Lifestyle vs Pills for Diabetes - 3 Mistakes

Let me start with something I say to every patient with diabetes I work with.

No pill in the world, whether it contains pharmaceutical drugs or supplements, will ever take away the need to change and improve your lifestyle and eating habits if you truly want to combat diabetes fully and optimally.

No drugs, however advanced. No supplements, however expensive or however enthusiastically recommended.
Pills have a role. But they cannot substitute for the lifestyle and eating habits change that is also needed.

This is not a controversial statement. The evidence behind it is solid and consistent. And yet, in my years of coaching people with diabetes, I see the same three mistakes being made, repeatedly, by people who genuinely want to manage their diabetes better but are unknowingly working against themselves.

Here are the three mistakes. See if you recognise any of them in yourself.

Watch the short podcast episode below, or read on.

Mistake 1: Underestimating the Power of Lifestyle and Eating Habits in Diabetes Management

Almost every person with diabetes knows that lifestyle and eating habits matter. But knowing that something matters and knowing how much it matters are two very different things.

Most people think of lifestyle change as a good-to-do. Something that will make a modest difference to their blood sugar. Something that is worth doing if it is not too inconvenient.

That is the mistake. Appropriate and adequate lifestyle and eating habits change is not a good-to-do. It is a must-do. And the difference it can make is not modest at all, it can be huge. It can be the difference between blood sugar that is barely controlled on increasing doses of medication, and blood sugar that is genuinely well managed with real improvement in the overall trajectory of the condition.

I hear this often during coaching sessions: "Doctor, I did not realise that a change like this could make such a big difference. If I had known, I would have made the effort to do this much earlier."

That is the cost of underestimating lifestyle. Not just the inconvenience of the change you delayed. But all the time the condition was progressing while you waited.

Mistake 2: Depending on Pills Without Addressing the Underlying Lifestyle Causes

There is a Chinese phrase I use often with my patients: 治标不治本 (zhi biao bu zhi ben) - It means treating the symptom without addressing the root cause.

Taking a pill to bring blood sugar down to an acceptable level, without changing the eating habits that are driving the blood sugar up in the first place, is exactly that. The number looks better. The underlying problem is still there, untreated, continuing to do its damage.

I understand why people make this mistake. Popping a pill is always easier than changing a habit you have had for decades. The pill takes seconds. The habit change takes months. There is no comparison in terms of effort required.

But the pill and the lifestyle change are not doing the same job. One manages the number. The other addresses the cause. If you only do one of them, you are only doing half the work. And over time, only doing half the work tends to show up in the outcome.

治 标也要治本 (Zhi biao ye yao zhi ben). Treat the number. And tackle the underlying causes too.

Mistake 3: Underestimating Your Own Ability to Change

This is the mistake that stops people before they even begin.

"Doctor, I have a sweet tooth. There is no way I can cut down on sugary drinks."

"Doctor, I do not like vegetables. I know they are important for diabetes management but I will never be able to eat more of them because I simply don't enjoy them."

I hear versions of this regularly. And what I hear is a decision. A decision that the change is impossible, made before the change has even been attempted.

In my years of coaching people with diabetes, I have seen this pattern reversed more times than I can count. Patients who were certain they could not change their diet, who then changed it. Patients who were sure they would never enjoy vegetables, who then found vegetables they genuinely liked. Not because they forced themselves to endure something unpleasant, but because with time, exploration, and the right guidance, their palate shifted.

万事起头难 (Wan shi qi tou nan) The beginning is always the hardest part. Not because the change itself is impossible, but because the beginning requires you to act before you have any evidence that it will work. That uncertainty is uncomfortable. Most people mistake that discomfort for proof that they cannot do it.

They can. You can.

Make the decision to start. If you fail on the first attempt, that is acceptable. What is not acceptable is giving up entirely. Keep trying. The people who succeed at lifestyle change are not the ones who found it easy. They are the ones who kept going.

The Common Thread

All three mistakes share the same root. A belief that lifestyle and eating habits change is less important, less powerful, and less achievable than it actually is.

Correct that belief and everything else follows more naturally. The effort feels more justified. The pill is seen for what it is, useful but not sufficient. 

Diabetes management requires lifestyle and eating habits change as its cornerstone. Not as an optional extra. Not as a nice-to-have. As the foundation on which everything else is built. There is no running away from that.

