Is It Possible to Tame Type 2 Diabetes?

Jeff O'Connell

| Dec 2, 2011

Jeff O'Connell is the author of "Sugar Nation: The Hidden Truth Behind America's Deadliest Habit and the Simple Way to Beat It."  I discovered his book while browsing the shelves of my local library, and I could hardly put it down. Though I have type I diabetes and O'Connell's book focuses on type 2, I found many of his thoughts applicable to my own health. His book is no doubt controversial, so I wanted to delve deeper into his daring claims and share his responses with the diabetic community. After reading my interview with Jeff, please leave a comment below to let Diabetes Health know what you think.

Rachel:  Tell me about yourself, personally and professionally.

Jeff:  I'm six-foot-six and weigh 190 pounds, so I'm hardly the poster child for diabetes or prediabetes. After graduating from UCLA in the late 1980s, I embarked upon a career in fitness magazine publishing. Along the way, I've been editor-in-chief at Muscle & Fitness, executive writer at Men's Health, and, presently, editor-in-chief at in Boise, Idaho. I've also co-authored four books, including the New York Times bestseller "LL Cool J's Platinum Workout." "Sugar Nation" is my first solo work, however. It was spun off from a Men's Health feature of mine called "The Thin Man's Diabetes."

Rachel:  How is Sugar Nation different from other diabetes books? Why did you decide to write it?

Jeff: Uniquely, "Sugar Nation" weaves together memoir, investigative journalism, and Men's Health-style how-to writing about diabetes and reactive hypoglycemia. The publisher, Hyperion, calls it a prescriptive memoir, meaning that readers can learn how to better manage their blood sugar through the prism of my experience. I hope that the personal story is a bit of a page turner, one that almost seduces readers into learning about diabetes and metabolic syndrome by accident. A million things have been written about this disease, but often the information is tuned out as being boring and pedantic. If I can hook people into reading about my family's experience with type 2 diabetes, a byproduct might be that they learn more about their own blood sugar.

That's really why I decided to write "Sugar Nation": to initiate the uninitiated. When I was diagnosed with prediabetes in 2006---on the heels of learning that my father had just lost a leg to the disease---I didn't have a clue about how to combat this health threat, despite working for Men's Health! Only because I had that position and those resources was I able to figure out a solution---one much different, by the way, from that suggested by the American Diabetes Association and other organizations. I thought, what chance does the average person who doesn't work for Men's Health have against this stealthy killer? I was incredibly fortunate and lucky, so I decided to share what I learned with others so that they might avoid my father's fate.

Rachel:  Diabetes organizations tend to put carbohydrates as the number one food source for people with diabetes---stating that the majority of our calories should come from carbs.  Yet you say in your book, "The dietary advice for diabetics being dispensed by the highest US medical authorities isn't just contradictory; it's also nonsensical."  Explain what you mean.

Jeff:  Diabetes is first and foremost a disease of glucose intolerance. Therefore, it seems logical to me to strictly limit the sources of that intolerance: sugar and other carbs that become glucose once digested. Yet the official guidelines basically tell diabetics to keep right on consuming the substance that's become toxic to their body.

We don't tell the lactose intolerant to keep drinking milk. So why do we tell the glucose intolerant to keep consuming glucose? No wonder one in three adult Americans now has diabetes or prediabetes. As one expert told me, this outcome is as predicable as a skin cancer epidemic would be if the official advice were as boneheaded as to bake in the sun.

A metabolic stress test called the glucose tolerance test has subjects drink a solution of 70 grams of pure glucose before measuring their blood glucose at selected intervals. But the official diabetes and dietary guidelines steer people toward a degree of carb consumption that approximates that amount at every meal! Granted, meals are usually mixed, which lowers their glycemic index, but that carb load is still overwhelming for the metabolic system of a vast swath of the population. So the pancreas is blitzkrieged every four or five hours for days, weeks, years, decades. No wonder diabetes is an epidemic.

Rachel:  Diabetes is a confusing disease. It seems like everyone, from medical professionals to drug companies, homeopathic experts, dietitians, personal trainers, and everyday people, has "advice" for people with diabetes. Your book, however, seems to boil down to some very simple rules or guidelines. How do you simplify a complex disease?

