Friday, August 24, 2012

Diabetes care is just a game of numbers that you can win

Most people with and without diabetes will tell you that  Diabetes management is complicated.
I don't believe that rumor.
  We know what the risk factors  for complications are !  Just numbers
  We have treatment goals proven to reduce the risk !       Just numbers
  We have effective tool tools for reducing the risk !
  You do not have to understand the number to correct it !
         Repetition , Discussion and Time will solve that problem
  The tools are available today in your doctors office ! Just ask . 
 Doc, will you help me reach my goal for  _________ ?
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  The studies we have discussed over the last few days supports the idea that the treatment of diabetes is not complicated and you do not have be perfect to be a winner

( DCCT study , UKPDS , CARDS , HEART PROTECTION STUDY and the STENO- 2 STUDY )
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Diabetes care is not complicated !  It is just a game of numbers !   A game you can win !
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The Steno -2 study simplified the task to 3 primary numbers " goals" and demonstrate the additive effect of fixing the numbers.

Two out of the 3 , blood pressure and lipids , can be corrected by just taking a pill (or pills ).

Heart disease is the primary cause of death and disability for people with diabetes. Reducing LDL cholesterol and lowering blood pressure have the most effect in reducing vascular disease , glucose control has the least. Glucose control , lowering the A1c to 7 , is most effective for reducing the risk for eye, nerve and kidney damage


The 3rd one , A1c , involves taking medication plus managing food intake

The Steno - 2  study also demonstrated that most of us are not always successful with food management and weight. The study found that most  participants gained weight and increased their waist circumference over the 13 years of the study. This is to be expected because most of our medications to lower glucose levels are associated with weight gain except  the GLP 1 agonist , exenatide( Byetta , Bydureon ) and liraglutide ( Victoza).

Controlling food intake is also a more time consuming game of numbers

Controlling food intake  concepts are not that complicated.
   *  It is not what we eat .  The problem is how much of what we eat .  PORTION Size !!!!
   *  BEING CONSISTENT  day to day with our food intake , especially Carbohydrates.

The " Dash diet " has simplified food management to a numbers game.
     ( please see my post  from May 19 , 2012 and March 1, 2012 -Simple ideas that work)
 An 1800 calorie diet converted to numbers

                     fruit   vegetables    dairy    grains     meat      nuts/ beans    fats    sweets
servings          4          4                3         7             1.5             0.5              2         0.5

Just numbers !!!  
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 Click on the previous post below to review

Dash Diet, Simple Ideas That Work

My first road trip with the Dash diet as my passen...

The Dash Diet - My first 2 month Experience

Small improvements have a big impact
One other thing the classic studies ( DCCT, UKPDS , Cards , Heart Protection Study , Steno-2 )
revealed is that you do not have to be perfect, you just have to do a little better, to be a winner in 


little changes in BP and A1c can have Big a impact...

Treating multiple risk factors is additive

"Opportunity " to just do your best is successful ...

Headline- good news for people with type 2 diabete...

How can I delete this ? update final version

Have fun , Be smart and play to win
David Calder,MD

1 comment:

  1. Accept your shape, and learn to work with what you have. Stand in front of a mirror, and assess your shape. If you are small on top and larger on bottom, you have a pear shape. If you are wider around the middle, you have an apple shape. Thanks for sharing information.
    hcg1234

    ReplyDelete

Your comments and questions are appreciated. David Calder,MD