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2009-07-23 Gerardo Perez Diabetes Reversal

July 23, 2009, By Kirkham R. Hamilton, PA-C
© copyright 2009, Prescription 2000, Inc.
www.prescription2000.com

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KIRK HAMILTON: Welcome to Staying Healthy Today, a health-oriented radio show committed to bringing you key experts in the fields of nutrition, prevention and integrative medicine.

Hi, my name is Kirk Hamilton, your host of Staying Healthy Today. Our mission is simple. To provide you credible and usable health information from interviews and our educational resources to help you Stay and Be Well in the busy modern world. Please take a few moments before or after listening to this interview to browse through the Prescription2000.com website, the home of Staying Healthy Today Radio, for our free educational services.

Today's show topic is "How to Reverse Your Diabetes in 60 Days, A Case Study." Normally when I do these shows, I do an interview with a key researcher or an expert clinician, but today I want to do something a little different because I have interviewed in the past three expert researchers on diabetes and the role of plant-based diets and possible reversal, and those have been Dr. David Jenkins, Dr. James W. Anderson, and Dr. Neal Barnard. Today what I wanted to do was to take an actual patient, colleague and friend, Gerardo Perez, who is a longtime businessman in his mid-50s, who has struggled for the last 10 years or so with elevated blood fats, excess weight and elevated blood sugar and share his last 44 days of being on a very aggressive lifestyle modification program to reverse his diabetes of which he has been successful.

But before I get into chatting with Gerardo, I would like to just go over some diabetic facts that I think a lot of people don't realize on how serious an issue diabetes is. First of all, diabetes is a problem where we have elevated blood sugar. The blood sugar can cause damage to your blood vessels, your kidneys and your eyes. This occurs in two major forms. Type 1 diabetes means that you don't produce your insulin and usually it happens in children and it's a lot less frequent, and they have to take insulin for the rest of their lives. Now lifestyle modification is important, but they have to take insulin. Type 2 diabetes occurs in 90 to 95% of people who have diabetes, and this occurs usually in adults, but it's happening sometimes even now in younger people and it has to do with lifestyle in general. Generally these people are overweight and more sedentary. It's really becoming an epidemic not only in the United States but worldwide. Here's some simple facts and figures about diabetes. In the United States, maybe 8% of the U.S. population has diabetes or 24 million children and adults. Unfortunately, about 6 million of these don't even know they are diagnosed with diabetes. Then there's a condition called pre-diabetes. It's just a level of blood sugar between 100 and 125 when you're fasting, but this too can cause health problems. About 19% of the U.S. population has pre-diabetes and about a quarter of our population has blood sugar issues (adding together pre-diabetes and diabetes). Again most of these are related to lifestyle. Diabetes is the sixth leading cause of death in the United States. As you get older type 2 diabetes occurs more frequently in people over the age of 60, almost a quarter have diabetes. One in three Americans has diabetes, one in two minorities will develop diabetes in their lifetime. There's about 4,000 new cases of diabetes in the United States each day. Now worldwide it's even bigger. 180 million people worldwide now have diabetes, or 3% of the world population, and this may double in the next 20 years. So who cares if you have elevated blood sugar what are the problems? Type 1 and type 2 diabetes can cause the following: heart disease, high blood pressure, eye complications and blindness. It's one of the leading causes of kidney disease, sexual dysfunction, lack of blood flow to those areas or enervation, pregnancy complications, periodontal disease, periodontitis, dental issues, infections are higher in diabetes, poor wound healing, nerve damage. It's one of the leading causes of amputations, depression, and it makes it much more difficult for the elderly to carry out their daily activities of daily living. The economic costs are absolutely enormous. One of the things I think of when I was looking at the diabetic facts, that I think is most striking is the indirect costs which relate to absenteeism from work, reduced productivity in our work force, disease-related unemployment, and loss of productivity. In 2007 that was about 58 billion dollars. One out of every five health care dollars is spent caring for someone with diabetes and one in ten health care dollars is attributed to diabetes.

Lastly, before we get to chatting with Gerardo, the definition of diabetes is a fasting blood sugar above 125 which your physician can do anytime and you should always ask for whenever you get any blood work done. The prediabetic condition is a fasting blood sugar between 100 and 125. The normal range is somewhere between 70 and 100, and I like my patients below 90.

So, without further ado, Gerardo, I would like to thank you very much for coming on the show today.

GERARDO PEREZ: Thank you. Thank you for having me.

