DEAR DOCTOR. ROACH: I recently became a diabetic. Can you please give me some advice on how I can do this – HM
REPLY: I assume you have been newly diagnosed with type 2 diabetes caused by insulin resistance. Type 1 diabetes, usually diagnosed in childhood or adolescence, is an autoimmune disease caused by the destruction of the insulin-producing cells in the pancreas. It requires insulin.
Type 2 diabetes is a “stable” Diagnosis: Once the diagnosis is made, you will always have diabetes, even if your blood sugar becomes normal and you are not taking any medication “turning back” Diabetes. (This situation is called “Type 2 Diabetes with Lifestyle Controlled.”Most people can dramatically improve their control of type 2 diabetes, even if without medication they can’t get to the point where blood sugar is perfectly normal.
Diet is the first pillar of type 2 diabetes treatment. Reducing simple sugars and starches, which quickly become simple sugars in your body, is the first step. Protein, healthy fats, and carbohydrates from vegetables and (not too much) fruits are the cornerstones of any diet regimen, but you really should seek advice from a registered dietitian.
Movement is the second pillar. Exercise helps your body metabolize sugar more effectively. Any sort of regular exercise will help, but moderately vigorous aerobic exercise is probably the most important from a sugar metabolism standpoint.
Food intake and exercise performance together help address the third pillar, weight control. A clear majority of people with type 2 diabetes are overweight, but by no means all. If your weight is higher than it should be, weight loss is critical to controlling diabetes.
After all, medication is helpful. There are many new options, some of which (like metformin, liraglutide, and semaglutide) promote weight loss. Many people with diabetes need medication when diagnosed, but may still be able to avoid medication if they begin a healthy lifestyle that addresses all three pillars.
Not all drugs are helpful. Some medications (especially certain blood pressure and psychotropic drugs) are not ideal for diabetics because they promote weight gain and insulin resistance. A diabetes professional should review all medications, and patients may need to consider switching medications.
DEAR DOCTOR. ROACH: If the local supermarket offers normal ground beef with 7% fat or grass-fed beef with 15% fat, which is healthier, please? – E.
REPLY: Grazing cattle are higher in healthy fats, vitamins A and E. Grazing cows tend to be lower in fat, but the way the meat (I assume it’s ground beef) is sold in the supermarket is no longer true. Furthermore, I would refuse to characterize either option as a healthy option. While the health harms associated with saturated fat (much of the fat found in beef) continue to be hotly debated, it is clear from most of the data that the consumption of less red meat like beef and more grains, nuts, fish, legumes, fruits and vegetables lead to significant health benefits.
That’s not to say you can’t have an occasional burger. Much of the fat in a burger is lost in cooking. Whenever you cook one, you should make the tastiest burger you can. There is no compelling reason other than taste to choose one versus the other.
Dr. Roach regrets not being able to answer individual letters, but will include them in the column if possible. Readers can email questions to [email protected] or email 628 Virginia Dr., Orlando, FL. send
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