MOST DOCTORS DON'T TREAT DIABETES CORRECTLY

Report #7283

A report in the Journal of the American Medical Association shows that most doctors do not know how to treat late-onset diabetes. After two years of therapy with insulin, more than 60% of patients still have hemoglobin A1C levels about 8 which means that doctors are not preventing the complications of diabetes such as blindness, loss of hearing, nerve damage, strokes, heart attacks and kidney damage. Hemoglobin A1C measures how much sugar is stuck on cell membranes and is converted to a poison called sorbitol that causes cell damage. Cell damage in diabetes is caused by high hemoglobin A1C levels that are caused by high blood sugar levels after eating. The higher blood sugar levels rise after eating, the more sugar is attached to cells and the more likely cells are damaged.

Doctors usually prescribe insulin and drugs that raise insulin make diabetics hungry all the time. Then they prescribe a calorie-exchange diet that prevents their patients from eating when they are hungry. Instead doctors should prescribe Glucophage and Avandia or Actos, the only available drugs that lower high blood sugar levels without causing hunger. Instead of prescribing a calorie-restricting exchange diet, they should prescribe a high fiber, low-fat diet based on substituting whole grains for flour.

Whole grains are like pellets that absorb up to five times their weight in water and expand while they are in your intestines to make you feel full. I try to work my patients up to taking 500 mg of glucophage and 4 mg of Avandia or 30 mg of Actos. I tell my patients to avoid exchange diets and send them to Diana's cooking school to learn how to add whole grains to every meal.

By Gabe Mirkin, M.D., for CBS Radio News

JAMA November 26, 1997

Checked 8/9/05; see report #D222.