KIRK HAMILTON: How long have you known or thought you might be a diabetic?

GERARDO PEREZ: You know we have a family history in our family. I suspected that at some point I would get it, but until I went to my doctor and was told that my blood sugar was extremely elevated I really had no clue.

KIRK HAMILTON: Did you have a ballpark idea in your mind what diabetes was when he gave you your blood sugar reading? Did it make any sense to you?

GERARDO PEREZ: No it really didn't. My experience with diabetes was indirectly through people I knew, family members, and what they explained they would go through on a daily basis trying to feel good.

KIRK HAMILTON: What kind of problems did you think you might have with diabetes, if you had it?

GERARDO PEREZ: The very first thing that comes to my mind is losing my toe. I have a friend who lost half of his foot and his eyesight is going pretty rapidly. Whenever anybody says diabetes to me, I think of insulin shots, losing your toes, and going blind.

KIRK HAMILTON: So you had some idea for at least 10 years that your blood sugar was high. Why didn't you aggressively address it? What kept you from dealing with it?

GERARDO PEREZ: I think the thing that kept me from dealing with the suspicion that I may have diabetes was that I couldn't really compare what feeling great or very good physically was with feeling bad.

KIRK HAMILTON: Well tell me then when did you have any idea that you could reverse your diabetes once you really settled in that you had it? Did you believe that an aggressive diet and lifestyle program could not only reverse it, but do it in a very dramatic fashion within several months?

GERARDO PEREZ: Well, no, I did not. I really did not believe that if you committed yourself and followed a regimen that you could so dramatically change the way your body worked.

KIRK HAMILTON: So you decided to go on this program. Why?

GERARDO PEREZ: Well, because I didn't want to lose my foot and go blind.

KIRK HAMILTON: But why this time?

GERARDO PEREZ: Well I'm in my fifties. I, like every other Americans am going through stressful financial times, and it got to the point where I began to look at the quality in the remaining amount of time that I have in my life. By any statistical form I think it's about maybe 15 or 20 years, maybe 25 years, and I really wanted to make the most out of those remaining years.

KIRK HAMILTON: Well I'm actually baiting Gerardo because I know his course and for whatever reason that he committed this time, only the individual patient can tell you that. As a health practitioner I see a patient and five years after I mention something, the next week they do it. I don't know what the magic answer is, but I am very glad that Gerardo decided to jump in because it was an area of interest of mine, diabetic reversal. As I mentioned, I had reviewed the work of Dr. James W. Anderson long-time endocrinologist known for his work on the HCF diet and diabetes reversal; Dr. David Jenkins who invented the glycemic index, who is a very plant-based oriented clinician and encourages this for diabetes control and reversal; and Dr. Neal Barnard who wrote the excellent book, "Dr. Neal Barnard's Program for Reversing Diabetes." So it's fresh in my mind. An aggressive plant-based diet is what I asked Gerardo to do. Now here's the issue with patients. If you don't get quick results a lot of times patients just don't feel motivated to continue on something that's different and hard for them. So we decided to do this and not everybody can do this. You would have to have your clinician follow you. We put Gerardo on basically unlimited fruits and vegetables, all the nonstarchy vegetables he wanted to consume, and fruit, fluid and water. I think it was one cup of coffee or tea a day and Gerardo had to exercise at least aerobically, meaning walking briskly 50 to 60 minutes a day, and then start on some strength training. The goal was to dramatically drop Gerardo's weight, blood sugar and his blood lipids. Gerardo started on June 4th and he was 240 pounds and his fasting blood sugar was 238, which is obviously way above a 100, and his cholesterol was 268. In that 44 day journey to actually yesterday, he has dropped 26 pounds, his blood sugar has gone from 238 to 95, so he is technically not even a pre-diabetic, though we have hovered around that 100 range for the last week or two, and his cholesterol has gone down from 268 to 164. These are dramatic numbers by anyone's standards in 44 days.

So Gerardo take me through it. How hard was it initially for a big eater like yourself to just go on fruits and vegetables?

GERARDO PEREZ: Well at the beginning the first three or four days were really rough. The days occurred during the jazz festival that I like to go to, and you know you go there to have fun and you drink and you eat, and it was difficult. It wasn't until the three or four days went by, that I looked at my efforts and I said, "If I'm going to do this I really need to do this right!" Once I made that decision I really gave it 100%. It was difficult until I went out and bought a glucometer and I created a spreadsheet that tracked my blood sugar pretty much every two hours of my waking day. Before and after I ate, before and after I exercised. It was pretty impressive to see what simple exercise can do to your blood sugar in a short period of time and what my weight was at the beginning of the day, and what my weight was at the end of the day, what time I went to bed, what time I got up. Pretty much when I started to do the chart, I got really serious.

