case studies

IN THIS ARTICLE YOU WILL learn about some of the tremendous benefits that can be derived from a properly conducted fast.  When properly utilized, fasting is a safe and effective means of maximizing the body's self-healing capacities.  The results can be truly amazing. Before going on to describe some of the many advantages of fasting, let's define it.  Fasting is the complete abstinence from all substances except pure water, in an environment of total rest.  Let's also keep in mind that fasting is only one part of the total health-supporting program we call Natural Hygiene.

Health results from healthful living. No matter how successful a fasting experience might be, it needs to be followed by a consistently healthy lifestyle.  The requirements of health must continue to be provided, especially in the areas of diet, environment, activity and psychology.

The examples that follow are just a few of the many beneficial uses of fasting.

An aid in transition

During the past seven years I've worked with thousands of patients from all over the world who had a wide variety of disorders and health concerns.  A great many of these patients required a period of supervised fasting to achieve their health goals.  Virtually all of them needed to make lifestyle changes to achieve improved health.  Fasting made the transition easier!

My observation is that the best motivating factor in helping people adopt healthful living practices is often the positive reinforcement that comes with feeling good and healthy.

Fasting, for as few as five days to as many as 40 days, will often dramatically shorten the time it takes for  an individual to make the transition from a conventional diet and lifestyle (with all the associated addictions, pains, fatigue and disease) to the independent and energetic state associated with healthful living.

People who undertake a  fast in a supervised setting, tend to achieve health more quickly than those who attempt changes without a fast.  The intensive health education, plus the emotional support they receive during their stay, result in increased compliance with dietary and lifestyle recommendations.

A speedy recovery

When individuals try to make major dietary changes without the benefit of a fasting experience, they often become frustrated.  The transition to a healthful eating pattern can make you feel sick.  Symptoms such as fatigue, nausea, vomiting, diarrhea, abdominal pain and bloating, joint pain, headaches, skin rashes, irritability, depression, etc. are just a few of the common problems that can arise as the body attempts to eliminate toxins, metabolic byproducts, etc., and adjust physiologically to a health promoting diet.

It is difficult to get people to practice new healthful living habits for long unless they begin to experience some benefits quickly.  Changes that may take months (or even years) with careful eating may occur much more quickly if a properly supervised fast is utilized.  This is an important consideration because once people begin to realize their health potential, they become a likely candidate for a lifelong commitment to healthful living.

Overcoming addictions

Addictions to drugs such as alcohol, cocaine, nicotine and caffeine are examples where fasting can dramatically reduce the often protracted withdrawal symptoms that prevent many people from becoming drug-free.  Most people are surprised at how easy it is to quit smoking or drinking with the help of fasting.

Uterine fibroid tumors

Fasting can often be especially important in situations where drugs or surgery have been recommended.  When uterine fibroid tumors contribute to pain and excess bleeding, a hysterectomy, removal of the uterus, is often recommended.  A proper fast will often dramatically reduce the size and effect of these tumors.  I have treated numerous women who have been able to successfully avoid hysterectomy using conservative methods.  Ovarian cysts and cervical dysplasia also often respond favorably.

Back and neck problems

Back and neck pain are remarkably responsive to conservative care.  In my institution I utilize fasting, rest and exercise, improved posture and body use, and when appropriate, chiropractic manipulation and physical therapy.  It is interesting to note that often patients with chronic pain who have received extensive treatment, including drugs, surgery and manipulation, will experience dramatic improvement through the use of fasting.

A case history

I recently treated a young man, a Natural Hygienist since birth, who had been in a severe automobile accident four years ago.  He had suffered with constant neck pain and headaches since the accident.  His greatest concern was his tendency to pass out unexpectedly.  Apparently the dysfunction in his neck had interfered with the autonomic portion of his nervous system altering blood flow to his brain.

After a period of four weeks of care, which included a fast, followed by careful re-feeding and, in his case, spinal manipulative therapy, this individual made an excellent response.  At his three month follow-up he reported complete absence of neck pain and headaches and had not felt faint or passed out since his stay at the Center.

Cardiovascular disease

Most cases of cardiovascular disease are also responsive to conservative care.  In 154 consecutive cases of high blood pressure [hypertension] that I have fasted, 151 (98%) have been able to achieve and maintain normal blood pressure without the use of medications. [Complete details of this study will appear in an upcoming issue of Health Science.]

