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.
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.
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.
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.