Download Living with Diabetes: Dr. Draznin's Plan for Better Health PDF

TitleLiving with Diabetes: Dr. Draznin's Plan for Better Health
TagsWeight Loss
File Size595.6 KB
Total Pages189
Table of Contents
One: At the Beginning
	A Letter to My Reader
	An Introductory Case
	The Origin of the Draznin Plan
Two: Our Weight in Numbers
	Ideal Body Weight and Body Mass Index
	Obesity Rates Are Climbing
	Why Are We Becoming More Obese?
	Obesity and Its Relationship with Diabetes
Three: The Law of Conservation of Energy
	Energy Consumption and Expenditure
	How Calories Are Absorbed (or Not)
	How Calories Are Utilized (or Not)
	Insulin Levels and Activity
Four: The Draznin Mile: A New Concept of Exercise
	Understanding the Draznin Mile
	Getting Started
	Finding Alternative Forms of Exercise
Five: Insulin, Production and Storage of Energy, and Regulation of Weight
	Glucose in the Body
	Turning Food into Energy
	Case Study: Mr. G.
	Commonsense Conclusions
Six: A Person Does Not Lose Weight
	The Importance of the Hypocaloric Diet
	Understanding Dietary Composition
	Diet Plus Exercise
Seven: A Tale of Two Brothers
	Two Brothers, Two Treatment Plans
	Getting Individualized Care from Your Doctor
	Two Patients, One BMI
Eight: Treatment of Obesity
	Easier Said than Done
	Realistic Expectations
	The Energy Value of Foods
	Medications and Other Chemicals
	Medicating Prediabetes
Nine: What Shall I Do When I Stop Losing Weight Despite My Best Efforts to Keep My Diet and Exercise?
	Keeping Goals Reasonable
	Changes in Cognitive Function
Ten: The Draznin Calorie: A Better Way to Diet
	A Calorie by Any Other Name...
Eleven: Practical Advice
	Portion Size
	Added Sugars
	Glycemic Index
	Dietary Fat
	Eating Out
	Vitamins and Supplements
	Prescription and Over-the-Counter Medications
	Cooking and Eating at Home
	Grocery Shopping
	Dairy Products
Twelve: My Own Personal Struggle to Prevent Diabetes
	A Growing Boy
	Initiating Dietary Change
	Finding the Right Exercise Program
Thirteen: Case Studies and a Treatment Plan for Mr. K.
	Ms. Elizabeth E.
	Mr. Frederick D.
	Case Study 1
	Case Study 2
	Case Study 3
Appendix A: Recommendations Based on Ten Draznin Rules of Life
Appendix B: Frequently Asked Questions
Document Text Contents
Page 2

Praise for the First Edition

‘‘Boris Draznin is an accomplished scientist and clinician who provides a sound

scientific basis for his unique approach to the prevention and treatment of diabetes.

The emphasis is placed on obesity and lifestyle modifications. Importantly, both

sides of the energy balance equation—food intake and activity—are stressed. The

DrazninMile andDraznin Calorie are practical concepts that make his plan easier to

follow. Dr. Draznin’s numerous patient experiences exemplify his points while

offering a personal and comforting encounter for the reader. An important and

parting note encourages those at risk for diabetes, or with diabetes, to choose phy-

sicians with the knowledge, interest, and time to deal with this important problem.’’

–Robert H. Eckel, M.D., University of Colorado Health Sciences Center

‘‘The prevalence of diabetes and obesity has reached epidemic proportions in

America, leading to an enormous health problem. This new book by Boris Draznin

will be of great help to anyone trying to deal with the problem of excess weight. It is

highly readable, medically correct, and filled with useful, practical advice. Dr.

Draznin carefully explains the basic concepts of calorie balance and weight control

and then goes on to describe a lifestyle program that anyone can adapt to their own

needs. Using his approach people will be able to take charge of their attitudes and

behaviors towards calories and exercise and, thereby, take control of their weight.’’

