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S. J. Gislason MD
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 benefits to
be had with the newer medications, an overweight diabetic should exercise all the
therapeutic and preventative options available before considering medications.
The
most negative aspect of medication is that a drug prescription may be taken to mean 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 great disservice.
Drugs to Lower Blood Sugar
Our perspective is that the drug treatment of diabetes is lacking in convincing
long-term efficacy and there are an number of important concerns about side effects and
long-term adverse effects. Unfortunately, there is no evidence to suggest that taking oral
hypoglycemic medications reduces the long-term complications of diabetes. Oral medications
should not be considered as primary treatment.
There is also uncertainty about the different mechanisms at work in diabetic patients
and the selection of medication is not based on solid foundation of understanding who
benefits from what pharmacological interventions. The current choice is between a drug
which seems to improve glucose clearance from the blood but does not raise insulin levels
and another group of drugs (sulphonylureas) which seem to increase insulin secretion. The
majority of diabetics are overweight and have too much insulin so that the latter group of
drugs would not seem to be a good idea for most diabetics. Cheap Calling Cards To Ghana
A drug which would restore the function of insulin sounds like a good idea. A single,
ideal drug with long-term benefits may never be found since there are likely to be many
different mechanisms behind the failure of insulin to work properly and the dietary and
environmental determinants of this failure are likely to be multiple and very potent.
Medical treatment plans often give lip service to the life-style changes that
are required to control this disease and seldom are realistic about the difficulties
encountered by anyone who attempts major diet change. Medical treatment plans also are
unaware of or underestimate the intensity of habitual eating patterns and
the compulsive eating aspect of the diabetic
experience. Drugs are prescribed as soon as a patient fails to achieve diet control and
often provide a false of security that the problem is being handled. laptop battery life comparison
We realize that the task of changing and
then controlling eating behaviors long-term is not an easy one. The task is to
realistically assess your own eating behaviors, understand what has to change and then
recruit the necessary resources to make this change.
Go to Coping with Diet Change
According to the National Institute of Diabetes and Digestive and Kidney Diseases,
U.S.
Public Health Service.
"Oral diabetes medicines, or oral
hypoglycemics, can lower blood glucose in people
who have diabetes, but are able to make some insulin. They are an option if diet and
exercise don't work. Oral diabetes medications are not insulin and are not a substitute
for diet and exercise. Although experts don't understand exactly how each oral medicine
works, they know that they increase insulin production and affect how insulin lowers blood
glucose. These medications are most effective in people who developed diabetes after age
40, have had diabetes less than 5 years, are normal weight, and have never received
insulin or have taken only 40 units or less of insulin a day. Pregnant and nursing women
shouldn't take oral medications because their effect on the fetus and newborn is unknown,
and because insulin provides better control of diabetes during pregnancy.
There is also some question about whether oral diabetes medications increase the risk
of a heart attack. Experts disagree on this point and many people with
noninsulin-dependent diabetes use oral medicines safely and effectively. The Food and Drug
Administration (FDA), the agency of the Federal Government that approves medications for
use in this country, requires that oral diabetes medicines carry a warning concerning the
increased risk of heart attack. Whether someone uses a medication depends on its benefits
and risks, something a doctor can help the patient decide.
The purpose of oral medications is to lower blood glucose. Therefore, the person taking
them must eat regular meals and engage in only light to moderate exercise, to prevent
blood glucose from dipping too low. Medications taken for other health problems, including
illness, also can lower blood sugar and may react with the diabetes medicine. Therefore, a
doctor needs to know all the medications a person is taking to prevent a harmful
interaction. Lowering blood sugar too much can cause hypoglycemia with symptoms such as
headache, weakness, shakiness, and if the condition is severe enough, collapse.
Oral diabetes medications usually don't cause side effects. However, a few people do
experience nausea, skin rashes, headache, either water retention or diuresis (increased
urination), and sensitivity to direct sunlight. These effects should gradually subside,
but a person should see a doctor if they persist. For reasons that aren't always clear,
sometimes oral diabetes medications don't help the person for whom they're prescribed.
Investigations are under way to learn why this happens."
Weight loss can achieve this
goal; passive treatments with cholesterol lowering drugs are available. Our current choice
would be Simvastatin (Zocor) 10-40 mg daily. In the Scandinavian
Simvastin
Survival Study, cholesterol levels were reduced by 27% and the incidence of heart
attack is
reduced by 55% in diabetics.
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