Managing type 2 without meds or insulin

I was diagnosed with diabetes type 2 at the end of March of 1998 which makes it 16 years, 8 months and 2 weeks that I've been living with this health condition.
I remember all the naysayers I encountered when I announced that I was determined to manage my diabetes through lifestyle changes alone, avoiding going on meds or insulin. The battle cry of the naysayers was "Progressive, progressive, diabetes type 2 is progressive, you can't beat that!!!!"
Well I know now that was a load of crock as they say, at least for me. I just had my annual checkup with my endocrinologist and he determined that I was good to go for another year, without meds, as my hba1c was still below 7.0 (at diagnosis it was 8.6).
The formula that worked for me would certainly work for many others, if they are willing to give it a chance. The problem of course is that most people are so bogged down by the 'doctor just give me a pill for it and stop bugging me' attitude that they don't give their own body a chance.
There have been four mainstays of my diabetes management over the years, and I'll mention them here for anyone who's interested.
1. Information.
That's both information about your condition and how you are doing, and in general about diabetes and the latest developments. The first couple of years I checked my blood sugars up to eight times a day, now I'm down to twice a day. Those checkups tell me how I'm doing, what foods and activities work and what ones don't, and allow me to correct any problems before they become serious.
2. You are what you eat.
I've made some major changes to what I ate before I was diagnosed, without getting into any of those fad diets like Atkins, South Beach or Dean Ornish that sound good and appear to work for a while but are very, very rarely sustainable. The mainstay of my eating habits is the glycemic index which rates carbohydrates on how quickly they are transformed to blood glucose, along with portion control (eat untill you are 'not hungry' not till you are 'stuffed' and avoiding highly processed or genetically modified foods, including canola oil, frozen pizzas, and most items in the junkfood and snack shelves. Dinner yesterday was boiled pot barley, seasoned chicken legs fried in olive oil, steamed broccoli and simmered mushrooms, delicious, filling and not a bg raiser.
3. Activity.
If we were meant to sit still all day we would have been born without legs. Forget about those dreaded gym workouts or expensive exercise machines, they are totally redundant for anyone intent on using the muscles they were born with. In my case I go for a 40 minute brisk walk there times a day, each immediately following one of my 3 main meals, and if I feel my blood sugar rising too fast at other times I do 20 stepups - standing in front of my living room sofa, stepping up on to it and then back down. Amazing how you can feel bgs drop after only a few minutes of that.
4. Time management.
Stress, worry and anxiety all get in the way of proper diabetes management, in addition to raising blood sugars in their own right. It's quite an assignment for many of us to learn proper time management. In my case I ditched my television subscription 10 years ago and haven't regretted that for a moment. I also take the time every evening to plan my next day and make notes if necessary.
If all that sounds like an odd lifestyle I suppose it is, relative to what most people consider 'normal'. But I'm very happy with my self-management of diabetes, the weight-loss it all resulted in, and the feeling of wellbeing that living healthy brings with it. It's up to you if you can do the transition, but do not believe the mantra that diabetes is wildly progressive and that any attempt to manage it over time with lifestyle changes is impossible.
I know because I've done it and am continuing to do so, now in my seventeenth year.

Congrats on taking diabetes head-on, getting informed, making a reasoned plan, and then executing. Sometimes you have to get down and dirty with the details before habit kicks in makes things easier. Good for you for believing enough in yourself to do this. 17 years is a great run.

I agree about walking after meals, it has an amazing effect on blood sugar. I follow the data spun off of my various diabetes devices, pump, continuous monitor, and finger-stick meter. Tracking my progress using charts and graphs motivates me to keep on track with my goals.

As a T1D, I follow a carb limited diet; it makes dosing insulin safer using far fewer units.

I think lifestyle changes are some of the most effective interventions over a range of illnesses. Exercising just makes everyone feel better. I think most doctors don't like to pursue lifestyle route with patients since most resist. Talking to someone about changing their way of eating is comparable to asking someone to change their religion!

I think your comparison between the impact of lifestyle changes and religion is very appropriate. As people grow up they develop a routine which again puts them in a comfort zone, and challenging the validity of those routines becomes much like challenging what we believe in the spiritual area.
However, the spell can be broken, as I've experienced, and diabetes can be a good place to do that as the alternative to finding a good management solution is frankly really quite scary.

There was something I wanted to add to the introductory information I gave above, in case someone is considering going the self management route.
Sometimes things happen that we don't quite have control over, and that upsets our routines.
In my case one such incident happened about five years ago when I was waiting at a bus stop to go to work. As it happened I woke up a couple of months later, in a hospital bed, surrounded by doctors and nurses who told me I had just come out of a coma that happened when I had a cardiac arrest at that bus stop. I have absolutely no memory of that incident but have been told that a man at the bus stop gave me CPR until the ambulance crew arrived and thereby probably saved my life.
Anyway, after a year or two of recovery I was back to normal. Now the totally amazing thing was, my blood sugars had stayed stable during this whole time! You would think that being in bed, out cold, being pumped full of glucose heavy IV solutions, my hba1c would go way up but not.
I did a bit of research and the best answer I got was that when you manage diabetes with diet and exercise, unlike when you do it only with meds and or insulin, you get a two for one benefit. I.e. one month of good control gives you three months of good bgs.
In my case the years I had managed to control my blood sugars with exercise and good food, got me past that critical period while I was hospitalized and recovering from my cardiac arrest, without a high blood sugar crisis.
I'll say no more for now.

