Wednesday, August 22, 2007
Managing diabetes
As it stands now, diabetes is one of the more vexing problems that health care professionals deal with. At once, it is frighteningly common with 20 million carrying the diagnosis and the number still growing. In fact, around 6 million people don't even know they have it. The disease is linked to heart problems, stroke, blindness and kidney disease. At the same time, though, it is an extremely manageable problem, perhaps more so than many other diseases.

For diabetics, there are really five important tips to keep in mind:

1) Know your medications. Be familiar with the medications and understand their interactions and side effects

2) Build a power team of health care professionals, including doctors, nurses and nutritionists. Doctors are important but it is the nurses and nutritionists who will really help manage your disease day to day.

3) Keep levels in check. Certainly, if you are at risk for diabetes because of your weight or family history, get a fasting glucose test. A normal level should be less than 100. If you are diabetic, make sure to get something known as A1C tested which gives a longer-term look at your blood sugars. Of course, know your blood pressure and cholesterol levels. A1C should be less than 7 percent, blood pressure less than 120/80 and cholesterol levels less than 200 - some doctors say even lower. Also, make sure to get a proper eye exam every year and check your feet every day for any non-healing sores.

4) Stay active. Diabetes is not a death sentence. Get active and stay active. A diabetic can benefit from as little as 30 minutes of exercise five days a week.

5) Finally, a good diet. You will read a lot about diabetic diets, and it is important to pay attention to the basics of glucose control. Make sure, though, to get plenty of fruits and veggies and watch your risk factors for heart disease as well.

Truth is, we do have a problem with diabetes in this country and it can lead to heartache and suffering. Still, with what we already know, we can greatly reduce death and disability and give people back normal and healthy lives. Are any of you diabetics? How have you been able to manage your disease?

