Diabetes – a Low-Energy Disease

There is more to diabetes than elevated blood sugars; fat metabolism plays an important role as well. Since there has been quite a bit of discussion on this blog about Type II diabetes, especially in relation to being overweight, I have asked integrative physician Alexa Fleckenstein M.D. to explain the approach she has used successfully with her patients. Here is her response:

Conventional medicine manages diabetes – but it doesn’t cure it The conventional view of diabetes mellitus is as a disease of too much sugar in the blood. The medications designed to help the disease consequently lower blood sugar levels – by different mechanisms.

More recent research seems to imply that diabetes is more than elevated blood sugars – fat metabolism seems heavily involved too. But from the patient’s perspective, it looks like diabetes is a disease of too much appetite: Diabetics are hungry all the time. Ten percent of Type II diabetes patients are not overweight – but ninety percent are. Diabetes could be called a disease of abdominal fat leading to abominable consequences. Its poetic name honey-sweet (urine) flow certainly does not evoke the horrible consequences of this disease: amputations of limbs, blindness, kidney failure and dialysis, impotence, cancer, depression – to name a few.

But even in the light of these abominable consequences patients don’t stop eating. Diabetes is a billion dollar business for physicians and the pharma industry – no wonder a cure has not been found yet. And the patients “just won’t listen” to dietary advice. Why do they keep eating? Sebastian Kneipp (1821-1897) used to say “Large dinners fill coffins” – yet Sebastian Kneipp himself was overweight and could not refrain from eating his beloved dumplings, clearly unable to heed his own advice.

I am always struck by how much diabetics suffer when I talk to them. They seem to suffer from a profound fatigue – and eating seems to help. At least for a short while. They eat for energy. People have to make a living, take care of a family – and they are in a race to eat so they can function.

It turns out that diabetes affects the mitochondria, the energy factory of the cells – and diabetes reduces the energy output of the mitochondria. It is as if diabetics stack wood around the mitochondrial stove until that stove – buried under fuel that can’t be used – is unable to function any longer. Paradoxically, all the food hinders proper metabolism, and each too-large meal leaves the patient weaker and sliding further down the precipice to diabetic diseases. All that stoked wood is a fire hazard: Any moment the little energy factory can blow up into a catastrophic illness like heart attack, stroke or infection.

The low energy of diabetics affects their physical as well as their mental abilities. Exhausted as they are, diabetics scramble to make it through their daily activities – they just can’t face going to the gym as well . Of course, exercise would use up some of the stacked fuel and reduce the fire hazard – but they can’t bring themselves to move. Period.

Diabetics have the odds stacked against them even beyond poor mitochondrial function. I can think of several other mechanisms that would explain why diabetics overeat: Studies have shown that overweight people have different bowel bacteria than slim people, which means that the bacteria are craving their food. I liken it to a computer virus: The bacteria send their cravings to the patient’s brain and, obediently, the patient grabs for another piece of unhealthy junk. Furthermore, the abdominal fat is of a different quality than fat of other body parts: Abdominal fat sends out hormonal messages to the brain – again asking for more food since the fat cells need to be fed in order to grow.

Another strike against overweight people is that the more you eat, the hungrier you get. In times of scarcity such a mechanism that helped people survive. In lean times, one was less hungry; in times of gluttony (say, a mammoth needed to be devoured) people had more appetite. Nowadays, when lean times never occur, the overweight just suffer from incredible hunger pangs – which are largely not acknowledged by the medical community but are chalked up to “lacking willpower.”

Then there are food cravings induced by food allergies. We do not really know why this is so, but there is no doubt in my mind that you crave exactly the food you should not eat because it makes you sick. People usually don’t crave carrots and apples – they crave cheese and Twinkies and chicken wings.
And the above are just the innate reasons why overweight people cannot stop eating. Now consider the reasons which stem from our modern food production: New molecules are so alien to our bodies (either by themselves or in unnatural combinations) that more people than ever are experiencing food allergies – and food cravings. High fructose corn syrup and overly processed milk proteins lead the list, but artificial colors, artificial dyes, preservatives and altogether newly designed molecules are not far behind.

And the food industry uses to its advantages the ingredients people have a hard time saying “No!” Fat, sugar, salt make any food more yummy, regardless of its real nutritional value – which is usually nil.

In conclusion, diabetes is a genetic disease so with the above odds keeping up the damaging weight, diabetics have only one chance: To force “unnatural” changes on themselves, against their inclination. For the time being, medicine is no help – the pill that takes away those too large appetites has not yet been invented. So, this needs to be done: Feel your belly right now. If it is bulging at all, you are overweight. Then take your strenuous path: Get off the chair, away from the computer or TV, and start moving. And every time you want to eat, “need” to eat, grab your fat and convince yourself that you won’t starve if you don’t eat this moment. Keep to a schedule (three big meals or five small – but never a bite after dinner because the night is repair time for the body) and find a friend to walk with you – or kayak or swim or dance! This is your only chance for good health.

-Alexa Fleckenstein, M.D. author: Healthy to 100 and Health 2 0


Filed under diabetes, Healing, Health, weight loss

94 responses to “Diabetes – a Low-Energy Disease




  2. B.E. Lewin, do I understand you right that you are diabetic but not really overweight?

    If that is the case, you have a good chance of having gluten enteropathy (also called celiac disease or non-tropical sprue).

    You can ask your physician to test you for celiac – which is a bit iffy because their are three tests, they are somewhat expensive, and I have seen wrong negatives.

    You could also just leave out gluten (wheat, barley, rye and oats) and see how you are doing without gluten. Often, there is a dramatic improvement. And if you are at it, stop all dairy, too, because milk is a highly inflammatory food.

    Let us know how you are faring! And all the best!

    Alexa Fleckenstein M.D.


    • Steve

      Hi Doctor:

      I’m frustrated, I’m 57 years old, 5′-10″ and 158Lbs. I play a lot of tennis and consider myself in great shape and have been told that also. Did I mention I’m type 2 and have been so for 7 years. My last A1C was 6.1. I take Metformen 850 twice a day.

      When I play tennis (singles) in the the high heat 93+ within 30 minutes I’m physically fatigued, my legs just won’t move. Is there anything I can do to combat this?


      • Dear Steve, it looks like your email got lost during summer traveling. Sorry!!

        As I mentioned before, diabetes in people who are not really overweight, often occur in un-diagnosed celiac disease, or generally in gluten intolerance.

        Try to eliminate wheat, rye, barley and oats from your diet. Rice and quinoa often work better in these people but, truth be told, they usually do better without any grains. Just stick to vegetables, meats, fish, eggs -preferably organic. And add a good olive oil and coconut oil to meet your energy needs. Fat doesn’t make one fat – sugars and carbs do!

        Let us know hoe you are faring!

        And again, sorry for the enormous delay!

        Alexa Fleckenstein M.D.


  3. Charlene

    Hi, there. I would just like to have some advice if I should see a doctor.

    I am not exactly overweight but my weight “yoyo”s. I have problem with my appetite starting late last year. I would eat a lot and still never feel full. Originally, I thought it would be due to dietary problems. My family members consume more vegetable and fruts than meat. But later on, even when I start having regular meat intakes, I end up craving for the next thing after my meal.

