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This post comes on the heels of my most recent lost…”Let Me Clarify.”  Apparently I didn’t clarify well enough because I still get questions. I guess I will say it in the only other way I can think of…

Many of the readers of this page have heard a catchy saying, “treat the disease not the symptom.“ It makes sense, right? I’ve used the expression myself… a lot. If you have an infection, taking Tylenol for the fever (symptom) will not resolve the underlying infection (disease). Good analogy. It makes sense because frequently in traditional medical care, we typically only treat the symptoms, often ignoring or even worsening the underlying disease.

But as catchy as the saying is, there are times where it is JUST NOT COMPLETELY SAFE. If your symptoms are life-threatening or could cause further damage, then something needs to be done about that, WHILE ALSO treating the underlying disease. You cannot just ignore the symptoms, when they could cause you serious bodily injury.

A few years ago my family was on vacation. Prior to leaving for vacation, my son had the “sniffles.“ Nothing major, he just didn’t feel all that great. Midway through the vacation, I could tell that something was drastically wrong with him. I dragged out my “mom” bag and checked his temperature only to be shocked that he was running a fever of over 107°. While my husband was on the telephone finding the nearest emergency room, I placed my son into a bathtub to gently cool him down as well as giving him the max dose of Tylenol that was acceptable for his age and weight. Why? Tylenol would not fix the underlying problem. True. But right now his symptoms were life-threatening. So I was not going to ignore the symptoms, for the sake of the disease (pneumonia). I NEEDED TO TREAT BOTH, for now.  We continued treating with Tylenol, and the antibiotics he received from his hospital visit, until the fevers were brought to an acceptable level. Then, I tapered down on the Tylenol and gave it really only for comfort measures while we continued to treat with antibiotics until the infection was gone.

As I have wrote about many times, I have serious concern that many people with diabetes, for the sake of “treating the underlying disease,” are ignoring life-threatening “symptoms.” People are allowing blood glucose to be elevated to astronomical levels under the assumption that they are treating the underlying disease by stopping their insulin. Instead, a safer alternative would be to normalize blood glucose and embark on the most aggressive lifestyle changes that you are able to make and live with. Your “symptoms” will most likely drastically improve rapidly, which will also allow you to taper down or off from whatever treatments you are using.

There was no way I was going to ignore my sons “symptom” of 107° because it didn’t “fix“ the underlying problem. Leaving the fever untreated would have only lead to possible further complications. But because we treated BOTH the life threatening SYMPTOM while ALSO treating the underlying disease, he got well quickly, and suffered no ill affects to his long-term health. We were quickly able to stop the treatment for the symptom while continuing to treat the “disease.”

This is what I wish for you. That you use your current treatment (not necessarily at the same DOSE, obviously) to control any “symptoms” that could potentially cause further complications while you aggressively treat the underlying “disease” with lifestyle changes. Very quickly you will notice that your need for treating the symptom will lessen and lessen, maybe be eliminated.  It’s not like it’s going to be forever!  I’ve seen people get blood sugar under control in a matter of days to weeks when they begin to make drastic changes to their lifestyle.  There is just no reason to further jeopardize your health by completely ignoring “symptoms.”

Wishing you good health…safely

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Low Carb RN (CDE) by Kelley Pounds - 1w ago

As I have previously posted on this site, there is no ONE person in the low carb world that I am 100% in agreement with.  Some people I agree with on SOME things, but not other things.  I don’t mind speaking out about my opinions because I don’t sell books, I don’t make an income from this website and I’m not concerned about the size of my “following.”  This is not about money or popularity for me, it’s about using the things I have learned and the experience I have gained caring for thousands of people with diabetes, to help yet others.  I’m just a healthcare professional with a personal passion for helping people with diabetes and obesity try to improve their health.  I work with diabetes patients every day, it’s ALL I do, and I understand their unique needs inside and out.  And above all, I also deal with my own challenges with diabetes.  I live it 24/7.  

I think a danger exists out there.  Sometimes, when a person is seen as an authority on something, they become “trusted,” and then EVERYTHING that they say is trusted just because SOME of the things they say are true.  This happens all the time in life.  Sometimes it is INTENTIONAL.  People establish a common ground with you, get you trust them, and THEN sell you their “snake oil.”  Lol.  Sometimes it’s UNINTENTIONAL.  Someone accomplishes some good, we establish a trust with them, they gain some notoriety, develop a following, and we eat up everything they say. If they are an expert in one area, they “must” be an expert in all things. 

