No need for plant-based diet for diabetes, take Jardiance!

[StarchHEFP]

Of course, I'm not serious with the subject title! But I did come across this study which seems very suspicious to me. I don't know of any diabetic drug that reduces the chance of death. https://www.boehringer-ingelheim.com/press-release/jardiance-only-diabetes-medication-show-significant-reduction-both-cardiovascular-risk

I avoid this class of drugs with diabetes because many patients complain of frequent urination, UTI and yeast infections. Theoretically, drugs like Jardiance (SGLT2 inhibitors which work in the kidney to make you pee out more glucose) could lead to dehydration, low potassium, and diabetic ketoacidosis. The lawyers are already advertising this class of drugs as "bad drugs" on the TV.

Sometimes it's tough knowing that people could be SO much better with a plant-based diet, but they just won't do it, and would rather take $1000 / mo drugs instead! How sad. Very few patients in my humble experience are willing to give up their food addictions, no matter how many times I print out and give articles from Dr. McDougall's and PCRM's website! I've even tried Full Plate Living to very little benefit.

I know most people on this board complain their doctor isn't on board with this approach, but I'm a doctor here on this board complaining that most patients of mine couldn't care less about my approach!

I see patients literally having strokes and ending up paralyzed and unable to speak, because they couldn't get it together to change their lifestyles, even though I spent hours with them during a previous hospital stay and even let 1 of them borrow my Forks over Knives movie, and subsequently shared specific food plans and recipes with the pt and her son. I've seen patients go for lap band or gastric bypass, only to suffer from serious complications because again, they didn't want to take this approach to lifestyle. I had a patient drinking 2 gallons of milk/day in his 40's and smoking away his lungs, whom I spent a good 1-1/2 hours office visit, talking about how he DID NOT need to apply for social security disability as he could get out of all this rut by giving up the 2-3 gallons of milk / week and the cigarettes! He died within 1-2 years after that. His grieving mother ended up with a serious stroke because she herself drank 2 gallons / week of milk and I've repeatedly told her to give it up.

Should I just give it all up and just write the pill prescriptions and be on my way?

I've been called "too extreme" by other doctors and been told that lifestyle change does not work anyway, and I should be more mainstream and reasonable. I've been told even to tone down my anti-cigarette and anti-alcohol advice as even that's too extreme.

[pundit999]

I would love to have you as my doctor but you are not close by.

My family doctor of 15 years recently died of a heart attack at age 48. He saw my transformation as I reversed my heart disease. He saw the numbers and the medications that he had to eliminate or reduce. But alas, he himself could not bring himself to change his diet.

It is quiet sad. He was such a great doctor.

Such is life

On the bright side, my example has influenced at least 5 people. One has reversed his fatty liver, one has improved his prediabetes, two have lost a lot of weight, one is on path to manage his heart disease.

Even if you touch just one person, it will be well worth it, Doc.

[Ern2Win]

Even if you touch just one person, it will be well worth it, Doc.

Boy, I will second that!

Keep up the good fight. You have to be able to live with yourself after all. We know we are on the right side of this battle. Science and human experience align to prove it. Most Americans are so ethnocentric and ignorant of geographical differences and history. They haven't studied nutrition 10 minutes, but think they know from the popular press or some pseudo expert who wrote a book or Dr. Oz. It is very frustrating indeed. I can only imagine what you must have to deal with day in and day out.

I know a little of your frustration as we have a friend dying from a rare lung cancer after a 5 year fight. When I first brought up eliminating animal products and "The China Study", she just threw the standard cancer diet from the cancer center back at me. She wouldn't even bother to review the references I sent her. After a couple more years of treatment at MD Anderson, which included 2 surgeries and much chemo, MD Anderson finally told her there was nothing more they could do for her. She found the Block Center in Chicago that suggested going vegan along with their different chemo regimens. She told me that I had been vindicated. Ha, I didn't know that I was under judgement. Well, I thought thank god, maybe she has a chance now. But it was not to be. At the outset she was enthusiastic, but over time I witnessed how lax she became because it was inconvenient. We would go to pot lucks and bring our McDougall compliant food and offer her to join us. She would take some small serving, but fill her plate with other dishes obviously containing dairy. She never really bought in or did any study to build belief. So now she is on death's door. Of course, we cannot say she would have survived if she did follow the diet faithfully, but it was really the only chance she had. Now we will never know because she could not stick to the diet.

[StarchHEFP]

Even if you touch just one person, it will be well worth it, Doc.

Thank you for this! Just the kind of inspiring words I needed.

[Lesliec1]

Interesting post! You explained why I never just blame doctors. I mostly blame govt agencies like the ones outlined in The China Study because that's where the blocking of information starts. But it's everyone. Of course patients would rather just take a pill than have to do any work. Who wouldn't? I always say if drugs and surgery would actually work, I'd be all over that and go back to eating donuts. Too bad they just don't work, at least not long term.

How often do you actually reach a patient and change their eating?

I think somehow we just need to match up the informed doctors and the willing patients. I've given up trying to find a doc like you.

[pundit999]

Things are changing in a big way. In the just the time I have been on this diet (4.5 years), I have seen real progress.