    Please advise.


    • mike1969@teksavvy.com

      I used to have these crazy cravings until I found Intermittent fasting. If you have diabetes or other diseases you may want to consult with a doctor. I do the 16 hours fasting. I start eating at noon and finish my last meal at 8 pm. I don’t have the cravings I used to have. I do drink a lot of water though. If you’re interested in the science part google leangains. You will see the scientific studies the author provides. It is based on islam religious people who fast for 16 hours.

      I have found a lot of benefits of fasting. I have to admit when I first heard about I was against it.


      • mike1969,
        Going for longer periods without eating is generally beneficial to the body. Biggest fast of the day should be between dinner (as early as possible) and breakfast – it is called break-fast for exactly that reason. In medieval times, people were usually eating only two meals a day – one at about noon, in the fields where they were working. And one in the evening, around six pm, when they came home from work.
        These short-term fasts are good for everybody who is healthy. But they are not good for children, pregnant or lactating women, the feeble elderly and anybody with underweight and/or anorexia. Most diseases – heart disease, diabetes, arthritis, cancer, and so on – are getting better on fasts.

        Thank you for your input, Mike!

        Alexa Fleckenstein M.D.


  4. Charlene,

    Appetite and cravings have many different causes and are not easily figured out.

    Sometimes the craving is spiritual, and you are not craving food but a fulfilled life. Especially with kids, women tend to think about their own needs last, slowly building up a “meaning debt”. To remedy this, think about why you have been sent here on Earth to do what specifically that only YOU can do – if possible, of course, without leaving people behind that depend on you. This can take you a long way.

    Then there are certain diseases where increased appetite is physical: in high-cortisol or high-insulin states for instance (which, in turn, can be triggered by high-stress and sleep-deprivation), high stomach acidity or Zollinger-Ellison syndrome. Look at your stress levels and work on sleep hygiene; if your cravings don’t improve, see a physician. Likewise, some medication can induce increased appetite – ask your pharmacist.

    Lastly, certain foods induce cravings – and those are usually the foods we shouldn’t be eating: sweets, white starches, and everything you might be allergic to. You yourself seem to think you might have a tendency to diabetes and metabolic syndrome. Eating more leafy greens, cabbages and root vegetables, you might feed your body what it really needs.

    Eating sugar and white starches uses up B vitamins. Your body craves more food because it hopes for B vitamins in the next meal. If you then eat more sugar and white starches, your B vitamin deficit only increases – and cravings are spiraling up. With willpower, you can reduce food intake – but only for a short time. Yo-yo weights follow.

    You should see a physician – make sure she looks at you holistically.

    All the best!

    Alexa Fleckenstein M.D.


  5. Matt N.

    Well this article was depressing. It seems to be speaking to me personally. My question is, just how do I get the energy to exercise?

    I’m 43, 40 pounds overweight, and recently diagnosed as “pre-diabetic”. I’m sitting here staring at my treadmill, but I just feel so tired! People say “just get some exercise”, as if I would respond “Oh, why didn’t I think of that?” But at any given moment of my life, I could lay down and go to sleep.

    My weight is in my abdomen. I get tired, more than I used to. Even in the past year, I can feel it more. Now I hate going up the stairs. I’ve got two young kids, 3 and 6, I NEED to have more energy.

    I recently started walking a mile at lunch. After a couple months of that I don’t feel a bit different, and haven’t lost any weight.

    I wonder if there’s something, maybe an energy drink, that could give me the boost I need. I just checked my blood level and it’s 132, higher than normal for me. Maybe all I need is a cup of coffee. I’ll get one now, see if that helps.

    Thanks for any thoughts.


    • Matt N.,

      Most energy drinks boost energy via the sugar mechanism – and that would make your problem worse over time.

      Green tea is the one energy booster that not only increases your energy but also improves your health in the long run. So, I recommend green tea. If you never had green tea, it might taste like grass to you – it is an acquired taste. Don’t put sugar in it. Try to drink it as medicine. Avoid tea bags – rather look for loose tea. There is an incredible variety of green teas on the market. Unfortunately, they usually are better the more expensive they are. But even a cheap tea from a Chinese supermarket will have the good health effects.

      Raising two little kids can be very demanding, and at times depressing and lonesome. Do you have a spouse to share the burden, or is it all on your shoulders? Try to share parenting chores with other people in a similar situation – I would never have gotten this far without my friends who were there when the going got tough.

      The answer to your question is: There is no shortcut – and anybody who offers you a fast cure is lying. But you should discuss these issues also with your physician – sometimes people have low thyroid function and similar problems that add to the diabetes (if you had that, I also would check for gluten intolerance).

      The good news is that by walking daily, you have already made that important first step into health and have seriously begun to change your metabolism. Now, perhaps, try to walk one and a half mile every day – or row in front of TV. Stop all sugars and dairy (also for your kids), and see if you improve.

      Keep in touch!

      Alexa Fleckenstein M.D.


    • Katrina

      I have insulin resistance as well. My advice – go to a diatician. She can set you up on a diet that will help you loose the pounds and help your body manage it’s insulin resistance (frequent low carb meals/snacks). You will soon after feel more energetic! I am 20 and I can whole heartedly sympathize with your energy problem, but the diet has helped me get up and actually get some exercise in sometimes. Exercise, over time can help with your condition, more muscle cells absorb insulin and sugar easier than other cells. Over time you should have more energy!


  6. Kumar

    I am 39 years old and have type 2 diabetes, for over 10 years now. In the last 6 months or so, my cravings has been very high. I am not able to stop myself from eating or drinking, some thing or the other…every 30 minutes. My morning sugar levels are around 220 and it is getting very depressing. I will try the green tea suggestions (I am also addicted to coffee – I drink 10-12 cups a day).



    • Hi Kumar,
      I have asked Dr. Alexa to respond to you, but please be sure to talk to your doctor as well. Online advice should never replace consultation with your physician and should always be discussed with your healthcare provider.


  7. Dear Kumar,

    Those cravings are horrible. This is what makes you crave the wrong food:

    1. Overweight people are more hungry than thin people – way more hungry. It has to do with that when we were cave people, it was useful to eat more in times of plenty (say, a mammoth had to be devoured) and less in times of dearth.

    2. When you are eating the wrong foods (which is mostly dairy and empty starches and sugar), you feed the wrong bacteria in your gut. And when you crave food, it is actually the bacteria craving the food and sending messages to your brain to make you eat more of the wrong foods.

    3. If you have food allergies (and chances are, you have), your body craves those foods especially (I don’t know by which mechanism – but it clearly happens in people with allergies).

    4. Manufacturers make foods so that we crave them more, that is a fact. Because in history, people were always starving, more or less, it helped if you liked high-calorie foods like sweets, cheese, and so on.

    There might be other mechanisms that make you crave food – but these come to my mind.

    What can you do? Just knowing that these mechanisms are real might already help you – because it is not your personal fault that you crave wrong foods. You are hard-wired for it.

    Nevertheless, you have to break the habit. The best way is to eat tons of vegetables (with olive oil and garlic), because they starve the harmful bacteria in your gut and reset your taste buds. And don’t be afraid of good oils – you need the fat for feeling full and for brain function.

