Did you ever think you would have to pay so much attention to numbers? Your numbers.
Maybe they have gotten a little better since you were diagnosed, but not enough to say you are actually beating diabetes or even doing a good job controlling it.
You’ve been watching what you eat and taking the meds religiously. Why aren’t they working?
Maybe because the medications given for type 2 diabetes don’t treat the cause of type 2 diabetes.
Let’s break this down and see if that’s really true.
What causes type 2 diabetes? Insulin resistance.
What is insulin resistance? I’m so glad you asked.
Here’s the short version. Insulin resistance occurs when your body’s cells no longer respond to insulin the way that they are supposed to. Insulin’s job is to take sugar from the blood and put it into cells where it can be used for energy. Insulin will store excess sugar as fat. As long as there is some insulin circulating around in the blood, the sugar you eat will go into storage, either for short-term (ready for use) or long-term (also known as fat).
When your cells initially stop responding to insulin, your pancreas makes more insulin to overcome this resistance. This works for a little while, and insulin can shove more sugar into cells where it is really not wanted. This takes it out of the blood, so your blood sugar readings may stay in the highish normal range for a while. Even at this point, you have a lot of insulin cruising around in the blood in order to keep your blood sugar at that highish normal level.
Eventually, your cells are so full that they just cannot possibly take anymore sugar and that sugar stays in the blood. Tada...high blood sugar.
And, high levels of insulin circulating around in your blood. Those high levels of insulin are caused by insulin resistance.
High blood sugars can lead to significant problems, but so can high insulin levels. Those high insulin levels are one reason diabetics are at such high risk of heart attacks. Part of the problem with diabetic medications is that their focus has been on controlling blood sugar levels but not insulin levels.
This gets at the heart of why you are not getting any better on your medications.
It is why you are taking higher doses, adding different medications, and being threatened with “the needle” (insulin injections).
Clearly, this is not your fault. The medications don’t work to make diabetes better. And,they only work halfway to control diabetes.
Let’s look at what some of the common medications do. There are more diabetic drugs than these (because it’s a huge market), but these are the most common.
If you want to know which type of drug you are taking, just look up its drug class (that’s the medical lingo).
Sulfonylureas: These guys have been around for a long time. They include Glucotrol, Micronase, and Diabeta. These drugs tell your pancreas to put out more insulin. I hope you see the problem here right away. Type 2 diabetes does not occur because of the lack of insulin. There is already too much circulating insulin. Nonetheless, these meds can lower your blood sugar - for a little while. Until they don’t. Oh, and more insulin... means more weight gain.
TZD’s (thiazolidinediones): Avandia and Actos are included in this group. These drugs are supposed to help insulin work better on muscle and fat cells. Sounds like a reasonable plan. Too bad the side effects include heart failure and heart attacks (and having diabetes already increased your risk of heart attacks) as well as bladder cancer. Even though these drugs make insulin work better, we still haven’t gotten at reducing insulin levels significantly. And if you just make insulin work better, it allows that insulin to store more fat - you gain weight.
Biguanides - This is metformin. All of you pretty much should have been on this drug (and maybe at big doses). Metformin causes the liver to make less glucose (sugar). Its only target is blood glucose and it does nothing for lowering insulin levels.
DPP-4 Inhibitors: This includes Januvia. These drugs prevent the breakdown of an enzyme that breaks down glucose. Sounds like a little doublespeak. There is an enzyme that your body makes that can break down glucose. This drug keeps more of that enzyme around. These drugs can lower blood glucose, but do nothing to reduce your risk of long term complications of diabetes (like heart attacks). These drugs do not lower insulin levels, either.
SGLT2 Inhibitors: These include Farxiga, Jardiance, and Invokana. SGLT2 is an enzyme that works in the kidney to reabsorb sugar. If you block this enzyme, you pee out the sugar instead of reabsorbing it. While these drugs don’t have much impact on your A1C, they do reduce the risk of long term complications from diabetes. Because you have more sugar in the urine, you can get urinary tract infections (some serious) and yeast infections. When you pee out sugar, you also pee out more water, so dehydration is a possible side effect. While diabetic ketoacidosis does not normally happen in type 2 diabetes (it happens with type 1), it can occur as a serious side effect of this medication class (even with normal blood sugars). Other fun (but rare) side effects include pancreatitis and bone fractures.
While the above is not an exhaustive list, you should recognize some of the meds you’ve been on.
And last but not least, what about having to take insulin injections? If too much insulin is the problem, why add more?? (And it’s a sure fire way to put on more weight.)
While these medications are aimed at lowering blood sugars, they do nothing to lower insulin levels - which is the cause of type 2 diabetes. These medications are just delaying the inevitable and committing you to a lifetime of more medications and complications.
Do you need them? Yes. Initially.
Is there a way to control insulin levels that works better than these medications? Yes.
In a couple of weeks I will be opening up a program called Defeating Diabetes: The Simple 3 Step System for reducing your dependence on medications, preventing scary complications, losing weight, and finally finding freedom by reversing type 2 diabetes. For those who are serious about making some life-saving changes.
Stay tuned for more information about controlling your diabetes and this program.
I hope you have found this information helpful. Please let me know if you have questions by sending me an email at [email protected].