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Diabetes: Adding lifestyle changes to medication can deliver a knockout punch

September 28, 2017

About the Author

photo of Monique Tello, MD, MPH

Monique Tello, MD, MPH, Contributor

Dr. Monique Tello is a practicing physician at Massachusetts General Hospital, director of research and academic affairs for the MGH DGM Healthy Lifestyle Program, clinical instructor at Harvard Medical School, and author of the evidence-based lifestyle … See Full Bio
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November 17, 2017

I came across this blog seems like I will get real answer.
I have diabetes 2 (just got it not that high) and fat person (40 Years). After reviewing some sites and recommandation I bought a juicer and started juicing but there are fruits thoes are sweet. will it be harmfull for diabetes and I also heard juicing is good for weight loss.
Can you guide if its really helpfull for me?

Monique Tello, MD, MPH
November 20, 2017

Sure- this one is easy- eat the whole fruit! Either as is, or blended, like in a smoothie. This way you get all the good fiber as well.

November 15, 2017

WHO data estimates the number of people with diabetes mellitus (DM) type 2 in Indonesia will increase significantly to 21.3 million in 2030. this is very worrying

Monique Tello, MD, MPH
November 20, 2017

Yes, I agree, very concerning.

October 12, 2017

Great article Monique! I remember reading about this when it was released and thought exactly the same. Why was there not being more made of the reduction in medication that resulted in just a small drop in HbA1c? It’s a pretty important contributing factor!
In our clinics we base exercise around walking each day and focus on just fresh unprocessed foods and achieve great results even in those with long term insulin use.

Monique Tello, MD, MPH
November 20, 2017

Thanks Ray! Yes, that sounds like a good approach.

Alexia Clark
October 10, 2017

Agree with this zero sugar, zero grains approach entirely.

there is other ways to keep sugar level low. my father is eating leaves of mamejo plant(found in India). it is recommended by his friend and surprisingly it helps him to keep his sugar level low. infect he eats sweet once in a week but no spikes in sugar level. normally his sugar level is from 100 to 140.

hassan emad
October 8, 2017

Agree with this zero sugar, zero grains approach entirely. The much touted carb loading diet has not proven as beneficial as once believed partially because scientific research about lectin and leptin had not been done yet

Thomas Turk
September 29, 2017

Disinfo.. One month of zero grains and zero sugar reverses diabetes2. One reported reversal in 2 weeks. All grains are high in lectin plant phenols, chemicals that desensitize cell membranes to insulin, causing insulin over production. Grains are also high in leptin plant hormones that interrupt signaling between the liver and pancreas, causing insulin disruptions. These 2 cause obesity and diabetes2.
Wheat and most other grains raise blood sugar.  A slice of organic whole wheat bread raises blood sugar more than a candy bar.

September 29, 2017

Agree with this zero sugar, zero grains approach entirely. The much touted carb loading diet has not proven as beneficial as once believed partially because scientific research about lectin and leptin had not been done yet. A high carb diet from whole grains is more beneficial than one of simple carbs for a healthy, fully active person. For a sedentary person tending towards metabolic syndrome, it is not beneficial and seems to have proven itself to be detrimental.

Monique Tello, MD, MPH
October 6, 2017

I agree (and mountains of research does too) that refined carbohydrates cause and worsen diabetes. Added sugars and processed flours can be downright dangerous for many people. I imagine that an entirely carbohydrate-free diet (meaning eliminating whole grains as well as refined grains) could be even more successful in treating diabetes than just eliminating processed carbs, but, may be difficult for some folks to maintain over the long haul. A basic whole-foods plant-based diet can be successfully used to prevent and treat diabetes ( and may be more palatable to folks.

Dr Walter Schwager
September 29, 2017

“five to six exercise sessions per week, consisting of 30 to 60 minutes of supervised aerobic activity, along with two to three sessions of weight training; an individualized nutrition plan with dietary counseling, including calorie restriction for the first four months.”

These specific interventions are quite disruptive as they are difficult to integrate in a standard life style, and will result in low compliance. Walking, jogging, household activities and such are more likely to be maintained. Diets also need to be fine tuned: low carbs, low sugar, high fibre and such. Avoidance of pop drinks but also fruit juices.

Thomas Turk
September 29, 2017

including calorie restriction for the first four months.”.. Why calorie restrictions? it’s the carbs that fatten.. digested carbs 1st top up muscle and liver glycogen, the rest is rapidly converted to body fat in the mitochondria via the Krebs Cycle. Digested fats slowly convert to usable energy in the liver.

Monique Tello, MD, MPH
October 6, 2017

I agree, and your sound suggestions are similar to what was conducted. Many people don’t do anything active at all, and so a lifestyle intervention that includes supervised activity at the beginning can help people to get comfortable with, as well as get in the habit of, being active. I totally agree that physical activity should ideally be worked into a regular day as much as possible. I also agree that the type of foods consumed is far more important than the overall Kcal#, and in this case, the dietary intervention included a personalized nutritional plan. This likely included instruction on avoiding refined grains and other processed carbohydrates, as would be standard.

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