I just listened to People's Pharmacy today and the whole show was on plant based diet. There were great experts and doctors from reputed places such the Harvard and Standard that were promoting the whole plants diet. Lots of callers were already following the diet.

This information is really getting out. Mainly due to the Internet and social media.

I don't think they can put the jini in the bottle back again.

I do believe this is the future. 50 years from now people will wonder how this information was kept from the general population for so long.

[Werner1950]

Even if you touch just one person, it will be well worth it, Doc.

Thank you for this! Just the kind of inspiring words I needed.

Your presence here inspires all of us!
Stay faithful to what you know.
Someone once said, "...speaking the truth in love"

Love is not real without the truth.
And truth is hard to swallow without love.

[LowCarbIsDeadly]

Diabetic drugs. Treating the symptoms rather than the root cause.

[LowCarbIsDeadly]

Should I just give it all up and just write the pill prescriptions and be on my way?

I've been called "too extreme" by other doctors and been told that lifestyle change does not work anyway, and I should be more mainstream and reasonable. I've been told even to tone down my anti-cigarette and anti-alcohol advice as even that's too extreme.

Nope you shouldn't. Don't cave into the naysayers. Its never wrong to do the right thing. And you know this way of eating is the right thing rather than pushing drugs first. Continue to fight the good fight and stand up for whats right even if non of your colleagues around you follow suit.

[viv]

Did Dr. McDougall give up, did Dr Esselstyn give up? Can you imagine the push back they have received over the years from all corners, but they kept on, fighting the good fight to get the message out. How about Dr. Garth Davis, the bariatric surgeon in Texas who went plant based, imagine what it's been like for him.

Like the good doctors mentioned, you may have to think about reinventing your practice and/or finding the audience that is hungry for your message. Trying to convert the stoics is a tough call. We should all be so lucky to have a wonderful caring doctor like you who truly has the best interests of his patients at heart.

Viv

[patty]

Should I just give it all up and just write the pill prescriptions and be on my way?

I've been called "too extreme" by other doctors and been told that lifestyle change does not work anyway, and I should be more mainstream and reasonable. I've been told even to tone down my anti-cigarette and anti-alcohol advice as even that's too extreme.

I remember Dr. McDougall on the MS online video, share about his son's frustration while in Med School and Dr. McDougall shares just get through it. And Dr. McDougall sharing how angry the cardiologist doctors were when he was telling patient's they could heal with a plant base diet. I remember when he was on the radio here in the islands, and the health food stores were angry who would advertise about supplements before he went on, because he was sharing the only supplement you need was B-12.

Once you know it's the food, your head is in the Tiger's mouth. There is a book: Ishmael by Daniel Quinn, in essence Ishmael/a gorilla shares animals in the wild feed off each other, and questioning why wouldn't they leave knowing they are someone's next meal? The response was why would they leave because their meal is within range. In Waking the Tiger by Peter Levine shares animals, can collapse where they appear dead, and the predator looses interest because of the immobility and goes off. This is true in dealing with life on life's terms. Satiety from starch allows immobility where this too will pass. Fight or flight has consequences but when we emotionally detach there are none. Sometimes we have to do one of the first two.. to emotionally detach. In Celestine Prophecy shares there are 4 control dramas: intimidation, interrogation, poor me, and aloofness. Find the one you are matching, say poor me to intimidation.. the energy shifts. it is then on them:) They are going to have to recreate the dance or find someone else to dance. Just like your boys:) Everyone has a monkey on there back:) It's the food. The greatest addiction is "Me". Know you might not have the people you want to be in your life, but you have the ones you need to work on yourself.

Aloha, patty... you are the Best!!!

[veg tom]

How can 99% of the population be wrong. I think that is the way people think. The way I think is how can people keep making themselves sick. The latest restaurant, the latest food craze is so cool. We all know [ here] what the truth is.

[roundcoconut]

StarchHEFP, I wanted to offer you a few thoughts on how you see your patients and your practice.

Mostly, I'd encourage you to think of all the different frameworks in which you could see your non-plant-based patients, and then ask yourself which frameworks are going to be the most effective for you as a practitioner.

I'll say it like this: Let's say I'm a kindergarten teacher. And every day I go into work, and I read to my students. And let's say, I really do a good job of picking out wonderful books for the kids and bringing the stories to life, and my students really LIKE coming to my kindergarten.

Well, let's say that I start to get this idea of, "Every year, I read to these kids. And every year, none of them makes enough gains in their reading to be reading a chapter book by the time they are in first grade. Well, this totally blows. These kids don't REALLY want to read, and maybe I'll just give them lollipops and let them beat the crap out of each other on the playground."

So -- here's the thing I'm saying. You MAY want to adopt a different framework, whereby instead of seeing your patients as hostile, unwilling people who WILL NOT quit smoking or adopt potatoes instead of donuts -- you could see them as people who are more kindergarteners than sixth graders (need a lot more exposure and training before their solo efforts can take place).

