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Type 2 diabetes



I Have Diabetes – Now What? A New Patient’s Guide to Managing Type 2 Diabetes

There are more than 25.8 million people living with diabetes in the U.S., according to the CDC. They also say that adds up to just more than eight percent of our total population. It’s a tricky disease to manage and an expensive one, with a total annual cost of $2 billion. More startling? Eighty percent of cases are reversible, but that part is up to you.

If you’re one of the nearly two million newly diagnosed cases of diabetes each year, it can be worrisome, to say the least. The word strikes fear in those who have it, and worry in their loved ones. Life as you know it seemingly changes in an instance. But that’s OK. It’s a hard reality check to follow, but one that can literally save your life.

doctor patient

With Dr. Sarah G. Khan, our resident pharmacist and diabetes education expert, we’ve created your one-stop guide to diabetes for new patients. We’ll answer your questions, provide you with resources, and give you options to manage or reverse your disease.

1. Do you want to manage or correct your diabetes?

“I think diabetes is a combination of both managing and correcting,” explained Dr. Khan. “There are other factors such as illness and stress that raise blood sugars which aren’t always under a person’s control.” Ask yourself which path you want to take.

If you want to manage…
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‘Grazing’ Fad Being Put Out to Pasture with New Type 2 Diabetes Study

The six meal a day diet fad may be on the outs. In recent years, it’s been suggested that eating six small meals throughout the day, colloquially referred to as “grazing,” is a better approach to weight loss than the more traditional three squares. The American Diabetes Association has released a study confirming that eating two meals a day led to more weight loss than six small ones.

The study is by no means supremely revelatory—the sample size was a meager 54 people and they all had type 2 diabetes—but it has sparked debate over how many daily meals is appropriate for weight loss. Additionally, the researchers lowered the participants’ usual daily caloric intake by 500, which would lead to weight loss either way you slice it.

Empty Plate

In the ADA study, 27 people ate six small meals a day, and 27 ate just breakfast and lunch, skipping dinner entirely. Both control groups lost weight—an average of 0.82 BMI points for the grazers and 1.23 points for the minimalists—but there are flaws with both schools of thought. The average person is too busy to prepare and eat six meals a day, and refraining from eating entirely after lunch is just silly.


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Gastric Bypass May be a Better Treatment for Type 2 Diabetes

A year-long study regarding the connection between weight loss surgery and curing type 2 diabetes was released this week. The study showed that surgery seemed to be more effective than lifestyle change and medication for treating the disease. However, the tradeoff was that those who had the surgery were at a very common risk for complications. Is this just a one step forward and one step back scenario?

surgeon

The Associated Press reported that a new publication in the Journal of the American Medical Association is stating that gastric bypass surgery can effectively treat type 2 diabetes in patients with mild to moderate obesity. This means people who are about 50 to 70 pounds overweight.

While the glowing light of the words “treatment for diabetes” seems impressive, it was also stated that of those in the study who received surgery, a third of them developed serious problems during the first year after surgery. The typical complications include infections, intestinal blockage, and bleeding. And then there was a much smaller percentage who experienced much more severe complications.
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Invokana is a Revolutionary New Drug Treatment for Type 2 Diabetes

Invokana is the newest diabetes drug to hit the market and uses an innovative mechanism to help control blood sugar for type 2 diabetes. Invokana, produced by Janssen Pharmaceuticals, will make a splash in the market as this is the first drug of its kind.

invokana

The statistic for this drug that I’m most interested in is the reduction in A1C percentage. Hemoglobin A1C is the percent of glucose that is bound to red blood cells. It also gives a three-month big picture of the patient’s control of their blood sugar. The higher the number the higher the person’s daily blood sugars will be; the goal is to be under seven percent. Trials have shown that Invokana has lowered A1C percent by approximately 1 percent over 26 weeks with a 300 mg dose and a 0.77 percent decrease with a 100 mg dosage. A one-percent reduction is approximately a decrease of 14 points on an average daily blood glucose reading. Lower blood sugars overall will prevent complications which can include blindness, renal failure and amputations.
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Skinny-Fat Individuals Have Higher Death Rate Than the Obese

Just when you thought you knew what obese looked like, an army of skinny-fat people come marching along with little pot bellies hidden under their pear-shaped shirts. No, we’re not on the cusp of a diet-war, but diabetes and heart disease are waging a silent attack on people with normal weight obesity, also known as “skinny-fat.”pizza

While the term normal weight obesity sounds as absurd as fat-free Twinkie, it’s a new and legitimate condition that, according to the Mayo Clinic, may afflict up to 30 million Americans.

In medical terms, normal weight obesity is typified by a normal Body Mass Index (BMI), usually 18.5-24.9, with a large percentage of body fat. In layman’s terms, people with normal weight obesity appear to be thin and healthy, but have large concentrations of central obesity—pooch bellies—and stores of fat around vital organs.

Led by Dr. Karine Sahakyan, The Mayo Clinic conducted a nearly 15-year study of 12,785 subjects, specifically geared toward determining the significance of central obesity. The doctors used a fun, new scientific measurement called “waist-to-hip ratio”—muffin top to where God intended your jeans to sit—as a means to statistically legitimize belly fat. They found that subjects with a normal BMI and a high waist-to-hip ratio—skinny-fat people—”had the highest cardiovascular death risk and the highest death risk…” out of all other demographics studied.
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