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Reversing Dementia IS Possible

This is the story of a friend who wishes to remain anonymous. His words. His experiences. And they are amazing!

“I joined this group (a FB group) to help my mother who is 69 years old, has had type 2 diabetes for about twenty years now and has developed many complications although none of them are quite life threatening YET. She also has Alzheimer’s which makes it very difficult. She had followed the ADA guidelines yet she got progressively worse and now needs insulin. With her Alzheimer’s the doctor put her on a pump. Either one of my sisters, myself, or a visiting nurse checks on her twice a day to make sure she is under control. Recently one of my sisters or myself have been staying with her. She will go to the kitchen and eat huge bowls of cereal with skim milk or anything sweet or carby that is in the refrigerator so her levels have sky rocketed. My sisters have said its okay.

About a year ago I noticed a woman at my gym who I see periodically and has been losing a lot of weight. Then a few months ago I overheard her talking to some other people about her keto diet. I finally talked to her and she told me about her diabetes, she told me about this group, and she suggested ways to get my mother on it but my sisters did not agree at all and it has created a lot of fighting with them. I will admit that they do much more of her monitoring then I do but about three weeks ago I convinced them to take a break and I have been living with her 24/7. I know this woman Karen at the gym is not a health care professional but I hired her to come to the house to help get rid of the foods that are not on the diet and to stock the refrigerator with good foods. I was very afraid that my mother would start complaining about what I fed her especially because she was always complaining that we were trying to starve her even though she’s over a hundred pounds overweight and was eating three or four meals a day plus snacks. I should add that she has neuropathy and because of her Alzheimer’s she forgets to use her walker and so she also falls.

Karen went way beyond the time I paid her for and cooked some meals and visited with my mother. We never told her that we were changing her diet. After a few days she stopped complaining about being hungry even though she was already eating a lot less. Her blood sugar used to be from 60 to 350 and sometimes over 400. Now it has never gone above 172 and is usually under 140.

I cannot believe it in three weeks. She has also lost 18 pounds and is not falling. The biggest surprise to me is that she is not as confused and her memory is so much better that I can not believe it.

My sisters had been out of town but they came back and saw my mother one yesterday and the other two days ago. I showed them her insulin use which is less than half what it has been and her blood sugar levels. But they both cried when my mother started asking them questions about their trips and acted like a completely different person. She remembered their names and when my one sister said she was visiting her son my mother asked what college he was in. Well, she used to ask when he was going to graduate from high school. When my mother told her it was Lehigh she apologized and said oh yes, I’m sorry I forgot what is he studying? She said engineering and my mother was happy and said oh, just like his grandfather he would have been so proud.

We both cried again because my mother used to ask where he was and why he hasn’t come home yet. The other sister has a house down the shore and my mother asked her if that is where she was on her vacation. She never once yelled at them for not visiting her which she used to do even when they would come every day. And she is remembering to use her walker every single time now so she is not falling.

My sisters are now onboard. I have invited one to the group and the other promises to follow whatever I say. We have not seen her doctor yet but she has an appointment in a few weeks.

I have also been eating this way because that is what I have been feeding her and even though I don’t have diabetes I feel a hole lot better.

I want to thank everyone in this group. I have not said anything before because I’m not like that but I had to speak up now and thank every one. I also have to thank Karen V. for introducing me to this. She never asked for money but I had to pay her for some of her time. I’m sure she would have come out for free because she is so into this diet and promotes it at the gym all the time. I honestly thought at first that she must be selling something but I was surprised that no one here is selling anything accept getting healthy.

And one more thing. My mother has stopped asking for more of her Cinnamon Toast Crunch cereal or hot chocolate and now asks for more of the yummy bullet proof coffee which I sometimes make with tea instead.”


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Just What is Ketosis?

I often get the question, “what is keto?” Sometimes, I hear, “keto’s dangerous.”  Various myths surround the word “keto” and ketogenic eating.  So, I thought I’d address some of these common myths and tell you the real truth about keto.

