DEAR DR. ROACH: Any suggestions on how to reverse Type 2 diabetes? — C.B.
ANSWER: Strictly speaking, once you have diabetes, you always have diabetes, as the diagnosis is considered “stable,” or lifelong. However, many people can get diabetes under control without medications so that the blood sugar is always in the normal range, which is pretty close to reversing diabetes.
The three most important areas of controlling diabetes are diet, exercise and weight. While there is much information I can give on diet, the most important single factor is reducing sugar and starches (which rapidly turn into sugar). It’s not all carbohydrates that are bad — vegetables and legumes, which are mostly carbohydrates, have very little starch and sugar and high amounts of fiber, forming one of the bases of a healthy diet for diabetes, along with healthy protein sources. A registered dietician or nutritionist is an essential partner in diabetes care. Entirely (or nearly) cutting out breads, pastas and rice makes an enormous difference in blood sugar.
The body makes its own sugar, and regular exercise not only uses up blood sugar, but it also trains the muscles to use sugar more efficiently. Exercise alone will not reverse diabetes in people who have a poor diet, but the combination of a good diet and regular exercise is better than either alone.
Weight has an independent effect on blood sugar control, as a higher weight usually correlates to more resistance to insulin. However, a person can have Type 2 diabetes and be very thin, and most people who are overweight do not have diabetes. For most people, a diabetic-friendly diet and regular exercise will end up leading to weight loss, but it will always lead to improved health, even without losing a pound.
DEAR DR. ROACH: Lately, I’ve been hearing about a relationship between the COVID vaccines and a significant increase in heart-related deaths. Please review the latest information on this subject, and your recommendations. — D.P.B.
ANSWER: While there are multiple studies published and, unfortunately, misleading conclusions on social media based on faulty analyses, the best data come from the U.K., where all-cause mortality is very significantly reduced in people who have had the COVID vaccine, compared to unvaccinated people.
A separate analysis from the Florida Department of Health also found lower all-cause mortality in all age groups among vaccinated compared to unvaccinated. This is likely due to the fact that getting COVID is a major risk in multiple types of death, and the vaccine is effective at preventing serious COVID.
Certainly, in high-risk groups, such as people with heart failure, the vaccine prevents death very powerfully. Unvaccinated people are three times more likely to die from any cause than those who have been fully vaccinated.
My recommendation remains consistent. Everyone who can get the vaccine should get the vaccine, and it’s more important for people who have more risk factors. Older people, those with heart or lung problems, and those with problems in their immune system due to a medical condition, or its treatment, are at a particularly high risk and should ensure that they are fully boosted with the vaccine.
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Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.
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