TEN STEPS to Control Diabetes
by Mark Erik Meijer, MD

Mark Erik Meijer, M.D.
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Dr. Mark Erik Meijer’s book, TEN STEPS to Control Diabetes, helped hundreds of rural South Carolinians get control over their “diabesity.”  If you are an overweight Diabetic Type 2 and you need a blunt book to help you get your act together, then Dr. Meijer’s TEN STEPS to Control Diabetes is YOUR book:

Table of Contents


1. Understand How to Succeed............................7

2. How to Use This Book................................10

3. When You Run Out of Gas, You Run Out of Go..........14

4. Update on Diabetes Mellitus.........................18 

5. Progressive Disease, Sudden Problems................22 

6. Understanding Diet for Control of Diabetes..........26 

7. Lowering Resistance to Diabetes (Type 2)............30 

8. How to Use TEN STEPS to Control Diabetes............34 

9. STEP 1 for Control of Diabetes...............STEP 1-37

10. Why the Big Fuss?..................................40

11. Eat Your Vegetables................................44

12. Introduction: No Crap Diet for Diabetics...........48

13. Fats, Fads, Facts, & Fiction.......................52

14. The Battle of the Bulge............................56 

15. Why Eat and Drink?.................................60

16. Why You Eat Affects What You Eat...................64

17. Simply Read a Food Label...........................68

18. Nearer the Needle, Further the Forest..............74 

19. Remember Me, Type 1?...............................78 

20. STEP 2 for Control of Diabetes..............STEP 2-82 

21. The Means and the Goal.............................86 

22. Carefully Counting with a Calorie Counter..........90

23. The Laws of Physics Apply to You Too...............96

24. The More They Know, the Less They Know.............99 

25. Golly, Different Types of Diabetics Have Different

Types of Problems.....................................103 

26. Y'all Void' Missing a Meal Now, Yuh Hear?.........106

27. STEP 3 for Control of Diabetes.............STEP 3-108 

28. If Losing Weight Was So Easy, There Wouldn't Be So

Many Fat People.......................................112

29. Dumb Diet Questions/Answers for Dummies Like Me...116

30. Dieters on the Run................................119 

31. Look Who's Talking................................123

32. Sweet Beer, Either Way............................127

33. Finding Cause for Disease.........................132

34. The Do's and Don'ts of Eating.....................136

35. STEP 4 for Control of Diabetes.............STEP 4-142 

36. Dying to Run......................................146 

37. Mighty Mouth and Medicine.........................150 

38. Mouth Medicine....................................154 

39. Fixing Links You Can Fix..........................157 

40. Lifelong Monitoring Can Be Life-Saving............161 

41. Dead People Don't Smoke...........................164 

42. Suddenly It's a Heart Attack......................168

43. The Gospel on Cholesterol.........................172 

44. Deadly Mix and More Pills.........................176 

45. Goals for STEP 5...........................STEP 5-179 

46. Keeping Diabetic Feet.............................182 

47. Preventing Foot Problems from Diabetes............187 

48. Polyneuropathy: Battle Lines Drawn for Feet.......188 

49. Feet Physics and Good Footwear....................194 

50. Goals for STEP 6...........................STEP 6-198 

51. Preventing More than Heart Attacks................202 

52. Why Now?..........................................206 

53. Living Longer, Hearing Less.......................210 

54. STEP 7: Trying Exchanges...................STEP 7-214 

55. Seeing Drugs in a New Light.......................218 

56. The Most Abused Substance in America..............224 

57. Too Sweet to Be True..............................228 

58. Licking Sugar Cold-Turkey.........................232 

59. Killing the Ones We Love..........................236 

60. Dieters Can't Diet Alone, Especially at Home......239

61. Goals of STEP 8: Where Do We Go From Here? STEP 8-242

62. Drug Experiments and Experience...................246 

63. It May Not Be What You Think......................250 

64. Easy Overdose.....................................254 