KIRK HAMILTON: Tell us an average day. Take a person through your average day. You'd get up, what you'd eat and such.

GERARDO PEREZ: An average day is kind of funny because it's been pretty consistent after searching for my good day, as opposed to a bad day. I have been having pretty much all good days now. I'll get up at 5:30 or 6:00 in the morning, and I will immediately weigh myself and go prick my finger and take my blood glucose level and take my blood pressure. Then I will go and shower. Then I will have copious amount of fruit. I think that if people were to see just the volume of food that I eat they would probably be amazed because I'm eating a lot of food, just from a volume perspective. Then I hit the road and I'm usually at work by 8:30, 9:00 in the morning. By then it's been two hours since I've eaten so I prick my finger again and take my blood pressure again. Depending on what I ate, I can tell you what my blood glucose level is going to be. Then we move into mid morning and I prick my finger again before I have lunch. I like to go to salad buffets because I can eat all I want and typically after two or three trips to the salad buffet I am usually pretty satiated. Two hours after that I once again prick my finger and take my blood glucose level. I can tell exactly what kind of food I ate by how high my blood sugar is. Then evening comes along and about 30 minutes before dinner I will do another blood glucose test and I will have dinner. Then I usually wait anywhere between an hour to two hours after I have eaten dinner and I will prick my finger again and take my blood glucose level again right before I exercise. I exercise pretty vigorously. I calculate that I'm maybe burning 500 calories in an hour. I will immediately after I exercise and immediately before I exercise take my blood glucose level and I can drop my blood glucose level 50 points over that hour of exercise.

KIRK HAMILTON: I want to get a point across here if I can. Talk to people about when you go out and eat. I've been out with you - we've played this game. But when you go out and eat, number one, talk about how you eat, let's say at a buffet, and how you eat at maybe the local salad bar place and then I'd like you to give me your observations, not in a judgmental way - do you see what people put in their mouth reflecting their physiology or their bodies?

GERARDO PEREZ: Oh, absolutely! Go to Hometown Buffet and hang around the salad bar, and then hang around the real food or the other food, and you will see that there's a direct correlation in terms of not only the type of food that people eat, but the quantities that they eat it and what their weight and physical appearance is. You're not going to find a ton of thin people at Hometown Buffet, but those that are thin, you can tell because they're eating very, very small amounts of high caloric density food, very, very little meat, very little sauces and creams and oils. Their regimen appears to be more of the fresh fruits and salads and much much less of the processed foods and desserts and the carbonated drinks.

KIRK HAMILTON: Would you say that you ate just until you were full? I know there were restrictions on the type of food, but the volume was still there for the big eater.

GERARDO PEREZ: Well I won't make any bones about it. Sometimes I just ate out of frustration. Out of frustration that I couldn't go have the fried chicken, but nevertheless I ate a lot. I ate to the point where the waitresses would come over and say, "Aren't you going to have any fried chicken?" And I would say, "No, it kind of defeats the purpose." "I'm there to eat salad." And for the most part I can safely tell you that I never walked out of - and this is not necessarily a good thing, I never walked out of a restaurant feeling hungry. And maybe I should. Maybe the key is to under-eat, or just under-eat so that you don't feel full or stuffed.

KIRK HAMILTON: Well, you must have done something right because weight doesn't come off unless obviously you restrict your calories. One of the points I want to throw and interject in here is the concept that he brought up, what is called caloric density. The whole goal of eating plant-based diets and why they work (in weight control) is, number one, you get a large volume of food with reduced calories. That's number one. And we eat to fullness. There's the whole concept called volumetrics. We tend to eat to a certain volume of food. So what you want to do is consume food that has large bulk but has low caloric density. The second rule is you want to eat foods that have high nutrient density. What do I mean by that? If you had a handful of 100 calories of broccoli in your right hand and 100 calories of sugar in your left hand, they both provide the body of 100 calories of energy, but the broccoli in your hand has antioxidant compounds, fiber, bulk and vitamins and minerals that help protect you against disease. So that is the goal. If you eat those diets naturally, weight naturally comes off and this is what the Okinawans do and all healthy aging cultures do. They eat large volumes of food that are low in caloric density, high in nutrients, and they tend to limit animal foods. Gerardo did this to the extreme where we really limited his calorically dense foods because we wanted to do it (lose weight) quickly. I wouldn't recommend this for everybody unless you were followed by your physician, because I followed Gerardo very, very closely.

