Introduction My father was a closet diabetic. I always knew he had high blood sugar, but no disease was ever mentioned in the family. It wasn't until I was in the middle of writing this book that something clicked, and I asked my mom whether my dad had been diabetic. "He took insulin twice a day," she said. I was astonished. I am a physician, a specialist in internal medicine who should have known his father's medical history, but it wasn't until she divulged this information that it all started to make sense. In his disease progression, my father was the stereotypical candidate for type 2 diabetes. During his youth he was a thin, baseball-playing, athletic, Errol Flynn look-alike--a very handsome, dynamic man. As he aged, however, he stopped exercising and became sedentary. He began to develop the midlife paunch common to so many men. When he was in his late forties he had his first heart attack. By the time he was sixty he had developed congestive heart failure, and he died of cardiac arrest within the year. Losing him broke my heart. My dad was one in a million, and twenty years later I still miss him very much. As a physician, I know that more than 50 percent of diabetes sufferers end up dying of cardiovascular disease. But I also know that if we screen for the disease and catch it early, we have many tools to help reverse it while it is still in its incipient stage, which we call prediabetes. Once this condition has advanced to full-blown type 2 diabetes, these same tools and many medications are invaluable for lowering the elevated blood sugar that is the hallmark of the disease as well as helping to prevent or control long-term side effects. I can't help but wonder how much of what happened to my father could have been prevented or put off for years if his diabetes had been treated earlier or if he had changed his lifestyle. The same can be asked about eighty million Americans who are living with type 2 diabetes, not to speak of the roughly twenty-five million who have the disease and don't know it. Because diabetes develops slowly and doesn't hurt, far too many people are unaware they are suffering from this silent killer. Most of us would prefer to look the other way when it comes to dealing with an unpleasant health issue. Because screening is not mandatory, and many people skip their annual physicals, it's easy for blood sugar to creep up, along with blood pressure and weight, without any health care professional sounding an alarm. And not all doctors choose to discuss weight with their patients. A pity, because overweight and obesity go hand in hand with type 2 diabetes, which is why the disease is running rampant. I'd like to put a stop to that. It's our goal in this book to explain in very clear language not just what diabetes is and how it progresses, but more important, what can be done to control it. I don't want one more person to go through what my father suffered. Treatment plans for type 2 diabetes or prediabetes must be individually tailored. Because I can't see all of you as patients, I've teamed up with colleague Susan Wyler, a registered dietitian in private practice who also teaches in the graduate nutrition department of the University of North Carolina at Chapel Hill. Together, we've created a comprehensive tool kit that offers the broadest possible range of information on type 2 diabetes. This holistic approach, based on the very latest in scientific research, is most effective because it helps you take charge of your care in partnership with your physician. Between the two of us, we are widely versed in medical treatment of type 2 diabetes as well as the lifestyle modifications that are most effective for controlling the disease: proper nutrition, weight loss, physical activity, stress reduction, and diabetes self-management education techniques--everything you need to halt your disease and prolong your life. All these factors add up to The Diabetes Solution, a compilation of medical treatments and lifestyle behaviors that have been proven in scientific studies to improve health in the present and prevent complications in the future . Chapter by chapter, throughout this book, we explain each of them in detail, one step at a time. It's our fervent wish that you take this information and apply what is relevant to your life. We hope that the comprehensiveness and breadth of the advice will help you better understand your disease and how it can most effectively be treated. If this causes you to have a better dialogue with your health professional, then we have done a good job. Remember, no book can take the place of a doctor; use the information you find here to help yourself and to become a more educated patient. The Diabetes Solution is not meant to be a substitute for your doctor; it's meant to be an informative guide that will help you partner with your doctor for the very best results possible. As a physician with more than thirty years of clinical experience, I have found that patients are much more likely to take their medications correctly or change their unhealthy habits if they understand why doing so is important. My main tool as a doctor is not medication, it is persuasion, and my most powerful weapon is scientifically proven truths. I know that when I explain, in clear, simple terms, just what diabetes is, what harm the disease can cause, and how we can stop the damage, you will do the right thing for yourself. I have faith in you. The Diabetes Solution is your biggest ally. Throughout the pages of this book you will learn to understand what type 2 diabetes is, why it occurs, what damage it causes, and how you can prevent it. Together, Susan Wyler and I have devised a three-pronged attack: knowledge, medication, and lifestyle. Undoubtedly, if lifestyle changes alone can control your diabetes that is the best choice. But some people can't make the adjustments. They try to lose weight, but often fall back. Many just think about it. Soon months turn into years, and they are still obese. In the meantime, irreparable kidney damage or nerve damage may have taken place, just to name a couple of common complications of diabetes. This really is a matter of life and death. If you can't change your lifestyle or your blood sugar remains high, medication is your best friend. I stress the importance of diabetes drugs, including insulin where needed, until you get the diet and lifestyle changes under way. To help you there, we've developed a whole range of suggestions to improve your health. But the crown jewel of this book is the Blood Sugar Budget, a balanced way of eating that represents the healthiest diet for almost everyone and the most effective way for those with type 2 diabetes or prediabetes to lower their blood sugar and lose weight. You'll be surprised how much good food awaits you. The Diabetes Solution offers everything you need to know about type 2 diabetes and its precursor, prediabetes, neatly and clearly outlined. It is designed to be a tool that you can use practically, referring to it daily in conjunction with treatment recommended by your personal health care professional. I hope that The Diabetes Solution will inspire you, encourage you, and keep you on track. Here's wishing you a long and healthy life. --Jorge E. Rodriguez, MD Excerpted from The Diabetes Solution: How to Control Type 2 Diabetes and Reverse Prediabetes Using Simple Diet and Lifestyle Changes by Jorge E. Rodriguez, Rd, Susan Wyler All rights reserved by the original copyright owners. Excerpts are provided for display purposes only and may not be reproduced, reprinted or distributed without the written permission of the publisher.
