MY DIABETES II STRATEGY

What I know about Diabetes II so far is not much. But no one else knows much either.

Consider that a cell is a little creature all unto itself, with the coded gameplan tucked into its nucleus while it goes about its business in the sea-in-the-skin of a mammal. The anchored cells are dependent on the tide of the blood and lymph to bring them their food and remove their discards. The circulating ones ride that tide. One needn’t feel too badly about erythrocytes (red blood cells) lost through a cut or bloody nose, as Loren Eiseley so famously did when he fell on a cement sidewalk. Erythrocytes have no nucleus, which is basically the cell brain. Squamous epithelial cells are sacrificed to abrasion every day, sometimes with no pain, other times “with.” When I was a kid, those cells who lived over my knees lived sacrificial lives and were often fortified with scabs.

Hey, diabetes! Remember? Okay.

Every human being is different. The cells are used to different things and their nuclei may have different game plans. That counts. What is true for one person is not true for another. If your blood glucose is no longer automatically managed by your body, you will have to build your compensation around your own uniqueness as MEASURED by a glucometer. That’s the little machine deal that you put your drop of blood into and read your glucose level in a window. MEASURED. No guessing.

Glucose, which is the fuel of cells, cannot get into a cell without the help of insulin. If the insulin is missing or won’t work, you have Diabetes I, which is an older and better understood phenomenon. In Diabetes II there is some mysterious reason why the insulin can’t get the glucose into the cell. It might be the cell’s fault. Our little pocket glucometers measure glucose but none measure insulin. People with Diabetes II who have had their insulin levels checked by a lab may find that they have plenty. They may even find that they have too much because the body is still trying to pry those cells open so the glucose can get in. Insulin is toxic and will not do you any good if there’s too much.

The closer the environment is to the original environment of humans, the better, because the more likely the nucleus’ game plan is to fit. Today’s environment has become very different chemically and in the way of living. (I HATE saying "lifestyle.") There is considerable suspicion that because the incidence curve of Diabetes II is going up so quickly, there must be some environmental cause.

The trouble is that there’s been so much change and it is in such basic ways that it’s pretty tough to design objective tests that will definitively prove that THIS plastic ingredient or THAT level of TV watching or THE OTHER amount of soda pop swilling is what is giving go many people Diabetes II. Some say it’s likely to turn out that the condition is a variation on “autoimmune” disorders in which the confused warrior cells of the body can’t tell which cells to attack and cause “friendly fire” damage in one’s own body.

Though the scientists and doctors (those of them that are scientific) are confused about all this, raw personal experiment plus some provisional research can help. As follows.

For many decades (probably since the first granolas came out of the closet) I’ve noted certain people, usually female, who looked particularly healthy, slender and energetic. They said their secret was eliminating all white sugar, white flour, corn fructose, processed foods, and (sometimes) nightshade foods (potatoes and tomatoes) from their diets. After I began to eat this way, I lost the extra fifty pounds I’d been fighting for a long time. When insulin can’t get glucose into the cells, it converts the glucose into fat and just parks it.

What that actually means for me is that I eat very little bread (and look on the package for ingredients, not buying any with fructose or a lot of preservatives), NO sugar (white or brown) or corn fructose (check package), an absolute minimum of processed foods (mostly condiments which are eaten in very small amounts), no white potatoes -- I do eat tomatoes. I’ve been doing this since diagnosis, a little over two years.

I eat meat sort of according to Weight Watcher guidelines (preference to chicken and fish, not a huge amount, de-fat as much as possible, include eggs) and huge amounts of green stuff. In fact, the biggest danger to my health these days is probably contaminated bagged salad greens. I’m wishing I had my salad spinner back, though it was a big nuisance, since all the advice about “patting dry” greens with paper towels is an even bigger nuisance.

The amounts of food I eat are drastically reduced. But when I first started to convert over to this low-carb diet I did it mostly by adding rather than subtracting. Some things, like carbonated pop, I’d already dropped out. I began to make bran muffins off the All-Bran package, adding walnuts and berries, and to eat one or two a day. I tried to snack on olives, string beans and peapods, those nice individually packaged cheese sticks, peanuts in the shell (takes longer so you eat fewer), and similar low glycemic (dense and slow to digest) foods like baby carrots and celery. It does not help that my teeth are disintegrating from old age and too many filings. I bumped butter in favor of whipped cream or ricotta cheese on my toast.

If you do all this, the temptation to pick up packaged cake-lings or chip bags diminishes because you’re not hungry. Then it’s a matter of breaking habits, but I’ve tried to do that by substituting new habits that knock out the old. In a BBC movie (!) I came across a family that habitually put a record on the old 78 turntable and danced together for a while after supper. I’d love to get this habit going. Fun and good comapny are powerful tools.

The first time I went back to my first doctor (who turned out to be a bad fit) she asked what I ate for lunch and I told her beans. She was horrified, saying “no one” eats beans for lunch and also beans as in “pork n’ beans” are loaded with sugar. The can label confirmed this latter. (The former, the female doctor’s opinion of what people do and OUGHT to do, is why I changed doctors.) I ran a little test on myself and discovered that pork n’ beans take my blood sugar up to 180. Then I read every label on every kind of beans at the supermarket and found enormous variation. I buy the lowest possible. The next step would be to slow-cook or pressure-cook my own beans, but I haven’t gotten there yet. Portions sizes as described on cans are also a revelation. I mix something with high calories with low-calorie foods, inventing as I go. Refried beans with olives and green beans. Black beans half-and-half with cottage cheese plus green chiles.

When one begins to think about blood glucose, people will NOT tell you what your reading should be. 100 is normal. If you go below seventy or so, you begin to feel funny. If you go above 140, damage begins: deterioration in one’s toes and eyes and damage to the lining of the kidneys. Kidney cells are up against the urine, of course, and if the urine is too high in glucose, the cells begin to plasmolize -- that is, their inside fluids begin to be pulled out. If you’ve put salt on a slug to kill it, you know what the damage can look like -- a vivid cautionary memory. So the goal is to keep one’s blood glucose somewhere between eighty and maybe a hundred and twenty or so. This means neither over nor under eating and eating constantly, browsing. Very fashionable.

The pharm industry wants to take over your glucose readings and run them via pills, the same as your blood pressure. Resist but don’t eliminate pills. They do make a difference. But the key to the old thing is the glucometer. I call mine R2D2. It’s my friend. But I don’t want a fussy C3PO for a doctor. I maintain my right to be human in the interest of my cells.