Life's 2 Short

By Pieter C. Naude

We have been sold so many lies for the sake of perverse profits. Big Food, Big Agri, and Big Pharma do not have our best interests at heart. Only profits.
If you think the medical profession is without fraudulent intentions, you need to reconsider your beliefs. Profit is what drives marketing campaigns and narratives. It is not to share vital information; it is to get you and your healthcare provider to add one more drug to your portfolio.
Metabolic conditions like obesity, type 2 diabetes, and hypertension are merely managed; not cured. People become sicker, and this is the goal: to turn peoples' conditions into a lifelong income stream.
Big Food makes you sick; Big Pharma manages your condition. No attempt is made to reverse any condition – they only add more drugs. Insulin resistance and type 2 diabetes are fast becoming the biggest health threats of modern life – mostly due to poor lifestyles.
Every 30 seconds, somewhere in the world a leg is lost to diabetes.
In this book, the author traces a line through the reasons and root causes behind some of these conditions. Aimed at the patient base and in an easy-to-read format, this is not an academic showpiece – rather, it's an important chat with the man on the street. It is a pharmacist's perspective on type 2 diabetes, lifestyle, nutritional principles, and positive outcomes – ending with a clear plan to take back your metabolic health through nutritional and lifestyle changes.
Our health is contracted to various well-meaning professionals, and that is good. It keeps us alive. But – should the control panel not be in your own hands?

• Language: English
• Publisher: Pieter C. Naude
• Release date: Nov 20, 2023
• ISBN: 9798223281023

Book preview

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Copyright © 2023 Pieter C. Naudé

First edition 2023

All rights reserved. No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording or any information storage or retrieval system without permission from the copyright holder.

The Author has made every effort to trace and acknowledge sources/resources/individuals. In the event that any images/information have been incorrectly attributed or credited, the Author will be pleased to rectify these omissions at the earliest opportunity.

Published by Pieter C. Naudé using Reach Publishers’ services,

P O Box 1384, Wandsbeck, South Africa, 3631

Edited by Nikki Burnette for Reach Publishers

Cover designed by Reach Publishers

Website: www.reachpublishers.org

E-mail: [e-mail]

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Pieter C. NaudE

[e-mail]

Every 30 seconds a leg is lost to Diabetes somewhere in the world.

A startling 67% of amputations in the US are because of type 2 diabetes mellitus,¹ of which 75% could have been prevented.

A pharmacist’s perspective

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¹ E. Almekinder, ‘Diabetes and amputation: Everything you need To know To avoid amputation’, The Diabetes Council [website], 1 June 2020, https://www.thediabetescouncil.com/diabetes-and-amputation-everything-you-need-to-know-to-avoid-amputation/ (accessed 24 April 2023).

Dedication

Without the authors in the last chapter, I would not have been in such good metabolic health at the age of 65. Their constant struggle against the narrative and the curse of incorrect health protocols is a truly great battle.

Without them, I would not have even contemplated writing this book.

My wife, best friend, and the world’s greatest cook made it possible to follow a lifestyle which is outside the traditional paradigm. Her ability to adapt my diet continuously and the wonderful recipes she presents make it possible to follow this way of eating and enjoy every wonderful meal. Renette, you are the star of this show!

Family and friends who entertained my ‘weird’ eating habits and ‘strange’ lifestyle: Thank you!

The few patients who listened and changed their lives: You are my constant motivation. Thank you and keep up the good work.

In loving memory of my late brother Philip, who tried his best to control his type 1 diabetes but finally succumbed to sepsis in March 2023. You fought hard and bravely, brother. We tried everything but alas, your body gave in to the devastating infections. You are the reason for my lifelong passion for metabolic health and the management of diabetes and I dedicate this book to you.

The tide is turning on metabolic health. More people are seeing the light; more people are reaping the health benefits as explained in this book.

1

Introduction

Another book on diabetes and lifestyle? Surely there is enough literature on the subject, all researched, compiled and published by big-name specialists. There are textbooks, countless studies, musings about diet (with some awesome – or is it awful – recipes) and exercise regimes.

Yes, there are. But in my humble opinion, they aim most of those works at the academic community with strange terminology and countless tables and graphs. Are there sufficient books that speak to the patient in a language he or she can understand? Some books leave me gasping for air halfway through the introduction!

So, with over forty years in clinical community pharmacy, I may have seen more than a couple of prescriptions for diabetes and the subsequent cascade of metabolic conditions. This has always bothered me. I never saw a patient’s medicine profile reduce. It always escalated from one or two drugs to multiple items (some of which are added to reduce side effects from others). And rarely is the elephant in the room addressed.

