Author Sidebar: Dealing with an autoimmune disease can be very frustrating. Autoimmune diseases are difficult to diagnose because there is no one single blood test that confirms an autoimmune diagnosis. Unfortunately, this creates uncertainty from a medical perspective, which creates uncertainty in your own mind. And, this uncertainty can lead to anxiety, frustration, and fear due to the lack of a clear diagnosis and the lack of knowledge.
For most people with some type of autoimmunity dysfunction, the solution is usually some kind of drug that suppresses the immune system. If the disease pathology is diabetes-related, the solution is usually metformin (Glucophage) -- but, a lot of people have some discomfort with metformin, so, they're given and different drug, e.g. glucotrol, glyburide, glimepiride, etc. And, if that doesn't work, the doctors jump quickly to the ol' standby -- insulin.
Now, I'm not anti-drug -- in fact, drugs (specifically, insulin) saved my life. After I came out of the diabetic coma with a blood glucose of 1337, I was put on insulin to get my blood glucose back down into the 400-500 range.
So, although I was feeling better, eventually, the law of diminishing returns set in and the insulin started to have a negative effect on my health (weight gain, fatigue). I realized that I needed to better understand my disease and figure out what were the right foods to eat.
But, because there was so much conflicting information about what are healthy foods for diabetics, I had to go back to the basics of cell biology to understand how our cells respond to various foods and compounds.
This led me to define several categories of "dead" foods, which included foods that were promoted by experts as healthy foods, but are not actually that healthy, e.g milk, grains, wheat, cereals, beans, canola oil, soy, vegetable oils, fruit juice, corn, etc.
After I wrote my book, I started to meet people with Type 2 diabetes, who we were able to help very quickly. But, there were a few cases where the person had other health issues that "didn't make sense" at the time.
In most cases, these were clients who had been diagnosed as Type 2, but, the metformin didn't work or stopped working. So, they were put on insulin and they felt better -- for a while. But, they started to have other health issues: fatigue, brain fog, lethargy, unwanted weight loss, etc.
What we eventually discovered after a lot of testing (antibody blood tests, vitamin testing, hormone panel, heavy metals, etc.) was that the person had some kind of autoimmune dysfunction.
But, the medical solution here is a some kind of drug to suppress of "modulate" the immune system. But, most drugs cause the immune system to over-react! -- either the immune system under-reacts because the drug suppresses the immune system; or, the immune system over-reacts creating inflammation and an autoimmune response.
And, that autoimmune response can lead to an autoimmune disease such Type 1 diabetes, Type 1.5 diabetes, Hashimotos's Thyroiditis, lupus, etc.
But, what was even more interesting was that in over 91% of the cases, the person also had a leaky gut (Leaky Gut Syndrome). A leaky gut is a disorder where the small intestine becomes damaged with microscopic holes in its lining. These microscopic holes eventually allow small food particles, bacteria and toxins to pass through the lining and into the blood stream.
When that happens, the immune system thinks that the body is being invaded, so it mounts an attack to destroy and remove the "invader". Immune cells such as macrophages and neutrophils eat the bacteria and recruit more immune cells, including cytotoxic T cells (natural killer T cells) which destroy infected cells (some of which may be healthy cells such as the pancreatic beta cells).
Some of the immune cells (usually dendritic cells) activate T helper cells (Th1 cells), which, in turn, activate B immune cells, which produce antibodies to fight this invader. (This is one of the reasons why your doctor checks for antibodies in your blood -- to see if there is an overly active immune system or possible autoimmune disorder).
The good news here is that instead of relying on drugs to suppress the immune response, you can heal your leaky gut and rebalance your immune system by modifying your diet to remove any possible foods that may cause your immune system to over-react, e.g. gluten, milk, grains.
FYI: Most people with these types of health issues experience a lot of fatigue, which is initially due to the cells being unable to pull in glucose and convert it to energy (ATP). When they exercise or take insulin, they feel a temporary lift in their energy levels due to the muscle cells getting stored glycogen from the liver or the insulin "pushing" glucose into the cells. To further complicate matters, a dysfunctional thyroid can contribute to fatigue issues as well.
Why Diagnosing LADA and Other Autoimmune Diseases Is So Difficult
On the surface, it may not seem apparent, especially to most people struggling with an autoimmune disease. Diabetes (blood glucose regulation), thyroid disorders/dysfunction, cellular inflammation, and autoimmune diseases are interconnected.
