Diabetes: Important Information

The goals of treatment for type 1 and type 2 diabetes. What kind of sugar to strive for.

When treating type 1 or type 2 diabetes, we set an ambitious goal: to keep the blood sugar level the same as in healthy people who do not have diabetes. If this can be achieved, then the patient has a 100% guarantee that he will not have the typical complications of diabetes: renal failure, blindness or foot diseases. The methods that we use to control blood sugar are at the same time good prevention of “age-related” problems: atherosclerosis, heart attack, stroke, diseases of the joints.

First of all, let's find out what sugar is observed in healthy slim people without diabetes. Dr. Bernstein has spent a lot of time and effort over the years to find out. He persuades to measure blood sugar of spouses and relatives of diabetics who come to his appointment. He is also frequently visited by sales agents, trying to convince him to use glucometers of the brand they advertise. In such cases, the doctor always insists that the seller measure his sugar with a glucometer that advertises, and immediately takes blood from his vein to conduct laboratory analysis and assess the accuracy of the glucometer.

In all these cases, in healthy people sugar turns out to be 4.6 ± 0.17 mmol / l. Therefore, our goal of treating type 1 and type 2 diabetes is to maintain a stable blood sugar level of 4.6 ± 0.6 mmol / l, at any age, before and after eating, stopping its “jumps”. Traditional diabetes treatments are a “balanced” diet and high doses of insulin. They do not allow to achieve such results, as if the diabetic did not try. Therefore, doctors simply show official high blood sugar levels to calm patients. And at this time, patients in full swing develop complications of diabetes.

How to maintain stable normal blood sugar

We propose a low-carb diet instead of a “balanced” diet to control type 1 and type 2 diabetes. On this diet, blood sugar hardly rises after a meal. The less carbs a diabetic eats, the less insulin he needs to prick. Small doses of insulin, unlike large doses, act stably and predictably. Sugar jumps stop, it is maintained steadily normal. Check out our Type 1 Diabetes Treatment Program and Type 2 Diabetes Treatment, which are listed below. If you carefully follow the regime, the blood sugar drops to normal in 2-3 days, and then all the time remains normal.

As for glycated hemoglobin, in healthy slender people this figure is usually 4.2-4.6%. Accordingly, we need to strive for it. At the same time, the official rate of glycated hemoglobin is up to 6.5%. It is almost 1.5 times higher than in healthy people! Worse, diabetes is started to be treated only when this indicator rises to 7.0% or even higher.

What is good diabetes control

The American Diabetes Association says that “strict control of diabetes” means:

  • blood sugar before meals - from 5.0 to 7.2 mmol / l;
  • blood sugar 2 hours after a meal - no more than 10.0 mmol / l;
  • glycated hemoglobin - 7.0% and below.

We qualify such results as “complete lack of control of diabetes”.

The official standards that the American Diabetes Association publishes and, following it, our native Ministry of Health, suggest that a diabetic will eat a “balanced” diet rich in carbohydrates. A diet high in carbohydrates requires you to inject large doses of insulin in order to somehow lower your blood sugar. A high dose of insulin leads to an increased incidence of hypoglycemia. Therefore, doctors and officials from medicine overestimate the rate of sugar in the blood, trying to reduce the risk of severe hypoglycemia, which is fraught with death or disability.

If diabetes is treated with a low-carbohydrate diet, insulin doses are required several times less. The risk of hypoglycemia is repeatedly reduced without the need to maintain artificially high blood sugar. The human body in such conditions works predictably. Observing a low-carbohydrate diet, a diabetic knows exactly what his blood sugar will be, depending on the food eaten and insulin dosages. Now he can plan his diet, physical activity and insulin injections so as to stably maintain normal blood sugar, like in healthy people. This means a vigorous state of health and zero risk of diabetes complications.