Our 7 year old daughter was diagnosed with Type 1 diabetes a year and a half ago. While it differs significantly from Type 2, we have found, after much trial and error, that a low carb diet works very well with her insulin regimen in the control of her blood sugar. Keeping her diet low carb (not no carb) allows her to have a lower dosage of insulin each day, which is a very good thing for long-term health. While getting enough exercise is not difficult for a young child, we still work to set a good standard of daily exercise, in order to set her up for a lifetime of that routine. She has recently learned to check her own blood sugar, which is also an important step to helping her become independent in her own health care. It's a daily challenge, but we are so thankful it's a manageable disease.
I love your comments every morning, they are very informative. But I did not hear mention of the effect of periodontal disease on diabetes this morning nor the importance of dental check ups to curb diabetes. I have included some articles below in regards.
People with diabetes are more likely to have periodontal disease than people without diabetes, probably because diabetics are more susceptible to contracting infections. In fact, periodontal disease is often considered the sixth complication of diabetes. Those people who don't have their diabetes under control are especially at risk.
A study in the November issue of the Journal of Periodontology found that poorly controlled type 2 diabetic patients are more likely to develop periodontal disease than well-controlled diabetics are.
Research has emerged that suggests that the relationship between periodontal disease and diabetes goes both ways - periodontal disease may make it more difficult for people who have diabetes to control their blood sugar.
Severe periodontal disease can increase blood sugar, contributing to increased periods of time when the body functions with a high blood sugar. This puts diabetics at increased risk for diabetic complications. Thus, diabetics who have periodontal disease should be treated to eliminate the periodontal infection.
This recommendation is supported by a study reported in the Journal of Periodontology in 1997 involving 113 Pima Indians with both diabetes and periodontal disease. The study found that when their periodontal infections were treated, the management of their diabetes markedly improved.
Controlled Diabetics Have
New Reason to Smile
CHICAGO – November 22, 1999 – Diabetes has long been known to increase the risk of severe periodontal disease. A study released today in the November issue of the Journal of Periodontology found that poorly controlled type 2 diabetic patients are more likely to develop periodontal disease than well-controlled diabetics are. In addition, the study further explains why diabetics are more susceptible to severe periodontal disease. Study Abstract *
The study concluded that poorly controlled diabetics respond differently to bacterial plaque at the gum line than well-controlled diabetics and non-diabetics, possibly due to elevated serum triglycerides. Poorly controlled diabetics have more harmful proteins (cytokines) in their gingival tissue, causing destructive inflammation of the gums. In turn, beneficial proteins (growth factors) are reduced, interfering with the healing response to infection.
"Increased serum triglyceride levels in uncontrolled diabetics seem to be related to greater attachment loss and probing depths, which are measures of periodontal disease," said Christopher Cutler, D.D.S., Ph.D., the study's lead researcher. "Diabetic patients should certainly be aware of their blood sugar levels, but it's also important they have their serum triglycerides and cholesterol levels checked by their physician on a regular basis. Reducing cholesterol and serum triglyceride levels, preferably through diet and exercise, may be the most important changes that diabetics can make to improve their quality of life, as well as their oral health."
The American Academy of Periodontology is encouraging diabetics to get a periodontal evaluation during National Diabetes Month in November, as recent research also has found that having periodontal disease makes diabetes more difficult to control. "We have a classic vicious cycle going on," said Cutler.
"Controlling your periodontal disease may help you control your diabetes," added Jack Caton, D.D.S., M.S., President of the American Academy of Periodontology (AAP). "Therefore, diabetic patients should be sure both their medical and dental care provider are aware of their medical history and periodontal status."
A referral to a periodontist in your area and free brochure samples including one titled Diabetes and Gum Disease are available by calling 800-FLOSS-EM or visiting the AAP's Web site at
The American Academy of Periodontology is an 8,000-member association of dental professionals specializing in the prevention, diagnosis and treatment of diseases affecting the gums and supporting structures of the teeth and in the placement and maintenance of dental implants. Periodontics is one of nine dental specialties recognized by the American Dental Association.
For more information, contact the AAP Public Affairs Department at 312/573-3243 or 312/573-3242.
* EDITOR'S NOTE: Representatives of the media may contact the AAP Public Affairs Department to receive a copy of the study Heightened Gingival Inflammation and Attachment Loss in Type 2 Diabetics with Hyperlipidemia. Abstracts of Journal of Periodontology articles are available to the public online.
Thank you, Dr. Gupta, for addressing the issue of diabetes in America. Having been diagnosed with Type 1 diabetes eighteen years ago, I am amazed at how the general public is still ignorant of the disease and the impact it truely has on our society. Given the obesity epidemic, poor medical infrastructure, and aging population, the US is a diabetes disaster in the making.
While I agree with all of the information in your blog, I've experienced the multiple blocks and pitfalls while trying to maintain good blood sugar control that make following your suggestions so difficult.
1. Access to medical services. In short: no money or insurance, no medical service. Without insurance, a diabetic is limited in access to testing, medical attention, and supplies. Even with so-called insurance (also known as HMO's), I haven't had adequate medical treatment since I changed from an 80/20 insurance program and started with HMO coverage in 1995. With the complex referral/approval system in place, I simply can't afford to go to all the appointments, referrals sesions, and PCP sessions required by the HMO programs to access the services. I've had numerous occasions when I lost a day of work trying to access a doctor "in system" who was more than a 2 hours drive away from me simply because there was no one closer who was open to take new referrals.
2. Cost of medications. It costs me about $750 per month for my basic diabetes meds and medical supplies (not including heart or ulcer meds) when I am not insured, which has happened for five of the past ten years. This means, in the past, I have sacrificed all the optimal options (Humilin, insulin pump or Lantus) for good blood sugar control, and have used generic alternatives, which leave me with erratic blood sugar readings (ranging between 40 and 400).
3. Poor or limited medical advice. 15 minutes with a doctor who has only enough time to check my lab readings (when it is covered by HMO's, which has only been 3 years of past ten years for me) is not enough time to discuss my lifestyle issues or other challenges affecting my blood sugar control. Almost all of the doctors I have seen are simply so rushed to do what they need to, we haven't had the time to really sit down and figure out what needs to be done. I've received the canned "solution" for the problem, which really isn't a specific solution for my issues.