Why is this important to understand? Because if you try to diagnose and "fix" a thyroid problem by taking a thyroid drug, the drug does not address the interdependencies that may be affecting the thyroid, e.g. leaky gut, chronic inflammation, autoimmune dysfunction, etc.
Similarly, if you have a blood glucose regulation problem, taking insulin to lower your blood glucose, does not address other factors that may be driving your blood glucose levels, e.g. leaky gut, chronic inflammation, thyroid dysfunction, autoimmune dysfunction, etc.
Latent Autoimmune Diabetes of Adults (LADA) Overview
Latent autoimmune diabetes of adults (LADA), sometimes called Type 1.5 diabetes is a slow-onset version of Type 1 diabetes in adults.
Adults with LADA has been increasing over the past 10-12 years. Why is this happening? Because there are so many adults with Type 2 diabetes who have been taking diabetic medication for years, causing their pancreas to "wear out" and/or cause their immune system to over-react and become dysfunctional.
For Type 2 diabetics, their pancreas is working just fine -- but, it's working overtime, producing 2 to 4 times more insulin than non-diabetics. In addition, the diabetic medication does absolutely nothing to stop this excess insulin production and the spread of the diabetes!
The diabetic drug focuses strictly on artificially lowering the person's blood sugar and possibly his/her hemoglobin A1C, while the diabetes continues to spread its damage from cell to cell.
This artificial lowering of the diabetic's blood sugar gives Type 2 diabetics a false sense of security that the drug is actually working! But, the drug is only controlling the symptom of the disease, not the root cause! As a result, the disease continues to progress and cause more internal damage to the diabetic's cells, tissues and organs.
To make matters worse, the long-term use of diabetic drugs (e.g. metformin) may cause damage to the liver and or kidneys, especially if the liver fails to break down the drug into harmless chemicals.
In addition, some diabetic drugs (such as glucotrol) stimulate the pancreas to produce insulin, again, causing the beta cells to wear out.
In the meantime, the diabetic's doctor continues to increase the drug dosage and adds additional drugs until one day the doctor tells the diabetic that he/she has to go on insulin. And, this may eventually evolve into Type 1.5 diabetes (LADA).
In another scenario, a diabetic may take multiple medications for diabetes, high cholesterol (e.g. statin drug), and high blood pressure. This combination of drugs creates a toxic "drug cocktail" that causes harm to the liver, kidneys and especially the immune system. This harm to the immune system may create an immune system dysfunction, which can trigger an autoimmune response, which, in turn, can lead to an autoimmune disease such as Type 1 diabetes or Type 1.5 diabetes.
In a different scenario, as the diabetes progresses, the immune system may start to fail, causing an autoimmune dysfunction that can morph into a thyroid problem, lupus, Type 1.5 diabetes or some other autoimmune disease.
The bottom line here is that the reliance on drugs to lower one's blood sugar causes additional health problems that makes it even more difficult to control one's blood sugar or requires that the person go on insulin because the diabetic pills have lost their effectiveness.
In other scenarios, some Type 2 diabetics may be initially misdiagnosed as having Type 2 diabetes, but, they found out years later that have Type 1.5 diabetes or LADA. People with LADA do not have insulin resistance, which is a key characteristic of Type 2 diabetes. Also, people with LADA tend not to be overweight -- in fact, many of them struggle with unwanted weight loss and fatigue. In most cases, they end up developing an autoimmunity dysfunction, which is a key characteristic of Type 1 diabetes.
The National Institutes of Health (NIDDK) defines LADA as “a condition in which Type 1 diabetes develops in adults.” LADA is primarily a genetically-linked, hereditary autoimmune disease that results in the body mistaking the pancreas as foreign and responding by attacking and destroying the insulin-producing beta islet cells of the pancreas.
In reality, it's not the genetics ...
Type 1 Diabetes and Type 1.5 Diabetes Pathogenesis at the Cell Level
The following diagram provides an overview of how an autoimmune disease (such as Type 1 diabetes or Type 1.5 diabetes) develops at the cellular level.
Due to a combination of taking too many drugs (especially antibiotics!), eating the wrong foods, and accumulating a lot of toxins in the cells, this can weaken the immune system, making you more susceptible to infections, viruses, and other disease pathologies.