    Last piece of advice: Take a cold shower and do a little walking. Or gardening. Or cleaning out the basement.

    Good luck! Let me know how it will go. Be patient!

    Alexa Fleckenstein M.D.


  8. Since discovering higher than normal blood glucose levels about 10 months ago, I have been experiencing the problems that are explained here. Lacking energy many days of the week and non stop eating during each evening after my supper have been especially worrisome to me. Belly fat is another. Everything mentioned here brings it all together whereby I can now focus on the causes of my problems with untreated diabetes. I appreciate this site and the professional people who make this possible. V.F.


  9. Thank you Vaugh – comments like yours make it all worthwhile!


  10. Dear Vaugh,

    You are so welcome! Please, let us know how you are doing.

    And please, now that you want to change things, don’t fall into the “sugar-free” trap (or “fat-free”, for that matter). Stick to natural foods, vegetables mostly, and you will be fine. Let us know how you are doing!

    Alexa Fleckenstein M.D.


  11. Paige

    I am 36 years and I have type 2 for one year now, recently I realize I don’t have energy to do much.
    I work all week and on weekends I do house chores, but it takes me all day to do that because ever half hour I have to sit and rest for awhile to regain energy to start again.
    I am not overweight I weight 130lbs and I am 5″3.

    Recently my A1c was 4 and the doctors told me to keep it up, but a month after that I am having these low energy. Can you please give me some advice



  12. Alexa Fleckenstein M.D.

    Dear Paige,

    Yes, you have normal weight – which brings up the question why you have diabetes at all.

    Often, people with normal-weight diabetes have unrecognized gluten intolerance. You can just try a gluten elimination (no wheat, rye, barley, oats) or ask your physician to test you (I find the elimination more reliable than testing at times) and see how you feel. Eat rice and beans – they are allowed and good for you.

    Of course, I hope your physician has checked why you are so tired. It definitely is not normal – and I would not automatically chalk it all up to diabetes.

    If you are at improving your diet: Leave out all dairy too because it is a very inflammatory food and really damaging in a lot of conditions.

    Please, let us know how you are faring. All the best!

    Alexa Fleckenstein M.D.


  13. Sam Joner

    I have been reading a lot on here and have picked up some useful info. One thing I have found which works well for a good nights sleep, feeling more relaxed and focused is binaural beats. As strange as they may sound (excuse the pun) they are a very powerful method of relaxation.


    • marilyn

      My A1C l is at 14.9, I had two pancreatic attacks about 2 years ago, I have a damaged pancrea, I take 3 types of medication for my diabetes, I have cravings all the time and am always hungry, I try to eat all the right foods, I,m 5’6″ and weight 160lbs. also battleling with manopause, I eat fruits and vegetables, hardly any meat, mostly chicken breast, drink alot of water. I want to make sure that I am doing all the right things, by the way I am 53 years old, have no energy, always tired. also taking prozac for depression. Any suggestions?


      • Sorry, Marilyn, somehow this got lost in the shuffle.

        This sounds like a difficult situation. You can only start with small steps – literally steps. Right now, go for a ten minute walk. Which means: Leave the house, walk for five minutes, then turn around. Walk a little bit more every day.

        Leave out all dairy, and all sugars and starches (bread, , cake, cookies, pasta, potato, sweet potato, and so on), except brown rice. No sweeteners. Your case is so severe that only drastic measures will help. Eat vegetables and fresh fruit (don’t worry that they are too sweet).

        If you don’t do anything, you will soon get sicker. Go to my blog


        and read about “Diabetes – the Voracious Disease.” And stay in touch, and tell us how you do!

        All the best!

        Alexa Fleckenstein M.D.


  14. Marilyn,
    I have asked Alexa Fleckenstein, M.D., to comment on your post. She is traveling for another week, so it might take that long for her to reply. Please be patient!


  15. Excellent post. Will you please write much more about this topic.


  16. There is much more about integrative approaches to diabetes in Dr. Alexa Fleckenstein’s blog:
    (See also the direct link in my blogroll). I recommend you pursue this topic with the expert!


  17. James

    “For the time being, medicine is no help – the pill that takes away those too large appetites has not yet been invented”.
    Wow are you kidding. I thought a pill was invented not only for “those too large appetites” but for the energy problem as well.
    desoxyn? ritalin? Amphetamines have such a stigma attached to them because of the potential for abuse but come on perhaps there are people that really need this and can use it responsibly.


    • James,

      Yours sound like an easy answer to a complicated problem: just give them amphetamines, and presto! they will have energy.

      Unfortunately, the problem lies deeper: Because in diabetes the “energy factories” – the mitochondria – are affected, taking amphetamines will only get you deeper into the energy debt. For a while, the amphetamines would mask the deep underlying fatigue – and then one day you would crash.

      That is exactly what happens with “normal” amphetamine users; with diabetics, it would just happen sooner.

      There is only one way: Restore the mitochondria with better diet, sufficient sleep and moderate exercise.

      Alexa Fleckenstein M.D.


  18. tom flagg

    my grand daughter stella (10 yrs old) has just been diagnosis with type 1.. she is under the care at children hospital in chicago….any information you have would be appreciated.. thanks, tom


  19. Dear Tom Flagg,

    So sorry to hear the bad news!

    The most important information for you is to know that your granddaughter has been diagnosed with type I diabetes – which is very different from type II diabetes about which I talk so much.

    Basically, type II is more or less self-inflicted, whereas type I strikes out of the blue; medicine has not yet figured out where it comes from.

    Type I is a disease of lacking insulin – the cells that should produce insulin have been destroyed in an autoimmune process. Type II, on the other hand, is a disease of insulin-resistance. One might think of it as cells that have become so loaded with fat, that they can’t react well to insulin anymore – so it needs more insulin to make them function.

    Having said this: Diabetes type I is a disease that requires careful monitoring. It will ask a lot of responsibility of your granddaughter. Unfortunately, adolescents often rebel by willfully neglecting their diabetic schedule, and thereby threatening their future health. So, the best you can do is building a relationship of trust (not of control – the control has to come from your granddaughter), so that you can accompany her through the difficult teenage years.

    I recommend eliminating all dairy products from her diet as it seems to be implicated in the autoimmune process that destroys the insulin-producing cells. Healthy eating – with lots of vegetables – will protect her immune system. And make sure she gets enough sleep because stress seems another factor in the development of the disease.

    The most important thing is that she finds a physician who has her trust – she will rely on that doctor for many years to come.

    The good news is that your daughter is young enough that she will see new medical technologies – the hope in the moment lies with stem cells that might replace her destroyed beta cells.

    All the best for your granddaughter – who is lucky that she has a grandfather who cares.

    Alexa Fleckenstein M.D.


    • P Carlin

      Type 2 is self inflicted? Not genetic? Not advanced by other auto immune problems that are already at play? I understand that you are a medical professional and can have some experience in treating type 2, however I find some of your ‘sweeping’ statements to be offensive. Not to mention not correct for everyone.