The end result of this patchwork system of addressing personal diabetes needs is that I went from being 130 pounds and active to 290 pounds and scared to engage in any physical activity for fear of "compromising my safety". This failure to get good diabetes control was as a result of what I recently found out to be wrong medications, food alergies, and sloppy general diabetes management (partly mine and partly very bad medical advice).
I am now employed at an agency that has appropriate medical insurance coverage that will cover lab work, diabetes education, eye exams, dietician consults and visits with an endocrinologist. During the past three months I have been getting this medical attention I found out about the food alergy and switched to a vegan diet; changed meds to optimal insulin and cholestrol meds for my needs; and working with diabetes educator on exercise program that won't compromise my safety. My A1C readings dropped over 4 points, blood sugar is consistently under 180,and I've lost 18 pounds to date.
Simple answer: have politicians, doctors, and insurance recognize that diabetes is not only a disease of life but of lifestyle and have ALL of the treatment necessary covered by insurance. Not too many people I know could pay for the roughly $1800.00 in monthly costs I am running at the moment trying to fix over a decade of no or poor medical treatment. It would have been so much cheaper to focus on staying healthy rather than try to fix it after it's broken. But I guess that's what happens when we focus on illness instead of wellness.

C. Anne, Dover, NH
Diabetic foot disorders are one of the most common conditions treated by the 6,000 foot and ankle surgeons who belong to the American College of Foot and Ankle Surgeons (ACFAS). This non-profit medical association provides diabetic foot care guidelines and information on diabetic amputation prevention on its consumer Web site, More than 60 percent of lower extremity amputations in the U.S. will occur in people with diabetes, averaging 82,000 per year, according to the Centers for Disease Control and Prevention and National Center for Chronic Disease Prevention and Health Promotion.
Thanks for addressing the issue of diabetes, which effects millions of people. I just want to point out that diet can play a major role in preventing diabetes and managing diabetes. A vegan diet is especially helpful in managing diabetes. People who eat a low-fat, plant-based diet can reduce or eliminate the need for medication. People also tend to lose weight and lower their cholesterol when they switch to a vegan diet. Learn more at
I was just recently diagnosed with Type 2 diabetes.
Can eating low glycemic foods reduce your dependency on medication?
I just wanted to share a little bit about my journey to better health. In March, 2005, I began following a low fat vegan diet. I weighed 240 lb., my a1c was about 7, and I was beginning to lose kidney function (protein in urine). Now in August, 2007, I weigh 165 lb. (still need to lose some more weight), my a1c is 5.2, and my kidney function is in the normal range. I have discontinued my diabetes medicine and 2 out of 3 medicines for high blood pressure. My fasting blood sugar is now usually in the low 90's. I plan to continue my low fat vegan diet for life. It seems to be working for me. I now can enjoy my grandchildren! I would encourage anyone who is diabetic to try a low fat vegan diet. Dr. Neal Barnard's book Reversing Diabetes is a good place to start. A lot of free information is also on Just go to the diabetes icon and click it. I will say one last thing, a person does not have to go to any special store to purchase food. My regular grocery store has all the fruits, vegetables, legumes (beans), and grain products I need. In closing, I want to thank Dr. John McDougall for writing his books about a lowfat vegan diet and Dr. Neal Barnard for doing a study published in Diabetes Care in 2006, and writing Reversing Diabetes which supports the lowfat vegan diet as a way to improve the health of people with diabetes. I truly believe that they have saved my life.
Dr. Gupta,