Ketogenic diets were first used therapeutically in the early twentieth century; prior to the development of medications for seizures, a keto diet was prescribed to manage epilepsy and seizure disorders with fairly good results.  Today, it is prescribed by medical providers and typically provides 3 or 4 grams of fats, preferably medium-chain triglycerides, to every gram of protein consumed.  Ketogenic eating is often closely monitored by medical providers and dieticians when used to control or reduce seizure activity.  Studies have shown a 50% reduction in seizure frequency in half the people who try it, and in about 1/3 of people that use it, a 90% reduction.

Stories abound of medical providers in the early 1920s of “curing” seizure patients with fasting and low carbohydrate eating; once medications were introduced, ketogenic eating fell by the wayside until media mogul, Jim Abrahams, had a son with epilepsy that was difficult to manage with medications.  Dateline featured Charlie on an episode in 1994, where the family discussed their great success with ketogenic eating to reduce seizures.  This huge improvement prompted Abrahams to create The Charlie Foundation to help educate others about ketogenic eating as a treatment for seizures.  Throughout the 1990s, much scientific interest focused on ketogenic eating, and eventually, the movie, Do No Harm, was released; Meryl Streep starred in the story about a boy whose seizures were managed with a low carb, ketogenic diet.

Not long afterwards, Dr. Robert Atkins made the Atkins diet very popular among dieters; he published books and products geared to help people lose weight using high protein versions of ketogenic eating.  Atkins popularized keto eating significantly and his diet books and products remain popular today, even though the newest version of “the Atkins diet” is much higher in carbohydrates than his original plan.

With the use and popularity of the internet, more and more information became available over the last 20 years or so.  Research articles that once only appeared in expensive medical journals were making their appearance online and to the average consumer.  People tired of using the same old diet advice they’d heard for 50+ years, only to discover they gained weight, became diabetic or even BOTH.  Bloggers began writing about their personal successes with keto dieting; their before and after photos spoke volumes and their following amassed.

However, many nurses and doctors began to strike fear in the hearts of these keto-ers, and they began to say ketogenic eating is unhealthy & dangerous. Because their only knowledge of keto had always been associated with diabetic ketoacidosis, most providers shunned keto diets, and instructed their patients to “stop it immediately because it’s terribly dangerous.”  Patients were then stuck between a rock and a hard spot, so to speak.  They respected their providers – well-trained and highly educated physicians, nurses, & dieticians, but they also were firm in the belief that their health was better than ever before – terrific weight loss, lower glucose, improved A1c, and even healthier cholesterol levels.  How could this be?  How could something so helpful to so many be disregarded with prejudice by such educated medical professionals?

As I mentioned before, diabetic ketoacidosis is a very dangerous complication of diabetes and very, very high glucose levels; it’s most common in Type 1 diabetes, but does occasionally occur in Type 2.  When DKA occurs, glucose levels are typically over 300, ketone levels in the blood are very high, and electrolyte levels get really out of balance.  Potassium levels most often go very high, and this is one of the major reasons DKA can be life-threatening.  Potassium is vital for all muscle function in the body; too much potassium can cause extra-excitability or overstimulation to muscles – the heart muscle just cannot tolerate such stimulation; this excess stimulation can result in very dangerous heart beats and rhythms; some are deadly.

Can you see now, why many providers hear only PART of the word and freak out?  Let’s take a look at the entire phrase: diabetic ketoacidosis.  It occurs in people with diabetes and typically with very high glucose levels, usually over 300.  Normal glucose is less than 120.  The blood and urine will both exhibit high levels of ketones AND, electrolyte levels get so imbalanced that the blood is very acidic.  When this state persists for even a few hours, the person:

can become terribly confused,

complain of fatigue and loss of appetite,

may have shortness of breath, blurry vision, vomiting,

or exhibit an imbalanced gait.

All of these signs and symptoms are observed in concert, NOT in isolation, to make the diagnosis of DKA.  This condition requires careful insulin dosing and specific medical treatment, and is done within the hospital because of the dangerous electrolyte imbalances that can trigger fatal symptoms.  People are often on heart monitors, IV fluids, and round the clock glucose checks and routine insulin injections for 2-5 days.

Now, imagine that the above setting is the only place you’ve ever head the word part, keto.  What would YOU think if you heard it at the local community center?  Or in a chat with a friend? Or maybe online in a social media post?  Thus, the fear of the word “keto” was born.