65. Distinguishing Depressed from Depression..........257 

66. Beware Depression.................................261 

67. Goals for STEP 9...........................STEP 9-265

68. 'Til Death Do Us Part.............................270 

69. Confusion about Chest Pain........................274 

70. Accepting Human Error.............................278 

71. Failure to Understand Salt........................283 

72. Time for Thanksgiving.............................287

73. STEP 10, Finally?.........................STEP 10-291 

74. Conclusion........................................296

About the Author......................................298 

Order Form............................................299

Chapter sample:  6. Understanding Diet for Control of Diabetes

     Diabetes Mellitus (DM) is more often called “high sugar.”  It is a disease where the body no longer controls sugar (glucose) in the blood properly.
     Glucose is the body’s fuel.  Every cell in the body is like a little engine.  In order for the engine to run correctly, it needs fuel and air.  In the body, blood brings glucose and oxygen to every cell.  The blood picks up the oxygen from the lungs and it gets the glucose (fuel) from cells that store glucose and from the stomach (when we are eating).
     Everyone understands that they will die if their heart stops beating.  This is because the blood stops circulating to all the cells.  All living cells stop working and die when they are no longer supplied with air and fuel (oxygen and glucose).
     By far the most important “engine” in the body is the brain.  If brain cells do not receive either oxygen or glucose, they stop working and die.  Irreversible brain death occurs in about ten to fifteen minutes.  Therefore, it is a matter of life and death that all cells receive both oxygen and a good supply of glucose.
     The body has many systems designed to try to prevent death.  If you are knocked unconscious, you will continue to breathe by an automatic system despite the fact you are “out cold.”
     Since glucose is so important, the body has many ways to prevent sugar from becoming too low.  However, there are fewer systems built into the body to prevent sugar from becoming too high.  When the body’s system that controls the blood sugar is broken (which is diabetes), it is much more likely that the sugar is too high rather than too low.  But while a diabetic’s primary problem is that his sugar is too high, low sugar can also be a problem.  So really Diabetes Mellitus is a disease where the blood sugar is out of control, not just “high sugar.”
      Insulin is a hormone produced by an organ called the pancreas.  Digested food is converted into glucose (fuel).  Insulin tells cells what to do with glucose.  It’s not practical for a person to eat food constantly.  It makes sense that the body has a system for energy storage (gas tank).
     Some glucose is transported and “put in storage” (fat and muscle).  Some is used immediately.  Stored glucose can later be released and transported for use.  The transportation and use of glucose is controlled and coordinated by insulin.  Insulin provides the communication needed between cells throughout the body to ensure a good fuel supply in the blood stream.  When cells no longer respond to insulin or when there is no insulin to respond to, communication between cells breaks down.  If cells do not “hear” insulin, blood glucose levels will be “out of control.”  This is diabetes.
     Type 1 diabetics do not make insulin at all.  Without any insulin, blood glucose has to quickly rise.  However, most diabetics suffer from “insulin resistance.”  This is called Diabetes Type 2.
     The cells of Type 2 diabetics no longer respond properly to insulin (no longer “listen”).  Initially, the pancreas compensates for this by making more and more insulin (e.g., yelling).  Eventually, not enough insulin can be produced to overcome “insulin resistance.”  Then blood glucose rises.
    It’s the job of the kidneys to remove undesired substances from the blood stream so that it can be eliminated.  The kidneys also have to keep in what we need.  It makes sense that the kidneys would try to keep glucose from being eliminated.  However, the kidneys’ capacity to do their job can be exceeded.  Excessively high blood glucose levels exceed the capacity of the kidneys to keep the glucose in the blood.