Learning About Reversing Type 2 Diabetes

Type 2 diabetes may potentially be reversible if lifestyle and eating habits changes are made early enough, appropriately, adequately, and sustainably. If you have Type 2 diabetes and are not as equipped with the essential foundational knowledge about reversing Type 2 diabetes as you should be, I have a structured online learning programme that you might find very useful. You can find out more through the link below.

Find out more about the Reversing Type 2 Diabetes: Essential Basics - Structured Online Learning Programme Here

Related Posts

• Can Type 2 Diabetes Be Reversed? Dr Chan Answers
• Lifestyle and Eating Habits: Your Most Powerful Weapon Against Diabetes
• Lifestyle Coaching for Chronic Diseases: What It Is and Why It Matters

About Dr Chan Tat Hon

Dr Chan graduated from the National University of Singapore medical school in 1992. For the last ten years, his work has focused on lifestyle medicine. He works with healthcare and corporate organisations to design and deliver lifestyle behaviour change programmes, train health coaches and build communities engaged in cultivating healthy behaviours to combat diseases.

He also provides training and coaching to individuals with diabetes, hypertension, high cholesterol, cardiovascular diseases and other lifestyle-related chronic diseases through 1-1 personalised coaching, live webinars, and online courses.

• 1-1 Personalised Coaching with Dr Chan
• Online Courses and Programmes by Dr Chan
• Reversing Type 2 Diabetes: Essential Basics Online Programme
• LinkedIn Profile of Dr Chan Tat Hon

About This Podcast Episode

In this episode of The Habits Pharmacy Podcast, I share three common mistakes people with diabetes make about lifestyle and eating habits change. The three mistakes are: underestimating the power of lifestyle in diabetes management, depending solely or overly on pills without addressing underlying lifestyle causes, and underestimating their own ability to change. I explain each mistake and what to do instead.

Full Transcript

The following is the full transcript of the podcast episode above.

Lifestyle optimization is the cornerstone of diabetes management. If you have diabetes, improving your lifestyle and eating habits is a must-do. There's no running away from it. No pills in the world, whether drugs or supplements will ever take away the need to improve your lifestyle and eating habits if you truly want to combat diabetes fully and optimally.

If you're eating too much starchy food, too much high glycemic index food, and that is contributing to poor blood sugar control, you will have to work on changing and improving that. You would be deceiving yourself if you think that a pill, whether a drug or supplement, can fully mitigate that poor eating habit and allow you to continue eating that way without adversely affecting your overall diabetes management.

If you're not exercising enough, you just have to start exercising more. There is no magic pill, whether containing drugs or supplements, that can allow you to continue leading a sedentary lifestyle with little regular exercise, and yet get the full benefits that only exercise brings to help you combat diabetes holistically and optimally. If you're not managing stress well and that is worsening your insulin resistance, no drug, no supplement can shield you from the harm that stress is causing to your diabetes management. So when it comes to combating diabetes fully and optimally, lifestyle and eating habits change and improvement must be the foundation, the cornerstone of the endeavor. No pill in the world, whether containing pharmaceutical drugs or supplements, will ever replace the need for that.

Hi, I'm Dr Chan, and in this episode of the Habits Pharmacy Podcast, I want to talk about three mistakes that many people with diabetes make with regards to their expectations of and the use of lifestyle and eating habits in combating diabetes. Appropriate and adequate lifestyle and eating habits change and improvement must be the cornerstone of diabetes management. And yet most people with diabetes do not see, understand, or act on that enough. Why? From my experience in the past ten plus years coaching patients with diabetes to use lifestyle improvement to better manage their condition, there are three common reasons, three common mistakes why most people with diabetes do not make enough effort to optimally improve their lifestyle.

Mistake number one, many people with diabetes underestimate the power of lifestyle and eating habits in managing and improving their diabetes outcome. Mistake number two, many solely or overly depend on pills, whether it's pharmaceutical drugs or supplements, to control their blood sugar without addressing the underlying lifestyle causes. Mistake number three, many underestimate their own ability to make the necessary lifestyle and eating habits changes. Many do not even start as a result.

Mistake number one, underestimating the power of lifestyle in managing diabetes. Almost everybody with diabetes knows that lifestyle habits play a role in their blood sugar control, but most of them do not know nor believe how powerful, appropriate, and adequate lifestyle and eating habits change can have in achieving better blood sugar control, in achieving better diabetes management outcome. Many wrongly think that lifestyle change is merely a good-to-do that will make some small difference to their blood sugar instead of it being a must-do that can make a huge difference to their diabetes management.

