Early, aggressive treatment delays diabetes progression

Intensive early treatment is the best way to slow down the development of type 2 diabetes, according to University of Texas Southwestern Medical Center in Dallas.

Diabetes is a progressive disease. Over time, the body's ability to produce insulin declines. Researchers say that if a patient can maintain insulin production, the disease is easier to manage.

Preserving beta cell function

A UT Southwestern study subjected participants on intensive treatment with insulin for three months. This was followed by a regimen of either the anti-diabetes drug metformin or three types of diabetes medications.

Both intensive drug regimens resulted in steady insulin-producing beta cell function for three and a half years after a patient's diagnosis.

These two intensive treatment regimens resulted in excellent control of blood sugar levels. They were well tolerated and safe.

Intensity matters

Researchers say that what matters is the intensity of the treatment, regardless of the method used to attain excellent blood glucose control.

"The point is that whatever you choose, make sure it's intensive," said Ildiko Lingvay, MD, assistant professor of internal medicine and author of the study. "We have shown that this preserves beta cell function, and that's the key in changing the course of the disease."

When treating early diabetes, clinicians typically emphasize lifestyle changes first. The American College of Physicians suggests losing weight and dieting before starting drug treatment.

In addition, the American Diabetes Association recommends the use of the anti-diabetes drug metformin plus similar lifestyle changes.

Dietary changes

A healthy diet is an important part of managing diabetes. However, the UT Southwestern researchers say that it may be challenging to sustain significant dietary changes for the long term to avoid periods of high blood sugar, which leads to complications.

Fruits, vegetables and whole grains are the core of a healthy diet for people with diabetes, according to Mayo Clinic. These foods are high in nutrition and low in fat and calories.

People with diabetes can also help maintain blood sugar levels by counting carbohydrates and eating low glycemic index foods.

Glycemic control

The glycemic index measures how a carbohydrate-containing food raises blood glucose levels. A food with a high glycemic index raises blood sugar more quickly than a food with a low glycemic index.

According to the American Diabetes Association, carbohydrate-containing foods with a low glycemic index include dried beans and legumes, non-starchy vegetables and some starchy vegetables, most fruit, and many whole grain breads and cereals.

Meats and fats don't have a glycemic index because they do not contain carbohydrates.

Carbohydrate counting

For most people with diabetes, carbohydrate counting is a core tool for managing blood glucose, along with regular exercise and diabetes medication.

Research has found that both the amount and type of carbohydrate in food affect blood glucose levels, according to the American Diabetes Association. It also says that the total amount of carbohydrate in food is a stronger predictor of blood glucose response than the glycemic index.

Sources: UT Southwestern Medical Center, Mayo Clinic, American Diabetes Association

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