Have no fear, however! Keto is a word PART – not a whole word.  As a word part, all it means is that ketones are produced in the body.  Just as we discussed above, ketones ARE present and elevated in DKA.  But ketones can also be present during a stomach bug because vomiting & diarrhea can alter the body’s use of fuel, causing a NATURAL state of ketosis.  Ketosis simply means that the body is burning fats instead of sugars for energy.

Burning sugars for fuel is easier for the body and so, the body will follow the path of least resistance; it will burn glucose for fuel as long as it’s present in the bloodstream.  However, the bloodstream only WANTS about 4 grams or 1 teaspoon of glucose floating around in it all the time.  So there may not always be a steady amount of glucose for all the activities your body wants to enjoy.  A good example is a workout at the gym; how many of you “carb-up” prior to your workouts? Why? Because the 4 grams of glucose is not sufficient to meet the energy needs of your workout.  The major problem is that the body isn’t going to let all that glucose STAY in the blood and a lot of it won’t be needed for exercise; so, intake of glucose triggers the pancreas to release insulin.  Insulin’s job is to quickly move glucose OUT of the bloodstream; insulin transports glucose out of the blood and INTO fat cells for storage.  If we were meant to consume huge amounts of carbohydrates, don’t you think our bodies would be much more tolerant of having hundreds of grams of glucose INSIDE the bloodstream?  This erratic process results in very high glucose levels that alternate with very low glucose levels, and can eventually contribute to symptoms of fatigue, thirst, and frequent urination – or diabetes.

However, if we restrict carbohydrate intake, the blood level of glucose stabilizes, less insulin is needed to manage the carb intake, and the fluctuating peaks and valleys of glucose control fades into a much more stable range  because the body learns to be fueled by ketones.  Ketones are made in the liver from fatty acids.  Fatty acids are the smaller components of the fats we eat.  One of the most common ketones is beta-hydroxybutyrate that is a fatty acid our bodies obtain during the digestion and breakdown of butter; in fact, it is butter’s namesake.  This particular ketone is used for energy and is also helpful in digestive processes; it crosses the blood-brain barrier, and is thought to be of clinical relevance in treatment of epilepsy, depression, anxiety, and even cognitive impairment.  Now, don’t you want to add MORE butter to your plate today?

Can you see now, how the use of ketones for fuel is actually healthy and beneficial?  And how ketosis and ketoacidosis are 2 totally different and separate concepts?  Ketosis is a natural process the body uses for fueling activities, and ketoacidosis is a terrible and dangerous health condition associated with out-of-control sugar levels.

Another common question I hear often is about testing for ketones “to be sure I’m in ketosis.”  Well, you certainly CAN test for ketones, but testing can get expensive and if you’re consuming less than 20 grams of carbohydrates daily, your body WILL go into ketosis.  It won’t have a choice.  Our bodies need fuel – either glucose or ketones are the preferred fuels.  During the transition period, people do report bad breath as a result of increased ketones in the blood.  The body actually is a bit confused at first; it’s been burning glucose for all these years and now, there’s no glucose coming in to the system.  So, the body senses a need to rid itself of “excess” ketones, so you exhale some and some are expelled in urine; a few accumulate in blood.  After about 4-8 weeks (on average), most people will have become “fat-adapted” and will no longer experience bad breath or ketones in the urine.  Why? Because the body has learned to utilize all the energy available; it won’t continue to “spill” or waste the fuel it needs for body processes.  Testing after this length of time is often frustrating to people who think that somehow, they are no longer in ketosis.  That is NOT true, however.  It’s simply a matter of efficiency; the human body doesn’t waste much; it’s wired to conserve, reserve, and reuse many chemicals and products.  Ketones are fuel for the body and will NOT be routinely wasted.

Testing for ketones is pretty unnecessary for most people eating a low carb diet; for people with very high glucose levels, it may be necessary during the transition phase from high carb to low carb eating, because of the risk for developing DKA.  Urine & breath testing aren’t always reliable, and once fat adapted, you won’t be spilling any ketones in either of these waste products.  Blood ketones can be tested, if necessary, and is the most accurate measure.  The image below is from the book, The Art & Science of Low Carb Living, by Jeff Volek and Steve Phinney.  In this image, you can see the area of optimal blood ketones is MUCH lower than those typical of a patient in ketoacidosis (far right).  You can also see by the rise in the green curve that the brain and muscles function optimally in this healthy range of blood ketones.  Ketosis is the natural process by which the body uses fats, or specifically ketones, for fuel.  It is normal and natural.  It is not dangerous.  It won’t cause harm.