Set the target blood sugar level

So, in healthy adults who are not obese and not pregnant, blood sugar usually turns out to be close to 4.6 mmol / l. In children, it is usually slightly lower. Within 1 hour after a meal, saturated with “fast” carbohydrates, sugar in the blood even in healthy people can remain elevated. This phenomenon cannot be considered natural. Because throughout the history of mankind, people for food “fast” refined carbohydrates simply were not available. The diet of our ancestors became rich in carbohydrates no more than 10 thousand years ago, with the development of agriculture, and before that there was much more protein in it.

Nowadays, residents of developed countries eat more than 70 kg of sugar per person per year. This includes not only table sugar, but also one that is added to food and drink in their industrial production. Our ancestors could not eat in the whole of their life such amount of refined carbohydrates, which we now eat in a year. Therefore, the human body genetically did not have time to adapt to the consumption of “fast” carbohydrates. Based on all these considerations, we ignore the blood sugar jumps in healthy people after a meal overloaded with carbohydrates, and set a target blood sugar level in diabetes 4.6 ± 0.6 mmol / l.

For patients with type 2 diabetes who are not treated with insulin at all or who receive very small doses of prolonged insulin, Dr. Bernstein recommends setting target blood sugar levels of 4.4-4.7 mmol / l before and after meals, i.e. with narrower deviation. For patients with type 2 diabetes who are treated with solid doses of insulin, as well as for patients with type 1 diabetes, the situation is more complicated. When their blood sugar drops, the body cannot “turn off” the effect of the insulin injected. Therefore, there is always a risk that the level of glucose in the blood will drop too much, i.e. hypoglycemia will occur. Therefore, for safety reasons, for such diabetics, the initial target blood sugar level can be set to 5.0 ± 0.6 mmol / l. When you get used to living with such sugar, then smoothly lower it to 4.6 ± 0.6 mmol / l over several weeks.

All diabetics are advised to adjust their blood sugar as soon as they find that it is higher or lower than the target values. For this purpose, injections of small doses of “fast” insulin, as well as glucose tablets are used. Read more articles on the relief of hypoglycemia and insulin dosage calculation. As a result, our blood sugar remains stably normal, as it was with our ancestors before the development of agriculture.

When you need to specifically keep high sugar

There is an extensive list of circumstances in which the target blood sugar level should be set elevated. All of these situations apply only to insulin-dependent diabetics who may be at risk for hypoglycemia. Here is a list of them:

  • Before starting treatment, a diabetic patient lived with very high sugar for many years.
  • At the very beginning of diabetes treatment with insulin injections.
  • For diabetics engaged in heavy physical labor.
  • For young children who have a high level of physical activity and unpredictable.
  • If the patient can not or does not want to strictly observe the regime.
  • With diabetic gastroparesis.

If a patient with diabetes before the treatment started, the blood sugar was very high for a long time, then he will experience the unpleasant symptoms of glycemia, if you immediately try to lower the sugar to normal. In this situation, we set the initial target blood glucose level much higher, and then gradually lower it to normal within a few weeks. Example. A patient with diabetes lived a long time with blood sugar of about 14 mmol / l. In this case, at first its sugar is lowered to 7-8 mmol / l and allowed to get used to the “new life”. And then further down to normal.

How to act when the patient is just beginning to treat his diabetes with insulin injections? In the early days, patients often make mistakes when insulin dosages are calculated. And this is normal until the habit is developed. You just need to use a safe strategy to protect yourself from severe hypoglycemia. For example, you can initially seek to lower blood sugar to only 6.7 mmol / l. For several weeks, painless insulin injections are combined with total control of blood sugar. They made sure that sugar never fell below 3.8 mmol / l - and only after that we gradually increase insulin dosages in order to reduce sugar to the target level.

For patients with diabetes who are addicted to insulin who are engaged in hard physical labor, there is an increased risk of hypoglycemia. Therefore, they may be advised to keep blood sugar higher than our usual target level. The same applies to young children who have a high and unpredictable level of physical activity.