Angina and intermittent claudication are examples of conditions that will often respond rapidly to fasting.  Often patients can achieve freedom from pain and medications within a few days or weeks.  It is not unusual to see cholesterol levels drop as much as 100 points with diligent effort.

Gastrointestinal disorders

Disturbances of the gastrointestinal system, including esophagitis, gastritis, colitis, constipation, bloating, and the symptoms associated with so-called "candidiasis," usually respond well to conservative care.

My most recent case of gastrointestinal disturbance was a young woman with severe colitis [inflammation of the colon].  She reported severe, constant bleeding through the rectum.  She said that despite continual medical treatment with cortisone, implants, and a wide range of other medication, she had bleeding with every bowel movement for eight years.  Her physician had explained that surgery would have to be performed.

After we had eliminated her medications, a period of fasting was undertaken.  Within a week, the constant pain was resolved. By the 10th day, the passing of blood and mucus had stopped.  After two weeks of fasting we began to carefully feed her.  Her bowel movements were blood-free from the first.  At her three-month follow-up she reported feeling great and completely free of any significant bleeding or problems.

Diabetes

Many chronic degenerative conditions respond well to fasting and a Natural Hygiene lifestyle.  Diabetes is no exception.

Working with diabetic patients is very satisfying because the consequences of the disease are so devastating and the results with conservative care are usually so dramatic.  Most adult onset diabetics can be brought under control and freed from the use of insulin and other medication through the use of fasting and a carefully followed diet and lifestyle program.  Such a program will allow most diabetics to achieve a high level of function and the ability to maintain normal sugar levels without medications.

There are exceptions

Not everyone is a candidate for fasting. There are a number of factors to consider before a fast is recommended.  My procedure is to first review the patient's medical history and perform a comprehensive physical examination including appropriate laboratory or specialized diagnostic tests.  I then review my findings with the patient and make appropriate recommendations.  These may include dietary and lifestyle recommendations.  These may include dietary and lifestyle changes, exercise programs, etc., and, when indicated, fasting.  When fasting is indicated, patients stay at my institution.

Not every individual or every condition will respond to conservative treatment.  Occasionally medical care may be necessary.  When a medical consultation or treatment is indicated, the safest methods available should be utilized.

Where to fast

With the possible exception of very short fasts in acute disease, such as a cold, fever, etc., all fasting should be undertaken in an institution under the direct supervision of a doctor trained in fasting supervision.  A certified member of the International Association of Hygienic Physicians would by far be your best choice.

Fasting in an institution offers several advantages.  The most important is the constant availability of an experienced doctor to guide and advise you.  Most institutions have an educational program designed to help you better understand Natural Hygiene, the science of health.  The benefits of being in a clean, quiet and emotionally supportive environment should not be underestimated.

In addition, a timely and proper termination of each fast is critical to the long-term success of the patient.  Fasting under the supervision of a trained, qualified doctor is your best assurance of a well-conducted, beneficial fasting experience.

A Case Study:

Chronic gastrointestinal disorder

A woman came to the Center recently who had suffered chronic constipation for more than 20 years.  She complained that she had not had a single spontaneous bowel movement during that time without the assistance of enemas, colonics or laxatives.

She fasted with us for a period of 12 days, during which time she experienced mild discomfort and referred low back pain.  On the fifth day of feeding after the fast, she was having spontaneous, normally formed bowel movements, and she had continued to have them since.

The long-term follow-up for people who stay on the Natural Hygiene dietary program is excellent.  Chronic constipation is definitely a problem that people can learn to live without.

Alan Goldhamer, D.C.                     

A natural process

Fasting, or the abstinence from food, is a means used in nature by all creatures from the beginning of time.  Either by instinct or intelligence this means has been used to assist the body to relieve itself from discomfort, pain and disease.

Regulatory and reparative processes of the body are given unimpeded encouragement by the temporary omission of food.  No other form of health care can boast the rewarding and gratifying results in the elimination of disease and the restoration of health.

Fasting, once considered a fad, has gained acceptance not only by a constantly increasing segment of society and has also earned the stamp of approval by many in the scientific community.

Under qualified and experienced supervision, fasting is the greatest gift which can be given to an overburdened, sick body without benefit of any other form of therapy or treatment.

William Esser, N.D., D.C.