Hopefully, this article has provided you with a decent amount of information that will help you understand ketosis and how it impacts our bodies and health.  For more personalized help, please feel free to send me a PM via Facebook or Twitter.

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Keto Pepper Poppers

Just in time for the big game, we have a delicious low carb finger food to add to the table!

12 jalapeños, seeded and halved

8 ounces of softened cream cheese

3 tbsp. sour cream

1/2 cup grated cheese (any type or combo)

2 tsp minced garlic (More can be used)

1/2 tsp onion powder

Preheat oven to 375. Mix all in mixer until well blended. Spoon into pepper halves. Place in baking dish or on cookie sheet.

Bake for 9 minutes and then turn to broil for 3-5 minutes, just until tops begin to brown.


Depending on the types of cheeses you choose, carb count is approx 1 gram per jalapeño half, or 1.5 -2 grams for every whole pepper.

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Creamy Keto Soup

This recipe is a great base for most any type of creamed soup you enjoy. I used frozen spinach in my batch, but sautéed Brussels sprouts,  mushrooms, or asparagus would work just fine instead.

Creamy Keto Soup

32 oz heavy cream

1 1/2 cup water or broth

6 oz cream cheese

1 cup shredded white cheddar

1 tsp minced garlic or 1/8 tsp garlic powder

1/4 tsp salt

1/4 tsp pepper

1/8 tsp cayenne pepper powder (optional)

Heat all ingredients in medium saucepan over low heat, stirring nearly constantly. Add additional seasonings to taste after about 20 minutes and all ingredients have melted and mixed well.

Add 1 – 1 1/2 cups of frozen chopped spinach or other veggie of choice. Most veggies will do best if sautéed or parboiled prior to adding to creamed mixture.

Heat thoroughly over low heat with frequent stirring; total cook time for my batch was about 45 minutes.  You can cook over low heat for a longer period of time, but remember that heavy cream will reduce down over time, creating a thicker Soup. Serve.
Makes approx 2 quarts of Soup, unless you cook it down to thicken it more. Keeps well for several days in the fridge. I also think it tastes even better the next day!!

This creamy soup base is totally awesome for cooler fall days! Let us see your version; post pics of your Creamy Keto Soup on our Facebook page.

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Measures of “Improving Health”

Recently, another health care provider mocked my use of the phrase, “improving the health of my patients”, saying that it’s vague and not measurable.
Her comments gave me pause, because the goal of every nurse I’ve ever met has been to help people improve their health. Ask any nurse why he or she became a nurse, and you will hear a variety of ways people say it. We nurses help people get well, better, or over a health obstacle. How is that measured?
First and foremost, there are many parameters used by health care providers to measure health. With diagnoses of diabetes and hypertension, we measure glucose and blood pressure, respectively. But we often have difficulty quantifying how people feel when they lower their glucose or blood pressure. When patients return for follow-up and I’m able to tell them their hemoglobin A1c dropped from 8.9 to 6.4 after weeks of diet changes and effort, people are thrilled. They grin from ear to ear. They clap. They shake a fist in the air. They “high five” me. Some even do a “happy dance.” What is measurable here? Yes, the glucose levels are numerical and easy to track. But how does anyone put a scale on happiness or joyfulness? Can the idea that diabetic complications no longer pose a looming hazard to health be measured? How is relief quantified when kidney damage has improved?