Jeff:  Insulin resistance characterizes type 2 diabetes. That is, cells become resistant to the hormone insulin, which should normally usher glucose into those cells. Without this guide, the glucose has nowhere to go. So it ends up where it shouldn't, wreaking all sorts of havoc on the heart, brain, kidneys, eyes---you name it. That's why diabetics urinate excessively. The body desperately tries to expel this extra glucose, knowing it's toxic even in slightly elevated amounts.

One of the themes of "Sugar Nation" is that a lifestyle-induced disease begs for a prescription of lifestyle change: exercise, carb reduction, and weight loss when necessary. The answer isn't pumping people full of drugs.

Rachel:  You have kept your blood sugars stable despite being considered at high risk (your father had type 2 diabetes) by eating a low carb and high fat, protein, and fiber diet, taking supplements, and exercising. Is it really possible to sustain that discipline for a lifetime?

Jeff:  I'm certainly a work in progress, but I believe the answer is yes. There's a lot at stake, and I've seen the cost of noncompliance up close and personal. You wouldn't wish a diabetic demise on your worst enemy, let alone a loved one or yourself. Daily exercise is something you should be doing anyway, and I actually enjoy my low carb diet immensely. I don't feel deprived at all. All these strategies working in concert make me feel energized, fit, and attractive rather than tired and sick. Why not keep at it for life? I see no reason not too, but many reasons to continue on this course I've chosen.

Rachel:  Many people with diabetes find the holidays particularly trying. There are so many opportunities to over-indulge, and holiday travel makes it difficult for them to stick to an exercise plan. What strategies help you get through the holidays happy and healthy?

Jeff:  Yeah, that's tricky for many people. Regarding exercise, keep in mind that you don't need to be grinding away on a treadmill for hours on end. Simply training in a focused way for 20 minutes a day makes a huge difference. Just be consistent. The salutary effects of exercise on glucose metabolism have a half-life just like drugs do. Take a small-to-moderate "dose" of exercise every day.

Diet-wise, remember that protein and non-starchy vegetables are always fair game. You just need to avoid potatoes, stuffing, desserts, and the like. Wine, ultra-light beer, and diet soft drinks are all okay too, although you shouldn't go overboard with any of them. There are also some great recipes out there for dishes like faux "mashed potatoes" made from cauliflower, which taste a lot like the real thing. Be creative; do your homework. This is a matter of life and limb. It's worth the effort. Trust me.

Rachel:  A diabetes diagnosis can be daunting and devastating.  For the newly diagnosed, what hope and encouragement can you offer?

Jeff:  There are actually many, many reasons to be hopeful and optimistic. You can reverse this disease by changing your lifestyle in fun and compelling ways. How great is that? Imagine if you were given that option after a cancer diagnosis. You'd be jumping for joy, right? There's this semantic debate about whether you can "cure" type 2 diabetes, but what you can surely do is keep it in a stalemate almost perpetually. Maybe you're not "cured" technically, because reintroducing too many carbs would jump-start the same disease process. But if diabetes remains in abeyance, what's the difference? You've still won.

Rachel:  Is your book receiving any attention from medical professionals or large health organizations?  What is the general reaction?

Jeff:  Not surprisingly, the book has been embraced by low-carb experts and practitioners, the paleo crowd, and alternative medicine devotees, but ignored by mainstream health and dietetic organizations, which is to be expected. The effort it took to write the book would have been worth it a thousand times over if only one person used it to avoid my father's fate. Instead, I receive letters every day from individuals across the land who are taking back their health and body after reading Sugar Nation. That's what matters to me.



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Categories: Blood Sugar, Carb Load, Diabetes, Diabetes, Faux Mashed Potatoes, Food, Glucose Intolerance, Lifestyle-Induced Disease, Losing weight, Low Carb Diet, Noncompliance, Prediabetes, Reactive Hypoglycemia, Sugar, Sugar Nation. Jeff O\'Connell, Type 2 Diabetes, Type 2 Issues

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Posted by Steve Parker, M.D. on 27 November 2011