They say it takes about 3 weeks before a chore can become a habit.
The problem with most diet plans and good intentions is that people don't have the patience to wait 3 weeks for results, if after two weeks it still feels like a boring chore without immediate results they give up and move back to the same old unhealthy.
In my case it took about three months before my change in lifestyle became an enjoyable habit rather than a new chore, but I've been immensely rewarded for my patience.
I think that television has a lot of responsibility for the short attention span of people in this day and age.

Amazing story! Nancy

Once you look back on a successful change, it looks so much easier. Then you wonder why didn't do it sooner!

I haven't owned a TV since 2001. I do watch some video entertainment online, though. I agree, I think our collective attention span has deteriorated.

Watching movies or other entertainment - even if it is on a tv screen - is still not the same as watching television, which, at least when I was growing up, was commonly known as either the boob tube or the idiot box. I think it has a lot to do with the short bursts of actual television in between the many commercials, desensitizing people to following and absorbing anything that requires more than five minutes of their attention.

So. I've been managing my T2 without meds since 2007. I adopted and adapted Bernstein's approach, which is simpler to me. I just count the damn carbs. The glycemic index hasn't really worked for me. There are supposedly okay items I can't eat without a spike. But I was also, for my first couple years able to test 6-7-10 times per day to figure out what foods work for me......

A recent development that makes this approach even more relevant: In the 5 weeks before my hypothyroidism was diagnosed about 18 months ago, I gained a lot of weight without changing the way I ate or exercised. I still managed a 5.3 A1c. Yes I've been lower, but I was glad to know that even with that awful weight gain, closely monitoring my carb intake still worked. Oh--and I never feel deprived. I still feel like I eat like royalty!

I am also, at 64, entering a difficult period for exercise and trying to adapt my regimen to bad arthritis from many knee surgeries, nerve damage in one foot due to a systemic reaction to a spider bite, and fibromyalgia, diagnosed in 1996. I still am engaged in purposeful movement for 60-90 minutes daily, but it is not as vigorous as it once was. Am developing a sitting workout.....

Blessings on all our paths to living well in spite of our common Scourge.....Judith in Portland

You might want to join this Group

(join it no matter your a1c btw)

Tor, I applaud you for your accomplishment, discipline, and success! I'm type 2, and you've followed a path I simply can not.

On the other hand, perhaps you could re-assess your attitude a bit and be less judgemental toward those that don't share your particular priorities, interests, and values 100%. For example, the thought of

boiled pot barley

turns my stomach. Conversely, I love pizza and have it now and then and just account for it with proper insulin administration -- pretty much what my pancreas would do if it was working.

So understand that there are others, like me, that take all this in but have a different perspective. You're fine with all sorts of limitations in your diet -- I'm not. My perspective is such limitiations are neither "normal" nor necessary when I can treat the problem and enjoy, say, cake and ice cream at a birthday party by treating the problem, rather than accomodating it.

Again, sincere happiness and admiration for you. Just asking you understand that there are others of us that come at this from a different perspective, are successful at managing their Type 2 diabetes with their approach (my a1c is 5.8% using an insulin pump and CGM to achieve tight control, I was over 11% 18 months ago). Also please understand that I too can do this without insulin... If I eat very low-carb, or go total ketogenic, I can keep my BG in line without any meds.

I just don't want to. For me, that would truly be suffering from this disease.

I agree about walking after meals, it has an amazing effect on blood sugar.

To expand on this a bit, it doesn't matter whether you walk before or after a meal for the same effect. Actually, I've found I get better results (i.e. seemingly more BG moderation) by walking before rather than after.

My theory: Increasing sensitivity before digestion starts dumping glucose in the blood helps keep BG levels down, which keeps elevated-BG-induced IR more at bay. In other words, the glucose has somwhere to go right away after eating, tissues that are thirsty to soak up some sugar.

Exercising after gives BG a chance to start rising before increased sensitivity, then a sort of steady-state is achieved at a higher level where glucose is absorbed at about the same rate it's digested. When done, you're at a higher level that now needs a correction.

That's my theory, anyway, based on my own experimentation and data. Unfortunately, taking that walk in the morning before breakfast is, uh, well, something I'm still working on :-)

I haven't had a TV for more than 15 years now. When I'm in a waiting room where one is playing in the background, my jaw generally drops at the sort of drivel I see.

You can't be a successful diabetic, I think, if you won't think for yourself. So I understand the TV analogy.