It is important to note that throughout this book, the term diabetes always refers to type 2 diabetes mellitus (T2DM). Type 1 is another, almost unrelated condition, the management of which falls outside the scope of this book. There will be a short section on the differences and why it is important (in fact, crucial) to take the steps to make sure which form of this debilitating condition you may or may not have.

Can a pharmacist even address a field that sits squarely in the domain of the family doctor or specialist endocrinologist? And managed in most cases by well-meaning dieticians? Based on the training we received (in my case, in the seventies), I do not think so. They did not train and/or equip us to enter this field in any other way than to dispense the prescribed medicine on the written instructions of another healthcare professional. We may not even discuss the merits of the prescription with the patient. Our regulatory body makes it clear in our ethical rules we are not allowed to question the treatment. Yes, we are obliged to give advice on how to take the drug, side effects, interactions, and other important pharmacological information. Nothing else. No probing questions on the reasons for a particular drug that was added to the growing list of chronic medications. Follow the instructions and hand over the medicine.

But nothing can stop one from wondering why and how this individual is treated the way the doctor decided. Is it the right way? Is it the only way? Could I maybe add value to the treatment and management of a particular condition? Those questions have plagued me countless times, and have now after forty years spilt onto the pages of this book. I now want to address the elephant and add value.

What makes me a quasi-expert in diabetes? I would venture to state: years of research, reading, talking to patients, more reading, and teaching my beliefs to newly diagnosed diabetics. And a few things happened in my life which steered me down this path.

• My pharmacy tutor during my internship in 1980 was a Type 1 diabetic, as was his young daughter. He taught me more about Diabetes than any professor could attempt. I learned about his lifestyle and diet, the dos and don’ts, and the use of insulin (which at that stage was still animal-based and not nearly as refined as they are now).

• In 1984 I diagnosed Diabetes in my older brother. Type 1. He became my case study as I followed the progression of the disease over the years. He recently passed away after an eight-month battle with various infections following a hip replacement in 2022. It made me very aware of the perils a diabetic has to face with infectious conditions.

• In the period 2000–2008, I became a very serious cyclist, competing in many of the iconic cycle races in South Africa. It was obsessive in a way. I was bulletproof (or so I thought). Despite over twenty hours a week of hard training, I could never get my weight to the ideal level of professional cyclists. In addition, I had a clear tendency to easily regain weight during periods of less intense training. What was wrong? Why did I always carry this small amount of visceral (central) fat? A little belly?

• During this period, we started a weight loss clinic in my pharmacy on the south coast. Based on the principle of reducing starchy carbohydrates and sugars, we had some amazing results. Although I preached the lifestyle, I did not follow it, as I thought the body needed carbs to function at the level I was at with cycling. I did not go deep enough into the science and the consequences. No wonder I never got rid of the little tummy!

• After a devastating bout of pneumonia in 2013, I all but stopped cycling. On advice from a pulmonologist, I maintained a very low level of exercise. The weight piled on and soon I was 10kg heavier than in 2008. So, what, you may wonder. With my brother’s diabetes in mind, I started regular testing of my fasting glucose levels. It was always in the ‘normal’ range but in the upper bracket.

• Then came the COVID-19 period. Confined to quarters. No walking, no cycling. Soon another 4kg appeared as if from nowhere. With the scare of the outcomes of this new disease in people with co-morbidities (diabetes, hypertension, overweight), I went for an HbA1c test (see later). Horror upon horror, mine was 5.9% - now classified as pre-diabetic, or a better term insulin resistant. That was the turning point. I knew I had to do something.

With all the prior knowledge obtained, I switched gears away from the pharmacological management of sugar metabolism to lifestyle management. Clearly, I needed much more scientific proof that I was on the right track. Enter the world of low-carb and intermittent fasting (IF). Countless hours of reading and intense study followed, with new heroes discovered and new principles adopted.

And the weight?

Despite a much lower training intensity, I lost the recently added 4kg in a few weeks, then the earlier 10kg, and finally another 2kg. I was now weighing less than I had during the intense cycling period almost twenty years before!

And the insulin resistance?

HbA1c is now maintained at between 4.8% and 5.1%. There is no classification for such readings. It is merely normal (and healthy). In the process, I stopped taking medicine for heartburn (Omeprazole) and reduced the dosage of my hypertension drug (Perindopril) from 8mg daily to just 2mg daily. I may soon stop it completely. At 65 years of age, taking only half a blood pressure tablet