An empowering rest

Fasting is simply a process of deep physiological rest.  This rest period helps you rebuild functioning power and recover from the energy dissipation caused by hectic daily schedules and abusive living habits.

When outside stressors, dietary and therapeutic influences are eliminated during the fasting state, fasting reveals the baseline status of your body.  This enables you to become more sensitive and connected to your body.  This connection fosters a greater awareness of the instinctive biological and emotional requirements that are essential for the maintenance of health and wholeness.

Frank Sabatino, D.C., Ph.D.

Unfounded fears about fasting

Unfounded fear is a peculiar state of disease within the imagination, arising largely out of a lack of knowledge.

If we are slaves to unfounded fears, we are also slaves to beliefs and practices and action which are inconsistent with our well-being.  So it is a matter of necessity that we understand fasting and all its facets if we are to overcome the fears that are associated with it.

Many people attempt to solve the problems of life, the distresses of the body and the anxieties of the mind with food and drugs. They have great fear about not eating because they have experienced the headaches, the weakness and distress they associate with it, and they are convinced that food and drugs are the answer to their problems.

How can you convince someone that going further without food is a matter of necessity for the recovery of his health  Only through knowledge and enough suffering to change his attitudes.

The best way to dispel unfounded fear about fasting is with knowledge, knowledge that breeds confidence, confidence that engenders beliefs, and beliefs that result in correct action.

D.J. Scott, D.C.

Making wise decisions

Not everyone is a good candidate for fasting.  Many factors need to be considered before a fast is undertaken.  Not every condition will respond optimally to fasting and conservative care alone.  Occasionally, medical care may be necessary.       

At the Center we have established good working relationships with some of  California's best specialists.  When a medical consultation or treatment is indicated, the safest methods available should always be utilized.

Jennifer Marano, D.C.

Heightening your awareness

A wonderful thing about fasting is that it puts an interval between the behavior that you are accustomed to and the behavior that you aspire to.  We tend to be creatures of habit, and the ways that we are accustomed to eating and living feel as natural to us as breathing.  That is why it is so difficult for people to stop bad habits.  But fasting brings your present lifestyle to an abrupt halt.  It gives you an opportunity to pause, reflect and decide how you are going to conduct your life afterwards.  This enables you to make a break with your past and set off in a new, more positive direction.

There is nothing routine about eating after a fast.  Each meal is a celebration.  After fasting, you tend to be very conscious about what you are eating, and why.  Fasting heightens your awareness, as well as your appreciation for food.  By fasting, we learn to eat with reverence.

It is the non-doing aspect of fasting that enables us to make behavioral stopping and pausing and interrupting our usual patterns, as we learn to take more conscious control of ourselves.

There is no better way to stop a vicious cycle of self-destructive behavior than by fasting.

Ralph C. Cinque, D.C.

Throughout history, people have noticed that when they become acutely ill, they lose their appetites.  The early Hygienic physicians reasoned that there must be some physiological reason for this loss of appetite.  Through observation and experimentation, they discovered that fasting - the complete abstinence from all substances except pure water, in an environment of complete rest - allows the body to make a unique physiological adaptation.

In the fasting state, the duration and intensity of the symptoms of illness, such as inflammation, mucus production, fever, diarrhea, etc., are often dramatically reduced.  Fasting has been found to be the most efficient and powerful means available to facilitate self-healing.

Further experimentation and observation found that fasting is also effective in the resolution of chronic disease.  Chronic disease, including heart disease, diabetes, cancer, arthritis, respiratory illness, autoimmune disease, etc., can be the result of several different factors. These factors include inappropriate diet, such as the consumption of animal products and refined foods, the use of drugs, including tobacco, alcohol, coffee, etc., a lack of adequate sleep or exercise, or exposure to environmental stressors such as pollution, radiation, excess noise, etc., or excess psychological stress and hereditary factors.

Fasting is an important tool in resolving the symptoms of acute illness and chronic disease, but its benefits are not limited to dealing with symptoms.

Making the transition to healthful living

It is difficult to break habits and patterns of behavior established over many years. The typical Western lifestyle leads to taste buds acclimated to stimulating foods, muscles that are flabby, and a nervous system that depends on stimulatory drugs (such as caffeine) to keep it going despite a lack of sleep. Often, as people attempt to change their diets and lifestyles, they find healthful foods unappetizing, exercise painful, and the symptoms of withdrawal from stimulants unbearable. The slow process of detoxification that accompanies the cessation of bad habits can cause unpleasant symptoms that persist for weeks or months.

