Delayed insulin, overuse of sulfonylureas threaten lives in T2 diabetes managementApril 11, 2025
Most patients and doctors misunderstand that the aim of diabetes care is to control blood sugar, but the true reason to treat diabetes is to prevent complications which may be caused by hypoglycemic drugs. The aim of diabetes treatment is to prevent:
Experts say good glycemic controls (HbA1C < 7%) reduce diabetic complications. But, the true reason is patients who have good diabetic control use less drugs. The use of sulfonylureas can cause kidney complications, cardiovascular complications, beta cells apoptosis, and increase mortalities despites good control of blood sugar. Bind to ATP-dependent K+ (KATP) channel on the cell membrane of pancreatic beta cells. The oldest and most common medicine used in diabetes. Drugs in this class promote insulin release by binding to sulfonylurea receptor can result in hypoglycemia, weight gain, and beta cell apoptosis. I am opposed to the unchecked use of sulfonylurea drug because they bind the same receptor at myocardial cell impairs ischemic preconditioning and has arrhythmogenic effects (Leibowitz Diabetologia 1996;39:503-514) and increase overall mortality (Simpson et al. CMAJ 2006;174:169-174). Compared to metformin, sulfonylurea users had an increased risk for persistent declined in GFR, end stage renal disease, and death (Kidney Int 2012;81:698-706) Nutritional supplements and dispelling the myths 1. If you eat right, you don’t need to take vitamins. 2. It is important to follow the Recommended Dietary Allowances (RDA). 3. Supplements do nothing beyond making expensive urine. 4. Vitamins and minerals are dangerous Targeted nutritional supplements for diabetes Why is there such a negative bias among physicians against nutrition in general and nutritional supplements in particular? There are many misperceptions about nutritional supplements and refuse to understand the importance of vitamins and supplements.
Benfotiamine and Pyridoxamine Special B’s to biohack the glycation end products Benfotiamine (active B1)
Lipoic acid
Vitamin C and other anti-oxidants re-generator
Stabilizing NF kappa B transcription factor: anti-inflammatory effects
What to expect if you have diabetes There is secondary diabetes not just type 1 and 2 Primary diabetes
Secondary diabetes
In Type 2 diabetes management, beta-cell function progressively declines despite treatment.
What kinds of diabetes patients need insulin?
Measuring C-Peptide levels to determine endogenous insulin secretion Insulin is produced in the pancreatic beta cells by enzymatic cleavage of the prohormone precursor proinsulin to produce insulin and C-peptide in equimolar amounts.
Obesity and exercise a powerful therapy for diabetes Everyone knows exercise is a healthy habit, unfortunately, few people make the effort required to exercise regularly. Personalized diabetic care needs personalized lifestyle advice, not just ”eat less and exercise more”. Exercise enables glucose to enter the cells, particularly those of the muscles even when the insulin is not present. Exercise may get more lip service but less action than any other therapy for diabetes. 1. Exercise protects the cardiovascular system and help prevent diabetic complications. 2. Exercise improves blood flow. 3. Exercise elevates HDL cholesterol. 4. Exercise lowers triglycerides. 5. Exercise have stronger hearts. 6. Exercise strengthens the disease heart. 7. Exercise builds “collaterals”. 8. Exercise elevates moods. 9. Exercise improves oxygen utilization. Intermittent fasting for overweight diabetes and reversing diabetes success stories Try intermittent fasting Three men who had type 2 diabetes for 10 to 25 years — and who were taking various pharmacotherapies, including insulin underwent nutritional training and were instructed to fast for 24 hours three times a week for several months. On fasting days, they ate just dinner. On non-fasting days, they ate lunch and dinner. Low-carbohydrate meals were advised, and participants were seen twice a month for lab testing. All three patients were able to discontinue insulin within 5 to 18 days.