These feelings are not measurable, yet they are extremely evident in behaviors and attitude. Patients who work toward improving health exhibit gratefulness that good instruction is provided; is that gratitude measurable?
Measures are important in health care. Measurements of pulse or blood pressure provide vital information to us who render the care. I decided that some of you might be interested in knowing what measures we use for certain conditions so you can track your own progress over time.
With diabetes, one of the most important measures is glucose, of course; in addition, the hemoglobin A1c that tells us the average glucose levels over the past 90-100 days provides a good correlation to patient effort in managing the condition. While mainstream medicine will say that “good” diabetes control occurs when the A1c is around 7, many studies have shown that diabetic complications occur when the A1c runs higher than about 6.2 or so. Normal A1c levels run around 5 or less; why should people diagnosed with diabetes be forced to run glucose levels so high that we KNOW organ damage will occur? Is that going to help patients “improve their health”?
Elevated blood pressure is often associated with diabetes because high glucose levels cause thick, sticky blood; demanding that the heart pump thick, sticky blood to an overweight body will eventually result in high blood pressure. The heart will pump harder and with more force to move thick “syrupy” blood through tiny blood vessels, resulting in higher and higher blood pressure readings. When blood pressure increases, the heart muscle becomes compromised and weaker. Daily demands on the heart that continually exceed it’s designed capabilities can contribute to a multitude of vague symptoms which are not measurable, including headaches, fatigue, nausea, dizziness, or even mild swelling. While most of these symptoms have no quantifiable scale, patients will describe how much better they feel once blood pressure is lowered. While blood pressure is measurable, the feeling of lower and healthier blood pressure is described by patients as “improved health.”
If blood pressure remains untreated or poorly managed, heart failure and/or kidney damage begin to occur. Highly pressurized blood flow moving through the kidneys will damage the fragile vessels, reducing the filtering ability of the kidneys. Elevated glucose can also damage these tiny vessels, resulting in inflammatory responses by the body that are designed to patch and repair damage – but this natural response by the body can result in blood vessel blockages. Think scar tissue.

In this photo below, notice that cholesterol is serving as the patch, relating the damage to the blood vessel. Cholesterol isNOT the cause of clots; it’s part of the damage control/repair team of the body. In summary, how do we measure “improved health”? How can we quantify patient comments when they express gratitude for how they feel? How can we count the number of clinic visits these patients will NOT have? How do we track hospitalizations that do NOT occur for these patients? What evidence do we see when ER visits are no longer the norm for people with “normal” glucose or blood pressure? We can’t. But these numbers ARE real. These people ARE changing their lives and IMPROVING HEALTH!

If you want to take charge of YOUR health, email us for more info at

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Teresa Reversed Her Diabetes!


I am VERY honored to introduce y’all to a very special friend of mine.  I have known Teresa since our children were in kindergarten together, about 25  years ago.  She recently reached out to KetoNurses, looking for something different.  Here is her story in her words.

Teresa Toten, July, 2017


My name is Teresa, and I live in rural Mississippi.  I am a wife, a mother of four boys, and a grandmother to four.  Over the years, I have worked and taken care of my family, but I really did not pay attention to my health.  My weight slowly continued to creep up on me; after the birth of my children, I never really did go back to my pre-pregnancy weight.  I accepted the “fluffiness” as my new norm.  I worked, I came home, and the cycle repeated itself daily for years, leaving little time for exercise.


I have worked as a legal assistant for almost 17 years, during which time most of my work surrounded workers’ compensation claims and social security disability claims.  Little did I know, that I would also be injured on the job.  On February 20th, 2015, I underwent a multi-level anterior cervical discectomy and fusion (ACDF).  Recovery was slow and painful; in addition, I suffered another injury just weeks after my ACDF surgery – this time to my sternoclavicular (shoulder) joint and collarbone.  The doctor felt that the best course of action would be to undergo steroid injections along with trigger point injections.  Over the course of the next two years, I underwent many of these injections with little to no relief.

June, 2017

In July, 2016, I noticed that I was losing weight without trying; my hair was thinning and falling out in clumps; my face was red and splotchy; my vision was rapidly blurring, and I just all-around did not feel good at all.  I assumed that I was having an issue with my thyroid as thyroid problems do run in my family.  So, in August, 2016, I decided to see a doctor about my concerns.  He ordered the usual rounds of blood work and said he’d get back to me within a few days with the results.  Two days passed, and I received a call from the doctor’s office and said I needed to come in immediately to discuss the results.  I just knew it was my thyroid but at least I had an answer.