      • Dear P Carlin,
        Sorry that you take offense at my statement that type 2 diabetes is “more or less self-inflicted”. It is, indeed, related to excess weight and obesity in 85 to 90 percent of people. The rest get it often secondary to gluten intolerance (and often are the skinny diabetics). And no, the cause of type 2 diabetes generally is not autoimmune disease. But type 1 diabetes is linked to autoimmune mechanisms.
        Perhaps I should say the overweight, unhappy type 2 diabetics are the victim of our society that feeds them sugary sodas, diet drinks that further obesity, and information about nutrition that is heavily influenced by the food industry’s interests, not the patients’.
        But if I call type 2 diabetics “victims”, I take away the one power they have to get back to a healthy normal life: To decide what goes into their mouths, and what gets not, and to improve their sedentary ways.
        Genetics? Sure you only get type 2 diabetes if you have the genes for it. Unfortunately, most of us carry them. But when you look at photographs of the thirties, people on average were much slimmer – and carried the same genes. We should blame our lifestyle – or should I say: our lives – for type 2 diabetes.
        Getting angry about uncomfortable truths does not help. Going to action may help. Very soon my diabetes book will come out and you can judge firsthand if my sweeping statements make sense or not.

        Alexa Fleckenstein M.D.


  20. S. Eastling

    Dear Tom Flag,
    I just got a book called “Dr Bernstein’s Diabetes Solution” by Richard K Bernstein, MD. He is a type 1 diabetic. He tells his story in the book and what he has learned about Diabetes. He is now in his 70’s. He was diagnosed as a child also. This book may be helpful to you, it has been for me, a type 2 diabetic. All the best to you.


  21. Wow, great.
    My wife was complaining that , i am not active any more. I searched on google “diabetes low energy” and got this blog post. The information shared on this blog post is of most high quality and it will help many people like me who are suffering from type 2 diabetes.

    Type 2 is life style oriented diabetes. Change your life style before its too late.

    Amit Patekar


    • Dear Amit Patekar,

      Indeed, diabetes type two is a lifestyle disease – too much wrong food, too little exercise.

      About ten percent of affected people are not overweight; those should be checked for gluten intolerance (or some other metabolic disease).

      If you add some movement and better food (vegetables, vegetables, vegetables!) to your life, hopefully your wife says soon again to you: “Wow, great!”

      Alexa Fleckenstein.


  22. Ali

    Hi. What do you think of the relationship between stress and diabetes or pre-diabetes? Every time we stress it affects our insulin level right? And once we’re past the “fight or flight” reaction then we are set up for a craving… is that correct?
    I’ve been a “stress eater” for a long time. I still have many stressors in my life including a child with multiple special needs who is healing of vaccine reactions as well. Thankfully I’ve learned some things about how to use supplements.
    I am 52 and am quite overweight now and carry alot of it in the belly. I’ve started having health issues. What I’m learning is that perhaps I can become less insulin-resistant (and less fat and tired) if I am very careful for quite a while about eating balanced meals and snacks and avoiding sweets and also if I exercise. Destressing is a goal too but sometimes not easy. Because I now have joint issues I rebound on a small trampoline. It seems to be helping my muscle tone.
    I was told by a naturopathic doctor that when she has a craving she takes a hefty dose of probiotic and that calms the craving. I’m trying to remember to do that. It does seem to help some.
    I agree with you that hypothyroidism can be involved too. There’s a book called “Type 2 Hypothyroidism” by a Dr. Starr that is very interesting.
    Do you recommend that people use things like cinnamon and gymnema sylvestre to help regulate blood sugar? For anyone out there that likes to research the U.S. Library of Medicine has lots of studies involving herbs. I search with these key words – herb, herbal, bark, root, plant, leaves, berries, vitamin and vine. Use one at a time and add a word or two of what you’re looking for such as “anti-inflammatory” or “anti-diabetic”.
    Thanks for your excellent article. Blesssings! 🙂


  23. Dear Ali,

    You certainly have your plate full – and you have done a marvelous job reading up on the problems. I agree with everything you write.

    Here are some more ideas:

    1. Stress induces the hormone cortisol. High cortisol levels make you very hungry, and indiscriminately so. You cannot always avoid the stress, but you might be able to break down the stress hormones faster by going for a walk – instead of eating.

    2. When you get a craving, it is not so much YOU who has the craving but the bacteria in the gut. If you eat the wrong foods (mostly sugars, starches, grains) you are feeding those “wrong” bacteria. If you could leave out all (or most) of the foods that give you cravings, you will have far less of those cravings.

    3. I found helpful to feed cravings with some cooked vegetables. They go away immediately!

    4. On my website you’ll find a description how to do the “Five Minutes Meditation”. Doing even such a short meditation will refocus you and might bring you beyond the cravings in many instances.

    Dear Ali, I am aware that it always will be a struggle. But you show already all the bad effects of stress, obesity, diabetes – so it is wonderful that you started to turn around your fate. Let us know how you are doing!

    Alexa Fleckenstein M.D.


  24. Ali

    Thank you very much Dr. Fleckenstein. 🙂

    Your advice is very helpful and I will work to put it into practice. And you are very encouraging. So many health issues have seemed to come up almost at once for me… perhaps peri-menopause enhanced the stress.
    I’ve been overall very good about avoiding sweets and starches, grains and dairy. But the tummy fat seems so determined to stay. Is it true that if you are very very careful you can kind of reset your system in about four weeks as long as the thyroid is functioning properly? I’m just so hoping to have the weight finally start coming off in a more noticeable way. I did lose five pounds but now I seem stuck. I want the weight off because my joints need a break and so does my back and several other things. I also am supposing that insulin resistance is hard on my organs. My kidneys in particular weren’t too happy recently.
    Over at the U.S. National Library of Medicine http://www.pubmed.com there are studies on Berberine / Oregon Grape with regard to it’s effects on insulin that look very interesting. Do you think it would be good to supp with that?
    Thank you. I’ve been pretty miserable for several months but perhaps for the first time in many years I will find myself truly feeling healthy and good…. with reserves to help me with my little guy. 🙂 Ali


  25. Dear Ali,

    This time I do NOT agree with you: The weight loss should be really slow so that the body does not go into survival mode and defies weight loss.

    I always tell my patients not to lose more than two pounds per month!

    That might sound disappointing to you who wants to lose fast. But experience and science has shown that fast doesn’t last. The real challenge is to not regain any pounds during that month.

    I have an idea: I will write up a ste-by-step weight loss plan for you on my website – look there tomorrow or the day after tomorrow.

    Step # 1 will be: buy a green leafy vegetable (chard, spinach, kale, dinosaur kale, kohlrabi greens, etc), cook it with oilve oil and garlic – and eat it.
    Step #2 will be: Leave out all soft beverages – including “diet” beverages.

    I will write out the program, and explain step-by-step.

    Good luck for you, Ali – and good health to you!

    Alexa Fleckenstein M.D.


  26. Ali

    Hi. Thank you! I will start to enjoy some chard etc.. I don’t drink pop or juice… I’m eating pretty well. I may need to up veggies and lower protein though. I am off grains and dairy except some cheese.
    This link has a bit of info. on Berberine and insulin. That’s why I was asking about Oregon Grape. http://www.tasteforlife.com/whole-health/conditions-treatments/fight-diabetes-naturally
    I’ll look for the plan. I need to embrace vegetables beyond my fav zucchini. 🙂 Hugs, Ali


  27. Ali

    Sorry to be a pest…. 🙂

    Where would I look for the step-by-step weight loss plan?
    Thank you!