I'm not quite sure why my comments about what has worked for me should be interpreted as disparaging towards those who have different tastes or courses of action. I know for example that there are many who because of physical disabilities are unable to follow an exercise regime like I do, and others who because of their cultural or religious affiliations would find my particular mealplan unacceptable. However, I also remember how difficult I originally found it to switch to drinking tea without sugar but how today I'd probably find the taste of sugar in my tea to be disgusting. It also took a while to get used to replacing rice with pot barley, though today barley, being one of the original ancient grains and with a GI value of only 23, is one of my absolute favorite foods, when cooked properly and with added seasoning be it chicken stock or dill.

This is a good example of how important it is to test our blood sugar at different times, regularly. We are different in how we respond to food and to activity levels and the best personalized plans will be based on our own experimentation. Personally I find that if I exercise on an empty stomach, i.e. before eating, the result is a glucose dump from my liver which combined with the effect of eating right afterwards always results in very high blood sugar levels. On the other hand, when I walk immediately after eating, my blood sugar meter tells me how quickly and effectively bg levels drop or are prevented from rising.

What an inspiration - I joined this group over 10 months ago because I had been diagnosed with T2 & wanted to control it without meds. On Metformin. I met up with a fellow member who helped me navigate this condition as he has been able to maintain his condition 5 years through diet & exercise. I have had periods of tough going trying to learn the good & bad foods, but as I approach my first anniversary of being diagnosed I am doing very well. My beginning A1C was 10.1 & a BS of 350. At my last MD apt in September I was at 6.3 with a BS of 167. I've had trouble getting my early morning BS numbers down but have kept working at it. Testing 4-5 times day. Since September I have been able to keep my BS at 95-100 before meals & 110-120 after. And my fasting morning numbers have been 90-108. I ride 10 miles a day on my exercise bike & walk my dog. I can honestly say that I am making really good food choices now & believe that I can get off the meds hopefully at my next MD appointment in January. My friend who took me under his wing to answer all of my questions & gave me encouragement through these difficult months & reading your story (my friend sent me a text to tell me to read your story) I believe I can & will succeed. Congratulations & thank you for sharing your story because for those of us out here willing to change our way of life (eating & exercise) I know I can control this condition & not let it control me. It is a choice we make every moment of everyday. To those who would rather have pizza it is your choice on how you choose to control your condition. I have eaten foods that I never enjoyed in the past because now I can really taste them - I no longer have sugar in my system. I would never believed I would be saying what I have last year.

Looks like you are off to a very good start in your quest to live with diabetes type 2.
I actually owe a lot of my success to a mentor that I met online (at the Joslin Diabetes centre discussion board) just after I was diagnosed.
I had been posting about whether it really was possible to manage diabetes type 2 through diet and exercise alone, or if that, as many claimed, was a myth. This fellow, (screen name Hector) was type 1 but assured me that it was fully possible if I was sufficiently motivated. In his mid-70s at the time Hector explained how he had substantially reduced his type 1 insulin requirements by biking up to 30 miles a day, and watching carefully what he ate.
The fact that we rarely get that kind of advice from a doctor or other medical professional is mostly because after they've encountered a few hundred people who are NOT motivated to manage diabetes themselves but just want the doctor to give them a pill for it, they get discouraged and stop suggesting what many people shrug off as unwelcome meddling in their beloved couch potato and pizza lifestyle. It sounds harsh but I believe that for many medical professionals that is just a fact of their daily professional life.
Anyway, good for you on your flying start and best of luck with your continuing efforts. If I were to pass on one recommendation it would be to take the time to read one of the excellent books that have been written about the Glycemic Index and managing diabetes by selecting the healthiest foods. My favorites in that area were written by Rick Gallop, called 'The Glycemic Index' and 'Living the Glycemic Index'. As you may be aware the Glycemic Index was originally developed at the University of Toronto in the 80s by researchers alarmed that so many diabetics were dying of heart attacks before age 50, mostly attributed to the widespread recommendation to avoid carbohydrates and instead fill up on fat and protein. The GI has since been adapted as the recommended diet for diabetics in most western countries, possibly with the exception of the US where for some reason many dieticians still insist it is 'too complicated for regular folks to understand and follow'.

Tor, you are an inspiration for your success at maintaining your diabetes with exercise and diet alone. It seems I'm on the opposite spectrum of you with my diabetes. The more I do to control it with diet and exercise, the less control I am having with it. In a year's time, I've lost 51 lbs., increased my activity, eating to my meter with a low carb diet, yet my BG numbers are still climbing.

My rheumatologist is concerned but my endocrinologist is still optimistic about the diet/exercise regimen.

Very frustrating.

I am aware that different people respond differently to the same diet and lifestyle advice, so there is not one type fits all with regards to managing diabetes.
Has your endocrinologist suggested testing your insulin levels, in case you might be experiencing LADA or a transition to type 1? I's just a wild guess but the measures you have taken so far should normally counter most of the effects of insulin resistance in type 2, though they would not be able to resolve a lack of insulin as is the case with type 1.

Thanks Tor.

I've requested the antibody tests but he says he doesn't do those tests and steadfastly affirms I'm type 2. I do labwork Friday and will see him in two weeks. Hopefully there is a Eureka moment in the results.

Besides looking for another endo, I've heard from some friends that the supplements Biotin and Chromium Piccolate (sp?) controls BGs as well. So that's something I might check into.