Speeding up the process

Fasting is a method of speeding up the detoxification process.  It can be an intense and sometimes unpleasant experience, but it is highly effective. After fasting, healthful foods often taste delicious, and pernicious habits often have much less appeal.  Fasting is the most efficient means available to overcome dependencies of a variety of drugs, including caffeine, nicotine, alcohol, marijuana and others.  Educational programs available at institutions specializing in fasting supervision help people to develop the skills necessary to select and prepare healthful foods, develop a sensible exercise program, and find emotional support.

Overcoming signs of illness

Some individuals appear and feel healthy but still manifest abnormal signs, such as high blood pressure, elevated blood levels of cholesterol, triglycerides, glucose, uric acid, or liver enzymes, etc.  Fasting is often extremely effective at allowing the body to eliminate the signs associated with disease.

Prevention

Many individuals have adopted a health-promoting diet and lifestyle to overcome disease. They may be completely free of all signs and symptoms of disease but choose to use fasting as a preventive measure to allow the body to eliminate the metabolic products that can accumulate within the cells of the body despite our best efforts. Fasting may offer its greatest potential in the prevention of disease.  Fasting also can be used as a diagnostic tool in uncovering sub-clinical pathology that may exist.

Doing it right

Whether fasting is used in the transition to a healthful diet and lifestyle, to overcome the signs and symptoms of disease, or as a preventive measure, it is a powerful tool for helping sick people to get well and healthy people to stay healthy.

The most important advice about fasting is: Do it right or don't do it.  Complete rest, a supportive environment, and professional supervision are required to ensure that fasting will be a safe and effective experience.

Case studies

The following case studies will give some insight into the many ways people can benefit from fasting.

J.W., a 36-year-old female, 5 feet 4 inches tall and 215 pounds, decided that she wanted to quit smoking, lose weight, overcome her "food addictions," and resolve a 15-year history of chronic constipation.  She also suffered from severe back pain and sciatica.  She had, in her own words, tried "everything," and in desperation came to the Center for Conservative Therapy's residential health care program on the advice of a friend who had undertaken a fast there two years earlier.

After her initial examination and two days of preparatory feeding, J.W. underwent a fast of 12 days.  She experienced numerous symptoms during her fast but did not experience any significant craving for cigarettes despite her one-pack-per-day habit of over 20 years duration.  She also did not experience any hunger after the second day of fasting.  She did experience nausea, a foul taste in her mouth, headaches, and low back pain.  After 12 days of fasting, J.W. underwent a 14-day re-feeding program.  By the fourth day of re-feeding, she was having normal bowel movements for the first time in many years.  She lost a total of 31 pounds.  During her re-feeding time, she received chiropractic manipulation and physiotherapy for her joint dysfunction, in conjunction with instruction on stretching and proper body use.  At the time of her release, she was free of sciatica and felt prepared to face the "real" world.

At her six-month follow-up, J.W. had managed to lose an additional 15 pounds, had successfully become an ardent non-smoker, had completely normal bowel function, and had remained free of back pain and sciatica.

M.T., a 46-year-old male, was suffering from macular degeneration [loss of central vision], high blood pressure, joint pain, and fatigue.  Despite his efforts at making dietary changes, his symptoms continued to progress, which was upsetting to him.  Blood pressure medications were only successful at reducing his blood pressure to 180/110, and they seemed to be interfering with his sexual function.

After three weeks of fasting and two weeks of re-feeding, M.T. was a "new" man. His blood pressure normalized without medications at 114/74, and his joint pain completely resolved.  At his follow-up a year later, he reported no return of the visual problems from macular degeneration, and his blood pressure was 120/74.

S.S., a 34-year-old female, had been ill for several years. She had been previously diagnosed as having chronic fatigue immune deficiency syndrome, Epstein-Barr viral infection, and chronic candidiasis.  She reported a history of depression, panic attacks, palpitations, and sleep disruption.  She seemed sensitive to everything she ate, including fruits and vegetables.

S.S. underwent a fast with the hope of reducing her extreme hypersensitivity.  Her fast was quite difficult, and after just 12 days it had to be discontinued due to extreme emotional volatility.  She had a slow recovery, but within four months of her fast she reported substantial improvement.  She was much less fatigued, was sleeping better, and could tolerate a wider variety of whole natural foods. S.S. will undergo another fast soon.