My diabetes was way out of control 6 months ago. My A1c level was at 10. I am so grateful to have come across Dr. Neal Barnard's book on reversing diabetes in January of this year. It changed my life. He recommends the low-fat, low-glycemic index vegan diet. I made that change in my diet and after three months, my Alc was down to a 7. I had blood work done about three weeks ago and my Alc was at 6.5, my cholesterol levels have also gone down considerably. I don't do much exercise, if any. I know I should. All of these improvements in my blood sugar and cholesterol level have been due to diet change alone. I take glucophage but hope to reduce and eventually eliminate this medication. As soon as I start an exercise program, I know my blood sugar level and cholesterol levels will improve to the point where I won't need to take the glucophage. I have also lost about 25 pounds. I feel full of energy and happier. There is so much variety in the foods that I eat and they are so delicious that I don't feel like I am on a "diet". Besides the fact that the food tastes great, I don't have to be measuring, weighing or counting what I eat as I was doing previously. I eat until I feel satisfied. My four new food groups are fruits, legumes, whole grains and vegetables. Since changing my eating habits and seeing the improvement in my health, I have been telling anyone who will listen about Dr. Barnard's book. I have come to realize that one of the main reasons why disease is so widespread is that we are not educated as to the benefit of a truly healthy diet. I hope that through this blog some light is shed on this and those afflicted with diabetes become aware that there is hope if they are willing to make a change in their diet. If I was able to do it, anyone can do it. Thank you for this opportunity to share my story.
Diabetes runs in my family. I do not have it... yet. I am so happy you mention nutrition, diet and exercise more than once. I am tired of nutrition and diet considered 2 separate ideas. If people ate with nutrition in mind they wouldn't need to diet. I just turned 30 and my eyes are getting blurry and I have been urinating at least 8 times a day. I had my blood suger tested, no sugar yet. I guess I just need glasses and need to lay off the coffee. When will Biology take center stage in society Doc? You can have and iphone, get a trip into orbit, and can even blog with a famous Doctor, but I can't get a cure for my cold soars.
Dear Dr. Sanjay :)
My dad had suffered from the disease called "cluster headache"
During the period of treating, he was overly prescribed with "steroid" by a doctor. As a result his blood sugar level was abruptly increased. Suffering from terrible diabetes....
It's an incident I still haven't forgotten.
Sees significant Rise in Diabetes Rate The diabetes rate in the Korea rose an alarming 60 percent among people in their 30s during the 2000s
I heard that dietary fiber helps to lower the level of cholesterol and blood sugar, which reduces the risk of heart disease and diabetes.
Also, doctors say Koreans' computer-obsessed, couch-potato life style contributes to both obesity and diabetes.
I exercise a lot, too.I have to with the way leat, if I didn't exercise, I'd gain weight, too. lol...Yeah, I'm trying to work some exercise into my daily routine.
I think, In order to stay fit,it is important to both eat right and exercise regularly. Also I always do stretching and yoga exercises to make my body limber.
Thank you for useful information. I really appreciate it.
Take care sir :D
In 2001 I was diagnosed with Type 2 diabetes. At 330# & 6', my A1c was 9.5%, total cholesterol was 225, triglycerides were over 500 & my blood pressure was borderline. My doctor advised weight-loss surgery & put me on metformin. I bought a glucose meter & started checking my blood sugar several times a day. Desperate to get my health back, I decided to go vegetarian for a month & see if my health improved. I also started to excercise everyday. I did a lot of research on the web & I felt so much better that after a month, I decided I didn't want to consume all the saturated fat & cholesterol in eggs & dairy. After 6 months my A1c had improved to the point where I could quit taking metformin.

In a year my weight dropped to 170#. I still eat a 100% vegetarian (vegan) diet, excercise everyday & at age 50 feel better than I did at 30! My current weight is 175#, my total cholesterol is 143, my triglycerides are 50, blood pressure is normal, & most important, my A1c hovers around 5% when I have it checked every 6 months. My quality of life has improved dramatically, to say the least!

