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To my twin brother, Dana. Friend. Confidant. Road Dog. Fellow
Warrior. You’ve always made the ride interesting at the peaks and in
the valleys. The 5 A.M. preschool hill runs will forever mold my
strength. Eternally bonded to you and in love.
INTRODUCTION
When I was just a young first-year medical student, my grandmother, the anchor
of our family, was diagnosed with type 2 diabetes. This was a tremendously
difficult blow to her, and thus the entire family, because she had been healthy all
of her life and never required medications or therapeutic interventions. She was
scared, and so were the rest of us as we struggled to understand not just why she
was so unlucky, but what could be done to make sure that she avoided all of the
devastating complications that can come from the disease.
Everyone looked to me because I was supposed to be the medical expert in
the family. But the truth was that I knew virtually nothing about diabetes; I was
just in my first semester of my first year. My reaction was like it always had
been when facing a challenge—take it head-on without fear and work extremely
hard to conquer it. So I searched for and digested every particle of information
about diabetes and what could be done to make a difference. The more I
researched and learned, the more convinced I became that diabetes was not a
death sentence like so many of us think. It was controllable through lifestyle
behaviors, as well as appropriate medicinal therapy if necessary.
I went home for the holiday that winter, sat my grandmother down, and
explained to her as best as I could what I had learned and what I thought would
make her life as normal as possible. She listened and she cried, not because she
was scared, but because I had given her back the hope that had vanished the
second her doctor had announced her diagnosis. The first thing we did was
change her eating habits. An old woman from the South, her typical cuisine was
loaded with fried foods and sugary treats. Sugar and butter have long been the
centerpiece of Southern cuisine and thus the foundation of many of the foods
that we ate at home. We immediately cut back on not just how many
carbohydrates she consumed but the types of carbohydrates. Getting them from
better sources was important in controlling her blood sugar, and this was a
change that could be made immediately.
The second thing we did was go down to the local gym, where she signed up
for a membership. This doesn’t sound too groundbreaking now, but my
grandmother was a plump little church lady who probably hadn’t exercised
regularly in fifty years. At the time I took her to the gym, it was not common to
see senior citizens there exercising with the younger crowd with loud music
piping in from the ceiling speakers. I had been an athlete all of my life, and
although I was new to medicine, I was a veteran sportsman. My brother and I
taught her the machines and devised a little workout for her that was challenging
enough but also something she could actually do. Here she was, my little
grandmother in pants and sneakers, walking her hardest on that treadmill next to
a 250-pound football player trying to do wind sprints. It’s an image that I will
never forget.
After three weeks of better eating (not perfect, but better) and a regimen of
exercise (four days a week, about 20 to 35 minutes each time), my grandmother
went back to the doctor for a follow-up visit. I will never forget what she said
when I talked to her on the phone from school. The first thing the doctor said
when he got the results of her blood work was, “What have you been doing?
Your blood sugar levels have gone down so much.” My grandmother proudly
told him that she was watching her sweets and that she was exercising. The next
thing he told her brought tears to our eyes. “I am going to have to cut your
medication in half, because your sugars are so low you don’t need that much
anymore.”
Diabetes can be frustrating and challenging and exhausting, but for the vast
majority of people who live with it, it is manageable and controllable. My
grandmother did it without many of the resources or facts that are known today.
She, too, was scared and sad, facing changes in her senior years that were
revolutionary and unthinkable. But she executed simple lifestyle changes that
made a big difference in her life, and she no longer felt like her diabetes was
controlling her; she was controlling it. Eighty million people are thought to be
prediabetic—on the verge of true diabetes—and most don’t even know how
close they are to that precipice.
This book is designed not only for prediabetics and those with diabetes but
also for anyone who simply wants to cut down on sugar consumption, lose
weight, and lead the healthiest life possible. In just five weeks, you can take your
life back and regain control of your health destiny, avoiding a lifetime of chronic
and life-interrupting illness. Blast the Sugar Out and put the life back in!
—Ian K. Smith, M.D.
April 2017
