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davidtrump

Diabetes Medications and Diet: Synergistic Success 1

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It's a tricky balancing act - using diabetes medications to keep blood sugar at just the right level.

You're coasting along, trying to "eat right," when suddenly you're confronted with a crisis -- sharing a very large pizza. It's so difficult turning away from pizza -- yet you face the inevitable blood sugar spike, with your diabetes drugs faltering under the carb load. If you're taking insulin, the mealtime dosage will need lots of attention.

There's also the weight gain issue: Too many calories pack on the pounds, which worsens blood sugar control.

It's serious business, keeping blood sugar and diabetes under control. There are too many health complications at stake to take it lightly. Over time, those blood sugar spikes take a toll on all your major organs and nerves throughout your body. It's nothing to take lightly. But good blood sugar control can prevent the worst complications of diabetes.

In recent years, new drugs that treat diabetes and various types of insulin have helped improve the management of diabetes and greatly improve blood sugar control. Some medication used to treat diabetes help drop weight and reduce blood cholesterol levels. But they can't do the work alone, diabetes experts say.

Lifestyle changes are essential -- a healthy diet, regular exercise, and weight loss -- in letting diabetes medications do their job, says David Nathan, MD, chief of the Diabetes Center at Massachusetts General Hospital and a professor of medicine at Harvard Medical School.

"If you have type 2 diabetes, your pancreas is still trying to release insulin," Nathan explains. "But if you have a rapid rise in blood sugar, it just can't keep up with the demand. With diabetes medicines, it's the same thing. They will work better if you don't challenge the pancreas -- if you don't have spikes in blood sugar."

Bottom line:

You've got to watch your diet.
Exercise regularly and maintain a normal weight.
Test blood sugar often as recommended by your doctor.
Follow your doctor's instructions when taking your diabetes medications.
There's no getting around it, if you want to live a good, long life.

Diabetes Diet Avoids Blood Sugar Spikes

A number of factors influence blood sugar levels after meals, but carbohydrates have the biggest impact, so watching what you eat is essential. You must learn to make wise food choices that won't cause blood sugar spikes -- yet indulge in an occasional pizza slice.

A dietitian or diabetes educator can help you line up a game plan for meals, says Roberta Anding, RD, a diabetes educator at Texas Children's Hospital in Houston. She is also a spokesperson for the American Dietetic Association.

After all, not all carbs are created equal. "A scoop of white rice is different from a scoop of brown rice," Anding tells WebMD. "The calories may be the same, but they act differently when digested."

Processed "white foods" -- white bread, white rice, cakes and cookies (made with white flour) -- are digested quickly, which causes sharp spikes in blood sugar. Even an apple -- highly nutritious and high in fiber in its natural form -- is done a disservice in processing. When an apple is made into applesauce or apple juice, it loses its fiber content.

"You see remarkable differences in the effect on blood sugar levels," Nathan explains. "The more processed the fruit, the faster the glucose level goes up -- and the higher it goes up. Getting more high-fiber carbohydrates in your diet will naturally slow the absorption rate, and will help the pancreas keep up with the insulin demand."

What are high-fiber carbohydrates? Everything your mother ever advised: vegetables, fruits, whole-grain breads, and cereals. Every colorful fruit and vegetable in your grocery's produce section -- broccoli, spinach, red bell peppers, fruits and berries of all types. Oatmeal is another great source of fiber!

Weight Gain vs. Diabetes Drugs

Weight gain poses its own problems for people with diabetes. The fight against weight gain has always been tough, as many older diabetes drugs may cause weight gain -- which further interferes with blood sugar control.

"The heavier you get, the more you're fighting a losing battle," Nathan tells WebMD. "If you're gaining weight, diabetes medications won't work as well, so you need more of the medicines -- which only makes your weight go up more."

Drugs like Byetta, Metformin, Symlin, and Victoza have made weight control a bit easier. These drugs stimulate the body's natural insulin-producing capability, plus patients may experience a decrease in appetite leading to weight loss.

Diabetes specialists typically prescribe these diabetes medications in combination with older diabetes drugs to get optimal blood sugar control. "It helps minimize the difficulties of dieting. ... People can restrict calories, exercise more, have more positive results in losing weight," says Anne Peters, MD, director of the clinical diabetes programs at the University of Southern California and author of the book Conquering Diabetes.

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