I know that if I hadn't adopted a vegan lifestyle & started exercising everyday, my weight would probably be close to 500# by now, I would have had at least one stroke or heart attack & most likely would have had toes or feet amputated due to out of control diabetese or possibly gone blind or be on dialysis. My only regret is that I didn't go vegan years ago.
At age 38 I was diagnosed 4 years ago with Type 1 Adult Onset.To make a long story short, my A1C was 13.7%, and as explained to me, I was probably two weeks away or sooner from being hospitalized. I was also told that I had led the most healthy of lives I was with all likelihood predisposed (genetically) to having diabetes. By my own admission, I certainly did not lead the healthiest life, but I am an active scuba diver, ride motorcycles, camping. So here I am with full blown insulin dependent diabetes, having only tolerated the pills for a short while, and building up a resistance in less than a year. I do my best to tow the mark and do what I need to stay healthy, my father in law is a long term diabetic and he has not taken care of himself, so I see the ravages of what the disease can do to you. What concerns me is the "other stuff" that goes with being diabetic that no one (including my medical support) discusses...
Taking insulin 4 - 5 times a day, imagine before every mouthful you need to monitor and inject insulin . . . for the rest of your life. Every day. Rotating and finding new areas to inject. If I hit a "bad spot" I would blossom into some of the biggest bruises - not pretty. My wedding morning I had a bruise that went from elbow halfway up to my shoulder. It's a hit or miss thing.
Having been a very spontaneous person, now my days are regulated by what to eat , how much to eat, how much insulin to take, when to take, how much excercise/activities would offset all of that. The preventative medicines that doctors want to put you on, and all those wonderful side effects.
Sick days take on a whole new meaning, not days to play hookie, but be genuinely ill.... oh and then there is not eating enough and suffering a low that can lay you out for a day to recuperate (which is inevitable, it happens....) diabetes with all the advances in medicine is still not an exact science (pardon the pun). There is a "diabetic depression" (can you blame us?) OH and they want to give you pills for that too, constant monitoring of cuts, scrapes etc. for infections, and the 6 month visits to monitor heart, liver, cholesterol, blood pressure, eyes, feet, teeth etc. Simple surgeries can become cause for concern......
Going on vacation can be a cause for stress, transporting enough supplies, storage of insulin, etc.
To be told "you might become diabetic" is simply not strong enough admonishment. People need to know the harsh reality of diabetes, pay more attention to the symptoms, be more informed BEFORE they become diabetic.
Manageable, yes.... but I disagree with it being made to sound acceptable.
Dr. Gupta,
Thank you for this. Here's an excellent resource: Know Your Numbers, Outlive Your Diabetes (Marlowe Diabetes Library, Feb 2006), the first-ever hands-on guide to help patients identify and manage their most critical health risks with diabetes: A1c, blood pressure, lipids, microalbumin, yearly eye exam.

Although these tests are widely accessible and easy to administer, fewer than 42% of adults with diabetes have either had these tests, or understand what the results mean, according to an April 2006 report by USA Today.
I was diagnosed with Type II diabetes about 18 months ago. I acquired Type II due to my sedentary, fast-food lifestyle. After much trial and error and frustration, I tried the South Beach diet. Through South Beach I found that eating a low-glycemic diet was the best control method for me. In fact, it has worked so well that my doctor has taken me off of my Metformin. I now control my glucose exclusively though my diet. Losing weight has just been an added bonus that will further help me manage my disease.
I have had type 1 diabetes since 2002. I have very good control. I started wearing an insulin pump since 2005 and found it to be very useful to help with better control of my blood glucose (my most recent A1C was 6.4 and every time it keeps getting better).

On the topic of the team of health care professionals, I wanted to note that the following should be a part of it:
1) An Endocrinologist: heading the team, since diabetes is an endocrine disorder.
2) A Cardiologist, since diabetes is known to cause heart problems more commonly than other conditions.
3) An Eye Doctor, since diabetes can cause retinopathy that results in irreversible damage to the vision.
4) Your general doctor, to help you look into the "other matters", such as your feet, etc.