At some point, these problems in combination with several harmful biological processes (such as inflammation and oxidation) can cause cell damage to one or more organs and/or tissues in the body.
If that organ happens to be the pancreas, the immune system tries to repair the cell damage by launching its immune cells to initiate the cell repair process. And, the first step in the cell repair process is inflammation.
Remember when you cut your finger and it turned red? That was a sign that your body had started the cell repair process, with inflammation being the first phase of the repair process. Something similar happens inside your body, when an organ or tissue is damaged.
Once inflammation is triggered, local macrophages send out cytokines (chemical signals) to recruit other immune cells such as neutrophils and macrophages to come to the site of the injury and eat up the dead bacteria and any invading pathogens to prevent the infection from spreading.
However, if the injury is extensive or if there are other health problems (e.g high blood sugar), this may slow down the immune system and reduce its effectivity. If this persists, the macrophages will continue to recruit more macrophages, which, in turn, recruit more macrophages, creating a vicious cycle.
If part of the problem is an invading pathogen, the macrophage eats the pathogen and presents part of the pathogen (antigen) to a dendritic immune cell.
The dendritic immune cell uses this antigen to notify the T cells to come and help fight the invaders. The T cells proliferate into T helper cells (Th1, Th2, Th17) to help recruit more immune cells and participate in the attack.
In addition, the cytotoxic T cells (or natural killer T cells) are activated so that they can directly attack and kill any infected cells. However, if the infected cells happen to be the beta cells, then, the Tc or NKT cells start to destroy the beta cells! Other immune cells such as the macrophages, who's job is to kill the invading pathogens, attacks the infected or damaged beta cells, causing a further increase in the death of beta cells.
If this kind of attack continues without any intervention, the attack escalates. And, if there is an imbalance in the attack between Th1 and Th2 cells (or Th17 and Treg cells), this imbalance can trigger an autoimmune response, which can manifest into an autoimmune disease.
And, in this particular case, because the immune cells are attacking the pancreatic beta cells, this can lead to a reduction in the production of insulin by these beta cells. And, if there happens to be some low level infection or virus or other systemic health problem, this can accelerate the beta cell damage and lead to Type 1 or Type 1.5 diabetes.
p.s. If you're not into the science, this discussion about the cells may not make much sense. But, the key point here is that given that the problem is usually due to some external factor (e.g. bacteria, toxin, food, stress, etc.), taking a drug won't fix the problem. In fact, the drug can actually fuel the inflammation and accelerate the damage to the cells and spread of the disease.
Please Note: As you can see from the diagram, chronic inflammation fuels Type 1.5 diabetes (and Type 1 diabetes) and leads to the destruction of the beta cells. The key here is to understand that there are many factors and variables that can trigger and sustain the chronic inflammation, e.g. virus, infection, leaky gut, drugs (vaccines, antibiotics), "dead" foods, toxins, immune cells, etc. The key here is to eliminate these potential root causes as soon as possible.
It is imperative that Type 2 diabetics struggling with LADA change their diet immediately to a plant-based nutritional program such as the Death to Diabetes Nutritional Program or the DTD AIP & Autoimmune Diseases Nutritional Program. The longer you delay, the more damage that will occur or is occurring.
In addition, it is imperative to address the autoimmunity before it gets out of control. Use the DTD Autoimmune Diseases Wellness Program in conjunction with the targeted foods and supplements identified as part of the AIP & Autoimmune Diseases Nutritional Program.
From a medical perspective, LADA differs from Type 1 diabetes in that the disease progresses gradually. People with Type 1 diabetes are typically completely dependent on insulin within 12 months of diagnosis.
By contrast, many people with LADA still produce some insulin and may not require insulin injections for several years following diagnosis. They are often able to control their blood sugar through meal planning, oral medication, and lifestyle changes.
As the disease progresses and the beta cells are further damaged, the pancreas produces less and less insulin. There tends to be a gradual increase in insulin requirements, positive antibodies, and decreasing ability to make insulin as indicated by a low C-peptide.
People with LADA have increased levels of glutamic acid decarboxylase antibodies (GAD Ab), an autoimmune marker of an attack on the cells that produce insulin. Eventually this leads to an absolute lack of insulin. It is this insulin deficiency that identifies type 1 diabetes. This late-onset type of type 1 diabetes is known as 'latent autoimmune diabetes of adults', 'slow onset type 1', or 'type 1.5 diabetes'.