     When this happens, sugar spills out into the urine.  Diabetics with uncontrolled sugar urinate their fuel away.  This wasted fuel (glucose) can exceed our ability to eat and drink.  It also exceeds our bodies’ ability to use stored glucose from fat.  Fuel (glucose) for high energy demands is provided by breaking down muscle, rather than fat.  Therefore, uncontrolled diabetics lose their muscle mass, not fat, when blood glucose is too high.  Uncontrolled diabetics run out of gas.  (It is flushed down the toilet.)  Eventually, dehydrated and comatose, the uncontrolled diabetic will waste away and die.
      Imagine if you had a car with an engine that did not have a carburetor.  Remember, a motor works by burning fuel mixed with air.  Fuel needs oxygen to burn just like a wood fire.  The carburetor, for those who don’t know, mixes the right amount of fuel and air.  It then feeds this mixture slowly to the engine. Too much fuel in the mixture and the engine “floods” (it may clog up and not start, or it simply doesn’t run well).  With too little fuel, the motor will run out of gas and stop.  If you were given a car with no carburetor, to make it run you would have to spoon feed the right amount of fuel into the engine continuously.  If you dumped a whole bunch of fuel in at once, you would flood the engine and then later (down the road) you would run out of gas.
     A diabetic has a similar problem.  Their “carburetors” don’t work well.  Insulin is the carburetor for the body.  It controls how fuel mixes in the body.  Easting infrequently with large meals (like our traditional three meals a day) will “flood” the bloodstream with glucose (fuel).  In between big meals, running out of gas could be a problem.  If you eat too much fuel (food) all day, the engine stays flooded all day.  If you skip too many meals, you run out of gas.
     A continuous level of properly measured glucose with oxygen must be maintained in the blood.  If this is to be maintained when the “carburetor” is broken, food (fuel) needs to be “spoon fed” throughout the day.  Diabetics need to “spoon feed” themselves with frequent, small meals.  How much fuel there is in food is measured in calories.  The correct amount of food (measured in calories) needs to be eaten at each small meal.  Both when and how many calories is important.  Activity levels will determine how much food (fuel) is needed (a motor wide open takes more fuel than one that is just idling).  No diabetic can do well without a proper diet.  There is no insulin shot or any other medication that can overcome too many or too few calories.  Your “diet” is everything you put in your mouth.
     I hope you begin to realize how important a diabetic’s diet is to help control blood glucose.  It not only needs to be nutritionally balanced, it needs to be the right amount of “gas” (calories) at the right times.
     One can neither fast nor feast.
     Rather, it is a carefully measured caloric intake and six small meals a day that help keep the diabetic’s body “running” properly.  Every cell (motor) in the body is affected by glucose control.  Diabetics feel and live as well as they eat.  Proper fuel intake (diet!) for a diabetic is a matter of life and death. ©

You run out of gas, 
you run out
of go!

You run out of gas, you run out of go.


Chapter sample:  12. Introduction: No Crap Diet for Diabetics

     You probably wouldn’t be reading this unless you, or someone you know, has been diagnosed with diabetes.  Neglected diabetes makes people sick, so it is not a diagnosis that can simply be ignored.  Patients with poorly controlled diabetes feel very badly and sometimes do worse.
     In contrast, diabetics who maintain perfect blood glucose (sugar) control tend to do quite well.  Most also feel well.  The treatment for diabetes, correctly done, is very effective.  Therefore, it is worth knowing how to treat diabetes.  Any person, with this book and a doctor, can control diabetes.
     If the treatment for diabetes were simple, every diabetic would have perfect blood glucose control.  Most do not.  For those who have started treating this disease, the task at hand does seem formidable.  Many issues are complex and some are even controversial.
     You want to begin by finding the most “bang for the buck.”
     It is hard to find the best solution if you do not understand the whole problem.  Once you do understand the problem, you then also have to be willing to work on the solution.  But then you have to know how.  Only then can work began, one step at a time.
     However, have you ever had a problem so big that you did not know where to begin?  Have you ever been given directions so complicated that you did not know which way to turn?  For many diabetics and their families, that is what diabetes has been — a big problem with complicated directions.
     I have been a family practice doctor for more than fifteen years.  Over the years, it has saddened me to see how confused patients are about diabetes and what they should do about it.  Many want to do well, but do not know how or where to begin.
     In order to achieve any goal, especially those hard to reach, someone needs to make it clear what these goals should be.  Many patients and their families discover that modern medicine and scientists never seem to accomplish this.  The language of science has many words that only a scientist really understands.  “Experts” in the field of diabetes are still slugging it out on how to treat this disease.  It is not hard to understand why a lot of patients and their families are confused.
     A doctor cannot do for you what you must do for yourself.  Most people know this.  But you cannot do well if it is not clear what needs to be done or where to start.
     The “no crap” diet refers to both the need to eliminate junk food (“crap”) from diet and the need to make an improved diet as straight forward as possible.  The scientific babble commonly used in medical texts is “crap” most ordinary people do not need nor want to understand.
     Much of the material in this book is simple.  Some of it is very blunt.  I do this to make important information and goals straightforward.  The truth is not always what you want to learn.  Nevertheless, it is what you need to learn.  All “crap” stops here.
     I have always received a lot of praise from my diabetic patients for being a good teacher.  Some have also muttered that I am a good preacher.  In any case, diabetics armed with better understanding make better patients.  It is much easier for patients to decide how to control diabetes once the disease and treatment are clearly understood.
     Some authors attempt to simplify problems by writing material at a third grade level.  Doing so produces information designed for dummies.  While the average diabetic is not college bound, the average patient is not stupid either.  Anyone who can read or understand a newspaper should be able to follow my book.
     This book is written for people who have common sense but are not necessarily interested in getting a degree in medicine.  Everything is written to explain the “whys” and the “whats.”  Understanding the “whys” makes the “whats” a lot easier to remember and do.  Easierrrrr, not necessarily easy.


