Atkins Diabetes Revolution

This book was recently released by the Atkins estate, and is published by William Morrow, an imprint of HarperCollins. It is based on the research and clinical practice of Robert Atkins, MD and is compiled by Mary Vernon, MD and Jacqueline Eberstein, RN. They do a very good job of presenting the latest research in a coherent and accessible fashion.

Robert Atkins understood the connection between the "obesity epidemic" and the "diabetes epidemic" long before it was "officially" acknowledged. The first, and most important, point made in the book is that there are (by almost anyone's estimate) more than 5 million Americans running around with undiagnosed type 2 diabetes. There are many more millions of others who are on track for it, with blood sugar and insulin abnormalities which will not be disclosed by one fasting blood sugar once a year or so. By the time a person shows an elevated fasting blood glucose, the usual diagnostic sign post for type 2 diabetes, they've had abnormal glucose and insulin levels for years.

Type 2 diabetes is a continuum. It is just one step in a multi-stage progression from normal blood glucose metabolism to pancreatic burnout - the type 2 diabetic whose condition has degenerated to the point where he or she is prescribed insulin by injection. Long before such a person is diagnosed with type 2 diabetes, his or her metabolism has been greatly impaired. You don't just "turn up" diabetic. (The exception to this is abrupt onset, type 1 diabetes, which is an auto-immune problem wherein the beta cells in the pancreas are attacked and no longer produce insulin. It's a very different problem - not as common a disease, and except for end-stage type 2 - when the pancreas is exhausted and stops producing adequate insulin - the two diseases are very different entities. )

One helpful aspect of this book is it's discussion of pre-diabetes, the metabolic syndrome, gestational diabetes, and other pathologies of blood glucose metabolism which precede a diagnosis of type 2 diabetes, and the tests that can identify each stage. These are not strange or unrecognized tests. They are just not routinely done because they are more expensive than a fasting blood sugar as part of a routine blood panel. It is my belief that if you are overweight and have been for some time, or if you have type 2 diabetes in your family, it is worthwhile to look a little more closely at your blood glucose metabolism. If you are both overweight and have a family history, it's probably critical to do so if you wish to take steps to stop the progression at an early stage. For individuals with diagnosed type 2 diabetes, ABSCP (Atkins Blood Sugar Control Program) can usually reduce or eliminate the need for oral hypoglycemic drugs. Even for people with more advanced type 2 diabetes, at the insulin injection stage, adopting the ABSCP can usually obviate the need for insulin and reduce or eliminate the need for oral hypoglycemics.

A very important point here is that one does not really "heal" one's metabolism so to speak. One can stop the progression to retinopathy, neuropathy and other related pathologies. One can attain and sustain normal blood glucose levels and normal A1c (which gives a retrospective "picture" of blood sugar levels of several weeks) results. There is no evidence, however, that one can return to a pre-impaired state, such that one can return to a "normal" amount of carbohydrates.

In many cases, following the ANA (Atkins Nutritional Approach - the usual Atkins regimen as outlined in the Dr. Atkins New Diet Revolution), if followed as a life long eating plan - not a temporary weight loss regimen - will be sufficient to avoid all the systemic damage that diabetes will do to various organs and organ systems. However, for a person who already has measurable impairment of blood sugar metabolism, that may not be sufficient. In those cases, the ABSCP would be more appropriate.

What's the difference between the two? More attention to blood glucose levels is a big part of it and that means high carb "cheats" are not an option. More emphasis on increased daily activity levels is another. Further, there is a recognition that the ACE for a person with impaired blood sugar metabolism, even with exercise, may very well be very low and that it is not likely to change significantly. Finally, much more attention has to be paid to the glycemic impact of various food choices. For instance, 10 grams of carbs in the form of a serving of artichokes is NOT the same as 10 grams of carbs from a serving of parsnips. Flax muffins and twinkies (carb for carb) are NOT equivalent in terms of blood sugar impact. There's a difference and those of us who monitor blood glucose levels know it.

As I see it, a person with impaired blood glucose metabolism has a choice. (A person almost always has a choice. ) Follow the ADA diet, take your metformin, and watch your health and organ systems deteriorate, or trade in the pasta and krispy cremes for swiss chard and flax muffins, chuck the meds and feel fine. Either option is perfectly acceptable, as long as one is willing to take ownership of the consequences.

The consequences of both options are pretty well laid out in this book. The program is well explained, with the usual and, in my opinion unnecessary, anecdotal "stories" of individuals - each with a YMMV disclaimer. LOL! There is a very well done menu section, with menus for a month, each laid out - side by side- for 20 gm, 40 gm and 60 gm ACE's. Finally, there are the obligatory recipes. The good news is that, unlike prior Atkins books, these recipes are actually good. I recognized some of them as one's I'd already tried and liked from the Atkins web site.

I think this book should be required reading for diabetics, pre-diabetics, persons with a history of obesity or a family history of diabetes. The progam is designed to be followed by you AND your doctor. No one should play around with medications without the input of their physician.

I presume it's available at all the usual places.

__________________

Maggie, thanks for posting this review. I definitely will look for the book, because I want to buy it for my sister. She was diagnosed as having type 2 diabetes earlier this year. I don't think she as yet understands the whys, hows, wherefores, and potential consequences of poorly controlled blood glucose.

I suspect she was either given poor instructions or misunderstood the advice from her HMO. Anyway, she thinks she's doing okay as long as her blood glucose stays under 170, which I think is too high even for a post-prandial upper target.

I'm not in a position of authority to argue with the dietary guidelines she was given; but I hope seeing something printed by a doctor will be more convincing than my "nagging". At first, she was at least following the dietary guidelines provided by her HMO (whole grains, low fat, etc.), but now she's slipped and I see her eating a fair amount of junky foods.

She's a mature woman, and can make her own decisions - dang it! And, I'll go along - just so long as she follows my advice, that is! (she's very important to me after all).

Anyway, I hope the information in the Atkins book is convincing to her.

__________________
~~~Teelbee
Back to GOAL!!!
start weight: 176/goal range: 137-134/now: 138
Reached goal in Aug. 2003 - 4rd year of maintenance.

I have the book and love it.

__________________
A journey of a thousand miles begins with just one step!
90lb. club:butterfly

I was looking at this, but there's about 2390479873 (ok 3) different versions of the book, the last of which has yet to be published in paperback. Do you all think it's worth waiting for the new one? I think I'm going to grab a used copy of whatever I can, and then see what the new version brings. How new can it be?

Robin

__________________

The version I reviewed was published in hardcover in 2004. I would imagine that the only difference with the newer versions (I haven't seen them) would be that there is a significant amount of new research supporting the underlying principles.

__________________