Type II Diabetes: Managing Your Options

    Mark Graves, MD, Internal Medicine, Deaconess Clinic

    According to the Centers for Disease Control, over 29 million Americans have diabetes and of those 29 million, one in four people do not know they have diabetes.  Another alarming statistic is that currently, one in three people will develop Type II diabetes during their lifetime.  

    Risk factors include ethnicity, age, gestational diabetes during pregnancy, a history of inactivity, fat distribution and weight.  Managing Type II diabetes requires patient vigilance as well as a commitment to a treatment program. 
     


    Currently, management and treatment options for Type II diabetes patients include:
     
    • Lifestyle Choices - These may include reducing stress, participating in an exercise program and changing eating habits to reduce fat and sugar intake.  While lifestyle choices are an essential management tool, overhauling diet and activity level is challenging for most patients and adherence is varied.  
    • Traditional Prescription Options - These include Metformin, Sulfonylureas, Meglitinides, Thiazolidinediones and DPP-4 Inhibitors.  All of these medications serve to regulate the delicate balance of insulin and/or glucose within the body.  Patient compliance is easy but all of the options have side effects including but not limited to nausea, weight gain, joint pain, urinary tract infections and upper respiratory infections.  
    • Bariatric Surgery - For individuals with a high body mass index, bariatric surgery is sometimes recommended.  Weight loss aids in stabilizing blood sugar levels and for some patients, medication is no longer needed.  However, there is a substantial downside as it’s an invasive procedure with a significant recovery time. 
    • Insulin therapy - Insulin therapy aims to replace what the body isn’t producing.  As it cannot be taken orally, patients must learn to administer self-injections and the hesitancy to do so affects compliance.  This therapy promotes weight gain.
    • Semaglutide - A GLP-1 agonist, Semaglutide is currently in clinical trials as a promising new option for Type II diabetes patients.  GLP-1 agonists lower blood sugar and early evidence is showing weight reduction as well.  Semaglutide is taken orally thus increasing the chances of patient compliance  

    Posted: October 12, 2016 by Bill Donnelly

    Tags: diabetes, diabetes doctor, type 2 diabetes, type II diabetes

Comments
Dennis Martin
The current diet and medication recommendations set by the ADA are wrong to actually be successful in treating type 2 diabetes. Basically it treats the symptoms rather than the disease itself. The cause is insulin resistance and improper diet. I have found great success by following two diabetic specialists doctors recommendations, Dr Richard Bernstein and Dr. Jason Fung which both recommend low carb high fat diet, by using this diet accompanied with intermittent fasting you can force your body to use your own body fat as energy while improving your insulin sensitivity and treating the main problem with type 2 diabetes. My charts do not lie, I went from a 13+ hbA1c to a 5.4 hbA1c using this technique . I reduced my medications all along the way, lost weight improved my B/P and cholesterol levels dramatically. I think Bariatric Surgery is a short time fix for people who have weight and blood glucose problems. Most who do this still have a recurring problem unless they dramatically change what they eat which can be done without permanent body damage simply by diet and fasting. With any surgery there is a chance of complications and risk that overrides the final outcomes in the long run. The current system of treatment sets a patient up to fail always requiring more medication as the disease progresses. Gaining weight is a symptom of insulin resistance by eating the wrong diet and not being able to use the stored energy and fat the body has set aside. LCHF diet and intermittent fasting can cause the fatty liver and body fat to be used as your energy while improving overall health and weight loss. It will treat the disease itself : Insulin Resistance , causing the type 2 diabetic to improve lessening their medications and normalizing their blood glucose.
Dr Richard Bernstein has a great book out that I highly suggest any diabetic read, it is called ( Diabetes Solution ). He also has a website called ( Diabetes University ), where people can listen to his video answers to diabetic questions and concerns. Knowing what to do is much of the battle, knowing what and when to eat is key to this solution. Dr. Bernstein was a pioneer in improving and testing because he is a diabetic himself. He also has sit on some of the ADA committees for improving recommendations. He knows what is wrong with the ADA from the inside and how drug and research money has influenced their standings. His lifelong work with real patients including himself is a jewel of information for properly treating diabetes with diet and medications. If you really want success then I suggest you check out his work. I know how it has worked for me and wish to share that success.

I thank you for allowing me to comment Mark Graves, MD.
10/19/2016 1:15:58 PM
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