Day 1 of Keto Nutrition, April, 2017

I went in to the appointment the next morning, and he asked me if anyone had ever talked to me about the big “D”.  I must have looked confused so he patted me on the knee and said that it was diabetes.  We discussed my family history of diabetes (grandmother was diabetic; mother was hypoglycemic).  We discussed my personal history, my eating habits, my lack of exercise, my weight (200 pounds) and my recent surgery and ongoing injections.  He was concerned that my workers’ compensation doctor had not disclosed to me the dangers of rising blood glucose levels while on the injections, and I had been getting them for two years. He told me that my A1C was 12.8.  He explained to me that my blood was telling him the average blood glucose over the last three months was around 375; he also told me that those numbers were not good at all.  He immediately started me on Metformin ER, 500 mg twice a day but also wanted to test my kidney function before beginning.  The results came in… kidneys were okay.  So, he started me out on a long acting one called Tresiba.  I started out at 10 units.  My numbers remained high.  The next week, he added 2 units.  My numbers continued to climb.  My fasting blood glucose levels remained above 200.  My afternoon glucose levels barely dropped.  Insulin dosage increased.  So, after months of trying to stabilize my blood glucose levels, he added Novolog at mealtime.  This addition of mealtime insulin helped my afternoon blood glucose numbers come down a bit, but not where they needed to be.  So, he increased my Metformin to 2000 mg a day.


May, 2017

I attended every class that this small town offered to help me learn to manage my diabetes.  I followed the ADA guidelines to the letter.  My numbers continued to rise even though I was eating the way a diabetic is instructed to do.  I just did not understand why I could not get a grasp on my health, and this diabetes was trying to take over my life.  I meticulously kept a log of what I would eat on a daily basis, making sure that I had the proper amounts of protein, carbs and vegetables per the ADA recommendations.  My numbers continued to rise.  Yes, I managed to lose a few pounds in the process but was still grossly overweight at 188 pounds.
So, in frustration and heartache, I reached out to a friend of mine here at KetoNurses for advice on lowering my numbers.  She sent me links to articles on the blog, and she added me to a Facebook group whose main goal is to educate people on methods to use nutrition to help lower glucose and reverse diabetes.  I mean, what did I have to lose besides 2000 mg of Metformin, 30 units of Tresiba, and 16 units of Novolog (per meal) three times a day.  I was ready to get my life back in order, take control of my health, and come off of the medication I was on.


So, in April 2017, my keto food list in hand, I made my way to the grocery store to start my new way of eating.  I loaded my cart with items from the meat department, and produce department.  I did not shop down the center aisles for anything.  There were no foods in packages, boxes or bags.  There were no cereals, pastas, rice or potatoes.  There were no fruits, candies, cakes or cookies.  The only thing in my cart was good, wholesome and keto approved foods  I was ready to tackle this way of eating.

On day 1, I took a full length photo of myself.  I weighed in at 188 pounds.  And, I ate.  And, I ate.  I cooked using bacon grease.  I added fat to my vegetables.  I made a cinnamon apple butter tea.  I tracked everything that I did.  I measured all of my food so that my logs were precise.  Day 2 was more of the same.  On or about the 4th or 5th day, keto flu kicked in.  My friend advised me to drink salted broth.  I did and I muddled through the aches and tiredness.  Weeks went by, and I continued to count, to log, to experiment with my foods and my fats.  I got the hang of it.  However, it was not until my first doctor’s appointment after I started this way of eating that the realization kicked in.

My doctor made note of my weight.  He made note of my leaner appearance.   But what really got his attention was my blood glucose numbers; they rapidly fell and stabilized.  So, he had me decrease my insulin dosages and instructed me how to decrease it on my own so that I could do it by myself.  This visit was the first positive appointment I had with him since my diagnosis in 2016.  I was impressed.  So, I continued this way of eating.  I began to notice that my pants were looser, my acne was disappearing, my face was losing its puffiness, my energy levels were increasing, and I just felt better.  I discontinued my Novolog (3 injections a day) and my numbers did not go back up.  I was consistently getting blood glucose readings in the 80’s and 90’s which were a far cry from the 250-300 I was used to seeing.  So, I cut back on my Tresiba.  My dose was 30 units and I am down to 14 units per day.  I also saw my doctor this past week, and he said that he was proud of me.  He said that with the way I am going, that I should be off of my medications (blood pressure meds included) within the next 6 months.