  28. Dear Ali, show up on the “blog” site today or tomorrow.

    And if you miss it, the title will be “Fast Will Not Last – Step-By-Ste- Weight Loss Program” – and you will be able to find that in the CAPITALIZED index.

    Berberine and insulin has been looked at, and is promising. I personally think that not any one substance makes a difference, but eating a wide variety of plant food will. Because every plant adds hundreds of compounds to fight diabetes; Berberine is just one.

    Good luck, and let us know how you are faring!

    Alexa Fleckenstein M.D.


  29. Ali

    Thanks again. 🙂 I saw the naturopathic doc today… I’ve had some symptoms that to me…were scary… swelling on my right side and some others. She said she’d be more concerned if I were swollen on my left side (indicating a heart issue) and she told me my kidneys and bladder need attention and afew other things. Online today I learned that ongoing high blood pressure can damage the kidneys. I didn’t know this before and it’s good to know. I’ve had somewhat elevated BP for a while now… and will be sure to get that under control (naturally I hope!). I’m a bit encouraged…. I added a natural B complex from Standard Process yesterday and I think it really took the edge off my mental stress and I feel a bit more energy. I’m still eating healthfully and will get on my mini trampoline again soon. That has been a blessing…. very gentle yet it seems to really be strengthening my muscles and balance. Because my life has been so stressful with our little guy… up many nights fighting for his life…. and some other stressors…. it’s been hard to take care of myself. Thank God he’s doing better and I can put some attention toward some healing. I still have mega stress… but I’m learning new ways to handle it. And… I’m getting off the Killer Sugar Ride. It took me feeling really rotten to do so… sad to say… but at least I’m getting off and onto the Blessed Balanced Walk. I like this better. Hugs, Ali


  30. Marion Price

    I am male 86 weight 186 height 5.7 have recently had open heart with valve replacement and 1 bypass, I have taken rehab 1 hour for 10 hours and still feel tired. I know that the ice cream and pastries that I eat are not good for me and if as you say I will try the green tea and additional exercise to see if I can regain the energy that I need.


  31. Dear Marion Price,

    So, you know already what’s the right thing to do – it’s just so hard for some people to stay focused on what they really want.

    If the ice cream and pastries are the only good thing in your life, I wouldn’t want to take them away from you. If you have things and people to live for, perhaps you can throw that garbage food out. Stick to vegetables and fruit — and, at this time of the year, berries. Blueberries fight diabetes.

    Your tiredness might also come from the effect of anesthesia on the liver. So, get a good liver herbal concoction (I trust GAIA products, as they are not just cut herbs but herbal extract with more potency). Discuss the herbs with your doctor – especially if you are on blood thinners.

    All the best – let us know how you are doing!

    Alexa Fleckenstein.


    • mike1969@teksavvy.com

      According to Chinese medicine cold and raw foods and drinks impair the spleen. From what I read this mean your digestion is impaired. Not a good idea to eat cold foods or drink too much cold liquid. A small amount occasionally doesn’t hurt.
      Also I have found to be sensitive to tea, if you’re dehydrated (not clear urine) it’s best to stay away for a while. Also eating too many raw foods isn’t good so fruits should be reduced and stick with steamed or cooked vegetables. Poor digestion can lead a lot of illness from my understanding.


      • mike1969,
        I agree with your statements. Raw foods are overrated, it seems to me. But we have to allow for differences in genetic backgrounds: If you or your ancestors came from a tropical climate, you might get away with more uncooked fare. For most people, cooking (not overcooking!) gets more nutrients out of the food.
        Your tea comment I do not understand. It might very well be different with different kinds of tea. But, generally, I find teas excellent for rehydtration – much to be preferred over juices. of course, the old standby, water, might be the best, after all.

        Alexa Fleckenstein M.D.


  32. kishor

    This was a really nice topic to read. Myself a prediabetic patient for last four years have been trying to find out how to live a better life. The worst thing with me is wearing out very easily when working out. Recently i read online about CQ10. It says it helps mitrochondria to burn fats which really helps people with diabetes. If somebody has a idea about this supplement.



  33. scott lloyd

    hi ,doctor told me i had type 2 diabetes for just over a year i was quite a keen gym freak weight was 120 kg very muscular, noticed last year energy levels really low cant face going to gym after work or on weekends like i use to do .i stoped bodybuilding shakes ,as i eat very well over the years i could not put my finger on it ,doctor put me on metaformin said that i would feel better but i have not seen improvement diabetes is in my family as my father has died of complications from it and my mother has type 2 but shes 70 now. Im 35 shes had type 2 for about 15 yrs now and manages well i want to go back to the gym as before i read of bodybuilding diabetics but wonder how do they train really hard and build muscle ,forgot to mention as i do eat and train well in past i did have a sweet tooth of chocolate and it was a quick fix after gym can you help many thanks scott


    • Scott,

      Not all the information I would need are here – but these are a few preliminary thoughts.

      1. If you are well-trained and not obese, and your diagnosis really is type II (not type i), you might have an inborn metabolic problem – most likely a gluten problem, and you should eliminate wheat, rye, barley, oats. And while you are at it, I also would stop all dairy products (milk, cheese, yogurt, cream, and so on).

      2. You already realized you get the shakes when you follow your sweet tooth – so, leave out all sugar and artificial sweeteners (don’t buy “diabetic” stuff – they all contain artificial sweeteners which might be neuro-toxic).

      3. Before training have a meal that contains protein and fat (olive oil or coconut oil) and some complex carbohydrates (vegetables and/or beans). And if you are hungry after training, something similar afterward.

      4. As for rewarding snacks? Dark chocolate (preferably unsweetened – my favorite is chocolate nibs) – but don’t go overboard. The anti-oxidants in chocolate are healthy, and chocolate is also a mild pick-me-up.

      5.About your work-out – I can’t judge if you are doing something wrong. But at your age, you should be able to do about anything you set your mind to. Make sure your doctor is still looking what is behind this – because it is not normal for a young, training person to be affected by diabetes type II.

      All the best, Scott – and let us know how you are doing!

      Alexa Fleckenstein M.D.


  34. John

    Nice article dr. Fleckenstein. I don’t know that I have a question but rather not sure what else to do at this point. I am under the care of a doctor but doesn’t seem to help much.

    I am a male of 50 years. I am type II diagnosed 2 years ago, I am hypothyroid for 15 years, have severe sleep apnea for 9 years, B12 deficient, and Low-T for 2 years. Now as I said earlier, I am under care and prescribed for all three areas. I take Metformin for the diabetes, Levothroid for thyroid, and Testost CYP for the low-T. I take 3000 mcg of B12 a day with regular viatmins and D. After two years on the T shot I am barely breaking 300 on the labs. When I asked my doctor about this he stated, “If it hasn’t come up by now it’s not going to work so increasing it won’t help”. Even with all this and trying to maintain my diet to regulate blood sugars I have absolutely no energy.

    My diet is under the care of a dietician and I check my sugars after each meal. I typically eat every two hours being my meals and good snacks in between. Most of the time my sugars are around 140 after meals (2 hrs). I am on 1500 of Metformin a day.