I agree with O'Connell that over-consumption of sugar and refined starches often leads to type 2 diabetes and prediabetes, particularly when combined with obesity, a sedentary lifestlye, and genetic predisposition. (Our bodies easily and quickly convert potatoes and refined starches like white flour and white rice into blood sugar.) Yearly sugar consumption in the U.S. was five pounds per person in the 1800s, but is now up to 160 pounds a year. O'Connell is critical of most physicians and the American Diabetes Association (ADA) for not knowing about carbohydrate restriction and for inadequately promoting exercise. He accuses the pharmaceutical industry of having too much influence over physicians and the ADA. While admitting that taking a pill [is] much easier than reengineering the way you lead your life, he mostly lets patients off the hook in terms of taking control of diet and physical activity. I can understand that to a degree; physicians should be leading the way. I don't see that happening soon. Patients need to take charge now; many have already done so. Compared to a five-minute lecture in a doctor's office, this book will be a much more effective motivator for change. (Patients taking drugs with the potential to cause hypoglycemia need their doctor's help adjusting dosages while making these lifestyle changes.) The author tells us that we in the U.S. spent $12.5 billion on drugs for diabetes in 2007, nearly double the amount spent in 2001. It's only going to get worse going forward. We have 11 classes of drugs for diabetes now. Surprisingly, we don't know all of the potential adverse long-term side effects of most of these drugs. Phenformin was pulled from the U.S. market years ago due to fatal lactic acid build-up. Earlier this year, rosiglitazone prescribing was greatly restricted in view of adverse heart effects. If we can effectively address diabetes and prediabetes with diet and exercise, why not? (Clearly, diet and exercise don't always work, and type 1 diabetics always need insulin.) For those who won't or can't exercise regularly, be aware that carb restriction alone is a powerful approach. I heard more about reactive hypoglycemia a couple decades ago than I do now. It could be a precursor to type 2 diabetes. I think physicians lost interest in it because too many people were using it as a excuse for odd behavior when they really didn’t have hypogylcemia. This book may spark a resurgence in interest. O'Connell implies that the high revenues generated by diabetic drug manufacturers may not be justifiable. In fairness, I must point out that the same companies spend hundreds of millions of dollars just to get a drug on the market, and millions more on research for drugs that fail and never see the light of day. O'Connell recommends supplements: leucine, cinnamon, protein powder, chromium, alpha lipoic acid, biotin, magnesium. I've not done in-depth research on most of those. What I've read in the science literature about cinnamon and chromium has not been very positive or definitive. My favorite sentence: Along with a low-carb eating plan, a gym memership is the most potent antidote to type 2 diabetes.

Posted by Anonymous on 2 December 2011

Great article, Rachel! As the wife of a Type 1 diabetic, I found this encouraging and educational even though my husband's disease cannot be curbed. When he is regularly dieting and exercising, his A1C tests are better, he feels better, he looks better, and his sugars are so much more easily controlled. Conversely, when he doesn't do those things, he requires his basal insulin rate at which his insulin pump delivers to be more than doubled- and that doesn't even include what he has to bolus at mealtime! Thanks, Rachel, and to Jeff for your thoughts!
-G Lawson

Posted by DAR on 6 December 2011

Great interview! I'm going to get a copy of "Sugar Nation" to read. It's very refreshing and encouraging to find another book about controlling diabetes by avoiding the very things that cause BGL spikes instead of the dangerous advice given by the ADA and other "experts" who advise people to keep poisoning their bodies with carbs.

Severely limiting my carb intake has enabled me to keep my BGL under 100 at all times and my last A1c was 4.9. I take no meds; restricting carbs is enough for my body. My theory is that by keeping my BGL at nondiabetic levels, my body won't remember it has diabetes and won't develop diabetic complications like Jeff's father, my grandmother, and so many others have. I would really like to keep my feet, kidneys, eyesight, etc.

I have been trying to spread the word about controlling diabetes by limiting carbs for over 8 years. It can be hard to give up favorite foods, so I dream up low carb alternatives to help ease the transition to a healthy low carb lifestyle and share them online (through DARdreams). Like Jeff, I enjoy my low carb lifestyle and I wouldn't go back to eating carbage even if I could!

