Tuesday, June 28, 2005

Diet revision and Exercise are the Best Treatments for Diabetes 2

Diet Revision and Exercise are the Best Treatments for Diabetes 2

Standard medical treatment protocols for diabetes 2 always mention diet revision and then quickly proceed to medication options. While diet control is always mentioned, the critical, decisive importance of diet revision and exercise is not emphasized and in practice, diet revision is often neglected in favor of drug treatments.

Drug treatments of Type 2 Diabetes do not have a good track record. The main problem is the false belief that a drug or combination of drugs can rescue an individual from a disease-causing lifestyle. While there are theoretical benefits to be had with the newer medications, the long-term outcomes are not known. An overweight diabetic should exercise all the therapeutic and preventative options available before taking drugs.

The most negative aspect of medication is that a drug prescription means that the patient is passive, dependent and has been excused from making all the important changes that will preserve body parts and ultimately save his or her life. If the drug is taken as permission to postpone or forego the vitally important changes in lifestyle, then the prescription has done a disservice. Even with medication, precise diet control is still required to maintain reasonable sugar levels.

I do not advocate drug use with the exception of taking very low ASA and a diuretic that can be useful in controlling blood pressure. Whelton et al confirmed an earlier finding that inexpensive diuretics at low dose were effective preventing heart attacks and fatal heart disease in people with diabetes 2. In their study, there were more heart attacks in people with pre-diabetes on a calcium channel blocker than those on a diuretic. They concluded: ”Our results provide no evidence of superiority for treatment with calcium channel blockers or angiotensin-converting enzyme inhibitors compared with a thiazide-type diuretic during first-step antihypertensive therapy in subjects with diabetes, impaired fasting glucose or normal glucose levels.”

See the Book of Diabetes 2 by Stephen Gislason MD

Reference: Paul K. Whelton, MD, MSc; Joshua Barzilay, MD; William C. Cushman, MD; Barry R. Davis, MD, PhD; Ekambaram IIamathi, MD; John B. Kostis, MD; Frans H. H. Leenen, MD, PhD; Gail T. Louis, RN; Karen L. Margolis, MD; David E. Mathis, MD; Jamal Moloo, MD; Chuke Nwachuku, MA, MPH, DrPH; Deborah Panebianco, MD; David C. Parish, MD; Sara Pressel, MS; Debra L. Simmons, MD; Udho Thadani, MD; for the ALLHAT Collaborative Research Group. Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). Clinical Outcomes in Antihypertensive Treatment of Type 2 Diabetes, Impaired Fasting Glucose Concentration, and normal blood sugar. Arch Intern Med. 2005;165:1401-1409.