     When a lot needs to be done, a list of priorities needs to be created.  When doing so, it is important to ignore information about diabetes or dieting that is trivial, not true, not healthy, too confusing, not important, or not helpful.
     Most reasonable people become confused by all the complicated conflicting advice the American Diabetic Association, dieticians, doctors, nurses, friends, relatives, books, articles etc., etc., can provide.  A simple list of what to do that stands the test of time never seems to emerge.  One year they tell you to do this and the next year they tell you to do something else.
     At no time has the disease diabetes changed, but medical advice, goals, and priorities do so frequently.  The harder some patients try to keep up and understand this disease, the less some do.  It can be surprisingly hard to find clear goals to go by or which ones to begin with.
     For other diabetics, the worst enemy they face is themselves.  Even if it was easy to know everything that needs to be done to effectively control diabetes, most cannot simply do it.  Part of who we are is the way we do things and old habits (including bad ones) are resistant to change.  Reluctance to change “our ways” is a difficult obstacle for anyone to overcome.
     Not surprisingly, every diabetic finds problems that seem difficult to solve.  No one is perfect.  This usually makes controlling diabetes, at some point, difficult to achieve.  Solutions need to be found.  If you are not part of the solution, you are part of the problem.
     Diabetics cannot choose whether or not they have diabetes.  Rather, diabetics can choose whether they will control diabetes, or let diabetes control them.  It is well proven that diabetics who maintain normal blood glucose (“sugar control”) can avoid complications caused by diabetes.  They also feel so much better.
     You can, with this book, recognize old habits that must be eliminated and new goals that have to be achieved.  If you keep doing the same things, you will keep getting the same results.  Therefore, “trying” doesn’t count.  Like it or not, disease can force us to face grim choices.  Diabetes treatment is important.  Die “trying” or do better with success are your best options.
     The bad news is that there is no cure for diabetes.  The good news is that diabetes is one-hundred-percent treatable... but it is a lifelong, life-style change.  Some describe this treatment as a pain in the rear.  I call it the “no-crap” diet for diabetics.  You can call it what you want.
     TEN STEPS to Control Diabetes requires: patience, perseverance, common sense, the three “Rs” (readin’, ritin’ and ’rithmetic), repetition to aid retention (in other words, two more “Rs”!), and a desire to stay alive.
     If you feel the need to read the end of the book first, to see how it ends, don’t bother.  I will tell you now how it ends.  The book ends as it begins: “you can’t make chicken salad out of chicken crap.”  If you eat like an American, you will die like an American.  The treatment of diabetes, unfortunately, demands dietary changes and not just medication.
     It will take the entire book for you to understand what diabetes is, how diabetes needs to be treated, and what a diabetic must do.  This book is designed to help the diabetic who does not want to be harmed by this disease.
    TEN STEPS to Control Diabetes will show you the way, one small clear step at a time... ©

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