Subscribe for 17¢ / day

Addictive substances are usually found naturally, growing in the parts of a plant. Once humans realize they like a certain substance, they decide to cultivate the plant producing it. Humans then devise ways to extract the substance, refining it to its purest, most potent form.

This is the story of sugar, one of the biggest players in America’s growing diabetes epidemic.

Type 2 diabetes is a disease where the body stops responding normally to insulin. Insulin is a hormone that tells the body to remove excess sugar from the blood. The high blood sugar that results causes damage to our hearts, eyes, kidneys, blood vessels, and brains.

Several factors can contribute to diabetes including: genetics, obesity, poor diet, lack of exercise, and other lifestyle choices.

Nothing can be done to alter the role our genes play in getting and managing diabetes. Anti-diabetic medications also have a limited effect on diabetes control, and this effect deteriorates over time, especially if we continue to feed our bodies high amounts of sugar. Still, there are very powerful options available for the prevention and treatment of Type 2 diabetes.

The first and most powerful treatment we should undertake for preventing and managing diabetes is weight loss. In numerous, well-run studies, nothing outperformed weight loss at preventing diabetes. Nothing.

If your body mass index is above 25, then an initial goal of losing 5 percent to 10 percent of your body weight is a great start. Every two pounds lost increases your body’s response to insulin and decreases your risk of developing diabetes.

Ideally, we should aim for a healthy weight with a BMI under 25, but any weight loss is cause for celebration. You can calculate your BMI and learn more about weight loss at this website:

The second treatment we should undertake for diabetes is regular exercise. Exercise tells our bodies it’s OK to burn calories and lose weight. Something as simple as a brisk walk 30 minutes a day will improve our body’s ability to respond to insulin and, in turn, burn fat. The ideal exercise regimen would include both cardiovascular training — such as walking, jogging, or biking — and strength training such as gentle weightlifting.

The third treatment is a healthy diet. Eating healthier food, low in simple sugars, helps our bodies regulate the natural rise and fall in blood sugar after every meal. Many people hear “sugar” and think it’s just the stuff you put in coffee. But simple sugars are also abundant in white breads, white pastas, white rice, and numerous other grains and processed foods. Limiting the amount of white grains in our diets and replacing them whole (brown) grains or vegetables is a great goal.

Many of us — OK, most of us — have tried these three treatments only to find out how hard they are to sustain. This should not be a surprise, and more importantly, no one should feel ashamed when they can’t reach these goals. After all, evolution never prepared our bodies to lose weight voluntarily. This is why it is so important to see a diabetes instructor or educator.

RiverStone Health and Billings hospitals have diabetes management teams that will help you succeed in your goals of weight loss, exercise, and a healthy diet. They have nutritionists available with special training in diabetes management who can help you set up a healthy diet and effective weight loss strategies. You can contact our diabetes instructors and get involved with support groups by calling 247-3350.

Sugar is a hard substance to kick. Studies routinely show that people have as much trouble losing weight and dieting as they do quitting smoking. Getting help from a diabetes team improves your chances of success in preventing and managing your diabetes. As it turns out, the most powerful anti-diabetes medicine isn’t a medication at all … the most powerful diabetes drug out there is you.

Rob Smith, DO, a resident physician with the Montana Family Medicine Residency at RiverStone Health, can be reached at 247-3306 or