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clear search termsMDs and Diabetes and Eating Crow
A pretty intimidating thought for many providers, even those with medical backgrounds. Maybe it triggers some limiting beliefs about “not knowing enough” or being “out of my league”? I confess I used to have a few of those pesky thoughts too. But I didn’t let them hold me back. After all, courage is not an absence of fear; it’s a willingness to move forward in spite of it!
Here’s why you actually really WANT to work with an MD client, even if you’re an MD yourself. A doc satisfied with their own progress can be a referral-generating machine! Over the years, I have supported many docs as clients, and a few of them have been my favorites of all time. Dr. G was one of them.
I used to meet her at the food court next to the hospital where she worked in Boston. You only had to take one look at the droves of docs in scrubs scarfing down burgers, soda, and fries to know that there was huge opportunity at hand!
Dr. G came to me after “treating” her Type 2 diabetes for a year with Metformin. I’ll always remember what she said during our initial consultation, “So here’s the truth: I don’t really believe that diabetes can be completely undone. But if I’m wrong, I really want to know what you know. So I am willing to suspend disbelief and give it a try.”
Whew. Talk about an intimidating kick-off!
But to her word, she did give it an honest try. And Dr. G got amazing results! She was able to stop using Metformin after about 3 months. Her HbA1c went from over 8% to 5.6% in about 10 months Yes: less than one year. Clinically, that is going from essentially out-of-control diabetes to non-diabetic.
The work we did together follows very closely what we teach in SAFM’s curriculum where we have a stand-alone course on Metabolic Dysfunction. It worked like a charm. We made a number of critical changes, but there are a few specific pearls I want to share with you….
- Berberine. I’ve written about this amazing alkaloid before. Basically, it’s been shown in clinical study to be as effective as Metformin in improving insulin sensitivity. And it worked like a charm in this case too. We paired it with alpha lipoic acid, biotin, and chromium.
- 100% elimination of all grains….at least for a while. The major challenge in reversing diabetes is “shocking” cells back into higher insulin sensitivity. In most cases, I find this requires making more severe dietary changes for a short time – typically ~6 months. Don’t confuse the concepts of a healing diet vs. a healthy maintenance diet. Many practitioners are big fans of whole grains. But it’s important to remember that each client is unique. Some can well tolerate daily moderate servings of whole grains in fully countering insulin resistance, while others need to restrict carbohydrates much more dramatically.
- Magnesium. Insulin resistance impairs magnesium absorption. And low magnesium creates insulin resistance. A vicious cycle! Every single diabetic client I have ever supported had suboptimal magnesium, so be on the lookout for this combination. It’s important to ensure that it’s RBC (not serum) Magnesium being evaluated. Dr. G was clinically low and needed a hefty daily dose (nearly 1000mg/day of mag glycinate) to get her levels up to even mid-normal.
- Fat is Where It’s At. Dr. G was like many of our clients: still brainwashed about the supposed danger of liberal dietary fat intake. She was amazed that I recommended eliminating oatmeal and whole wheat bread entirely and adding in (a lot of!) avocado, eggs, and coconut oil. Dietary fat increases satiety (by triggering a hormone called cholecystokinin or CCK) and can help to alleviate cravings for more refined carbohydrates.
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Why have her take alpha lipoic acid, biotin, and chromium?
This combination of nutrients helps increase insulin sensitivity. Please explore the linked articles for more information:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4124142/
https://www.researchgate.net/publication/6326538_Chromium_picolinate_and_biotin_combination_improves_glucose_metabolism_in_treated_uncontrolled_overweight_to_obese_patients_with_type_2_diabetes
Is Berberine a readily available supplement?
Oh yes, definitely! I recommend Thorne’s Berberine-500 which is easy to find online e.g. Amazon.
https://www.thorne.com/products/cardiovascular-support/dp/berberine-500
Here’s a big question that’s been on my mind for quite a while. I feel that I’m part of two worlds: the functional medicine world learning from you and practitioners like Mark Hyman, Dr Axe, Dr Jockers, etc. And then the vegan, plant based world with teachers like Neal Barnard, T Colin Campbell, etc. Diabetes is a great example of the divide between these two worlds. Recommendations are very different and yet both camps cite plenty of anecdotal evidence as well as more formal studies to back their claims. My personal philosophy is aligned much more with the vegan side (although I’m not totally vegan), and I don’t want to let my personal views cloud my recommendations. So here’s the question to you: Could it be that this is just a matter of bioindividuality where some people will have better results (eg reversing type 2 diabetes) with one vs the other approach? Or is it possible that although these approaches are very different in many ways, it’s possible that the vast majority of people suffering with diabetes would see good results with either approach and then it’ a matter of them deciding which resonates more for them? Or do you… Read more »
Ahhh, a great question – and serendipitous timing. One of our next Clinical Courses is going to be on metabolic typing. As we well know, some people thrive with Paleo, and others thrive on a Vegetarian/Vegan diet. And there are of course many variations of both that accommodate our food allergies/sensitivities, our digestive limitations, our level of exercise/movement, and other unique needs. Our job is to help a client sort out what is best for their body and temperament. Of course, this best choice on a *visceral* level could be quite different or opposite what they may be trying to choose intellectually or based on a fad or the latest book they read or what their best friend or husband is doing or their political views. This is key because continuing to eat a diet that a person “wants” to be the best for them and ignoring the resulting dis-ease in their body is a recipe for ongoing illness. The body reflects this mental resistance physically. I had a vegetarian client once who wrestled with this for years but never got her immune system strong enough to combat a chronic infection and finally get well until she started eating meat.… Read more »
What happens if a client also has gout / kidney concerns as well as sever diabetes? Even though animal protein, nuts and seeds etc. are slightly acidic, when balanced with ample alkalizing vegetables, they should be healthy for them to eat right?
In my experience, most gout is actually caused by the elevated blood sugar in diabetes and also by high fructose intake. Usage of diuretic drugs for hypertension can also exacerbate gout. There is a detailed post in the Membership Q&A about Gout which you will probably find helpful. It is particularly important to drink plenty of water and to anchor their diet with low-glycemic vegetables (as you say). From there, yes, moderate animal protein and other whole foods should be fine. I would be sure to use benfotiamine to help protect the kidneys from the oxidative damage caused by the high blood sugar, but yes, changing their diet and reversing the diabetes is the ultimate path to healing. There are other key supplements targeted for gout such as tart cherry extract, which work quite well.