We briefly mention diabetics who are unable or unwilling to accurately follow the recommendations, strictly follow the regimen. They will inevitably have sugar jumps. If you do not overstate the target level of glucose in the blood, then these jumps will lead to hypoglycemia. This is essentially the same situation as in the usual treatment of diabetes, when the patient is fed on a “balanced” diet.

Worst of all, patients with type 1 diabetes have developed diabetic gastroparesis - delayed gastric emptying after eating. This is a complication of diabetes that makes it harder to control blood sugar with a low-carbohydrate diet. It causes blood sugar jumps that are harder to smooth out. In the near future on the site will be a detailed article on how to act in this situation.

What to expect when your blood sugar returns to normal

In people who maintain consistently normal blood sugar, long-term complications of diabetes do not develop at all. At the same time, even slightly elevated sugar carries the risk of developing diabetes complications. But the closer your sugar is to normal, the lower the risk of problems. Next, we describe in detail the positive changes that diabetic patients observe after they have learned to control their disease well.

Enhance energy, improve mental abilities

First of all, diabetics who diligently follow the regimen, quickly notice that they have disappeared chronic fatigue. More energy is growing, efficiency and optimism are increasing. Many patients, before they began to bring their sugar back to normal, say they feel “normal”. Later, after experiencing the results of a type 1 diabetes treatment program or a type 2 diabetes treatment program, they say they feel fantastic. Their well-being becomes surprisingly good. Many do not even believe that this happens to them.

Often, patients themselves, as well as their spouses and relatives, complain that diabetics have a poor memory. This means that they have a weak short-term memory for recent events. When blood sugar returns to normal, short-term memory improves significantly in patients with diabetes. Also, if the tests show a lack of thyroid hormones in the blood, then you need to contact an endocrinologist and take the pills that he will prescribe. This additionally helps to improve memory. So much so that after a few months the symptoms of senile dementia disappear. In the end, a significant improvement in memory becomes obvious to the diabetic himself and to those around him.

Numbness and pain in the legs disappear

Diabetic neuropathy is a disorder of nerve conduction that occurs due to chronically elevated blood glucose levels. Diabetic neuropathy causes many different symptoms and problems. Its most typical manifestations are problems with the legs, i.e., the legs hurt or, on the contrary, lose sensitivity. Once the blood sugar has returned to normal, some symptoms of diabetic neuropathy disappear quickly, while others may cause trouble for several more years. And in advance there is nothing to predict.

If you have numbness (loss of sensation) in your legs, then it can be hoped that this problem will gradually begin to subside after a few weeks of careful implementation of a type 1 diabetes treatment program or a type 2 diabetes treatment program. But in terms of the restoration of sensitivity in the legs, we do not promise anything in advance. Many people with diabetes have legs that are very sensitive to blood sugar levels. Such diabetics know when their sugar rises, because they immediately feel numbness in their legs.

On the other hand, in some patients who previously complained of numbness in the legs, after normalization of sugar in the blood, the legs suddenly begin to hurt. Moreover, these pains are very strong, and it is difficult to drown them with something. They may last for several months, but in the end inevitably pass. Probably, the nerves begin to generate pain signals at the first time when their conductivity is restored. In such a situation, you need to suffer, not going anywhere, over time, these pains will pass. The main thing is that the risk of having to amputate the foot or leg is reduced.

Problems with potency in men

Potency problems worry at least 65% of male diabetics. Probably, this percentage is much higher, just many do not recognize the doctor. Impotence is caused by impaired nerve conduction, atherosclerotic blockage of blood vessels that fill the penis with blood, or both. It may be partial or complete. If a man's potency is at least partially preserved, then it can be expected that as a result of the normalization of sugar in the blood, it will recover fully. And this can happen in a few weeks.