The National Institutes of Health estimates that 10 percent of people who have been diagnosed as type 2 diabetics may actually have LADA. A misdiagnosis of this nature can lead to months or even years of incorrect treatment, putting patients at a risk of further complications and frustrations as they attempt to find the best approach for controlling their diabetes.
If you’ve been diagnosed with type 2 diabetesbut your ability to control your blood glucose with lifestyle changes and oral medications has diminished over time, you should first find an effective diet that will help you. Specifically, find a diet that addresses the cell inflammation, immune system dysfunction, and other biological root causes of the diabetes -- a diet that includes vegetables, juicing, detox, etc. and excludes grains, milk, flour, etc.
If the diet doesn't help you, it may be the wrong diet. Otherwise, you may want to ask your doctor to test you for LADA.
Depending on the aggressiveness of the immune attack on the insulin-producing beta cells of the pancreas, people with LADA progress to need insulin injections at varying rates. Most people with LADA will be on insulin within six years of the time of correct diagnosis.
However, although controversial, we believe that the early introduction of eating healthy plant-based foods and avoiding "trigger" foods may preserve the remaining insulin-secreting beta cells for longer.
Medical Diagnosis of LADA
It is estimated that 20% of persons diagnosed as having non-obesity-related type 2 diabetes may actually have LADA. Islet cell, insulin, and GAD antibodies testing should be performed on all adults who are not obese that appear to present with type 2 diabetes. Not all people having LADA are thin, however—there are overweight individuals with LADA but who are misdiagnosed because of their weight.
Moreover, it is now becoming evident that autoimmune diabetes may be highly underdiagnosed in many individuals who have diabetes, and that the body mass index levels may have rather limited use in connections with latent autoimmune diabetes.
Also, many physicians or diabetes specialists don't recognize LADA or probably don't know the condition actually exists, and so LADA is misdiagnosed as or mistaken for Type 2 diabetes highly often.
C-peptide: This test measures residual beta cell function by determining the level of insulin secretion (C-peptide). Persons with LADA typically have low, although sometimes moderate, levels of C-peptide as the disease progresses. Patients with insulin resistance or type 2 diabetes are more likely to, but will not always, have high levels of C-peptide due to an over production of insulin.
Autoantibody panel: Glutamic acid decarboxylase (GAD) autoantibodies, radioimmunoassay (RIA) and insulin antibodies, radioimmunoassay, RIA are commonly found in diabetes mellitus type 1.
Islet cell antibodies (ICA) tests: Persons with LADA often test positive for ICA, whereas type 2 diabetics only seldom do.
Glutamic acid decarboxylase (GAD) antibodies tests: In addition to being useful in making an early diagnosis for type 1 diabetes mellitus, GAD antibodies tests are used for differential diagnosis between LADA and type 2 diabetes and may also be used for differential diagnosis of gestational diabetes, risk prediction in immediate family members for type 1, as well as a tool to monitor prognosis of the clinical progression of type 1 diabetes.
Insulin antibodies (IAA) tests: These tests are also used in early diagnosis for type 1 diabetes mellitus, and for differential diagnosis between LADA and type 2 diabetes, as well as for differential diagnosis of gestational diabetes, risk prediction in immediate family members for type 1, and to monitor prognosis of the clinical progression of type 1 diabetes. Persons with LADA may test positive for insulin antibodies; persons with type 2, however, rarely do.
Other characteristics of LADA that may aid in a proper diagnosis include:
- Onset usually at 25 years of age or older
- Initially mimics non-obese type 2 diabetes (patients are usually thin or of normal weight, although some may be overweight to minimally obese)
- Oftentimes, but not always, a lack of family history for T2DM (family history for type 2 diabetes is sometimes involved regarding a latent autoimmune diabetic adult)
- Persons with LADA are insulin resistant like, but at prevalence levels less than, Type 2
- Human leukocyte antigen (HLA) genes associated with type 1 diabetes are seen in LADA but not in type 2 diabetes
- Although some people having type 2 diabetes may inject insulin, this only rarely happens; in contrast, people with LADA require insulin injections around three to 12 years after so called type 2 diabetes diagnoses.
Critical Point: Once you have been diagnosed with LADA, find the root cause as soon as possible to stop the destruction of the beta cells! Also, in order to protect your remaining beta cells, change your diet to the low-glycemic Death to Diabetes Nutritional Program or Autoimmune Disease (AIP) Nutritional Program. This will reduce the inflammation, insulin resistance, oxidation, toxicity and other biological processes that are causing damage to your beta cells and your body's need for so much insulin.