Besides that, it is VERY useful and important to interact with other diabetics: look for local support groups or alternatively, join online communities. One of them (disclaimer: I founded it) is The impact knowing and talking to other diabetics has is hard to explain, but when it happens you wonder HOW you went about without knowing others "like you".
Dear Dr. Sanjay Gupta,

The only way I used to tune on to CNN in the past is by watching your program. The way now the shows are set up is just developing better and better.

I am a health educator and during my graduation internship, I have worked at the community health education department focusing on heart healthy program. Basically it is based on outreach and health and nutritional edcuation.

I observed that eating and health habits are very cultural oriented. A THanksgiving holiday proved very fatal to some people in the community I worked in. The local hospital showed numbers that incidents of heart attacks increased during holidays. We had to literally re-teach them to create healthy , low carb and low fat holiday dishes and trade alcoholic drinks for low carb non-alcoholic beverages. Further orientate on portion control.

It is quite a challenge to trade out that turkey gravy, pumpkin pie and cookies on that buffet table.

It is all hard work and mind control. Religious inspiration and community intergration works very well. The age group between 13 - 35 is hard to reach and educate, however children and elderly are easier to reach.
And don't forget, a low-carb diet is best for diabetics!
Dear Dr. Gupta:
I am wondering if you could help me. For the past few months my fasting blood sugar has risen to 110. The doctor indicated that this bares watching. I am 63 years old and my BMI is 22.5, but my blood pressure requires medication as does my cholesterol. Both meds are effective and I am now concerned that I might have to add an antidiabetic medication. The only change in my life is that I have relocated and have "reduced" many of my physical activities. Do you have any suggestions?
Thank you
I am a diabetic. Even though I am seriously overweight, I am finding that controlling diabetes is easy. I am also a chronic pain patient due to arthritis on the spine. That one is not easy. Controlling diabetes is a cake walk compared to controlling pain. Anyway, My advice would be: Number one, drink a lot of water, exercise as best you can, Don't eat junk food (snack items from a bag or box), don't eat anything white (except for milk, cheese). For example: Switch immediately to brown rice , brown bread, brown pasta, AND when you do eat bread, rise, pasta, eat a lot less of it. To fill yourself , eat more raw vegetables. A few simple changes and you'll be fine. DO NOT PANIC. This disease can be controlled with a few important changes.
The most important treatment of diabetes is prevention. Diet, exercise and healthy living would go a long way at helping one not to develop diabetes. Genetics has a large part in disease, but we are starting to find out that the way our family eats, handles stress, exercises etc. can be a contributing factor in the manifestation of disease. We do what our family showed us to do, but if that was unhealthy we must change our lifestyles.
Dr. Gupta - I was very interested in your program today about diabulimia. I was diagnosed last Fall as being pre-diabetic, and was able to turn that around with some simple modifications to my diet, (substituting whole grains and sugar substitutes for refined carbs and sugar) and it's had a very positive effect - just from that and a little extra exercise, I've lost over 20 pounds and gone down two sizes. The important thing here is that I've become a label reader and I'm much more aware of what's in the food I buy. It's surprising how many things are actually made from whole wheat flour - breads and pastas, my absolute favorites!
I always enjoy your programs - you state things in plain language and it's like having a conversation with my doctor. I have learned a lot from just watching your programs. I recently purchased "Chasing Life" - which I guess I'm now starting to do at age 57 - it's hard to come to terms with aging, but I'm trying to do a good job of it. Thank you for your insight and concern for people in general.

