2) TYPE 2 DIABETES CONTROL
f) A Fatal Error: Relying on Diabetes Medication
The most common and fatal error any person with type 2 diabetes can make is making the assumption that diabetes medication (or the "miracles of modern diabetes medicine") will control the disease. The version of the three legged stool outlined above does not have a fourth leg for diabetes medication (with the notable exception of insulin). That is because most diabetes medications have only a limited effect on the life expectancy of a person with diabetes. The only exception to this is insulin injections. Refusing to take insulin injections is a death sentence.
We don't include medication in the legs of our "three legged stool" because most diabetes medications only work well to control diabetes damage to the small blood vessels (so called "microvascular disease") in the body, so diabetes medication can prevent kidney problems, nerve problems and eye problems. But most persons with type 2 diabetes die from "heart disease" (the technical term is "macrovascular disease", or diseases of the large blood vessels which includes heart disease, arteriosclerosis, high blood pressure, peripheral arterial disease and stroke, but we'll simply use the term heart disease). The high blood sugar levels of type 2 diabetes do not appear to directly cause the majority of heart disease. But type 2 diabetes is almost always accompanied by heart disease (they appear to be caused by the same underlying factors) and the two diseases feed off each other, multiplying the effects of each other. One way to think of it is that anyone with type 2 diabetes should also be considered as having heart disease, and they need to think and act accordingly.
No diabetes medication has been shown to be significantly effective against the heart disease that accompanies diabetes. This is due to the fact that diabetes doesn't directly cause the majority of the heart disease. Rather diabetes and heart disease appear to be caused by the same factors, so if you have diabetes, you probably have heart disease. Blood pressure medications, cholesterol lowering medications, exercise, diet (both avoidance of high glycemic index carbohydrate and avoidance of saturated fat), and weight reduction have been shown to be very effective for control of heart disease in both persons with diabetes and "normal" individuals with high risk factors for heart disease (such a metabolic syndrome individuals). Such actions can reduce heart disease by 50% if the person with diabetes also controls his blood sugar.
There is another difficulty in relying on medication to control diabetes. In order to keep the level of sugar low in the blood the medications speed up sugar removal into the cells as fat and, to a lesser extent, onto the walls of the blood vessels as plaque deposits. By increasing fat deposition, most diabetes medications can actually decrease life expectancy by increasing weight, which in turn increases both insulin resistance and blood pressure, which in turn increases heart disease, which in turn increases mortality. Several research studies have showed decreased life expectancies for individuals with type 2 diabetes who are on medications for type 2 diabetes. Someone on diabetes medications needs to be religious about weight control. They have to accept the fact they are going to be at least a little hungry for much of the remainder of their life.
However, having said all that about medicines not being the fourth leg of the stool, we have to make an exception for insulin. If the type 2 diabetes has progressed to the point of requiring insulin, then the insulin must be used and used properly in order to stay alive. Note that it has been shown repeatedly that a well disciplined program of weight loss, exercise and diet can reverse the need for insulin in type 2 diabetes.
This Chapter 2) TYPE 2 DIABETES CONTROL
a) Introduction
b) The Range of Severity of Diabetes
c) Current Expectations for a Person with Type 2 Diabetes
d) Summary of How a Person with Severe Type 2 Diabetes can Live Long
e) Specifics of How a Person with Severe Type 2 Diabetes can Live Long
f) A Fatal Error: Relying on Diabetes Medication
g) The Consequences of not Controlling the Disease
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