I think we need to challenge everything before making decisions that will affect our health.  Then we need to see what works for us PERSONALLY and disregard what doesn’t, no matter what anyone else’s opinion is.  That is why I find it hard to agree 100% with one person.  

So, I need to clarify my position on something.  

There is advice out there that I believe is harmful, yet because of this doctor’s notoriety, people are jumping on the bandwagon, in my opinion, to their extreme detriment.  While I have felt that some of this doctor’s advice on obesity has been helpful, I believe some of his advice on managing uncontrolled diabetes is harmful.  This doctor’s philosophy is “get people off insulin (regardless of blood sugars) so we can claim that they are “cured” from diabetes.”  Dangerous, YES!  Sorry Dr. Fung, but I disagree.  

First of all, there is no “cure.”  Type 2 diabetes CAN be put in “reverse”.  I have written about this before (HERE).  Rather than being a chronic progressive disease, it can often be halted and improved, medications CAN be reduced and SOMETIMES eliminated.  I have written about this as well (HERE).  But that is NOT a cure.  The likelihood for the disease to, at some point, rear its ugly head is still there.  One will ALWAYS need to monitor and be watchful.  Cure would imply that it is gone…you don’t ever have to worry about it.  That is giving people a false sense of security.  (Not to mention that I would hardly call a person cured, who has wildly uncontrolled blood glucose.)  When my A1c was 5.1 on NO medication, I still did not consider myself cured.  It takes everything I can do…low carb, exercise, manage stress, sleep right, and regulate other hormones for me to maintain health markers like that, and it is not always possible.  So my health markers fluctuate.  Nothing has ever been “cured” despite normal markers and still no medicine (except thyroid).  

I think what happened is this…as I said before, Dr Fung emerged into the low carb community giving some good insights on obesity, and re-popularizing fasting.  It helped lots of people lose weight and by default, helped some people with diabetes.  That’s awesome!  He became seen as an expert in the low carb community.  Kudos!   Then he started giving his advice on management of uncontrolled diabetes and, for some of us, the hairs started to raise on the back of our necks.  Some who I deeply admire in the diabetes community had the courage to speak out early against this bad advice.  At first I supported Dr Fung, even somewhat defended him.  I thought his teachings could possibly be compatible with those of Dr. Richard K. Bernstein, whom I believe is the world’s foremost authority on diabetes. They both promote low carb, so they must be in the same camp, right?  No, not really.  Unfortunately, I learned that not all in the low carb community are on the same page.

Folks, there is never a problem taking insulin to replace what your body can no longer make (and there is a simple lab test that can reveal your body’s ability to produce insulin…if you are in question…ask for it).  What happens any other time you have a deficiency in any other hormone in your body? You REPLACE it.  Just like I need to take thyroid hormones because my thyroid can no longer make them efficiently, I will take insulin when my body can no longer make enough insulin to cover the minimal amount of carbohydrates I consume.  Taking insulin is only a problem when you intentionally use insulin to “cover” and support unhealthy lifestyle choices, especially if your body still makes plenty of insulin.  It is NOT a problem when you take what your body physiologically needs to survive and function.

As I said, I think Dr Fung has some useful information on obesity, but I wholeheartedly disagree with his advice on managing uncontrolled diabetes.  In fact, I have had such a conflict of conscience about whether to keep links to his content on my site because of how I feel about his dangerous diabetes advice.  People may think I agree with him 100% because he promotes low carb and so do I.  But I’m going to leave the links because remember, different things work for different people.  If weight loss is your primary problem, I think he has got some good insights and methods.  For that reason, I still have links to his content on obesity.  But if diabetes is your problem, please look elsewhere.  

Now I know many will object by saying “you’re wrong!  He helped me with my diabetes!”  I’m not saying he’s NEVER helped ANYONE with diabetes.  Low carb and weight loss HELP PEOPLE WITH DIABETES.  And for some, that is ALL they need to put diabetes in reverse.  That was all I needed.  Went low carb, lost 80 lbs, everything was normalized.  I’m not discounting that.  Lots and lots of people out there promote low carb and weight loss for diabetes.  Nothing is unique about that.  But for those people whose diabetes CANNOT be fully managed by lifestyle changes, and they are told to prematurely discontinue necessary diabetes treatment, believing that they are “cured,” I feel this is dangerous. 

People are so focused nowadays on weight that they will sell their health to the devil if they could just get a lower number on the scale.  And any person out there that can help people lose weight gains automatic popularity and book sales, REGARDLESS of what the pursuit of that weight loss has done to their health.  I’m not in that camp.  Health (and diabetes) first, weight next.

