Diabetes Treatment and Help: Q&A

Q: I am 52, female, and I have kidney problems along with diabetes. Is there any way I can slow down the progression of my disease?
A: The very first step of your diabetes treatment should be a complete health check that will establish what stage you are at. There are many problems that need to be addressed, such as blood pressure, anemia and possible kidney filtration. Additional diabetes tests are also recommended, such as ultrasound examination, to find out whether you have anatomic abnormalities, kidney stones or urinary track blockages that can also affect your health.
When the diagnosis is definite and based on a series of diabetes tests and examinations, an individual program can be offered by the doctor. This program will be aimed at addressing your condition and slowing down its progression. You need to seek diabetes help in case you suspect the presence of this condition.
If diabetes screening showed chronic kidney disease, you will be most likely prescribed an ACE inhibitor. These drugs are used to treat high blood pressure and are also efficient for patients with kidney disease.
Some supplements can also help you manage your condition. Vitamin D, for instance, has powerful properties and can prevent renal failure or slow down its progression. Q10 has antioxidant effects and helps regenerate the tissues of the kidneys, while folate is known for beneficial effects on vascular disease. L-arginine and alpha-lipoic acid prevent the progression of vascular disease, although this hasn’t been completely proved. All these supplements are beneficial for your health with no downturns.
However, besides diabetes medication and supplements, there are many other things that can be done by the patient. Smoking is one of the possible contributors, so if you are a smoker, consider some ways in which you can quit. A couple of punches of hypnosis or acupuncture treatment are likely to help you quit and slow down the progression of kidney disease.
Both diabetes and kidney problems can be dealt with at the same time. There are practitioners who seem to believe certain techniques (such as acupuncture) can help the patient recover the energy and cause positive changes in the behavior, resulting in a better lifestyle and eating habits.
This is very important as type 2 diabetes can be sometimes reversed if the person suffering from it is determined to change his or her lifestyle completely. These changes include maintaining a healthy weight, eating healthily and exercising in moderation. As your general health condition is improving, kidney disease is also likely to go away.

Q: I’ve been diagnosed with type 2 diabetes. I have done a small diabetes study myself and decided to exclude carbohydrates. I have a lot of excessive weight – 125 pounds – and I know I have to lose as much as possible of it. During the last two weeks I have been observing a low-carb diet, but the results haven’t been great – only 4 pounds so far. Meanwhile, my blood sugar levels have fallen significantly. Am I to continue?
A: It’s great that you decided to change your lifestyle to handle the disease. In fact, the progress that you are describing is very good, and the recommended rate is 1–2 pounds per week. This rate is optimal as you don’t run the risk of harming your body. This means that you need to eat 3,500 calories less per week, or 500 calories less per day. As you continue with your weight loss, you will notice that eating the same amount of calories doesn’t reduce weight anymore. At this point you will need to think about further reducing your caloric intake or just coming up with efficient exercise to help you burn calories.
It’s hard to say what is better and more effective – a low-fat diet or a low-carb diet. If we take a short period of time, it’s the low-carb diet that provides more obvious changes, but in the long run both these diets have the same result. However, there is the following concern connected with a low-carb diet: people tend to eliminate foods that are very important, such as fruits or whole grains, which results in the body not receiving enough nutrition. For the best results without harm to your health it’s recommended to eat a healthy diet, cutting down on both carbs and fats and in this way limiting your caloric intake.
Most importantly, if you manage to achieve consistent weight loss, you need to maintain it. You can do it by exercising daily, getting plenty of vitamins and minerals and adjusting your caloric intake depending on the progress you are making.