–Jerrold M. Olefsky, M.D., University of California, San Diego, School of Medicine

‘‘In his book, The Thinking Person’s Guide to Diabetes: The Draznin Plan, Boris

Draznin brings the same wit, excellence, and passion to the reader that he does in

person. The concepts of the Draznin Calorie and the Draznin Mile bring lightness,

reality, and possibility to the chore of day-to-day living with diabetes mellitus. Each

reader will find his or her own path using his approach. I heartily recommend this

book to all people with diabetes.’’

–Gerald Bernstein, M.D., F.A.C.P., Past President, American Diabetes Association

‘‘The Thinking Person’s Guide to Diabetes: The Draznin Plan is written by a world

expert in diabetes and obesity, but is readily accessible by the layman. It gives

practical advice to overweight individuals but is definitely not a fad diet book

because it is founded on evidence-based medicine. This excellent book offers a very

balanced approach to diet and exercise—it’s proven to work.’’

–Derek LeRoith, M.D., Ph.D., Chief of the Division of Endocrinology,

Diabetes, and Bone Disease, Mount Sinai School of Medicine

Page 94

Chapter Eight

Treatment of Obesity

Weight loss is really all about weight maintenance.Granted, it is difficult to shed extra pounds, but most
people can do it over a short period of time. What proves to be
exceptionally challenging, as I’ve said already earlier in this
book, is keeping the new reduced weight and not bouncing
back to the prediet existence.

How do we treat obesity? How are we going to advise Mr.
K., who is so eager to combat his weight problem? What do we
say to thousands of others with similar problems? The very first
step in considering a multitude of therapeutic options is to
modify our attitudes toward obesity (see Table 8.1). By ‘‘our
attitudes’’ I mean the attitudes both of physicians and of pa-

Society must accept obesity as a chronic health condition
and not just as a manifestation of weakness or sloth. His-
torically, obese individuals have
been considered unmotivated,
ugly, and somewhat lazy people
who are unable to control their
voracious appetites.

Society must accept obesity
as a chronic health condition
and not just as a manifestation
of weakness or sloth.


Page 95

Ironically, this perception is strongly supported by the nu-
merous diet books that create the impression that losing weight
is an easy, simple, and trivial task. These books offer recipes for
losing weight. Their authors imply that the key to losing weight
is widely known—it is in your hands, right in front of your very
eyes, jumping out at you from the pages of their best-selling
books. The implication is that obese people, those gargantuan
monsters, simply lack either interest in losing weight or the will-
power to become slim and handsome. Even though the recipe
for losing weight is readily available to them, these thankless
and thoughtless creatures pass up this wonderful opportunity
and simply do not wish to become masters of their own fate.
‘‘I have lost eighty pounds,’’ says a smiling thirty-five-year-

old woman from a full-page ad. ‘‘You can do it too!’’
‘‘I’ve lost thirty pounds in thirty days!’’ screams another

testimonial. ‘‘And I’m never hungry!’’
Not surprisingly, everyone who believes these statements

looks at the obese man or woman with astonishment and with
questions. If losing weight is so simple, how comewe can’t do it?

Easier Said than Done
The truth of the matter is that it is extremely difficult to lose
weight. Obese people and those who treat them know this.

Table 8.1 Treatment of Obesity

Step 1 Modify your attitude toward obesity
Step 2 Set realistic goals
Step 3 Assess your mental readiness
Step 4 Find a knowledgeable and willing physician
Step 5 The Draznin Mile
Step 6 The Draznin Calorie
Step 7 Modify your eating habits

Living with Diabetes82

Page 188

Low-carbohydrate diets, 57–58, 63–64,
66, 68–69

Low-fat diets, 22–23, 56–58, 88. See also
High-carbohydrate diets

Low-intensity exercise, 39
Ludwig, David, 66
Lunch, sample, 153

Macronutrients, 53
Ma huang, 94
Meal planning, 106–110, 128–129, 153
Meals, interval between, 163
Meats, 119, 126
Medications. See also specific drugs
absorption-modulating, 32–33, 93
adjustments of, when dieting, 122
insulin reduction, 164
insulin treatment, 47, 142, 143, 163–164
for prediabetes, 96–97
for weight control, 51–52, 53, 92–95

Mediterranean diet, 22, 58, 117
Men, 24, 40, 87
Meridia (sibutramine), 92–93
Metformin, 96
Middle-aged adults, 24, 36–37
Mineral supplements, 121
Mitochondria, 53
Monosaccharides, 112
Monounsaturated fats, 117
Muscle mass, body mass index and, 16–17

Nerve damage, 25
Neurotransmitters, 51
Non-exercise-associated thermogenesis

(NEAT), 29
Nutrient claims, 125
Nutritional recommendations, 21–23, 88.