My most recent A1C was done last week and the results are in…..  Last year it was 12.8…  Last week, it was 5.2.  What a tremendous drop!  My cholesterol was a little high at 205 but all other numbers were fantastic.  I enjoyed a great checkup, a great prognosis, a resounding “I’m proud of you” and a “keep up the great work” from my doctor.  He said to keep doing what I am doing, it obviously works. So, I will keto on and continue this way of eating.  It has saved my life, one buttery delicious morsel at a time.
As nurses, we recognize that diabetes has always been considered a progressive condition that always worsens, but we are here to offer another perspective and a totally different outcome for Type 2 Diabetes.  While diabetes may remain on your medical chart as a permanent diagnosis, it IS possible to reverse the condition to a point where complications are minimized or completely eliminated. 

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Fiber – Useful or Harmful?

Fiber has been encouraged for many years in the hopes that it would improve gastrointestinal motility, and many products have been sold advocating such use. Fiber has been recommended by all sorts of health care providers, including doctors, nurses, nutritionists and therapists. Is fiber truly helpful, though? Recent independent studies indicate fiber may be contributing to more symptoms and problems than it’s helping.  As a bulking agent, fiber is used to literally, fill up the space inside the large intestine. The large intestine cannot absorb fiber, nor break it down any further as it moves through the gut. Fiber that enters the colon will absorb excess water, swelling to its maximal capability, filling every space it can occupy. Over days and even weeks of regular fiber use, more fiber enters the large intestine and swells even more, gently pushing swollen fibers forward through the intestines. This action is very slow and can take 2-3 weeks in an average adult. The slow motility means that taking a fiber supplement today will not contribute to today’s bowel movement – not even tomorrow’s. It is the combination of these 2 factors that make us now question the benefits of fiber supplementation: swelling of the fiber and slow motility through the system. With fiber supplementation, many patients report worsening constipation, bloating, abdominal pain, weight gain, gas, cramping, shortness of breath, obstruction and even diarrhea within days of beginning a supplement. While the theoretical goal of fiber supplementation is to slowly clean out the large intestine, the mechanism by which this system actually occurs is problematic and poses some serious health consequences.

We’ve known for a long time now, that some people who consume a high fiber diet often develop diverticulosis – or enlarged pockets along the large intestine. What we have not known or understood is why/how the enlargement occurs, but I would venture to say with this new research data available, that the most likely causes of diverticulosis would be chronic constipation and/or possible high fiber supplement use. Allowing stool to move too slowly through the gut contributes to build-up of wastes, blocking adequate absorption, filling the pockets and getting “stuck” in them. Over time, these static wastes are pushed further and further into those pockets, forcing them to stretch out of shape and become enlarged, even though some stool continues to pass right on by that stuck stool. No symptoms are typically felt or noticed. This problem can create serious illness and severe complication in the form of diverticulitis and obstruction – both of which can be life-threatening.

Moving on to other nutritional aspects of fiber takes us into the nutritional info of foods. Counting carbohydrates is a common nutrition plan for lowering glucose and reversing many chronic conditions. Many low carb experts often instruct people to subtract fiber grams from total grams of carbohydrates, because the fiber is not absorbed or converted into glucose. For example, 1 cup of almonds contains approximately 20 grams of carbohydrates and 11 of them make up the fiber content; some low carbers will say that eating 1 cup of almonds actually only contains 9 grams of net carbs, and thus you only have to count the 9 grams in your calculation of carbs consumed. However, many people with diabetes find that they will have a rise in glucose above and beyond the 9 grams of carbs in that cup of almonds. Why? Some low carb experts suggest that some of the insoluble fiber can impact glucose in many people; in addition, normal gut flora include a variety of healthy bacteria that ARE able to break down some of that insoluble fiber, possibly resulting in glucose release into the GI tract/bloodstream. In addition, some of these insoluble fibers are used as artificial sweeteners, like mannitol, xylitol, & erythritol; manufacturers are catching on to the “net carb” craze and are beginning to produce and label many processed foods using these sugar alcohols. However, there are a couple of problems here; one problem is the elevated glucose with use of these products. The other problem is because these sugar alcohols are insoluble and not easily digestible, they often trigger abdominal cramping and diarrhea in patients, which alters normal gut flora, resulting in even more damage to the gastrointestinal tract and overall health.