I DO agree with Dr. Richard K. Bernstein, author of the Diabetes Solution.  He has had Type 1 diabetes for about 70 years and maintains normal blood sugars, weight and health markers.    It doesn’t mean I agree with Dr Bernstein 100% either (probably more like 90%…there are very minor areas where I have a slight difference of opinion about certain medications and the use of technology in diabetes management, these however are not major fundamental differences…).  When it comes to promoting normal (not diabetic) blood sugars, I’m 100% on board with him.  His patients get normal blood sugar AND reverse insulin resistance AND experience weight loss, not just achieving ONE of those things at the expense of the others.  He gets it ALL done with emphasis on health, not sensational “cures”.  

The fact is, every day that you are experiencing high blood sugar, irreversible damage is being done to your organs and vessels.  What little beta cell function you may have left, is being intensely overworked trying to get your blood sugar down.  It doesn’t matter if a certain DOCTOR doesn’t think high blood sugars are a concern, your PANCREAS DOES!  Therefore, your pancreas will do everything in its power to normalize your blood sugar, even destroying itself in the process of trying to do so.  Why?  Because high blood sugar is toxic.  And YES!!  I DO AGREE that EXCESSIVE insulin can be toxic too!  Really, I get it!  I’ve watched the insulin toxicity videos, I’ve read all the studies and books.  I get it…

But here’s the thing,  NOT EVERYONE WITH TYPE 2 DIABETES HAS HIGH INSULIN LEVELS!   I work with patients EVERY DAY who have Type 2 diabetes whose beta cell function has declined to that of a person with a Type 1 diabetes.  EVERY DAY!  They essentially make NO insulin (confirmed by lab test).  In fact, they are often, mistakenly, told that they now have Type 1 diabetes, not that they have autoimmune diabetes, but that they no longer make insulin, just like a person with Type 1. 

If you don’t know what is going on in YOUR body, how can you make life altering health decisions based on a book, or social media, or advice from a healthcare professional who has never treated YOU personally?  I’m worried folks.  People are out there just willy-nilly throwing away their insulin and “curing” themselves (not).  They are living with blood sugars that are 300+, because insulin is the “enemy”…and blood sugars are “irrelevant”…what??  I’m not picking on people that have done this.  I’m genuinely concerned!

One of my trusted friends in the diabetes community spoke out a LONG time ago against this bad advice (HERE).  I agree with him.  I have written about this topic before, (HERE). But I felt the need to come out a little stronger, as I still get contacted by people allowing their blood sugars to stay in astronomical ranges (200-300+) because they followed this advice and came off their insulin when they began a low carb or Keto diet, NOT waiting for blood sugar to normalize FIRST.  Since I haven’t been around much,  I thought people would have seen the obvious dangers in this advice a LONG time ago.  But people are still following it.   I’m scared for them and I’m willing to say something even if people unfollow the site, even if I get lashed back at by someone who doesn’t like what I’m saying.  Don’t care.  I won’t know about it anyways folks, no social media any more for me…ahhh!  People can argue back and forth about this and I will remain happily oblivious .  Please, though, don’t argue for my sake…not worth it…agree…disagree…personal choice.

Please don’t listen to ANYONE who tells you that normal blood sugar is irrelevant.  It’s paramount! Don’t make decisions about your health based on someone’s populararity or amount of book sales, even if he/she is a doctor.  Get the facts about YOU PERSONALLY.  No treatment works for all people.  Find out about you.  If your body makes lots of insulin, then yes, more insulin is NOT your ultimate answer.  Start with normalizing blood sugar and beginning the most intensive dietary and lifestyle changes that you are able to live with.  Then decrease medications as needed to avoid hypoglycemia.  If you wean completely off, awesome!  But don’t live with high blood sugar just to be medicine free and “cured.”  If your body no longer makes adequate insulin, then you need to help your body by giving it what it physiologically needs to achieve optimal health markers.

As always, this comes from my heart.  I have no ulterior motives other than you finding your path to health and wellness…safely.

Shout out to my dear friends in the low carb community whom I never get to speak with any more…Steve, RD, Franziska, Amy and all the rest.  My life does not allow me to be involved in social media or blog much…plus I’ve mostly said everything I need to say, lol!   But I’m still on the front lines of fighting diabetes everyday, helping people change their lives.  Miss all of you and send my warmest regards to all my friends and readers.  

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