if your blood sugar is over 240 mg/dl to prevent getting dehydrated. For the majority of people, the numbers come down fairly quickly with a significant change in diet. Check with your health care professional to see learn what target ranges are acceptable for you, as you change your way of eating. 
 
There is hope for diabetes! 
Dr. Trapp

 

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What food should I give up?

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What food should I give up?

Dear Dr. caroline,

I'm not sure I'm ready to go to a completely plant-based diet. What's one food I could give up that might help me now?

Signed,
Not Ready


Dear Not Ready,

Congratulations on your interest! If anyone had told me 10 years ago that I'd be eating 100% plant-based, I would have laughed, loudly. So I understand. I applaud your willingness to dip a toe in the water and begin to break the animal-foods habit. Some want to see the immediate benefits and are ready to dive in completely. For those people, check out the resources at www.21DayKickstart.org.  Others might need to build up their confidence. 

One food to banish? Easy. Make it cheese. Cheese on pizza, cheese snacks, cheese in your salad...The stuff is sneaky, and its everywhere; Thank you, Dairy Industry! Nutritionally speaking, the little bit of calcium cheese contains is surrounded by a big package of FAT. No nutritional value there. For people with type 2 diabetes, the fat you eat builds up inside muscle cells, and makes it hard for the insulin your body makes to do its job. Stop eating excess fat and poof - for many, blood sugar levels improve, as insulin starts working again. Most cheeses get about 70% of their calories from fat - not too far off from a stick of butter.
 
Another reason to avoid cheese? It’s a concentrated form of cow's milk, which is designed by nature to grow a small calf into a large cow. You are not a young cow, you are an adult human. Hormones in milk designed to grow a cow have been linked to growth of prostate cancer in men (by Dr. Dean Ornish's team, in 2009). Prostate cancer is fairly easy to detect; those hormones may promote other cancers, too. Why take a chance? Cheese is also a binding food, and can cause constipation, a major problem among adults in the U.S.  Lay off the cheese, and your need for laxatives or, for that matter, bathroom reading material, will be gone. 

"Wear cheese, don't eat it!"

"Wear cheese, don't eat it!"

Want a big dose of calcium, without the fat? Choose green leafy vegetables. Where do you think the cows get their calcium?! Beans are a good source, too. Limit excess salt, and do some weight-bearing exercises to build your bones. 
 
Worried you'll miss it? You might, for the first few weeks. Set it aside and the craving goes away. Your body will thank you!
 
There is hope for diabetes! 
Dr. Trapp

 

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