162 Joel Fuhrman, M.D.when they started. Most patients can stop all insulin within the first
few days. The warning I give to patients and their physicians adopt-
ing this program is not to underestimate how effective it can be. If
the medications, especially insulin, are not dramatically reduced, a
dangerous hypoglycemic reaction can occur from ovennedication. It
is safer to undermedicate and let the glucose levels run a little high at
first, then add back a little medication if necessary. This will mini-
mize the risk of hypoglycemia, or driving the blood sugar level too
low. Since this diet is so powerfully effective in reversing diabetes
and other diseases of nutritional neglect, it is essential you work
closely with a doctor who can help you adjust your medication dose
downward in a careful fashion.
Note: No diabetic patient on medication should make dietary changes with-
out the assistance of a physician, as adjusting the medication will be neces-
sary to prevent hypoglycemia, or excessively lowering the blood sugar level.I typically continue or begin Glucophage (metformin) or other
similar drugs. The newer medications that do not interfere with
weight loss are safer than the older oral medications diabetics used in
the past. Eventually, as more weight is lost, these patients can have
normal glucose levels without any medication. They become nondi-
abetic, though diabetes can recur should they adopt a more stressful
and girth-growing diet.Gerardo Petito is a patient I began seeing about ten months ago.
His case exemplifies the outcome I see with other diabetic patients
on a regular basis. Gerardo stated that his main reason for coming to
me was that he wanted to control his diabetes better. On his first
visit, January 18, 2000, he was taking three medications: Accupril 20
mg, for blood pressure, and two medications for diabetes, Glucophage
500 twice daily and fifteen units of insulin twice daily. He had been
on insulin for seven years. His fasting glucose in the morning had
been running around 175 with this regimen. His blood pressure was
140/85 and he weighed 256 pounds.After a lengthy discussion, Gerardo agreed to follow my dietary
advice. I instructed him to cut back his insulin dose to ten units the
evening of the visit and to five units the following morning; after
that, he was to take no more insulin.
When Gerardo came back for his second visit two weeks later, he
weighed 237, a loss of nineteen pounds in just two weeks. His glu-