Gut flora? Hey, what is that? Well, our intestines are lined with millions of microscopic bacteria that aid in intestinal lining protection, digestion, absorption, and immunity. In fact, some experts now believe that more than 90% of our immune system lies within our intestines. Nearly all of our bodies’ healthy bacteria are located within the intestines, and the job of these bacteria is to break down fiber that your body wasn’t able to break down. During this bacterial digestion of fiber, short-chain fatty acids, like butyrate, are formed and are used to help maintain a feeling of fullness for a long time and maintain the health of the lining of the intestines.

Once the normal balance of healthy bacteria is altered, digestion and absorption are impaired, the lining of the gut is damaged, and inflammation develops. Inflammation within the gut can trigger a wide variety of symptoms and health conditions, including diarrhea, irritable bowel syndrome, leaky gut syndrome, obesity, diabetes, Crohn’s and more. If altered gut flora is contributing to poor digestion, absorption, and diarrhea, how will the body obtain nutrients? How will the large intestine properly push wastes on through the system? If the short-chain fatty acids are no longer produced by the healthy gut bacteria, we get hungry again and again – we eat more often, and we’re more likely to eat nutrient-poor fake foods. If the specific short-chain fatty acid, butyrate, is not available for increasing energy production and for cell replication, damage to the lining of the intestines may be serious, resulting in a variety of illnesses including cancer. Combine all these factors and significant intestinal conditions develop or worsen and health is impaired.

So what does all of this information mean? In summary, it means that fiber may be useful for digestion, but not as added supplements, tablets, or pills; rather, the body much prefers natural forms of fiber – low carb vegetables and pre-biotic vegetables – but because of likely glycemic impact, fiber grams should always be counted on a low carb nutrition plan. The only way to know for sure if these insoluble fibers impact your glucose is test. Use a glucometer to check blood sugar prior to eating insoluble fiber. At 1 hour increments, re-check glucose levels and watch the trend over 4-6 hours.

Probiotics can be purchased over the counter and come in a variety of formulations; some come in single strains, while others come with a combination of healthy bacteria. Probiotic supplements contain active, live healthy bacteria, that are released during digestion to colonize the intestines. There are no specific recommendations or guidelines to take probiotics, although many people claim daily is optimal, while others say weekly is sufficient.

Another digestive aid is called a pre-biotic, certain vegetables or foods that actually serve as nutrition sources for the healthy bacteria within the gut. Pre-biotics include asparagus, sauerkraut, kefir, kumbucha, fresh garlic, leeks, and onions.

As mentioned previously, short chain fatty acids (SCFAs) are essential to our digestive system. While there are several SCFAs, butyrate is probably the most common and one of the most useful; butyrate is helpful at maintaining intestinal health and one of the best sources of butyrate is real butter.

What causes altered gut flora? Well, let’s start by taking a look at some causes. Smokers often have higher risks of GI conditions, including ulcers. Diabetes and the medicines used to treat it often cause terrible gut flora, especially metformin. Approximately 85% of people with reflux have been found to also have chronic constipation, and the medicines used to treat reflux significantly alter the pH and thus impair the ability of healthy bacteria to enjoy an optimal environment. Antibiotics are designed to kill off fast-growing bacteria, in order to treat infections, but the antibiotics have no idea that they are supposed to only kill the bacteria causing your sinus or skin infection; antibiotics are most commonly recognized for causing abdominal cramping and diarrhea – symptoms of gut flora imbalance. Simple little GI viruses or mild cases of food poisoning nearly completely empty the gut of healthy bacteria. As you can see, almost anything can alter the health of our intestinal tract.

So, what does all this mean? In general, it means that 1.) our guts may need some fiber in the form of non-starchy vegetables, 2.) healthy bacteria are necessary for optimal digestion, 3.) any GI upset can alter the normal gut flora,

causing a wide variety of GI symptoms, that alter health. 4.) Probiotics can be helpful at restoring normal gut flora, and a couple of weeks later, adding in prebiotics is often helpful at maintaining GI health.

One special note: recently, I’ve seen marketing of soil-based probiotics. I’d caution you to avoid using these probiotics, as humans weren’t meant to consume soil. Animals consume soil in small amounts when grazing and can use these types of bacteria in the gut, especially ruminants – like cows. But these probiotics can actually be harmful to humans.