TREATMENT OF DIABETES

D215

Gabe Mirkin, M.D.

FIRST, KEEP BLOOD SUGAR FROM RISING TOO HIGH AFTER MEALS: When you eat, your blood sugar level rises. If it rises too high, sugar sticks to the surface of cells. Sugar, by itself, is harmless, but stuck on cell membranes, it is converted to a poison called sorbitol that causes heart attacks, strokes, blindness, deafness, kidney damage, burning foot syndrome and impotence. The key to treating diabetes is to prevent blood sugar levels from rising too high after meals.

It is far safer to have your blood sugar remain elevated slightly for a long time than to have blood sugar levels rise very high and return quickly to normal. Refined carbohydrates, such as bread, spaghetti, macaroni, bagels, cookies, crackers, rolls, refined grain cereals and white rice cause almost the same rise in blood sugar as a tablespoon of table sugar. To keep blood sugar levels from rising too high:

*Severely restrict dietary sugar and refined carbohydrates in bakery products, cereals and pasta.

*Eat fruit and root vegetables (carrots, potatoes, beets, etc.) only with meals, so other components of foods will slow down the absorption of sugar from the fruit.

*Eat lots of whole grains. They release their carbohydrates very slowly, and also help to suppress your appetite.

SECOND, USE AS LITTLE INSULIN AS POSSIBLE: Insulin is a bad hormone. It constricts arteries and causes heart attacks and strokes.(1) It makes you hungry all the time, causing you to overeat and become fat. It causes the liver to convert all extra calories to fat.

You want to keep blood sugar levels from rising too high after meals while taking as little insulin as possible. Three new drugs help to do this:

*Glucophage: prevents the liver from releasing sugar from liver cells into the bloodstream.

*Actos and Avandia: sensitize cells to insulin so less insulin is required.

*Amylin: keeps food in the stomach longer, so it is not absorbed as fast and blood sugar levels rise more slowly, so they do not go as high.

Also see report #D222.

1)S Vanveen, PC Chang. Modulation of vasoconstriction by insulin. Journal of Hypertension 16: 8 (AUG 1998):1157-1164.)

Checked 8/9/05