So if you have diabetes, don't make this mistake. Don't underestimate the full power of lifestyle in diabetes management. When appropriate and adequate changes and improvements are made to your lifestyle, there is potential to not just achieve significantly better blood sugar control, but also the potential to minimize disease progressions and prevent and reduce complications. "Doctor, I didn't realize that a simple lifestyle change like this can make such a big difference to my blood sugar control. If I had known, I would have made the effort to do so much earlier." That is something I hear often during lifestyle coaching sessions with my patients.

Mistake number two, solely or overly dependent on pills, whether pharmaceutical drugs or supplements, to control blood sugar without addressing the underlying lifestyle causes. Because popping a pill is always infinitely easier than making the effort to change and improve one's longstanding hardwired lifestyle habits. So many people wrongly think that instead of changing and improving their lifestyle, they can solely depend on pills, whether medications or supplements, to achieve acceptable blood sugar levels.

There is a popular Chinese phrase, zhi biao bu zhi ben, meaning merely treating the symptom, the sign, or the number without tackling the underlying causes. For example, taking a pill to bring down high blood sugar without addressing the lifestyle habits that cause the high blood sugar in the first place. So many people wrongly depend solely or at least overly on pills to zhi biao bu zhi ben, that is to merely bring down the blood sugar level to acceptable levels without doing anything to tackle the root causes.

Mistake number three, underestimating your own ability to make the necessary and significant lifestyle and eating habits changes. I often hear things such as, "Doctor, I have a sweet tooth. It is impossible for me to cut down on sugar-sweetened beverages or sweet desserts." Or, "Doctor, I don't like vegetables. I know they are important for good diabetes management, but I don't think I can ever increase my vegetable intake adequately because I simply don't like vegetables. I will then just take supplements instead." These people have given up trying to change or improve their lifestyle habits before they even start because they underestimate their own ability to change. They put a glass ceiling on themselves.

In the past ten plus years of coaching people with diabetes, I've seen countless patients who were surprised by their own ability to adapt. They were not only able to make changes to their lifestyle eating habits, they even grew to love their new healthier routines. That is why I always tell my patients with diabetes, whenever I identify areas in their lifestyle eating habits that need improving, I will tell them this: changing longstanding habits is never easy, but it is entirely possible, and many would find that it is not as hard as they originally feared. The important thing is to make the decision to try. Make the decision to start the journey of change. Of course, it is not easy. You may even fail on your first try. When that happens, tell yourself that it is okay to fail, but it is not okay to give up trying. So long as you keep trying, you will eventually succeed.

So these are the three common mistakes many people make with regards to lifestyle change versus pills when combating diabetes. If we truly want good outcomes in managing diabetes, changing and optimizing all aspects of our lifestyle and eating habits must be the cornerstone, the focus of our endeavor, regardless of whether we augment that with some help from pills or not. There is no running away from that. No pills in the world, whether pharmaceutical drugs or health supplements, will ever take that need away.

So if you have diabetes, I want to encourage you to avoid making these three mistakes. Number one, don't underestimate the tremendous power of lifestyle change in controlling and combating diabetes. Number two, do not zhi biao bu zhi ben. Do not be solely or overly dependent on pills, whether drugs or supplements, when combating diabetes. Do not simply depend on pills to achieve good blood sugar levels without tackling the underlying lifestyle causes of high blood sugar and insulin resistance. Zhi biao ye yao zhi ben. Treat the number and tackle the underlying causes as well. Number three, do not underestimate your own ability to make the lifestyle and eating habits changes necessary to control your diabetes, however unwilling you are, however daunting it may seem. Wan shi qi tou nan. The hardest part about changing lifestyle and eating habits that you have had for decades is the beginning. But I can confidently assure you, so long as you're willing to start, it will become easier and easier. And so long as you do not give up, you will eventually succeed in making the changes necessary.

And finally, I want to highlight something very important to every person with Type 2 diabetes, and that is Type 2 diabetes may potentially be reversible if lifestyle and eating habits changes are made early enough, appropriately, adequately, and sustainably. But the window to reverse Type 2 diabetes does not remain open forever. The earlier you attempt to do so, the better your chances of success.

I have a structured online learning program called Reversing Type 2 Diabetes: The Essential Basics, which I developed to help people with Type 2 diabetes equip themselves with the must-know foundational knowledge of reversing Type 2 diabetes. If you are keen to know more, the link is in the description of this episode.

I hope you have enjoyed this episode of the Habits Pharmacy Podcast and found it useful. I am Dr Chan. Let your habits be your medicine to combat diabetes and other lifestyle related chronic diseases. Eat well and be well.

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