Mar 19thDisobeying Doctor’s Orders

I got diagnosed with type 2 diabetes just in time for my 40th birthday (happy birthday to me!). The first two doctors I had were pretty good. Each of them would spend half an hour to an hour per appointment explaining what I needed to know, going over test results, explaining medications and their side effects, and, most importantly, asking questions and listening to what I was telling them was going on in my body. They both also were relatively familiar with different dietary approaches to diabetes and natural remedies. As long as my hemoglobin A1c and lipid numbers stayed within goal, they were encouraging and supportive. Funny that though they lived in different cities they had gone to school together and knew each other well. After a few years, A1c was 5.5 on 2 grams of metformin and 2 grams of cinnamon per day. The following year, I missed my follow up and ran out of metformin, but when I finally went back in, A1c was still well below goal at 6.3 with just the cinnamon. At the time I was doing a somewhat modified Atkins Diet.

Fast foward 2 years. That last good A1c on just the cinnamon must have produced a certain amount of over confidence. After we moved this past summer, I went in to get established with a new physician, and A1c was now up to 11.8 and triglycerides were 590. Wow! What happened? This doctor, though, was quite a bit different from the first two. The first thing that disturbed me was the 15 minute appointment model – even for a new patient visit. How do you address a brand new patient with an extensive history in 15 minutes unless you’re running a sausage factory? I mentioned the cinnamon, but got the impression that the doc wasn’t a big fan of home remedies. She also wasn’t a big fan of the Atkin’s approach and recommended a diet with 60 grams of carbohydrates per meal and not so much concern about fat or protein. At first I misunderstood and thought she said 60 grams per day, which would have been closer to what I had been used to on Atkins, but no–it was 60 grams per meal.

I tried her approach for a couple of months until the next appointment. Blood sugars were all over the map – but consistently high – still in the 200s to 300s, seldom below 200. Next appointment, still only 15 minutes in length, two new meds prescribed with no time for explanation, and reinforcement of the 60 grams of carbs per meal, and a brief indication that if these medications didn’t do the trick then her next step would be insulin, and come back in 8 weeks. The numbers in the 300s all the time and the reference to insulin had me a little freaked out, so I figured I’d better try to do what she said. The patient information sheets for the new drugs made me a little uncomfortable, though. I already had occasional mild problems with a couple of the prominent side effects of these two meds, and I wondered how my body was going to react. But lots of people are on this very same combination of 3 medications, so it must not be that bad. Right?

Well, within days, my occasional leg swelling at night turned into constant swelling in both my hands and feet, and my occasional indigestion turned into 2 big bottles of Tums gone in the space of about 4 weeks. After a while, I stopped both the new meds, and both problems disappeared within days.

A brief period of discouragement followed, and then I was flipping through the channels one day and came across a program called Blaine’s Low Carb Kitchen. Bingo! It had worked before, maybe it would work again. After looking up some recipes, I went out the next day and bought some flax seed meal, almond flour, and soy flour to make my breads with and a bunch of veggies and went back on Atkins in earnest. Fasting blood sugar the morning I started was 211 (normal less than 100). That was a week ago, and I have yet to have another reading over 200. In fact, the last two days, all my checks have been in the 140 range. I even had a 126 before dinner today. Wow!

Thoughts? First off, I’m not fond of the 15 minutes and out model I’ve experienced here. I know doctors are under a lot of pressure to make their clinics profitable, but 15 minutes for a new patient visit? I don’t think so.

Secondly, If something was working for a patient previously, why not let them give it a try again. Does diabetes really get harder to control, as this doctor told me during my first visit, or is the standard advice really just overloading the body with something it can’t handle?

Third. For 5 years I worked in a genetics clinic at a major teaching hospital. One of the doctors I worked with specialized in metabolic disorders. The approach for those childhood metabolic disorders is not to keep feeding the substance the kid can’t process, but rather to restrict it severely. If the major malfunction in diabetes is that the body no longer process carbohydrate properly, why overload that process? Sorry if I’m being simplistic here, but if I can get my blood sugar where it needs to be in less than a week simply by changing what I eat . . . .

The picture above is of the very yummy low-carb cookies i made tonight. Instead of white flour, they’re made with almond flour. Instead of sugar, Splenda. If I keep finding recipes like this one, I might just do okay this time – even if I do disobey doctor’s orders.

1 cup almond flour
2 tsp. baking powder
1/2 tsp salt
1 stick of butter
3/4 cup Splenda
1 tsp vanilla
4 tbsp. almond butter
2 eggs.

Preheat oven to 400. Sift together flour, baking powder, and salt into a bowl. Creeam butter with Splenda. Add vanilla and almond butter, add eggs. Gradually stir in the dry ingredients until mixed. Spoon onto greased cookie sheet and bake 10 to 15 minutes until lightly borwn. Remove from oven and let cool on rack. (makes 24 cookies – about 1 net carb per cookie)