HBA1C

I am a Type 2 diabetic and an Internal Medicine physician. The problem with Insulin and drugs like micronase, glyburide, and actos or avandia is that they all promote weight gain. Weight gain is the worst problem you have right now because it increase syour Insulin resistance and ultimately makes your diabetes worse if you cannot control your diet. Insulin stimulates hunger and it tells your body to either use the exta sugar in your blood to burn as calories or store in fat. My experience is that not only do many fellow physicians not have a good grip on nutrition, neither due the diabetic nutritionists. The vast majority of patients who are taught the ADA diabetic diets fail. Tracking the equivalents becomes onerous and undoable for most people. They also recommend carbs that for some of us will invariably run our sugar up even at the serving size they recommend. The ADA is a big organization and big organizations become political and change their tactics more slowly than is best. Your nutritionist may be more savvy, some certainly are, but most aren't in my personal experience. I recommend the Sugar Busters book to give you a better understanding of T2DM and to give you a better perspective on the kind of carbs you should shy away from. As long as you don't have an infection, or other medical cause for higher blood sugars, the treatment is weight loss period. Especially weight loss that maintains muscle mass and promotes fat loss. This requires a mixture of resistance exercise (weight lifting) and cardio exercise that is appropriate to your size and fitness. Combine this with diet and you will definitely see weight loss and improvement. I am using a plan from www.musclenow.com (No profit affiliation) sucessfully. You must discuss a plan of exercise with your MD since you may run into trouble with blood sugar drops on Insulin or other diabetic medications which lower blood sugar by stimulating Insulin release. You may need to taper and stop Insulin with this sort of plan, and must do this in close alliance with your doctor. I disagree with the idea of the Insulin Pump. If Lantus which has a lower tendency to cause weight gain, but nevertheless causes it is effective then a carefully planned use of a pump may give you even better control with less weight gain. Newer pumps carfelly control glucose especially if you test multiple times during the day and input the sugars into the pump. The easiest way for a T2DM patient to lower glucose is to fast for 24 hours and you will see a drop unless something else is wrong. (You can't do this on most diabetic meds including Insulin, your sugar will drop) Metformin may be helpful since it does not lower blood sugar below normal in most instances. Once again, discuss this with your MD. I have had this same problem lately even though I am exercising, watching what I eat, I am running higher sugars. I don't treat myself so I am going to my doctor for some help. I am off all diabetes meds including Insulin, and I don't want to go back on them if I can somehow turn this around. Good Luck, I will be watching to see how you do! Marcus Williams MD