Posted by Anonymous on 6 December 2011

I have been living this lifestyle since I was diagnosed in 1996. I have excellent BGL control. However, my first experience with a Diabetic counselor left me very confused. She told me I could have between 15 and 30 grams of carbs with each meal. I can't have that many in a day or my BGL goes way up. Diabetes is different for every diabetic and the trick is to find out what works for you. Thankfully, I stumbled on this method early on. Many diabetics that I have spoken with have learned the same things through trial and error. How great to have a book that helps the n ewly diagnosed to begin practicing this regime sooner rather that later. I think doctor's should prescribe this book for all their patients. But doctors follow the "party line" and don't tell them how to manage their Diabetes successfully, mainly because they don't have any personal experience with the disease. I learned more from fellow diabetics, that I did from any one in the medical field.

Posted by Green Lantern on 6 December 2011

SANITY! It's great to see someone point out how absolutely wrong the ADA is in its recommendations for carb consumption, and to state the obvious: If the problem is carbs, remove them to help solve it. Great article!

Posted by bonnynemia on 6 December 2011

Yes, it is possible to tame type 2 diabetes.

For more than 20 years, despite my sky-high diagnosis fasting sugar of 468 mg/dl, I have been totally depending on 100 minute of daily exercise as my only anti-diabetes medication. I have never considered the heart-healthy, natural, fresh (raw or cooked) foods I have been eating 3x/day because most of them are carbohydrates.


Posted by chanson3633 on 6 December 2011

Thanks for the interesting interview. I'm a Type 1, but I have a feeling I would agreed with Mr. O'Connell's book.

Posted by Anonymous on 6 December 2011

I agree with the Jeff's comments. I think the reason that reduced carb intake is not always recommended is not as simple as it sounds. People in general simply can not just lose weight, at will, much less control the exact type and quantity of food. Many type II's I know (I'm one) have been told that 45 carbs per meal is o.k., but we know that is way too much. You guys in the mid 5 or less A1C are more disciplined than most. It is a big problem and the community compensates by prescribing more oral meds or even insulin w/o really giving it a hard try. Besides, the Dr. only has 5 or 10 minutes to spend with you to get you out the door.

Posted by larry139 on 7 December 2011

It is good to have another voice to the public. The ideas in Sugar Nation have been presented and practiced by Dr. Richard K. Bernstein for years. His book is more of a detailed medical approach. Every diabetic or insulin resistant person should read his book: Diabetes Solution by Richard K. Bernstein, MD.

Posted by Anonymous on 7 December 2011

I dont think that it is right to say that the American Diabetes Association, The American Dietetic Association, along with nutrition experts are giving false or dangerous information. Organizations like the ADA spend millions of dollars backing up thier claims with extensive research. Health care professionals and diabetes educator dedicate thier lives to help people with diabetes. And there is certainly not any money in choosing to be a diabetes educator. The "diet" or "meal plan" that organizations such as the ADA, recommend that you eat a balanced diet. As far as carbohydrates go (or all foods for that matter), it is recommended that you choose carbohydrates that are nutrionally dense such as fruits, vegetables, high fiber starches, and fat free diary. Most of the vitamins and minerals in our diet come from carbohydrates. The other question I pose is how can you eat a high fiber diet (25-35 grams per day)but only eat 5-10 gram of carbohydrate all day? Has any one noticed that fiber is part of the TOTAL CARBOHYDRATE when you read a food label? Fiber comes from foods that are carbohydrates. Also in promoting a high fat diet you also promote an increase in saturated fats, trans fats, and cholesterol. Even if you are eating lean meats they still contain the fats (saturated and trans) listed above. Fat is very calorically dense, many times people who try to follow this very strict and unrealistic diet gain weight because the amount of calories they are consuming increases significantly. Fat packs more than double the amount of calories that carbohydrates and protiens do. I encourage people to focus on the big picture. There is no easy quick fix for diabetes. I encourage people to do thier home work in term of researching lifestyle choices, take into consider the size of the study, who is funding the study (becuase it may be a bias opinion, espeically if they are trying to sell something), how long the study lasted, the environment of the study, and where the outcomes maintained 1-2 years later. For majority of people a low carb diet is a sort term solution, with long term cost. Lastly, I'd like to remind everyone that the best place to get your vitamins and minerals is from your diet. Supplements are not FDA regulated and they do not have conculsive evidence to back up thier claims. If you are questioning the high revenues from drug companies you may also want to question the companies that sell nutrtional supplements as they are a billion dollar industry.

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