Gretchen Becker, A1C Secrets: in Type 2 Diabetes

Gretchen Becker may live on a farm in a peaceful and quiet town in Vermont, but you might be surprised to know this farm-gal also has an incredible background in biology and journalism after studying for 8 years at Radcliffe/Harvard as a PhD Candidate, and is an author of two peer-reviewed papers in Harvard’s journals.

Diagnosed with type 2 diabetes in 1996, Gretchen is more than just a patient advocate, she has a wealth of medical knowledge on living with this disease. With a rich background in medical journalism and as the author of several books on diabetes, Gretchen is now a freelance editor of medical books and journals and lives on a small sheep farm. 

Gretchen is the author of “The First Year: Type 2 Diabetes” and “Prediabetes” and coauthor of “The Four Corners Diet,” and regular contributor at HealthCentral.

Here, Gretchen shares a few bites of wisdom she’s learned over the years about achieving her A1C goals through nutrition, exercise, medications, and good old fashion blood sugar testing!

Looking back at when you were first diagnosed, and your first few years of life with diabetes, is there anything you wish you’d know back then that you know now?

Yes.

1. The statement that “Losing just 10 pounds will make your diabetes go away,” which I was told, isn’t true for many people, although it’s true for a few.
2. Being put immediately on insulin, so your blood sugar is in normal range, can help preserve beta cells, although it can also make weight loss more difficult. They hadn’t really studied this back then, although in the early 1980s, some patients were hospitalized and put on a machine called the Biostator for two weeks. The Biostator was essentially an artificial pancreas, and it kept the blood sugar completely normal for those two weeks. It took two years for these patients to see their blood glucose levels rise to the pre-study levels. But the machine was cumbersome, and you couldn’t use it at home.
3. The most important person in diabetes control is the patient, and fellow patients can often help educate you faster than your medical team.
4. How have you seen your A1C vary throughout the years?
5. 
   
6. I was diagnosed with an A1 (an older test) of 16, which is an A1c of about 13. For a year or so, on metformin, my A1cs were about 7, but at that time I was on my own version of the ADA diet (substituting 3 vegetable exchanges [5 g each] for each carb exchange [15 g each]).
7. Although I lost weight, I got tired of being hungry all the time and gradually switched to a LC (low-carb) diet. Because the switch was gradual, I never had the difficulty some people have at first, with fatigue etc., but I also didn’t quickly lose a lot of weight as some people do when they go from high carb to low carb. I couldn’t seem to get my A1c under 6.0 with Metformin, so I went on a basal insulin. My last A1c was 5.2 percent.
   My exercise program doesn’t change much. In the summer, I have a lot of outdoor work, cutting brush, tilling the garden, shoveling manure, having a full-time battle with vegetation of all kinds, and stacking wood. When the vegetation calms down, I walk about 1.5 miles a day. However, I don’t walk when it’s raining or snowing, when it’s over 90 and humid, or when it’s under 20, especially when it’s windy. There isn’t room in my house for exercise equipment, and I probably wouldn’t use it if there were. I used to lift weights, but I find that terribly boring and stopped.
8. The pressure to eat the perfect “diabetic diet” cannot only feel incredibly overwhelming but also very confusing because there are so many different nutritional philosophies out there. As someone with a deep understanding of nutritional chemistry, how have you made sense of today’s vast nutritional philosophies for your own life with diabetes?
9. I’ve never felt any pressure to eat the perfect diabetic diet. I eat what works for me, and it might be different from what works for you. I started out thinking the ADA knew what it was talking about, but my first question to my doctor was, “If diabetes is a disease in which we can’t metabolize carbohydrate, why is the ADA telling me to eat a lot of starch?” So I was skeptical from the beginning, and when I saw that Dr. Richard Bernstein agreed that the ADA diet was harmful, I listened to him and not the ADA. I also felt very deprived being allowed only 2 oz of meat per meal on the ADA diet and was never satisfied after a meal. Now I usually eat only 3 oz of meat, sometimes 4, but just that extra ounce fills me up.
   What works for many people is to “eat to your meter.” If a certain type of food makes your blood glucose rise a lot, don’t eat it, or eat tiny portions. Test a lot, especially in your first year when you’re still learning a lot. Write everything down. Try to vary only one thing at a time for the best results.
   What about the mental part of your life with diabetes? How do you handle stress or burnout around the daily responsibilities of this disease?
   I think for a type 2, the problem of social isolation on a low-carb diet is greater than the various responsibilities of measuring blood glucose and taking meds. Most of my friends seem to be vegans or at least supportive of low-fat “plant-based” diets that are invariably high in carbs, so it makes getting together for meals difficult. I can’t go to the potluck suppers that are so common in small-town Vermont unless I bring my own food along. But I’ve always been a hermit, so that’s not too bad. I live alone, and I think that makes it easier as I don’t have to cook carby meals for other people.
   At my age (73), so many of my contemporaries have serious medical problems that I realize the diabetes is a piece of cake compared with what they’re going through. When faced with a disease, many people think, “Why me?” Before I got diabetes, when I saw contemporaries die of brain tumors or ALS or cancer, I sometimes thought, “Why not me?” I suppose it’s a form of survivor’s guilt. So now I don’t need to feel guilty about being disease-free.
   I think it’s more difficult when you’re younger and your contemporaries are mostly healthy.
   Anything else you’d like to share?
   Diabetes is not a death sentence. Well, we’re all going to die, but you can have a long life with diabetes. So you’re in this for the long haul, and it’s worth taking some time at the start to educate yourself about this disease. Then figure out what works best for you and stick to it so your future will be bright.
10. http://www.diabetesdaily.com/

"The most important person in diabetes control is the patient, and fellow patients can often help educate you faster than your medical team."

How true is her comment above, the low carbers at DCUK gave us far more help and guidance than any advice we received from our medical professionals.

Graham