A.S., a 74-year-old female, had been diagnosed as having breast cancer 10 years ago.  She had undergone a lumpectomy, but had refused all other medical treatment.  Since then, she has been totally committed to healthful living and has been absolutely compliant with all the diet and lifestyle recommendations.

Once each year she comes to the Center for "preventive" fasting.  She usually fasts for 10 days without significant symptoms.  On her most recent fast, although she arrived feeling great, by the second day she had a fever of 101 degrees and was in extreme discomfort.  It was not until the eighth day that her fever broke and she felt wonderful again.  I believe that this represented a significant healing crisis, since all her laboratory results were within normal limits.  She has had no recurrences of cancer and continues to do well.

 
 

THERE IS GENUINE HOPE for those suffering from diabetes.  In a great many cases, unnecessary suffering and premature death can be prevented. This is especially important information because diabetes mellitus is the seventh leading cause of death in the United States.

Diabetes is a disorder of carbohydrate metabolism.  In simple terms, the body cannot deal with sugar in the normal way due to a lack of insulin.  Insulin is a hormone, produced by the pancreas, which allow cells to absorb sugar.  If there is not enough insulin, or if the body fails to respond to its insulin, sugar builds up in the blood.  This is called hyperglycemia, and it can do great damage to many areas of the body, especially to blood vessels and nerves.  It leads to blindness, kidney failure, sexual dysfunction, and increased risk of heart attack and stroke, nerve damage (neuropathy), and many other problems.

The types of diabetes

Type I is commonly called "juvenile onset diabetes" or "insulin dependent diabetes" because it often begins when an individual is a child or young adult and insulin injections are required to control blood sugar levels.  In Type I diabetics, the pancreas cells that produce insulin are destroyed, and the body produces little or no insulin.  These people must receive insulin injections in order to live.  About eight percent of all diabetics are Type I.

Type II is called "adult onset diabetes" or "non-insulin dependent diabetes" because it most often affects people over forty years old.  These people do make insulin but their bodies do not use it properly.  Roughly 90 percent of all diabetics are Type II.

Early symptoms of diabetes and typical medical treatment

The earliest symptoms of diabetes are usually excessive thirst and frequent urination.  Weight loss, in spite of increased hunger, often follows, and can progress to nausea, vomiting, and anorexia (loss of appetite).  The onset of diabetes tends to be abrupt in children and much more gradual in older people. When diabetes is suspected, laboratory tests of urine and blood are used to confirm the diagnosis.

Medical treatment of diabetes is often directed by doctors called diabetologists; doctors who specialize in helping diabetics control their blood sugar.  Type I (juvenile onset / insulin with a combination of diet, exercise and insulin.  Type II (adult onset / non-insulin dependent) Diabetes can often be controlled with diet, exercise and lifestyle measures alone.  Unfortunately, in common practice many diabetics do not know how to (or simply won't) Control their diet, exercise and lifestyle adequately and medical doctors routinely prescribe oral medications or insulin to regulate blood sugar levels.

There is controversy regarding dietary recommendations for diabetics.  The American Diabetes Association recommends a diet that allows up to 30 percent of calories to be derived from fat.  Experimental evidence, however, suggests that a low fat diet, less than 15 percent, is preferable.  For example, Dr. James Anderson of the University of Kentucky placed 16 insulin treated diabetic men on a special high plant fiber diet with only 11 percent of calories from fat.  After only 16 day, these patients were able to reduce insulin use by 58 percent.  They showed an increased number of insulin receptors, which means their bodies, became more sensitive to insulin.  This is just one of many studies that have been published supporting a low fat, natural foods approach in the management of diabetes.  Despite the scientific evidence, very few medical doctors are recommending this approach.

Correct diet crucial for diabetics

A major problem for diabetics and non-diabetics as well, is excess fat and oil in the diet.  Fat and oil decrease the body's sensitivity to insulin, allowing the blood sugar levels to rise dangerously.  In one study, Dr. S. Sweeney fed young, healthy medical students a very high fat diet for two days and then gave them a glucose tolerance test.  Virtually all of the students showed blood sugar levels high enough to classify them as diabetic. Some were quite severe.  All of the students, blood sugar levels returned to normal when placed on a low fat diet.

