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Insulin is not the solution but the problem in type II diabetes. As you all know there are two types of diabetes. Type I diabetes, where there is total absence of Insulin production. Insulin is the key to their survival and will get very sick within days if they do not get insulin. On the other hand type II diabetes is an insulin resistant state with the production of insulin eventually fails to produce more in the presence of resistance to insulin action. The blood sure goes up about 15 to 18 years after the problem has started. It has become fashionable by doctors to give glucose reducing medicines, because we are myopically look at the elevated blood sugar. It is common for primary care physicians to give Sulfonylurea class of drugs and try to control blood sugar. Almost all patients will gain weight and the medication dose will have to be increased to control sugar and eventually when they fail, patients will be started on insulin. If you happen to go to an Endocrinologist he is more than happy to start you on insulin because it is all about sugar control. They have treated type I diabetes this way. However there is a far better way and that is to fix the insulin resistance which is the fundamental problem. Once we deal with this fundamental problem the need for Sulfonylurea and insulin progressively decreases to the extent that they can be stopped and life becomes stable and weight loss occurs. What is very important to realize that type II diabetes is a complex metabolic disease where diabetes, obesity, high blood pressure and high cholesterol coexist. Insulin at high levels in circulations promotes the high blood pressure and is a stimulant for the atherosclerosis which is the “Silent Killer” in type II diabetes. So I am here by providing hope to patients with diabetes to not only do well with sugar control but also reduce significantly the other problems that kills in diabetes. Insulin is not the solution but the problem, It is this high levels Best Diabetes doctor in Gurgaon. Best obesity expert in Delhi
Diabetes & blood glucose control There are several factors in glucose control in diabetes. One of them is self glucose monitoring at home. This is not educated to patients, but is an important way to keep a track of where is our diabetes going. Is it well controlled and whether certain types of food affect our blood glucose. It is a way to learn what foods have what kind of foods have what kind of effect. It is also important to remember that the blood sugar is highest in the morning. So the first blood sugar check is a good way to look at the worst fasting blood sugar. Best Diabetes doctor in Delhi, India.
How to loose weight, control diabetes and blood pressure. Dr Gupta's rules of five: You should avoid five white things in your diet: (i). Avoid white bread, atta bread and brown bread but you can have multi grain bread. (ii). Avoid all pasta and noodles in the first 3-6 months of treatment. (iii). Rice in all forms is to be avoided in the first 3-6 months when we are trying to get your insulin resistance fixed and bring your blood sugar under control, you should try using quinoa rice which is a protein, when appropriately cooked, can be very tasty and can help in controlling blood sugar. (iv). Do not drink tea without sugar because this will encourage you to have breads, biscuits and rusks etc. Use Sugar free, Splenda, Equal or Stevias which is the best. You must avoid all forms of biscuits and rusks. (v). Milk is an important component of the diet but you should avoid cow or buffalo milk, if you do have to take it then remove the cream twice before using it. Ideally you should try and Consume toned milk which is available in packets.
Medical treatment of Diabetes. There are two types of diabetes. In Type 1 diabetes there is total absence of Insulin production. Hence life is dependent on Insulin for these patients. The patient gets very sick, if the insulin is not taken for a couple of days. Usually we use two types of insulin. A basal insulin which takes care of the daily metabolism of the patient and a meal time bolus to cover the rise in sugar with meals. Once we figure out how much the patient needs, we have to adjust their doses depending on type and quantity of diet and exercise. Type II diabetes which accounts for 95% of diabetes patients, is an insulin resistant state with a relative decrease in insulin production in the presence of insulin resistance. Most doctors are inclined to treat this as a sugar diabetes problem. As a result are caught up in chasing the sugar with insulin or Sulphonylureas drugs. But this is a silent vascular disease and a “silent killer”. This is a complex metabolic disease. It is a combination of 4 major abnormality often referred to as the “terrible quartet” comprising of central obesity, high blood sugar, high blood pressure and a complex cholesterol abnormality. It is pivotal in type II diabetes; we address all four problems simultaneously. In order for the patient to do well, we must look at the patient holistically. Doctors need to assess the blood pressure, pattern of Cholesterol abnormality and fix their insulin resistance. Chasing the sugar, is a myopic approach to sugar control and increase in weight. Patients continue to gain weight and we keep increasing the dose of the medicines. Finally the patient is put on insulin and the patient never succeeds but continues to being a victim of diabetes and continues to have vascular events like, vision deterioration, stroke, heart attacks, kidney failure and amputation of the limbs. But today we have good medicines for insulin resistance, vascular-protection, cardio-protection, eye protection and kidney protection. Patient can be helped with good and appropriate treatment to become a “victor” and have hope of a better tomorrow. The doctor must spend the time to listen and assess the patients needs and a customized approach of medical management can reduce complications and perhaps reverse some of the complications that have already happened. Diet and exercise and life style modification will always play a pivotal role in the final outcome. For more information please visit www.diabeteshypertension.com. Dr Narendra K Gupta, best diabetes doctor in Gurgaon and Delhi
Management of type two diabetes is not just treating diabetes as a problem of blood sugar. It is the Insulin Resistance that is the fundamental problem. This needs to be fixed. Diet and exercise are very important and then using Sulphonylueas oral medicines or short term use of Insulin to control the diabetes. Dr Narendra K Gupta, Best Diabetes specialist in Gurgaon. Best diabetologist doctor in Delhi NCR
Yet another patient on insulin has stopped taking 136 units of Insulin and his blood sugar that was out of control has become very good and his HBA1C has come down from 12.3 to 7.6. He has lost 8 kg in the last 4 months. So what is it that makes all the difference at Diabetes & Hypertension Center and Dr Narendra Gupta is that we focus on prevention of complications and we are just not only focussed at blood sugar as a cause of diabetes but rather the effect of diabetes. The true cause of diabetes is insulin resistance and secondary beta cell failure. We focus on fixing the insulin resistance with medication, diet, exercise and emotional well being. Only with a comprehensive management plan, that we can truly improve the patient. The doctor must listen to their problems but as a coach firmly guide that in the right direction. One has to address the multiple problems of the patient i.e. Kidney damage, nerve damage, blood sugars, high blood pressure, cholesterol, hormonal imbalance and emotional support. It is only then that we will be able to change the life of the patient. Dr Narendra Gupta, best diabetes doctor in India
Now that winter is here and so is the marriage season, we tend to eat a lot of calorie dense food. Most people don't exercise as much. Both will lead to gain in weight and diabetes going out of control. It is important not only to watch our diet but drink lots of water and go for walks. Make sure to visit your doctor, specially when you are not doing well. Dr Narendra Gupta, best diabetes doctor in Gurgaon. Best diabetes doctor in India.
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