    I have tried all the gimmicks as I like to say to increase my energy. The drinks, the powders, the green and raw foods, and nothing seems to work.
    I keep telling my doc that I feel sick all the time and lethargic. Yet he says I am fine that all my labs come out fine. Basically says keep trying and lose weight. Ok, so I’d like to do that too. I’m sure not all obese people with medical conditions sit on the couch and say I want to be fat.

    I want to work out and I want to be healthier for my family but I don’t have the energy or the umph to do it and by now how to do it. I don’t know what else to do but feeling cruddy and sick all the time is not a happy life. Any ideas?


    • Dear John,
      Yours is a sad story – and I can’t say that I am too impressed with your doctor. I hear you – you want to do the right thing, but you have no energy.

        Remember to check all Internet advice with a health professional you trust.

      For starters, let’s summarize your complaints: obesity, hypothyroidism, low vitamin B12, nausea, fatigue, low testosterone.

      You have tried a lot of things. It is always dangerous to make a diagnosis if one hasn’t seen the patient but it strikes me that you might have a gluten problem: Cravings, obesity, low B12, low thyroid. That combination shows to a common factor; Something is poisoning your body, and gluten is under suspicion. Gluten is contained in wheat, rye, barley and oats.

      So, if I were you, I would eliminate two foods TOTALLY from your diet: gluten and dairy. Dairy not so much for what you tell me, but dairy is always suspicious; You are no babe anymore, and you don’t need milk – neither from your mother nor from a cow. And, because you are diabetic, you should have absolutely no sugar and no white starches.

      You are a typical example for SAD – the Standard American Diet. It has sapped your energy and the joy of life out of you. Manufacturers have sold you artificial food that has no nutritional value, have taken your money for no good return. You can continue as is – or you can fight back – before it is too late! As a first step, be sure to eat ONLY FRESH FOOD. Nothing processed.

      Now, if you don’t know what you can eat, I don’t blame you – it will be hard work to learn anew. It sounds like your doctor has given up on you and is not teaching you how to eat better. You are not helped with the plain advice to lose weight – I know you want to lose weight. But how?

      Here is a quick meal plan:
      Breakfast: A can of beans (any kind you like, but change varieties often), with olive oil, and some dried or fresh herbs. You can also put in cinnamon – but no sugar. Cinnamon (about a teaspoon full) lowers blood sugar.

      Lunch: A salad and/or a soup (no noodles!). And no bacon bits, cheese, bread, dressing on the salad, only olive oil and vinegar. But one hard-boiled egg would be fine.

      Dinner: Meat, vegetables (all vegetables taste great simmered with garlic, olive oil, pepper and salt!), brown rice or quinoa or amaranth. – Of all these foods, you can eat as much as you want – I don’t want you to starve yourself! Only, if you don’t improve, would I then suggest that you take in smaller portions. But often, just eating the right food makes you lose your cravings after a while.

      For dessert and snacks you can eat fruit as you want, but only about a cup per session. Avoid bananas.

      With low vitamin B12, you need injections if your numbers don’t come up fast. Because low B12 can lead to dementia – you don’t want to go there. The B12 part is most urgent of all. – I also would want to know how high your vitamin D is, your homocysteine, your blood lipids. I know you are concerned about your testosterone – but I am more concerned with your life. And how can that part function if all the other parts of your body are diseased?

      And, of course, you should do some exercise. I urge you NOT to go to the gym. But I want you to go out every day for ten minutes during lunch break, or around noon for a ten-minute walk. Ten minutes means: You walk five minutes in one direction, then turn on your heels, and walk five minutes back. Do you think you can do that? Try it for a few days. Then, after three days, go six minutes forth and back, for three days. Then seven minutes, and so on. If you do not feel ready to go up with the time, stay on that level – for as long as you want. Go ahead only if you feel like it. But never go back. If for some reason you have to skip a day, don’t go back – restart where you left off. But make sure you don’t skip days.

      Last piece of advice: All this would be so much easier if you can mobilize friends, neighbors, strangers to walk with you. That way you will enjoy it and stick with it.

      Dear John, come back, and tell us how you are faring! I wish you to invite back into your life the joy that has been sapped out of it.

      Alexa Fleckenstein, MD


      • John

        Hi me again Dr Fleckenstein,
        It’s been over a year since you commented. I thought it was time to come back and let you know what is going on today.

        I took all of your suggestions and added them into my life with the food changes and exercise. I walk two to three times a day now. Up to three miles at a time. I felt I was doing well with these but for some reason my BG’s kept going up.

        I switched doctors back in February this year. She increased my Metformin from 1000 a day to 2000 plus added Acrobose at 300mg a day. My last A1C last week went up from 8.2 to 9.6 so the increase of medication doesn’t seem to be hitting it just right. I saw the max for Metformin is 2550 a day. I’m wondering why she did not max that out for me as well. I’m afraid the next motion will be to add insulin. My daily BG’s average is 302. My ranges have been from 225 to 346.

        I’m not feeling any much better since a year ago. I pretty much have to force myself to ignore that I feel bad and just keep moving. It would be nice to not feel sick all the time. Not sure what else to do at this point. I know I recently started the Acrobose so I’ll give it a bit of time.
        Thank you, John


      • Dear John,

        I am extremely sorry – your letter must have fallen through the racks. Probable that your letter arrived while I was traveling, and I never caught up. It is more than a year later now – really unforgivable.

        What you say sounds to me mostly like you are ingesting one (or more) ingredients that really bring up inflammation in your body – something your system can’t deal with at all. From my distant viewpoint (unfortunately, I haven’t seen you) the most likely culprit are sugars, starches and grains. What I would suggest (if after that long year of waiting in vain you even still want to listen to me) is to leave all those items out of your diet. And don’t replace sugar with artificial sweeteners. You might have a few hard days because the wrong bacteria in your bowels surely will protest if you stop their food supply – but very soon it will become much easier, namely when you have starved them out of existence (or at least have greatly reduced them).

        Also, make sure you are not damaging through beverages what you have healed with foods. Everything that goes into your mouth should be healthy!

        In case you wonder what is left to eat (my new diabetes book has more detailed ideas): Beans with dried or fresh herbs and olive oil for breakfast; salad and/or soup for lunch. A freshly cooked dinner with several vegetables every evening, with small amounts of organic meat, fish eggs.

        Please, accept my sincere apologies!

        Alexa Fleckenstein M.D.


  35. cher Jedamski

    Dear Doc, I am 54 and have been informed that I have diabetes. I am overweight, but have been walking 3 miles a day for the last two years. I have lost about 40 pounds over the last several years. The weight just does not seem to come off very fast even though I have started walking at a faster pace, and for several weeks added strength exercises. I do not have a hunger problem, and for a couple weeks have added high protein shakes twice a day instead of meals, plus one meal of low carb vegies and fish. My question is : What else can I do? Is the protein shakes a good idea? I really want to get rid of the diabetes and not have to take any meds.


    • Dear cher Jedamski,

      My patients are advised by me not to lose weight faster than two pounds per month. Why? Because it is relatively easy to shed the pounds, but hard to maintain the weight loss. With your forty pounds you seem to be doing just fine. Your exercise regimen seems to be perfect.

