Type 2 Diabetes and Insulin Treatment

New research suggests that treating type 2 diabetes with insulin therapy + metformin improves outcomes when compared to the traditional exercise, weight loss, and oral hypoglycemic agent drugs when needed. Three years into a 6-year study at the University of Texas’s Southwestern Medical Center, results showed that the insulin-treated group had fewer hypoglycemic episodes, gained less weight, and reported high treatment satisfaction [1].
While an abundance of my patients state that they will never take shots, I found this research interesting. As a clinician, I am deeply concerned about hypoglycemic episodes for patients on insulin regimens. Without the fundamental understanding of carbohydrates, carbohydrate counting, and insulin dosing, insulin therapy can open flood gates of displeasures and dangers. This research, however, recommends a sliding-scale of insulin dosing which is determined based on blood sugar readings [1].
Interestingly, the International Diabetes Foundation states that 3.8 million people will die from diabetes and related illnesses each year. With the number of diabetics growing from 20 million to 246 million in the past 20 years, diabetes is without a doubt a growing disease state among the US and other countries. The highest increases in diabetes cases are occurring in developing worlds, such as India (40.9 million) and China (39.8 million) [1]. I would’ve never guessed.
Yesterday’s diabetic diet went like this…

Breakfast:
2 whole wheat waffles (2 carbs)
2 Tbsp apple butter (1 carb)
cappuccino with 2 Tbsp sugar-free International Delight (0 carbs)
     Total: 3 carbs

Lunch:
1 serving chili (1 carb)
6 wheat crackers (1 carb)
1 small apple (1 carb)
8 oz. V8 Fusion Light (1 carb)
     Total: 4 carbs

Dinner:
1 cup mini shredded wheats (2 1/2 carbs)
1 cup skim milk (1 carb)
     Total: 3 1/2 carbs

Snack:
1 small banana (1 carb)
1 cup skim milk (1 carb)
     Total: 2 carbs
 
[1]. Research Points to New Way to Treat Type 2 Diabetes: Insulin First. Diabetes in Control. October 21, 2009.
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