Diabetic Living - Fall 2010

You can’t completely reverse the hormonal imbalance of type 2 diabetes, but a combination of actions can solve the high fasting blood glucose problem. “With your health care provider’s guidance, experiment,” says Arlene Monk, R.D., CDE, a dietitian and diabetes educator at the International Diabetes Center at Park Nicollet in Minneapolis. Here are some actions that may improve morning numbers:

Start, change, or add medication. “Most people need to start a blood glucose-lowering drug at diagnosis to fight the insulin resistance and the hormonal imbalance,” says Marty Irons, R.Ph., CDE. The most common starting medication, metformin, cuts down on glucose overproduction overnight. Beth DeLauder, 46, PWD type 2, from Stafford, Virginia, takes metformin, as does Pete. They both say it’s been one factor among many lifestyle changes to help lower their fasting blood glucose levels.

Newer drugs are prescribed as
starting or add-on medications when
blood glucose goals aren’t met. The
oral dipeptidyl peptidase- 4 (DPP- 4)
inhibitors Januvia and Onglyza keep
more GLP- 1 hormone circulating.
The more potent injectable GLP- 1
agonists Byetta (twice daily) and
Victoza (once daily) increase the
amount of GLP- 1 available. Some
people also experience weight loss
while using these medications.

Shed pounds. Weight loss, especially soon after diagnosis of type 2 diabetes, can help the hormonal disturbances, increase insulin sensitivity, and lower blood glucose levels. The best approach: “Make lifestyle changes, choose more healthy foods, trim the portions of less healthy foods, and crank up your physical activity,” Monk says.

You’ll see blood glucose drop before the pounds do. “Losing weight pushed my A1C from 6. 9 percent to 5. 8 percent and my average fasting blood glucose from 140 to 100,” Beth says. She’s lost 35 pounds by minimizing processed foods and added sugars and sticking to her carb counts. Pete, who weighs about