Unfortunately, if the “old friend” does not show signs of life at all, then often nothing can be done. This means that the vessels are already strongly affected by atherosclerosis, and normalization of sugar in the blood does not help. Try the treatment methods described in our detailed article “Impotence in diabetes”. Everyone knows about Viagra pills. Few people know that Viagra has a few "relatives" from competing pharmaceutical companies. It makes sense to try them all to determine which pills will suit you best. Read more in the article, the link to which is given above.

Also keep in mind that hypoglycemia is extremely negative for male potency. After an attack of hypoglycemia, impotence may suddenly appear for a few more days, at the most inappropriate moments. In this way, the body of a diabetic man seems to be punishing his master for negligent attitude. This is an extra argument to more often measure the blood sugar level with a glucometer and not save on test strips.

Development of renal failure is inhibited

A low carbohydrate diet does not cure the kidneys per se. It is assumed that the kidneys restore themselves when the chronically high blood sugar stops poisoning them.The amount of protein in the urine decreases after a few months, but this process can last for 1-2 years. Also improves the rate of glomerular filtration by the results of blood tests.

Doctors usually advise to limit protein intake so as not to overload the kidneys and thus delay the development of kidney failure. Dr. Bernstein assures that this is not correct. Instead, you need to limit the intake of carbohydrates and make every effort to maintain normal blood sugar. Be sure to read “Low-carbohydrate diet and kidney diabetes complications.”

Save your eyesight with diabetes is real

Complications of diabetes on vision are diabetic retinopathy, cataracts and glaucoma. All these problems are much improved when a diabetic takes his blood sugar under control and keeps it stable in normal conditions. As with other complications of diabetes, it all depends on the severity of the disease, i.e., whether it was time to properly treat it with a low-carb diet.

Normalizing blood sugar is the best way to treat eye problems in diabetes. All the treatments that are offered by ophthalmologists, by their effectiveness for the preservation of vision and some did not lie with the type 1 diabetes treatment program or type 2 diabetes treatment program. Of course, if you have already developed severe complications of diabetes on vision, then you cannot do without medical help. At the same time, laser coagulation of the retina or other medical measures may complement, but not replace, the patient’s own actions in treating diabetes.

Other improvements

On a low-carb diet, the results of blood tests for “good” and “bad” cholesterol, triglycerides, and other cardiovascular risk factors are significantly improved. This can be observed, if you pass the tests before the “new life”, and then again after 2 months. The test results will continue to gradually improve for about a year.

Proved that chronically elevated blood sugar inhibits the growth and development of children suffering from type 1 diabetes. If you have time to normalize sugar in childhood or adolescence, young diabetics usually begin to grow and develop rapidly, catching up with their lag.

The most harmful manifestation of diabetic neuropathy is gastroparesis, that is, partial paralysis of the stomach. Diabetic gastroparesis leads to a slow emptying of the stomach after eating. This complication greatly impairs the control of blood sugar on a low-carbohydrate diet. Thus, diabetic gastroparesis makes it difficult to deal with the rest of the complications. Read how to control diabetic gastroparesis.

The main improvement that you will experience is the feeling that you have the death sentence canceled. Because the terrible complications of diabetes - kidney failure, blindness, amputation of the foot or the entire leg - you are no longer threatened. You may know diabetes patients who live with the problems listed above. This is not life, but sheer torment. People who diligently carry out our type 1 diabetes treatment program or type 2 diabetes treatment program are greatly relieved because they do not threaten to share the fate of the rest.

Maintaining normal blood sugar in diabetes, like in healthy lean people, is a real goal if you follow our recommendations diligently. Your health and your quality of life depend only on you. In addition to your loved ones, it no longer interests anyone. The state, on the contrary, is interested in getting rid of diabetics early in order to reduce the burden on the budget.

However, we hope that prudence will prevail. A low-carb diet will sooner or later become an officially recognized method of treating diabetes. But this happy time is still far away, and you need to act now to live a normal life without disability from diabetic complications.

Watch the video: Diabetes and Metabolism Specialist, Endocrinologist: Leonor Corsino, MD, FACE, MHS (April 2020).