OR: You can realize that you're kinda burnt out on these kindergarteners, and move up to teaching 6th grade. Or even tutor some kids in the 6th grade. Because I imagine it CAN get old, perpetually offering your patience and your education, to people who are just little seedlings, and won't show any efforts at first. So maybe you DO work with far more patients who already have the exposure to a plant-based lifestyle and are ready to put down some roots and grow some shoots? This would mean, maybe giving some talks locally that will put you in touch with people wanting the kind of practitioner you are. And really putting the word out, that you are looking for patients who want to get off their meds with lifestyle medicine.

Mostly, I am saying that, I see the beginnings of burnout in some of the words you wrote. And I don't think burnout is necessary -- I think you choose it, with your perspectives, frameworks, and decisions -- and can UNCHOOSE it with new perspectives, new frameworks, new decisions.

I dunno! There's your unsolicited advice for the day! Never go a day without getting some unsolicited advice, right???

Please know that I am pulling for you, and think we need both kinds of practitioners, and you just need to decide which one lights your fire. If you have a heart for these sad-sack cases who have no clue why eating all that bacon isn't a great idea, then wonderful. If you are being called to deal with people on the plant-based bath, then equally wonderful.

Curious what you think!

[Skip]

Should I just give it all up and just write the pill prescriptions and be on my way?

I've been called "too extreme" by other doctors and been told that lifestyle change does not work anyway, and I should be more mainstream and reasonable. I've been told even to tone down my anti-cigarette and anti-alcohol advice as even that's too extreme.
Top

If I was a doctor in your situation, I would simply give my patients their best options from best to worse and let them decide what they want to do. You can't stop a patient from eating bacon, ham and cheese but you have an oath to help them which should include trying to educate them about food. If they won't change their diet, give them the best pills and procedures options that you think might help them.

For example, suppose the patient is extremely obese and would rather die than change their diet. In a case like this, gastric bypass surgery seems to be a reasonable option.

[StarchHEFP]

StarchHEFP, I wanted to offer you a few thoughts on how you see your patients and your practice.

Mostly, I'd encourage you to think of all the different frameworks in which you could see your non-plant-based patients, and then ask yourself which frameworks are going to be the most effective for you as a practitioner.

I'll say it like this: Let's say I'm a kindergarten teacher. And every day I go into work, and I read to my students. And let's say, I really do a good job of picking out wonderful books for the kids and bringing the stories to life, and my students really LIKE coming to my kindergarten.

Well, let's say that I start to get this idea of, "Every year, I read to these kids. And every year, none of them makes enough gains in their reading to be reading a chapter book by the time they are in first grade. Well, this totally blows. These kids don't REALLY want to read, and maybe I'll just give them lollipops and let them beat the crap out of each other on the playground."

So -- here's the thing I'm saying. You MAY want to adopt a different framework, whereby instead of seeing your patients as hostile, unwilling people who WILL NOT quit smoking or adopt potatoes instead of donuts -- you could see them as people who are more kindergarteners than sixth graders (need a lot more exposure and training before their solo efforts can take place).

OR: You can realize that you're kinda burnt out on these kindergarteners, and move up to teaching 6th grade. Or even tutor some kids in the 6th grade. Because I imagine it CAN get old, perpetually offering your patience and your education, to people who are just little seedlings, and won't show any efforts at first. So maybe you DO work with far more patients who already have the exposure to a plant-based lifestyle and are ready to put down some roots and grow some shoots? This would mean, maybe giving some talks locally that will put you in touch with people wanting the kind of practitioner you are. And really putting the word out, that you are looking for patients who want to get off their meds with lifestyle medicine.

Mostly, I am saying that, I see the beginnings of burnout in some of the words you wrote. And I don't think burnout is necessary -- I think you choose it, with your perspectives, frameworks, and decisions -- and can UNCHOOSE it with new perspectives, new frameworks, new decisions.

I dunno! There's your unsolicited advice for the day! Never go a day without getting some unsolicited advice, right???

Please know that I am pulling for you, and think we need both kinds of practitioners, and you just need to decide which one lights your fire. If you have a heart for these sad-sack cases who have no clue why eating all that bacon isn't a great idea, then wonderful. If you are being called to deal with people on the plant-based bath, then equally wonderful.

Curious what you think!

RoundCoconut, thanks so much for your advice. I really appreciate your suggestions. I think I'm ready to move up to the "6th graders" the challenge is probably to recreate a practice where I get matched up with those patients who have an open mind and a willingness to change. I once heard an interview with Julieanna Hever in which she said she does not take any clients anymore who don't want to move to a plant-based diet. This way, she can best utilize her talents and patients can get the most out of her advice. I would love to be part of a practice where patients seek out the best in lifestyle changes, like the "True North" center or Dr. McDougall's practice, or ideally, a practice like Barnard Medical Center in Washington D.C. The big challenge is uprooting the family and putting down roots somewhere else. In Chicago, things are very slow to change since most of the hospitals couldn't care less about plant-based diets because the bariatric surgeons aren't happy, the cardiologists and cardiac surgeons aren't happy, they see someone like me as a threat. The hospital suffers from lost revenue from people actually getting healthy.

Your post really makes me think, and you're absolutely right.