Q: I am a type 2 diabetic and have had this condition for 17 years. Several days ago a nurse was showing me how to give myself the injection, and she said something that surprised me a lot: that I am now a type 1 diabetic. Now I am completely confused: I have adult-onset diabetes, and type 1 is a childhood-onset one... Could you please clarify that for me?
A: No, the only fact that you have started insulin therapy doesn’t mean you are now type 1 diabetic. The most probable reason may be that the nurse was referring to the old system, according to which insulin-dependent people were classified as type 1 diabetics, while non-insulin-dependent people as type 2 diabetics. This system is not used anymore because it was very confusing.
The problem most people have when trying to classify the disease is that both conditions involve very high blood sugar levels. The difference lies in the causes and the symptoms.
Type 1 diabetes is present when the cells in the pancreas responsible for the production of insulin are destroyed by the antibodies. These antibodies are produced by the immune system and are aimed at defending the organism from external threats (bacteria, viruses, etc.). They can be detected in blood tests. Type 1 diabetes incidence is higher among children, while not so many adults are likely to get it. Despite the age, the pancreas in the type 1 diabetes patient doesn’t produce enough insulin, so insulin therapy is required to avoid serious complications.
Type 2 diabetes is a more serious condition that accounts for most cases of the disease. 90% of all the people with diabetes have type 2; it’s usually caused by a combination of factors: genetic predisposition and obesity. These factors have not been completely studied, although some of them have been investigated very thoroughly. Only a small number of type 2 diabetics have experienced neither of these factors.
In most cases type 2 diabetics do not need insulin injections when the disease is first diagnosed. Even as the disease progresses, the pancreas is able to produce insulin, but this amount is usually not enough for the body to function properly. There is diabetes medication that can be taken to increase the secretion of insulin or decrease the resistance of the body to it. However, with time the pancreas produces less and less insulin, so insulin injections become a necessity. In some cases insulin injections can be prescribed before this becomes an urgent need to ensure the level of glucose is managed properly. However, this doesn’t mean that the type of disease from which you are suffering changes; it’s the method of diabetes treatment that is altered.

Q: My husband has been recently diagnosed as “prediabetic,” after suffering a heart attack. I’ve done some online diabetes study and learnt a lot about the condition called “insulin resistance.” The information I learnt gives me reasons to believe my husband is insulin resistant, not prediabetic. What is the difference between these two conditions and how are they treated?
A: Prediabetes is present when the levels of glucose in the blood are abnormally high, whereas insulin resistance describes the way someone can develop this condition. So, they are not exactly two diseases – they are cause and effect; in other words, insulin resistance leads to prediabetes.
Sugar is necessary for our body to function, as it energizes the cells and fuels them with nutrients. To deliver the nutrients, sugar has to travel in the bloodstream and get delivered through the walls of the cells. Inside the cells sugar is transformed into energy and nutrients. Insulin is a substance produced in the pancreas as a reaction to the increasing levels of sugar. Insulin makes it possible for the cells to absorb sugar through their walls and break it down. Insulin resistance happens when the walls of the cells are no longer influenced by insulin, i.e. they resist it.
In most cases, adults diagnosed with prediabetes also have insulin resistance, while a small number of them have the deficiency of insulin. If the cells of some organs (such as liver and muscles) become resistant to insulin, glucose is not able to enter the cells. Instead it accumulates in the bloodstream and the levels exceed those considered healthy – that’s when we speak of prediabetes. This condition is diagnosed when the level of glucose exceeds the norm but is still lower than the values of diabetes. For prediabetes the fasting value is 100 to 125 mg/Dl, or 140 to 199 mg/Dl two hours after a glucose load.
Insulin resistance can also affect the metabolism of cholesterol. The pancreas, trying to fight the resistance, secretes bigger and bigger amounts of insulin, which results in high blood pressure and is very bad for the arteries.
Prediabetes treatment has the following purposes: to slow down or prevent, depending on the stage, the onset of cardiovascular complications and diabetes. According to research, people with prediabetes who lead a healthy lifestyle, eat a balanced diet and lose excessive weight can reduce the risk of developing diabetes by 58%. Another research study confirmed that the risk of diabetes decreases by 31% if the right diabetes medication is taken (metformin, for instance).

Q: I’ve heard your feet can indicate if you are developing diabetes, and that diabetes patients experience specific problems with their feet. How does it happen?
A: Microangiopathy is one of the complications of diabetes, when the walls of capillaries (the smallest blood vessels) become abnormally thick and weak, which causes them to bleed, leak protein and fail to deliver nutrients to certain parts of the body. This can lead to very serious consequences – damage to the eyes and kidneys. All these conditions will result from the capillaries failing to perform their usual functions.
Sometimes a condition called neuropathy occurs; it is characterized by the nerves being damaged because of its starvation. The nerves in the feet are the longest in the whole body, which means they are more likely to be affected. If you experience an overall decreased sensation in the feet, numbness, “pins and needles” and burning pain, these may be the earliest signs of the condition called peripheral neuropathy. The danger of decreased sensation lies in the fact that you will be less likely to notice small injuries to your feet, which can result in infections and even deformities, e.g., if you place your foot in uncomfortable positions without noticing it.

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