Common sense approach to treating Type II diabetes

Medicine is an extremely complex science. Yet sometimes, I am struck by how simple things really are if we just let them be.

Doctors tend to make things as complicated as possible. Get drug companies involved, and the waters get even muddier. Popping a pill may seem like a simple solution, but as we’ve learned over the years, those quick fixes don’t solve the problem very well – and all too often, they just create new ones.

And many times, the healthiest, safest, and simplest solution was right under our noses the whole time.
Skip the drugs – start with simple steps first
That’s becoming more and more apparent in the case of Type II diabetes, one of the biggest public health threats facing the world today. Incidence rates of Type II diabetes are climbing higher each year. Pharmaceutical companies have spent astronomical amounts of time and money developing drugs to treat it, but as the numbers show, they’ve had little effect. Hundreds of doctors have spent countless hours in meetings, analyzing the data and trying to come up with scientific explanations and protocols for treatment.

Meanwhile, a growing body of evidence is showing that all those drugs and all that analysis may not be necessary. The best approach for the prevention AND treatment of Type II diabetes is a simple, natural one – good, old-fashioned dietary changes, weight loss, and exercise.

New research from the Diabetes Prevention Program Research Group reinforces that point. In this study, doctors at 27 health care centers across the country recruited 3,234 people who were not yet diabetic, but exhibited elevated glucose levels. Participants also had to be considered overweight, with a body mass index of 24 or higher. They were randomly assigned to one of three groups: 850 mg of the prescription drug metformin (Glucophage) twice a day; a placebo taken twice a day, or “an intensive program of lifestyle modification.” The lifestyle program included achieving at least a 7 percent reduction in body weight, following a low-fat, low-calorie diet, and getting at least two and a half hours of moderate exercise each week (about 20 minutes per day).Participants in this group participated in at least 16 one-on-one educational sessions on diet, exercise, and behavior modification.

The researchers followed the group for an average of 2.8 years. And here’s what they found: metformin reduced the incidence of diabetes by about 30 percent versus placebo, but lifestyle changes slashed the incidence rate by more than HALF – a full 58 percent. Plus, patients in the metformin group had SIX TIMES more gastrointestinal side effects than those in the lifestyle group.
Simple doesn’t mean easy

A 30 percent reduction isn’t bad – but a 58 percent reduction is certainly better. And the bigger gain comes with added benefits, like improved overall health, reduced cardiovascular risks, and higher energy levels. A lifetime of drug treatment comes with the risk of gastrointestinal side effects, and a hefty price tag.

Obviously, not everyone can eliminate Type II diabetes through diet and exercise. And I know that the lifestyle approach can be one of the hardest to maintain over time. Believe me, I’ve struggled with my own diet and exercise habits enough to know how difficult it can be.

But I’ve also seen the disastrous results of band-aid approaches that cover up symptoms without addressing the root issues – and the dangerous side-effects of the prescribe-first-ask-questions-later technique.

If you have Type II diabetes, talk to your doctor about your treatment plan. Make sure you’ve given solid lifestyle changes a chance before you rely solely on prescription drugs. Map out the steps you can take – one at a time – to change your diet and exercise habits. And be sure that your doctor re-evaluates your situation periodically, as your need for medication may change over time. Remember, drugs should be a last resort, not the first line of defense.

Source: The New England Journal of Medicine 2002;346:393-403

Copyright 1997-2002 by Institute of Health Sciences, L.L.C.