Conquering Diabetes

By Michael Dansinger, MD

Diabetes is a serious disease that doctors cannot successfully manage without a high level of input and cooperation from each patient. Therefore, patients must become educated about how to deal with diabetes in order to stay as healthy as possible. Unfortunately there is much to learn, and learning this information is often challenging for patients. There is a wealth of information available from doctors, nurses, diabetes health educations, dietitians, personal trainers, patient advocates, health coaches, book authors, magazine articles, websites, and blogs. All of this may seem like “too much” information for patients – they can feel overwhelmed and, as a result, become passive rather than engaged and proactive.

There are hundreds of books marketed to patients with diabetes. Each book has similarities, yet each is unique in its own way. It can be challenging for a patient who wants information and inspiration to know which books are worthwhile, especially because each individual reader is unique in terms of personality, lifestyle, food preferences, activity preferences, medical conditions, and other factors. In other words, not everyone who reads the same book will have the same reaction to it. Nevertheless, it is fair to say that some books are better than others in a general sense, and many patients could benefit from some guidance in the area of diabetes books.

I have read a good number of books about lifestyle, nutrition, exercise, and health, and have served on expert panels for the specific purpose of rating and ranking such books for consumers. I am fascinated by the similarities and differences between the books out there, and have often found such books to be a source of inspiration to push harder both personally and professionally. As a result of considering the merits of so many types of health-related books, I have developed some viewpoints about how to think about the universe of health books.

I believe that the existence of such a broad range of books is a good thing. I am grateful for the diversity of styles and strategies and eating plans, etc. There are definitely “different strokes for different folks”, and in this case I am not in favor of a “one-size-fits-all” mentality.

I’ve talked about “dating the diets” by trying a variety of eating strategies, and the same principle applies to diabetes books. Some individuals will prefer to “date” until finding “the one” they like best and then making a long-term commitment to staying faithful like in “marriage”, even when there are challenges. Others prefer to keep moving from one approach to the other, looking for variety, novelty, and new sources of inspiration, in an effort to avoid monotony and boredom.

The books range in terms of the scientific evidence they discuss. Most books about diabetes and health refer to scientific evidence but the interpretation and selection of research studies can vary substantially. The tremendous diversity of scientific studies, combined with the known limitations of existing scientific evidence, means that much of the science is open to interpretation and debate. This means there is tremendous room for “artistic license” and hypothesizing about what the existing studies might mean. We all want “the truth”, a deeper understanding of how the body works, and what to do to maximize our health, but the fact is that consensus is often lacking, while diversity of mindsets, approaches, opinions, and philosophies are the reality with diabetes books.

There is a difference between “pseudoscience” versus a “unique interpretation” of the science. The former is inconsistent with scientific evidence and is most certainly incorrect, and the latter is usually plausible, unproven, and possibly false. In either case, following the advice or wellness strategy suggested by the author of such advice often works well in terms of health benefits, even if the underlying premise is incorrect, mistaken, or false. Many false beliefs can result in positive changes when the approach is harmless. For a silly example, suppose someone erroneously believed that foods that are shaped like round spheres have special healing powers because of their shape, and therefore one should eat some of this type of food at each meal. This would result in a significant amount of fruit intake with likely health benefits, even though the underlying pseudoscientific premise is false. More often I see unique interpretations or liberal stretches with ideas and interpretations that seem like exaggerations of minor pieces of scientific evidence. These “over-interpretations” or “unproven ideas” are sometimes the major underlying premise of an entire nutritional philosophy, but this does not necessarily pose a health problem. While I am interested in always getting the facts straight and knowing what mainstream experts consider to be valid interpretations of scientific evidence, I also favor a tolerant/liberal posture and artistic leeway when it comes to making sense of the vast gaps in our scientific knowledge. When some questionable idea sounds dangerous or concerning I’m not shy about saying so.

Various health and nutrition strategies range from conservative to extreme. Conservative strategies are generally more mainstream and extreme ones are not.More extreme strategies often produce more dramatic results, but the drawbacks might include greater challenges with long-term adherence, sustainability, risks, or side effects. Often times the more extreme, unusual, or novel a strategy or philosophy is, the more intriguing it is to learn about. Mainstream approaches that cover the standard principles can be written up in clever and interesting ways, but sometimes these plans seem dry and boring.

In the coming months I’d like to provide reviews of various wellness books for patients with diabetes. Most of these books will have nutrition plans, and with the assistance of nutritionist Caitlin Quinn, RD MS, I will summarize and share my comments about the nutrition and wellness programs described in each book. I will cover a broad spectrum of books one could buy from on-line booksellers or bookstores, ranging widely in viewpoints and philosophies. In the end, I’m aiming to help the reader find an effective and sustainable plan that fits his or her personal needs, values, and personality.