      Protein shakes (or ANY shakes) are not a good idea because no powder from a can can be considered a fresh meal. With vegetables – if you otherwise have no starches – you can even eat root vegetables (except potatoes). I think.

      For me, an easy breakfast consists of a can of organic beans, olive oil, pepper and salt, and a handful of fresh or dried herbs. Is no work at all, and filling enough to get your day started.

      Lunch can be a salad, or a soup, a can of sardines, or a green smoothie. Don’t use dressing with your salad; just go for olive oil and vinegar. Keep it light but make sure there is some oil or fat in whatever you eat.

      Your dinner sounds good to me. Look out if you find new vegetables once in a while, to stretch your horizon.

      Are you having any sugary snacks – worst of all, with High Fructose Corn Syrup (HFCS)? What makes us overweight are simple starches (sugar, white flour, breads, pasta, cakes, cookies, crackers, sandwiches, burgers, and so on) – leave them out! And lastly: No dairy products, because they contain growth-hormone-like property that will increase insulin resistance and make cancer cells grow. Which means: no milk, yogurt, cheese, butter, cream; no milk solids either.

      Pat yourself on the shoulder for the good work you have done! And tell us how you will do! I wish you determination!

      Remember that online medical advice should never replace consultation with your healthcare provider.

      Alexa Fleckenstein M.D.


  36. Greg

    I have been diabetic for 8 years now. I recently gained some weight and I am currently in my second round of the Insanity workout (very high level). I have really low energy. Everything goes to working out and my workday. I feel as though I can go to sleep at anytime during the day. I take vitamins and I have had my levels checked blood glucose has been around 130 mark and I am overweight but have no energy, what can I do?


  37. europeannaturalmedicine

    Dear Greg,

    You feel awful – your despair comes through in your letter.

    I have to start out that I am not an Internet miracle healer – you need to be in contact with your primary physician, because you could have more than overweight and diabetes to explain your fatigue.

    BUT: Diabetes surely can make you feel that lousy.

    The foods that are addictive and keep a diabetic low, are only a few. One can avoid them with planning: 1. Dairy. 2.Trans-fats (nothing deep-fried, hydrogenated, and so on). 3. Sugars, High Fructose Corn Syrup (HFCS) and sweeteners (sweeteners spoil your taste buds and make you fall for the next treat). 4. White starches (including potato and corn).

    Eat a diet loaded with fresh vegetables – two or three different ones at a meal). If you are hungry, eat meat, fish, eggs. Always have plenty of good fats (olive oil, virgin coconut oil) in your meal they take away hunger. Fat does not make you fat – simple carbohydrates make you fat! Have some fruit, but not excessively. For healthier starches eat brown rice or legumes (garbanzo, beans, peas) – but not too much since they are starches, too).

    Great that you are doing that exercise program – sounds forbidding to me. But if it motivates you – go for it!! Simple walking and biking does it for me.

    Don’t feel your life is deprived when you can’t eat Standard American Diet (SAD). Feel that you are entitled to a healthy body without constant exhaustion!

    All the best – and let us know how it goes!



  38. jimmy

    I am a goner. 35 YEARS of diabetes. It is too much. Well, cats help.


  39. Jimmy,

    Don’t go – wait until my diabetes book will come out! I am spending this beautiful summer on writing the book so that people like you may have hope! Until the book will come out next year, the secret code is: Vegetables, vegetables, vegetables! And absolutely no dairy!

    My thoughts go out to you!

    Alexa Fleckenstein M.D.


  40. Margie

    I will soon be 60 years old and am diabetic, although not on medication as yet. I am also approximately 100 pounds overweight, am on 4 different kinds of medications for hypertension and I have sleep apnea. I had a thyroidectomy last year and my knees are shot. My outlook on life is not much better. I am seriously considering weight loss surgery but am aware that it is not a quick fix and often doesn’t work long term. I am frightened, anxious and mostly tired. All I get from doctors is I need to lose weight (duh!) and exercise more. I truly do not eat as much as my weight indicates but am totally addicted to sweets. Your recommendation of 2 pounds a month sounds great for others but I don’t feel I have that kind of time. Any suggestions?? (by the way, I just happened to stumble upon this forum last night and its wonderful!!)


  41. europeannaturalmedicine

    Dear Margie,

    Roanne and I appreciate your friendly words!

    But I feel so sorry for you that you think you can’t even try to lose those two pounds per months – because without a try, where will you go??

    Have you liked sweets already since childhood – were you always addicted to them? Or has something bad happened in your life so that you need a consolation?

    Don’t give up, Margie!

    Alexa Fleckenstein M.D.


  42. Margie

    Hmmm….Guess it’s safe to assume I’m not getting a response here. Movin’ on…..


    • Margie – so sorry the response was delayed – Please see Dr. Alexa’s comment on 8-27 below.


    • europeannaturalmedicine

      Dear Margie,

      So sorry my answer was lost in the end-of-summer shuffle – I wrote it immediately. But then there was a glitch, it seems.

      I wish my diabetes book was already out – but it will be a few months before publication. Have you looked on my personal blog? I have written a few entries about diabetes type II, and perhaps they will help you.

      Really, Margie: Don’t give up on yourself! And not on us either, please …

      Alexa Fleckenstein M.D.


  43. Margie

    Thank you for your reply. I did not receive your message from the 27th until today…not sure how that happened.
    It is not that I don’t believe I can lose 2 lbs a month. I just feel like my health problems require a faster ‘fix’. And yes I have alway craved sweets….no traumatic experiences to blame it on. I don’t want to have the surgery but am beginning to feel it might be my only reasonable choice.


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  46. Chris

    I’m of the 10% I lost alot of weight. I’m 45 no risk factors and yet just found out I’m Diabetic. Today is weird my sugars are good. But I still have arm pain and lack of energy. I’m not fat . In fact went from 150 to 135 lbs. Any explanations?


    • Chris, At this distance it is hard for me to say what is wrong with you. Your arm pain might come from a pinched nerve in your neck. Have you been checked for gluten intolerance – or just tried a gluten-free diet? That could explain your fatigue and weight loss. Your sugars might be getting better with that bit of weight loss, which is good – but on the other hand I wonder why you are losing weight. Are you trying to? I hope you are seeing a good physician who can help solving these puzzles.

      Anyway, all the best – and tell us about your progress!

      Alexa Fleckenstein M.D.


  47. Sankalp Bhargava

    sir, my father is suffering from diabetes. He is not feeling to eat anything which he like or a diabetic person should eat. He is also suffering from low energy. What to do now, Is there any big consequences for this type of disease?


  48. Dear Sankalp Bhargava,

    Sorry to hear that your father has diabetes – but it is good to hear that you care! I assume it is type 2. The consequences – if nothing is done to change his ways – are dismal: Blindness, kidney failure, amputations, death are some of them.

    He has no energy, but perhaps somebody can put fresh meals with lots of vegetables and herbs and spices in front of him. And perhaps you can take him for a walk every day? Best is during daylight, but every movement helps. Start with five minutes, and build up.

    Show him that you care for him, nudge him gently, but not harshly. That might help him the most.

