As a result of modern medicine, type 2 diabetes is often treated at the symptom level: lower glucose levels, control side effects, make people feel better for a while. But it’s an endless cycle since for example insulin injection leads to weight gain, which leads to more insulin resistance, which leads to worse diabetes, which requires more insulin.
Don’t get me wrong, modern medicine is amazing. I’m not one of these people who dismiss it and advocate herbal or woowoo replacements. Modern medicine works and can achieve incredible things. But it’s sometime badly prescribed. After all, doctors just want their patients to report feeling better and sometimes that means taking a shortcut that doesn’t address the source of the problem. I always consider doctors engineers, not scientists: they have someone with a problem, they want to make it disappear. For that they’ll use their tools, medication, but not always aim it at the right thing.
I’m not dissing doctors or engineers. I’m both: engineer and doctor in science (PhD). But given the time doctors have with each patient, treating symptoms is often an acceptable shortcut. Making people do the right thing is difficult: telling people to change their diet, change their habits and their life is very hard. They will resist because they don’t want a hard life. So instead of fighting with patients to make them do the what they need to do, it’s easier to attack symptoms with medication. Medication doesn’t argue back at you.
Medication in that context has the perverse effect of removing incentive and responsibility. If medication is supposed to make you better, why would you do anything? Just let it do its job. Some doctors fear that with medication, people, including the medical profession, lose sight of the root cause of type 2 diabetes: fat leading to insulin resistance through interaction with insulin and cell membrane. Unlike type 1, type 2 diabetes doesn’t mean the body doesn’t secrete insulin, it often secretes massive amounts of it to the point of exhaustion. But the cells have become resistant to its effect.
When I started on my diabetes journey, my goal wasn’t to learn to live with diabetes. It was to get rid of it and take no medication in the long term. I had seen the effects of retraining the body through my cat’s journey with diabetes. I knew diet was the key. I was planning to do the same to myself.
I started with a HbA1c over 7.5%. Not super high compared to lots of people who go years without being diagnosed, but high enough to be definitively in the diabetic range. I had gone through the prediabetic range already without knowing it. On day one, I started reading the research on diabetes and what diet changes would be needed. I changed my diet straight away. I went the hardcore route, with some glucose withdrawal symptoms for about two weeks (24 hours headaches), to be sure I’d achieve suitable weight loss.
My doctor prescribed me Stagid, aka Metformin, a couple of weeks later to try to control my insulin resistance. My glycemia levels were already back consistently under 130mg/dl by that point. After 3 months, with a HbA1c down to 5%, I asked my doctor if I could stop medication. He decided to continue 3 more months to be sure that my levels were stable and stayed low. I suspect he didn’t trust me. At 6 months, with an HbA1c of 5.1% and 33kg weight loss, he decided of his own accord to suggest stopping all medication. I didn’t even have to ask. I was medication-free again and had achieved one of my primary goals.
He said something that you rarely hear a doctor say: “if all my patients were like you, my life would be so much easier”.
There is nothing extraordinary. For some it will be a long journey, for some it will be shorter. But in a lot of cases, diabetes control and medicine-free life are attainable in a short amount of time with the right effort. Type 2 diabetes is beatable.
Obviously, needless to say that you should never change your medication without discussing it with your doctor.