Beat it

Beat it

Controlling diabetes with low-carb diet takes some adjustment


ILENE RAYMOND RUSH

A few things I adore: butter pecan ice cream, fresh-baked sourdough bread, and peaches. A few things I no longer eat: butter pecan ice cream, fresh-baked sourdough bread, and peaches.
(OK, I did indulge in a scoop of homemade butter pecan in Cape May over the summer, which I downed in record time. But it was the first time I had eaten ice cream in a year.)
I'm not talking about giving up gluten or going on a weird crash diet. Not even about the currently trendy paleo lifestyle.
For me, it's all about dealing with my type 2 diabetes and finally acknowledging that my high blood sugars were primarily due to eating carbohydrates. And that the only way to lower my sugars without additional medication was to step away from carbs.
After a one-year experiment with this type of eating, the medical results are in: A test of my average blood sugars - known as an A1c - over three months yielded a reading of 5.7 in August. Anything less than 5.7 is considered normal; 6.5 and above indicates diabetes.
My endocrinologist, Daniel Rosenberg of Endocrine Specialists P.C. in Willow Grove, was able to reduce my medications to one pill of metformin twice a day.
I am not recommending this plan as a universal panacea. But at the moment, it's working for me.
Diabetes facts are frightening: A 2014 report from the Centers for Disease Control and Prevention notes that more than 29 million people in the U.S. have diabetes. By some estimates, one in three people will have the disease by 2050.
Though genetics play a role in determining whether you develop type 2 diabetes, it's "becoming increasingly clear that overconsumption of carbohydrate is somehow connected to both the epidemics of obesity and type 2 diabetes," according to a recent paper by the University of Alabama.
The review, conducted by a consortium of 26 physicians and nutrition researchers, suggests the need "for a reappraisal of dietary guidelines due to the inability of current recommendations to control the epidemic of diabetes."
"Diabetes is a disease of carbohydrate intolerance," says Barbara Glower, vice chair for research in the UAB Department of Nutrition Sciences and lead author of the UAB study. "Reducing carbohydrates is the obvious treatment."
Diabetes is not for the fainthearted. Twenty-nine years ago, pregnant with my first son, I was diagnosed with gestational diabetes. Seven years later, during my second pregnancy, the condition returned.
The first time, I treated it with diet and exercise (some days up to three hours of swimming and stationary biking); the second time, the doctor gently insisted I inject insulin.
Six years after the birth of my second son, I was diagnosed with type 2 diabetes. It wasn't entirely a surprise: My father had diabetes, and, during my freshman year at college, I had added a freshman 15 that never seemed to leave my hips.
So began my saga of dealing with diabetes. What to eat, when to eat, how to exercise, when to exercise, what drugs to take, and when to take them.
Given this need for vigilance, the disease can roll over your life like an alien force, making you question every bite you put into your mouth. Taking your blood sugars, then trying to figure out what caused a spike or a drop, can often be a mystery.
Mornings may be the worst, because sugars can spike overnight. Or it might be after exercise, when sugars can plunge. I've had sudden highs and lows in Walgreens, behind the wheel, during parties, at the gym.
Very-low-carb diets are not for everyone.
"A lot depends on how much insulin your pancreas is able to squeeze out," says Rosenberg. He worries about people who will translate this into a bacon-and-egg diet, which can cause plaque buildup in the heart; about some who will go on and off the diet, provoking even more unstable sugar readings; and about those with kidney disease who should not consume excess protein.
"Ninety-five percent of people can't stick to this way of eating," he says. "They'll go on it for two weeks and then quit." Obstacles include dealing with social situations that revolve around food and family members who can't get with the program.
But in October, put off by taking injectable medications to lower my sugars (first Byetta and then Bydureon), I decided to take the plunge. In the past, I had nibbled around the idea: abandoning pasta one week, eating only whole-wheat pasta the next. This time I went cold turkey.
And here's the secret: It isn't really that hard. At least not after the first month or so. By adding more protein to my diet (mostly egg whites, fish, and low-fat cheeses) and eating plenty of low-carb vegetables (goodbye sweet corn, hello broccoli), I've been able to keep to it. On occasion, I add a bit of sugar-free chocolate to the mix, but, mainly, if I'm hankering for something sweet, I settle for a handful of nuts. I haven't given up alcohol, and allow myself a drink a day, which does add a few carbs.

Sure, I miss that butter pecan. But I have to admit: The benefits have outweighed the costs.