See also Draznin Calorie
Nuts, 127

attitudes toward, 81–83
case studies, 145–149
causes of, 20–23
diabetes and, 15, 23–26
health risks of, 15, 23–24, 25
measurements of, 14–17

prevalence of, v, 17–20
risk of death and, 19
treatment of. See Weight loss
upper- vs. lower-body, 17

O’Neal, Shaquille, 17
Orlistat, 32, 33, 92, 93
Ornish diet, 64–65, 66, 67

Patience, 60
Pedometers, 160
Personal commitment, 5, 154–155, 158
Phentermine, 51, 94
Physical activity. See Exercise
role of, 4, 5, 76–79
selection of, 85–86, 157

Pioglitazone, 96
Polyunsaturated fats, 116–117
Pork cuts, 126
Portion sizes, 108, 111–112
Poultry, 126
Prediabetes, 96–97, 150–151
Primary care physicians, 78–79
Procedural learning, 102–103
Protein metabolism, 49–50, 53, 54
Proteins, dietary, 54

Race, diabetes risk and, 24
Resources, 167, 169–170
Restaurant dining, 108, 119–120, 129
Resting energy expenditure. See Basal

metabolic rate
Restraint, dietary, 89
Retinopathy, diabetic, 25–26, 44, 141, 143
Risk of death. See Death, risk of
Rosiglitazone, 96
Roux-en-Y surgery, 95

Saint-John’s-Wort, 94
Satiety, 50, 51
Satiety center, 51
Saturated fats, 116–117
Sedentary lifestyles, 21
Self-directed programs, 86
Serotonin, 51
Serving sizes, 108, 111–112
Sibutramine, 92–93

Index 175

Page 189

Snacks, 127–128, 153
Soy products, 127
Stationary bikes, 43
Stress test, 44
Sugar, blood. See Blood-sugar levels; Glucose
Sugar Busters! diet, 63
Sugars, dietary, 112–113, 123–124
Supplements, 120–122
Surgery, bariatric, 86, 95–96
Swimming, 43

Teenagers. See Children and adolescents
Thermic effect (TE), 29
Tofu, 127
Treadmills, 42, 160
Type 1 diabetes. See Diabetes, type 1
Type 2 diabetes. See Diabetes, type 2

Unsaturated fats, 116–117

Very low-density lipoproteins (VLDLs), 64
Vitamins, 120–122
Voluntary energy expenditure. See Activity


Waist circumference, 17
Walking, 40–42, 159–160
Weight, hormonal regulation of, 49–50
Weight, ideal, 14–15
Weight gain, anxiety and, 160–161

Weight loss. See also Draznin Plan
attitude modifications and, 81–82
caloric intake recommendation for, 87
diet and exercise combined for, 4–5, 67,
68–69, 71

difficulty of, 82–84
eating behavior modification, 87–89
energy balance and, 28–31, 55, 61
energy value of foods and, 89–92
exercise routine for, 87. See also Draznin

goal setting, 84, 99–100, 157
individualized care for, 5, 72–79
maintenance of, 4–5, 99, 100–101
medications for, 32–33, 51–52, 53, 92–96
mental and emotional readiness for, 85
physician selection, 85–86, 157
plateaus in, 98–99, 165
realistic expectations for, 84–85
seven steps of, 82

Weight Watchers diet, 66
Women, 24, 40, 87
Worldwatch Institute, 17
Wyatt, Holly, 100

Xenical (orlistat), 32, 33, 92, 93

Yudkin, J., 21–22

Zone diet, 63, 65, 66, 67


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