Now Gerardo I would like you to just share also - we have about four or five more minutes here. Tell people how you felt during this. Some people might have thought you couldn't go to work, you couldn't exercise, you couldn't think straight if "I was doing all that stuff." Tell people how you felt.

GERARDO PEREZ: There was really no difference in terms of how I physically felt or mentally felt, apart from the actual angst that comes from seeing a piece of carrot cake on the other person's plate, but I didn't feel deprived necessarily, especially after a week or so of doing it. I didn't feel like I had a low energy. I didn't feel like...I wasn't obsessed with the fact that I couldn't have sweets or I couldn't have oily stuff or I couldn't have meat. A lot of my friends said that I was on a cleansing diet, and I said, "Well I don't really feel like I'm on a cleansing diet." It seems like it would be a lot more stressful to be on a cleansing diet. I pretty much restricted my caloric intake, my food, to lots of greens and didn't have oil on it. I pretty much ate as much as I wanted of it.

KIRK HAMILTON: So what's going to help you continue? If you continue in this fashion, I have no doubt that you're technically not a diabetic at this moment, and I believe that diabetes is reversible. I think the data is there and the evidence is there. What is going to keep you motivated from this time forward? We have an epidemic of people who lose weight, gain it back, the yo-yo effect. Have you learned something that you think you can apply? Once you get to your target weight, which is what? What do you want to weigh?

GERARDO PEREZ: In college I weighed 185 pounds, which is 20 more pounds than I'm carrying now. If I can get somewhere between where I'm at now and there, that would be great.

KIRK HAMILTON: Alright, let's say you get there and then you're going to be able to lean out your diet. Obviously soon - we added some beans recently, a little bit of brown rice, and down the line we're going to increase, when we consistently stay below 100 mg/dl of the blood sugar, we are then going to add good complex carbohydrate in a little more liberal fashion. When you go out in the real world and eat again and you're free to eat, do you think you're going to be able to do it?

GERARDO PEREZ: I think I am going to eat differently than I did before, and I think that my goal will be to keep my weight down and my exercise regimen at par with what I am doing now. It's remarkable how much your blood sugar goes down after you exercise, and I think that is what's going to keep me on track is if I can normalize it - normalize my diet to include small amounts of protein, small amounts of sweets, in moderation obviously. I don't want to have to crave anything and I'm beginning to realize that I can satisfy my craving with a lot less of what I was eating.

KIRK HAMILTON: Tell me about, as we wrap up here - do you think stress played a role in your blood sugar? Did you see it fluctuate with - I know you're like many business people, you're going through intense times. So how did that affect it (blood sugar)?

GERARDO PEREZ: Absolutely! I would have a stressful meeting. I'd go take my blood glucose and it would go up literally 10, 12 points. I would have a bad meeting, go and take my blood glucose and it would be up six or seven points from the previous time when usually it will go down, it would go up. Stress definitely has a huge effect, not only from a psychological point of view, but from a physical point of view and, even though you can't avoid stressful meetings at times, I think that if you can approach your health from the point of view of managing that stress levels at the same time you're managing, what food you're ingesting, I think that you'll be a lot more successful. The other thing is to really be able to be committed to the point where you're actually tracking things and you know exactly what the numbers are. That's the beauty of what I did and I'm doing. These devices that they make now are pretty much within very, very low tolerances and you know what your blood glucose is and then you can backtrack and say, "What did I eat two hours ago?" And sure enough you had a piece of yam or something. And you say, ‘God, could that little piece have done that, " and yeah that little piece of yam can do that.

KIRK HAMILTON: Well, we have to wrap it, Gerardo, and I just want to go over the highlights. Gerardo Perez is a middle-aged man who has taken control of his health and he has lost 26 pounds in 44 days; he has taken his fasting blood sugar from 238 to 95 and his cholesterol from 268 to 164, and essentially he has reversed his diabetes without medicine on an aggressive lifestyle management program.

So, in closing, I want to thank you, Gerardo, for your candor and just your great effort and I think that your example will help a lot of people when they hear this. And I want to thank you, the audience, for listening today on this edition of Staying Healthy Today Radio. And remember until next time, Stay and Be Well.

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