Medical Treatment for LADA
LADA often does not require insulin at the time of diagnosis and may even be managed with changes in lifestyle in its early stages such as exercise, eating right, and, if optional, weight loss. However, some clinicians believe that insulin should be started at onset or as soon as possible, rather than using sulfonylureas or other diabetes pills for initial treatment.
Moreover, it is not clear whether early insulin therapy is of benefit to the remaining beta islet cells. Also, some studies now indicate that some of the diabetic drugs may lead to beta cell dysfunction.
Initially, a person with LADA may respond to oral diabetes medications, eating right and lifestyle changes, although beta cells continue to be damaged and LADA patients should be closely monitored.
Some studies have demonstrated that the use of sulfonylureas and the insulin-sensitizing drug metformin, may increase the risk of severe metabolic disorder and beta cell dysfunction in persons with LADA. When blood glucose can no longer be managed through lifestyle and medications, daily insulin injections will be required.
80% of persons initially diagnosed with type 2 but test positive for GAD (an indication of LADA) progress to insulin dependency within 6 years (some sources say between 3–12 years after diagnosis). Those who test positive for both GAD and IA2, however, will progress more rapidly to insulin dependence.
Living with any chronic illness is stressful, and patients with diabetes, let alone LADA, may be more prone to depression and eating disorders as a result. Counseling, therapy, and participation in support groups can play an important and positive role in the lives of persons with LADA.
Part of diabetes therapy should include patient education about diet, exercise, stress management, immune dysfunction, and handling their diabetes on "sick" days.
Patients need to understand how to manage their diabetes, as well as how to address their autoimmune dysfunction. In addition, patients need to understand how to recognize, treat, and prevent hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar) and how to give injections of insulin and glucagon. Blood glucose levels should be checked at least 4 to 6 times per day if a patient wants to manage their diabetes more effectively.
Root Causes of Autoimmune Diseases and Beta Cell Dysfunction
Despite many of the scientific advancements that have been made in diabetes pathology, there is still a lack of understanding about how the immune system attacks healthy cells, causing various autoimmune diseases such as Type 1 diabetes, multiple sclerosis, lupus and celiac disease.
Some of the causes of autoimmune dysfunction include the following:
- Bacteria, Fungi, Parasites, Other pathogens
- Environmental/chemical toxins, e.g. heavy metals, pesticides
- Prescription drugs (antibiotics, vaccines, steroids)
- Chronic inflammation
- Oxidative stress
- Lack of sunlight (Vitamin D deficiency)
- Nutrient deficiencies, e.g. Vitamin A, Omega-3s, iodine
- Food intolerances, e.g. gluten, grain, cow's milk, dairy
- Leaky gut syndrome
- Stress and anxiety (stress hormone imbalance)
- Heredity or genetics
Some of the causes of pancreatic beta cell (β) dysfunction include the following:
- Diabetic drugs such as Glucophage, Glipizide, Glucotrol, and Amaryl either wear out the beta cells or cause damage to these cells.
- Chronic inflammation over a period of years
- Viruses, other pathogens
- High blood glucose levels and excessive oxidative stress damage a key enzyme that guards insulin-producing beta cells.
- Chronic exposure to hyperglycemia can lead to beta cell dysfunction that may become irreversible over time, a process that is termed glucose toxicity.
- A high-carb diet or a diet full of processed foods and fast foods may lead to beta cell dysfunction.
- Leaky gut syndrome
Note: There are 5 stages of progression associated with most cases of beta cell dysfunction. Refer to the Death to Diabetes Blog for details.
Please Note: Although it is highly unlikely, but, if you are a completely healthy adult and suddenly develop Type 1 or 1.5 diabetes, it is highly probable that your body was attacked by some kind of virus. Consequently, it is imperative that you get a comprehensive set of viral blood tests and other blood tests immediately to determine the root cause -- that is the specific virus that triggered your disease. Unfortunately, there is no single virus test, so your doctor has to perform a multitude of antigen-specific or specific antibody tests for every possible virus! Why? Because each virus has its own antigen and antibodies, making this a daunting and expensive testing process. Also, it is urgent to go beyond treating the blood glucose problem and immediately begin treating the virus/infection before too many beta cells are destroyed!