Greetings,well I too was just diagnosed with this problem about 2 weeks ago.I am 36 and have been relativly healthy most of my life.I have never been overweight but was a heavy drinker until about 3 yrs ago when i gave that up.I have lost about 50 pounds in the past year and began this sudden urge of constant thirst.After letting this go on for about a month I finally saw a doctor and found my a1c at 12.7 and blood sugar around 500.I am now awaiting test results to see what type of diabetes i have and where the heck it came from.There is no history of this in my family so this came to be a shock to me when i found out,especially when one of my children is autistic which already made our life complicated.I am finding out quickly though that managing this can be done but you have to be willing to change your ways and do what the doc tells you to do.Thanks to cnn for helping to spread the word and educate folks on diabetes
Okay, I have not been diagnosed with Diabetes, but Reading about people with diabetes and seeing that story about that girl who decided she is not taking meds to lose a pound sort of worries me. She is heading directly where the previous girl in the story before her's is gone to if she does not get someone to talk to her. I feel that if we know something we all have a responsibility to get to her and get her to change for her safety. I did hear Dr. Gupta say he hopes she finds help. I feel that she may wait until too late and its our responsibliity to aggressively get to her and change her mind so she can do what she needs to do before it is too late!!! that one pound that she needs to lose is useless if she is gone from here.
Dr Gupta, this has nothing to do with lead but I saw your piece on alzheimers this morning. I make an herbal tincture which actually reverses alzheimers. My father has had two massive strokes. He lost the entire left side. He, by the way is left handed. He, after two years of these herbs, walks, remembers and signs his name ands
uses the computer. He is not quite 100% but probably 70%. Another friend has a wife with alzheimers. She has advanced from not being able to hold a conversation or knowing people, to knowing everyone, holding conversations, being able to read and comprehend etc. A complete reversal. I also have an arthritis formula which remopves the arthritic buildup from the body. One case in point Maria Isabel a client from Mala Peru has gone from being completely bedridden to walking with a walker and much more. I can be reached at 816-886-7238 or My name is Daniel Smith. Too many people are suffering needlessly. You seem to have a sincere but sientific heart. Sincerely, Daniel Smith.
Yes, diabetic, Type II, diagnosed two years ago. One of the first things I did was make it a priority to reduce my A1C. It started at 12.6 and is now 5.6. I did this through educating myself about the condition, learning about improved nutrition, taking medication, addding more exercise, and dropping some weight. Probably most important was my attitude--I believed I could do it if I wanted to. If I can do it, anyone can.
My wife, brother, mother, and now I all have diabetes. My wife has practically lived in the hospital for the last 3 years from serious complication of diabetes - blindness in one eye, several amputations, End stage kidney disease, Intestinal Ischemia, and Gastroparesis (paralysis of the stomach). My brother also suffers from End stage renal failure.

They call Diabetes the silent killer. That is only half-true. It is silent at first, but oh boy is it loud later on. I am taking care of myself now, on a diet, taking my meds. I am scared to death I will suffer the same fate as my wife, and be in a position where I cannot take care of her. Our future is not very bright, and this country's health care system is a throw away system - everything is great until you really get sick and doctors get frustrated and want to "throw you away".

Don't ignore the signs!!!!! Diabetes is a killer, but a slow killer. The side affects will leave you hospitalized, in pain, and miserable.
Regarding type II diabetes; there is a "control" and there is also a "cure".

Your medications are the control. Meds DO NOT prolong life in diabetics (look it up or ask your doctor to confirm this), they only prevent complications of the disease. Each day you take your meds you help control your risk of experiencing the complications of diabetes.

The cure is weight loss. About 85% of those who loose a significant amount of weight through diet and exercise are able to stop taking their meds, even insulin (sounds like a cure to me).
I live in New Brunswick, Canada and the only difference that we have with diabetes from your country is the way we measure and use our meters. For me with Type 2 diabetes is I strive to measure between 5 and 6 on my meter.
I weighed 292 pounds 1 year ago and I was measuring close to 10 on the metr reading. I went on a weigh management program with the help of a dietician and my good wife, who lost 60 pounds the previous year. We are both off our meds and my wife even lowered her blood presure to the point where she is taking only 1 bp med at the moment. Diet, excerise and faith in the fact I could do this. I am now down to 257 pounds and I have to loose and 40 pounds. Dr Gupta please do not give up on your constant message, diet and excerise, diet and excerise as I hope to live to a 100, but seriously America shed those pounds. It worked for us up here in the "frozen white" North
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