DEAR DR. ROACH: Any suggestions on how to reverse type 2 diabetes? –CB
ANSWER: Strictly speaking, once you have diabetes, you are still diabetic because the diagnosis is considered “stable” or lifelong. However, many people can control their diabetes without medication, so blood sugar always stays within the normal range, which is pretty close to reversing diabetes.
The three most important areas of diabetes control are diet, exercise and weight. Although I can give a lot of information about diet, the most important factor is the reduction of sugar and starches (which quickly turn into sugar). Not all carbs are bad – vegetables and legumes, which are primarily carbs, contain very little starch and sugar and high amounts of fibre, being one of the basics of a healthy diet for diabetes, as well as healthy protein sources. A registered dietitian or nutritionist is an essential partner in diabetes care. Cutting out breads, pastas, and rice entirely (or nearly so) makes a huge difference in blood sugar levels.
The body makes its own sugar, and regular exercise not only uses up blood sugar, it also trains muscles to use sugar more efficiently. Exercise alone won’t reverse diabetes in people with 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 greater weight is generally correlated with greater insulin resistance. However, a person can have type 2 diabetes and be very thin, and most overweight people do not have diabetes. For most people, a diabetic-friendly diet and regular exercise will eventually lead to weight loss, but it will still lead to better health, even without losing a pound.
DEAR DR. ROACH: Lately I’ve heard of a relationship between COVID vaccines and a significant increase in heart-related deaths. Please see the latest information on this and your recommendations. — PBO
ANSWER: Although there are many published studies and, unfortunately, misleading conclusions on social media based on flawed analyses, the best data comes from the UK, where all-cause mortality is very significantly reduced in people who received the COVID vaccine, compared to unvaccinated people.
A separate Florida Department of Health analysis also found lower all-cause mortality across all age groups among the vaccinated compared to the unvaccinated. This is likely because contracting COVID is a major risk in several types of death and the vaccine is effective in preventing severe COVID.
Certainly, in high-risk groups, such as people with heart failure, the vaccine is very powerful in preventing death. 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 vaccinated should get vaccinated, and it’s more important for people who have more risk factors. Older people, those with heart or lung problems, and those with immune system problems due to a medical condition or its treatment are particularly at high risk and should ensure they are fully immunized .
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Dr Roach regrets that he cannot respond to individual letters, but will incorporate them into the column whenever possible. Readers can send questions to ToYourGoodHealth@med.cornell.edu or mail to 628 Virginia Dr., Orlando, FL
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