Type 1, Type 1.5, Type 2 Diabetes Comparison
Although it may not seem apparent, there are some distinct similarities as well as differences between Type 1 diabetes, Type 1.5 diabetes, and Type 2 diabetes.
The following chart gives you a high level overview of the comparisons between these 3 different yet similar diseases.
Why is this important? Because of these similarities, certain aspects of the Death to Diabetes Nutritional Program for Type 2 diabetes can be used for Type 1 and Type 1.5 diabetics, with some slight modifications.
However, over the years, the number of modifications grew. As a result, it became easier to define a specific nutritional profile for autoimmune diseases. This became known as the DTD AIP & Autoimmune Diseases Nutritional Program, which is part of the DTD Reverse Autoimmune Diseases Wellness Program.
Alternative Health & Autoimmune Disease Treatment Strategy for LADA
In order to reduce and possibly eliminate the need for drugs, use the DTD Reverse Autoimmune Diseases 10-Step Wellness Program, to address overall diabetes management, blood glucose control and the root causes of your autoimmune system dysfunction.
Nutritional Strategy to Fight LADA
Follow the nutrient-dense diet (of the DTD AIP & Autoimmune Diseases Nutritional Program) that includes green, leafy and bright-colored vegetables, such as broccoli, Brussels sprouts, spinach, kale. If possible, eat organic vegetables to reduce your toxic load exposure to pesticides and other chemical toxins.
Make sure that you add key foods and supplements that help to fight most autoimmune diseases (especially leaky gut) including: fermented vegetables, wheat grass, bone broth, extra virgin coconut oil, chlorella, spirulina, l-glutamine, collagen protein powder,and unprocessed cod liver oil.
In addition, include anti-inflammatory foods such as wild salmon, sardines, blueberries, and extra virgin olive oil.
Also, eat herbs, foods and use compounds with antiviral properties such as echinacea, licorice root,astragalus; garlic, onions, lemons, turmeric, extra virgin coconut oil, and medicinal mushrooms; and colloidal silver.
Maybe just as important, make sure that you avoid the "trigger" foods, drugs, toxins, and chemicals that may trigger autoimmune dysfunction and damage the beta cells, e.g. white flour (alloxan), wheat, gluten, grains, cow's milk, most dairy, vegetable oils, canola oil, legumes/nuts, some diabetic drugs, and possibly other OTC/prescription drugs.
Use raw juicing to help get key nutrients into your cells and to help strengthen and rebalance your immune system.
Perform a periodic cleanse and detox to help remove accumulated toxins within your cells that may contribute to chronic cellular inflammation and excess oxidation.
If necessary, perform the Leaky Gut Repair process to repair any damage to the lining of the small intestine.
In addition, use nutritional supplements to complement your nutritional program, e.g. l-glutamine, Vitamin D3, Vitamin B-Complex.
However, always try to obtain your vitamins and minerals from the food first before opting for a supplement.
As mentioned on the Type 1 Diabetes web page, use some of the following nutrients, which have been identified to possibly help protect and/or regenerate the insulin-producing beta cells:
-- Berberine (found in bitter herbs such as Goldenseal and Barberry)
-- Bitter Melon
-- Curcumin (from the spice Turmeric)
-- Gymnema Sylvestre (“the sugar destroyer”)
-- Niacinamide (Vitamin B3)
-- Nigella Sativa (“black cumin”)
-- Sulforaphane (especially concentrated in broccoli sprouts)
-- Swiss Chard
-- Vitamin D3
Next Steps to Wellness
Before you reach a point where you are totally relying on the drugs to manage your diabetes, get one or more of the following books to help you (the sooner, the better):
- Death to Diabetes book
- Autoimmune Disease book
- Power of Juicing book
- Cleanse-Detox book
- Raw Food Diet book
Use these books in order to address more effective diabetes management, proper blood glucose control and autoimmune system dysfunction without the need for diabetic drugs.
And don't forget: As long as you rely on the drugs, you will always be diabetic and your body will continue to deteriorate and rot from the inside out -- until one day you find yourself having to deal with one or more health problems with your eyes, kidneys, feet, nerves, heart, brain, etc.
And, those health problems will eventually evolve into one or more of the major diabetic complications, e.g. blindness, amputation, kidney failure, heart attack, stroke, etc.
Don't let this happen to you. Stop it now, while you can!
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