Efficacy and safety of Intermittent Fasting (IF) in people with insulin-treated Type 2 diabetes Forty-six people were randomized to an IF or control group. Dietary counselling and continuous glucose monitoring was provided. Coprimary end points were the change in HbA1c from baseline to 12 weeks and a composite end point (weight reduction= 2%, insulin dose reduction= 10%, and HbA1c reduction= 3 mmol/mol). Results:
Conclusion:
A diet to improve insulin sensitivity Few, however, have had a doctor sit down with them and help them understand how powerful dietary changes can be in improving their insulin sensitivity and controlling their diabetes. There is an inherent bias in the medical profession against nutrition in favor of using drugs to treat patients. Is there an ideal diet for all diabetics? Unique, as differently in our biochemical make up as we are in physical appearance and personality. There are some basic principles regarding food and health that are indisputable. What is the human body designed to eat? Our bodies are not designed to handle a lot of meat. We are more adept at food gatherings, and the structure of the mouth and teeth is designed for plant foods that must be chewed well and mixed with the digestive enzymes in the saliva. The human intestinal tract, which measures forty-eight feet in length, fits the proportions of the fruit eaters much more closely than it does those of the meat eaters. Since lions are not partial to salad, why do we flood our system with meat? It is like putting diesel in the gasoline tank of your car. No one would do that. It is against the design specifications of the machine. However, that is exactly what we do when we regularly load each meal with meat and other animal proteins. A diet for reversing diabetes Simple versus complex, or high versus low. The primary dietary guideline given to patients was to eat complex carbohydrates and avoid simple sugars. Back in the good old days, it was generally accepted that there are two basic types of carbohydrates, simple and complex. However, research over past twenty years has added a twist to the simple/complex carbohydrates concept: the glycemic index. It is a way of evaluating foods according to how quickly they are metabolized into glucose. Generally speaking, it is easy to figure out, because most of carbohydrate we think of as complex have a low glycemic index value and most simple sugars have quite high value. Products that contain a lot of sugar and white flour obviously have a high glycemic index, thus it should be avoided. One of the most unhealthy diet is white flour, yet we eat it like there is no tomorrow. The average person eat toast, pancakes, noodles for breakfast, a sandwich or hamburger or noodles for lunch. That adds up to a whole lot of refined, processed, fiber-less white flour with a very high glycemic index that shoots up glucose levels. Furthermore, many of the flour-based foods we eat, such as cookies, cakes, and pastries also contains sugar. But even if you don’t add sugar to your food, you are likely eating more than you think, for most of the sugar we eat is hidden in processed and prepared foods. The bottom line is that the bulk of vegetables, fruits, grains, beans, legumes, nuts, and seeds in their natural unprocessed state are an excellent foundation for a therapeutic diet aimed at improving insulin sensitivity and treating diabetes. Refined sugar, white flour, and other processed foods, as well as few natural plant foods that have a high glycemic index rating, should be avoided. Quality is paramount The foundation of the optimal diet for diabetics should be unprocessed plant foods, primarily those that are low on the glycemic index. More than half of your caloric intake (60%) should be obtained from these types of carbohydrates. The reminder of your diet should contain approximately equal amount of high-quality fat (20%) and lean protein (20%). In conclusion, the recommendations are general guidelines. The quality of the food you eat is more important that the precise percentages of this and that. By making intelligent choices among a wide variety of healthful foods, you can improve your cells’ sensitivity to insulin, lower blood sugar levels, and reduce or eliminate your need for medication. You will also likely decrease your chances of developing diabetic complications, and above all, increase your likelihood of a long and healthy life. For decades researchers and medical publications had made it clear that simple lifestyle changes were exceptionally effective therapies for patients with these diseases. However physicians were ignoring the appropriate use of nutrition and exercise in treating diabetes and other degenerative conditions. While drugs are sometimes necessary (as is insulin for type 1 diabetics), they are often prescribed before safe, effective lifestyle changes have been given a proper trial. Once you understand the limitations of drug therapy for the treatment of diabetes, you will be motivated than ever to get started on this program for reversing diabetes. With current explosion of technology, we stand convinced that the answer is just around the corner. While we are waiting, however, our patients continue to suffer, not because of the breakthrough, but because we ignore the only answer necessary for many of them: a disciplined diet program, exercise, and targeted nutritional supplementation that the patient views as the most important part of his or her treatment. Personalized diabetic care requires empathy
To give personalized care, they must know that the guidelines are tailor made clothes, not made as one size fits all clothing. |
EXPLORE FURTHER
|
Not so sweet: The connection between erectile health and diabetesDiabetes increases the risk of developing ED 3.5 times
|
|
Women with pre-term delivery, gestational diabetes and rheumatoid arthritis at higher risk of heart diseaseThree times at higher risk of cardiovascular deaths
|
|
Diabetes: Subtle signs you should not ignoreSubtle signs include urinating often, thirsty, urinary tract infection, weight...
|
|
Diabetic retinopathy: A common cause for blindness in adultsThe most common eye disease
|
|
Empowering children with type 1 diabetes mellitusIs complete avoidance of sweets and sugar the solution?
|
|
Can diabetes be reversed?Discover the power to reverse diabetes through nutrition and lifestyle
|
|
Maggot debridement therapy: Rescuing limbs from amputationAn innovative modality for the treatment of chronic wounds
|
|
Diabetes treatments continue to evolveGlucagon-like-peptide-1 receptor agonists increases the secretion of insulin
|