    All the best for your father, and you!

    Alexa Fleckenstein M.D. (and not really a “sir”).


    • Sankalp Bhargava

      thanks for your suggestions. It really worked but my father is little low now also but i think he will be fine soon sir (sir is because you are my senior)..


  49. Hello, I read an answer to a question sent by a type 2 diabetic, in reference to never having energy, and like myself, wanting to sleep all of the time. I have zero energy, and no matter what I eat, and how much exercise I do, I feel even more tired. Alexa Fleckenstein M.D. recommended loose green tea. I used to drink green tea in tea bags, with a half cup of splenda per gallon, it did not change the way I feel, so I stopped drinking it. I too am type 2 diabetic, still trying to lose weight, I am 51 yrs old, I walk all day at work, and I literally mean all day, come home, take care of my babies, than I push myself to work out for 1 to 2 hours. I can’t seem to conquer it any longer, most of the time I take care of my babies, and right to bed I go, than get up, have my coffee, and shower, get dressed, and off to work I go, STILL EXHAUSTED. Please help me find energy, I truly need to get this weight off. I am 4ft 8in, and I weigh 175.6, I so badly want to feel good again, and start living again, but I’m just too tired. Can u send me suggestions for a loose tea flavor that would taste good, and where can I get some. Thank You for your time, and please respond soon. Thank You Genny


    • Dear Genny,

      You seem to suffer from the two main problems in diabetes type 2: exhaustion and hunger (you might be fighting your exhaustion with food – without success, as you found out).

      It sounds as if you are moving plenty throughout the day, so your problem lies in how much you eat, and what you eat. Stated simply: There are food that inflame your cells, and add to diabetes, weight, exhaustion, and so on. And there are inflammatory foods that slowly but surely will heal you.

      In my new book “The Diabetes Cure”, which will come out at Rodale’s in August, I name the two worst offending and highly inflammatory foods: dairy (milk, cheese, yogurt,and so on) and sugars/white starches. The healing foods are all the vegetables (except nightshades: tomato, eggplant, bell and hot pepper, potato).

      Of course, there is more to it, but those are a few simple things you can start with on your way to better health.

      Let us know how you are doing, Genny! And I am curious: Who are your “babies”?

      Alexa Fleckenstein M.D.


  50. I would like to thank you for the efforts you have put in penning
    this blog. I am hoping to see the same high-grade blog posts by you
    in the future as well. In truth, your creative writing abilities has encouraged me to
    get my own, personal blog now 😉


  51. Yes! Finally something about diabetes and heart disease.


    • Thank you, blood pressure! I actually learned this from my patients: They are always exhausted, and always hungry – and for them I wrote my diabetes book.

      “The Diabetes Cure” has been published at Rodale’s, and in the moment is available only directly from them. But in late fall, the paperback edition will be out generally, then it can be ordered from any bookstore, and also be found on Amazon.

      For yourself, I hope you can use these insights to improve your health and your life! You obviously are searching for solutions!

      Alexa Fleckenstein M.D.


  52. Peter

    Hi Alexa. This article has described me exactly. I though I was going crazy with my food cravings and depression and what I thought was just ‘laziness’. I was diagnosed last week with diabetes. You have put a new perspective on everything and have brought hope. I can’t thank you enough. Peter


  53. Dear Peter,

    Thank you for your praise!

    The diagnosis of diabetes is not a death sentence – it is a wake-up call. We have been told for too long that indulging in processed, over-sweetened, artificial foods is the way Americans will be happy. In reality, unnatural foods make us fat and unhappy.

    One of our friends finally woke up, started to eat healthful foods (vegetables mostly, with some organic meats, fish, eggs thrown in), and he could stop his insulin. He had been for years on a downward-spiraling course, bedridden, and with mental problems as well. Now he is up and around, talking, and partaking in life again.

    Peter, let us know about your progress!

    Alexa Fleckenstein M.D.


  54. Lina

    I have had Type II for 10 years, am over weight (about 35-40 lbs), do not crave food nor am hardly every hungry, I eat because I know I need to. I cook all the meals which are very healthy, almost never eat out, and do not eat desserts. I am always tired and foggy in the a.m. but get a bit of energy in the afternoon hours. My blood sugar even with Metformin 2x a day at 1000 mg did bring my blood sugar readings in the morning to the 110-125 range. Now it is back to the 145-160 range, and I am feeling more and more tired. Not sure if it is time to get rid of my doctor and pursue a new one. I joined the YMCA and tried my best to work out for an hour on the threadmill and did resistance training 20-30 minutes. Two days is all I can get out of my body, my feet hurt for days and I am extremely exhausted afterwards…. Ugh, why, why, why me.


  55. Diabetes is very scary. Need medication and a good way for the diabetes.


    • Dear Adel Adelia,

      Yes, diabetes is a very scary disease, it renders us blind and impotent, fatigued and listless, on dialysis and unable to do simple chores.

      In the beginning, when you go on my program, you will still need your old medications. But Once you get going (literally!), you might be able to drop one medication after the other – and never look back.

      Get going today! And all the vest to you!

      Alexa Fleckenstein M.D.


  56. Dear Lina,

    Sorry I am a bit late with my answer – I was traveling.

    You are experiencing what so many diabetics experience: Extreme fatigue. I don’t think that the answer lies with exercise in the gym. I think the answer lies with more little movements throughout your day at home, at work, at play, and so on. Also, with a better nutrition, consisting of freshly cooked meals. And perhaps more sleep – I don’t know your habits.

    I am embarrassed about recommending my own book – but the answers are all in there. I have seen patients come off insulin when they tried my ideas. Surely you will be helped, too!

    All the best!

    Alexa Fleckenstein M.D.


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  60. mamta

    I am 30kgs over weight. Diabetic. Following diet. How to counter fatigue post my walking and breakfast?


    • mamta, For people like you I have written my diabetes book! Because my heart goes out to you all who drag themselves through their lives instead of enjoying every minute! Weight and fatigue, of course, are linked.

      The book starts out with the 50 reasons why we overeat, and then gives you all kinds of advice. Diet alone will not get you where you want to be – so many lifestyle issues play into it! And the appendix has many easy and delicious recipes, too. People have told me they have lost fifty plus pounds on my ideas – and without bad pills!

      Let us know how you are faring! I want you to be happy and healthy!

      Alexa Fleckenstein M.D.


  61. rahul

    My father age is 50 and he is suffering from diabetes some times headache and also his right hand stop working suddenly for a while so suggests me something sir I am from India and we are economically not good so suggests the right path to us please sir


    • Dear Rahul,

      Your letter was overlooked – I apologize!

      You must be very worried about your father! Is your father overweight? Is he taking any pills?

      Are you living with him so that you can have some influence on his habits? Because he needs to move more – going for a walk every day, even if it is a short walk. And working in the house and the garden.

      Is he eating too many sweets? Can you educate him (without force) to eat better? Tell him you are worried about him. You say you have not much money – but can you make him eat more vegetables? And all the great spices of India – they usually all are good against diabetes.

      Is you father depressed? Is there anything that could make his life better? More interesting?

      Let me know! It speaks for you that you want to help your father!

      Alexa Fleckenstein M.D.


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