A diet derived exclusively from whole natural foods such as fresh fruits, vegetables, whole grains and legumes, combined with a moderate aerobic exercise program can enable most Type II diabetics to maintain normal blood sugar levels without resorting to medications of any kind.  Type I diabetics will often be able to obtain much more stable blood sugar on significantly reduced levels of insulin.  Experimental evidence suggests that this combination of diet and exercise can slow down or even stop the degenerative changes associated with diabetes.

In our practice, we have had tremendous success with the use of dietary change with both type I and Type II diabetics.

Fasting can be beneficial

With Type II diabetics, we often utilize a period of fasting to stabilize blood sugar levels and eliminate the need for medication.  Fasting appears to facilitate the body's healing response.  Changes that can take weeks or months to occur with careful feeding occur much more rapidly when fasting is utilized.  Some diabetics with very resistant high blood sugar levels will not respond adequately without fasting.  Careful monitoring is absolutely essential in fasting Type II Diabetics to insure that adequate insulin is present to prevent any associated problems.

While most Type II diabetics produce enough insulin to process the natural ketone bodies produced by the body during fasting, Type I (insulin dependent) diabetics do not produce insulin.  Fasting is generally not used in the treatment of Type I diabetics.  However, diet, exercise and lifestyle modification are extremely beneficial.

Two case studies on diabetes

The following examples are typical of the results we see with diabetes patients at the TrueNorth Center.

Recently, a woman 64 years of age came to our facility. She had been having trouble with frequent urination and an acetone odor to her breath.  When she first saw her family physician sugar was noticed in her urine and blood tests revealed a blood sugar of over 500 mg/dl (five times normal).  Her doctor diagnosed her condition as Type II diabetes and put her on a diabetic diet and diabetes pills.

This approach did not work, and her blood sugar levels remained very high.  Additional medications were tried without success.  The week before her arrival at the Center her blood sugar levels were 258 mg/dl despite maximum dosage of oral medications.  The woman claimed to have been on a strict vegetarian diet and was not overweight.

After a review of her medical history and a comprehensive physical examination and laboratory testing, we placed this woman on a fast.  She remained at the center and was given only distilled water.  Her activities were restricted to resting, listening to educational tapes, participating in our group activities and quietly interacting with other patents and staff.

During her fast she was monitored carefully by daily examination, and by blood and urine testing as was appropriate. She fasted for a total of 9 days and followed that with 12 days of careful feeding on a diet derived exclusively from whole natural foods.  While fasting she developed several symptoms common to fasting including nausea, periods of weakness, a foul taste in the mouth, headaches and some joint pain. By the end of her stay her blood sugar level was within normal limits, her symptoms of fatigue had resolved, and she was free of all medication.

A follow-up visit one month later found this woman to have normal blood sugar levels without the use of medication.  She had excellent energy and vitality and a newfound positive outlook on life.  An interesting side note is that her blood cholesterol and triglyceride levels were markedly reduced and chronic depression was no longer present.

Some patients are able to overcome diabetes without fasting.  Mild problems with high blood sugar levels will often respond to a careful program of dietary and lifestyle modification.  A vegetable based diet and appropriate exercise will often allow the body to heal itself so that the need for medication and its inherent risks can be eliminated.  An example is a 78 year old man who came to us because of back pain.  He had been on diabetes pills for several years and still maintained excessively high blood sugar levels.  He was terrified at the idea of fasting but agreed to follow a diet and exercise program that I designed for him.  Within about three weeks we were able to help him eliminate the need for medication entirely.  It has been several years now and he is quite well.  He uses no medications and reports that he feels better now than when he was 60 years old.

Not all diabetics respond so easily.  At the Center we have seen many, especially Type I onset diabetics, cases that presented a great challenge.  Type I diabetics do not produce enough insulin.  Usually, they will continue to require some insulin indefinitely.  With careful attention to diet and lifestyle it is often possible to greatly reduce the amount of insulin needed and help to stabilize even the "brittle" diabetics, those who have difficulty controlling their sugar levels.

We find working with diabetic patients to be a very rewarding challenge.  They often respond remarkably well despite years of frustrating, unproductive care.  Because the consequences of the disease are so devastating, a real deal of satisfaction can be derived from helping the diabetics avoid the typical route of disease and degeneration.