12) DIABETES MEDICATIONS
b) Diabetes Medications
There are many oral medications which have been developed and approved for the treatment of the blood sugar problems associated with type 2 diabetes. Most medical physicians will start out with either no drug treatments or very conservative drug treatments and ask the patient to monitor their blood sugar before meals ("pre-prandial"). They will then check the patient's recollection of blood sugar levels after two or three months and the A1c levels and adjust the medication accordingly. They typically will also watch the weight of the diabetic and encourage them to lose weight. But this is often a very frustrating task as most individuals with type 2 diabetes just can't muster the will power to lose any significant amount of weight. If you are genetically programmed to be obese and genetically programmed to have type 2 diabetes, weight loss can be a huge, often unsurmountable problem. This is especially true since most diabetes drugs just shunt blood sugar into fats which increase a person's weight and the deposits on the walls of an individual's blood vessels. This is also one of the reasons doctors are loath to immediately prescribe a host of drugs. A side effect of most diabetes drugs is weight gain, so any person with type 2 diabetes on several drugs needs to be very motivated in order to lose weight.
As we have pointed out elsewhere, the three major support legs of the diabetes "treatment stool" are weight loss, exercise and diet. Medication is not one of the legs because it typically has little effect on mortality rates. It can even be counterproductive. Medication shunts excess blood carbohydrates into fat storage. Fat storage increases weight, increases insulin resistance, increases blood pressure, and increases heart disease and mortality. In the ACCORD study, 27.8% of the intensive drug treatment group gained more than 22 pounds while only 14.1% of the less intensive drug therapy group gained more than 22 pounds. The intensive drug treatment group had significantly higher mortality and the study was actually stopped because of it. The UKPDS study showed no difference in mortality with drug treatment, while the VADFT study had a statistically insignificant increase in mortality with drug treatment. The University Group Diabetes Program (a study of the effectiveness of sulfonylureas) and a meta-analysis of the efficacy of Avandia showed significant increases in heart disease and/or mortality rates with the drug treatments. It has to be emphasized that all these studies found significant improvements in quality of life issues (blindness, kidney disease, impotence, neuropathy, cognitive decline, etc.) with drug treatment. Patients on diabetes medications have to control their weight if they want to live longer!
If an individual with type 2 diabetes doesn't take these medications, the excess blood sugar will be excreted by the kidneys, severely harming the kidneys in the process. But this excretion of blood sugar by the kidneys can be much more damaging to the body than a little fluid retention or a minor increase in blood lipids. Damage to the kidneys can result in kidney failure and the need for dialysis in some individuals. Dialysis is very hard on the body and will reduce life expectancy considerably. Seventy five percent of those individuals with kidney failure will die within five to ten years if they can't get a kidney transplant. This mortality from kidney failure would not have shown up in any of the studies mentioned above as it takes many years to result in mortality. But it would show up in quality of life issues in the studies. As mentioned elsewhere, we are not a medical doctor so we are not dispensing any advice on taking diabetes medications.
Current Chapter: 12) DIABETES MEDICATIONS
a) Introduction
b) Diabetes Medications
c) List of Potential Medications
d) Insulin Injections
e) Blood Sugar Testers
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