Adena Health Focus December 18, 2019

Quality of Life Choices

Healthy lifestyle decisions can go a long way toward the best management of your diabetes

Dr. Kirk Tucker, Adena Health System’s Chief Clinical Officer, Head of Clinical Operations and a practicing internist specializing in adults with chronic illness, says there are ways to lower your medication expenses. Tucker has helped many patients reduce their need for insulin, and he has Type 1 diabetes, so he speaks from personal experience.

Although he is a diabetes patient himself, his advice is specific to those with Type 2. That’s because, according to Tucker, they may sound alike but are two completely different diseases. Type 2 is vastly more common representing about 98 percent of his patients.

Type 1 is an autoimmune disease and usually begins in childhood. The immune system attacks the pancreas’ ability to make insulin. Type 2 is currently classified as a metabolic disease and traditionally presents itself in mid to late adulthood although Tucker is seeing it more in obese children. Type 2 is progressive insulin resistance caused by the pancreas needing to make more and more insulin to keep up with the body’s glucose levels, which are often high because of poor diet choices and inactivity. Eventually, the pancreas cannot keep up with the demand.

The Medication Roadmap

Tucker explains that there are three distinct treatment options: 1) injectable medication, 2) oral medication, and 3) diet and lifestyle.

When a new patient comes to Tucker, he needs to know how out of control is the diabetes. To figure that out he measures hemoglobin A1C levels, a type of diabetes control assessment. To avoid complications of high blood sugar, a person needs a reading that’s a minimum of seven. If the initial reading is close to seven, Tucker starts with a long discussion about diet and lifestyle. In contrast, if it’s in the teens, that person requires immediate medication (oral, injectable, or both) to lower the numbers. Ideally, those with the higher readings will eventually get their numbers closer to seven.


Tucker is adamant that diet and lifestyle should always be the first option for everyone even before they reach an official diabetes diagnosis. Good health practices reduce a person’s chances of ever getting the disease.

When Tucker’s diet and lifestyle discussions are taken seriously, patients whose hemoglobin A1C readings are closer to 7, have the chance to wean themselves off medication entirely.

In regard to diet and exercise, Tucker takes a three-pronged approach: sugar, carbohydrates and exercise.

On Sugar.

“I explain that sugar is now a poison. You must stop eating it. No more donuts, sweet tea, soda, or candy,” says Tucker. “I start with the obvious early on because I don’t want to shock folks.”

This means if you have an M&M habit every afternoon or a mid-morning pastry, it’s time to end those practices and replace it with something that provides nutritional value. Plus, the less you eat sugar, the less you will crave it.

On Carbohydrates.

Most people get their carbohydrates, which your body converts into sugar, from breads (including cakes and muffins), pastas, and starchy vegetables like potatoes. Tucker suggests you don’t have to quit entirely, but portion control is paramount. He points out that bread is a vehicle to carry food to your mouth, so don’t use it.

Tucker advises eating your starchy vegetable last. Always try and fill up on your protein and vegetables. Only then, if you’re still hungry, eat your potato.

On Exercise.

“Exercising 30 minutes each day is as good as getting a shot of insulin,” Tucker saves.

Thirty minutes of aerobic exercise can be anything from riding a stationary bike to walking in the neighborhood. Ultimately, Tucker wants his patients to lose weight, but to do so in a sustainable, healthy manner.

Tucker acknowledges the price of insulin is driven by a complex system of politics and economics. Lifestyle change, he points out, is free.

“An ounce of prevention is worth a pound of cure. Emphasis should always be on prevention,” Tucker says.

To schedule an appointment with an internist, call Adena Internal Medicine at 740-779-4700.