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Question:

From Annapolis, Maryland, USA:

I am 60 years old, 5 feet 2 inches tall, 202 pounds, and I take Glucovance. I have pretty much ignored my type 2 diabetes because I don't feel bad, but I recently had to have surgery which has made me think more about my overall health. I have been reading the Atkins' diet book, and it would appear to be a fantastic diet for people with diabetes. In the book, they caution that you discuss the diet with your physician if you are taking medicine for diabetes.

The doctor did not want to discuss it, didn't even charge me for the visit, and simply referred me to a dietitian, expressing the opinion that I was quite stupid to wish to follows a diet put out by someone I had never met and which I got from a book. I am planning to visit the dietitian but have some questions. Atkins speaks of the difficulty of losing weight while taking medication to treat diabetes. What would be the potential consequences of simply stopping the diabetes medication and following the Atkins' diet rigorously? Once somebody has started taking these medications is it ever possible to control the diabetes with a controlled carbohydrate/sugar free diet?

Answer:

The benefit of the Atkins' Diet for people with diabetes is an ongoing debate. I am glad that you have decided to see a dietitian to discuss your options. I would strongly urge you not to go off your diabetes medication no matter what diet you choose. You are taking the maximum dose of Glucovance in order to control your blood sugar. As you start to lose weight, it is possible you will be able to slowly decrease your medicine under your doctor's supervision.

JS

Additional comments from Dr. Stuart Brink:

Weight loss may be key to controlling blood pressure, lipid and also blood glucose abnormalities. It doesn't matter whether you use Atkins' or any other treatment program. It will be important to have you frequently monitor blood glucose readings before and 1-2 hours after breakfast, lunch and dinner so that you can monitor what is going on.

You should talk with your doctor again about your plan to stop medications, but usually this can be tried. If the blood glucose levels stay high, then you will need to go back on the medications. If the blood glucose levels move downward as you lose weight, then you may not need them. The Atkins' diet is just one of many dietary programs that are successful for individual people. Latest research suggests that is works but not 100% -- same as other diets. No single dietary approach works for everybody, and an important way to lose weight is to in case daily activity coupled with fewer calories going in each day.

You are wise to begin to take your health care more seriously. Lipids should be checked. Liver and uric acid levels should also be monitored by your physician and checked periodically while you are on the Atkins' or any other diet to see how you are doing, make sure things are not getting worse and are improving etc. You and your dietitian and your diabetes team need to discuss this and plan an approach that makes sense, is safe and includes such monitoring.

SB

DTQ-20030730001137
Original posting 11 Aug 2003
Posted to Daily Care and Type 2

  
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Last Updated: Tuesday April 06, 2010 15:09:48
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