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strizzl t1_j1e3mrq wrote

Reply to comment by lame-borghini in Despite improvements in insulin formulations and delivery over the last 30 years, diabetes control has not improved among US adults, and disparities for minority and uninsured adults worsens by Ordinarymangodoctor

Diabetes in 90% of type 2s is completely manageable with diet. Access and education to appropriate foods and poor impulse control is what drives the majority of uncontrolled diabetes. I do not fault majority of patients for this either: they didn’t create the crappy education system, lobby to the government to create a “food pyramid” that promotes carbohydrates, or elevate the costs of transport of fresh fruit and vegetables. That was all failure of our system. The fix is too complicated for a public entity with no incentive to address so it’s up to individuals to take care of themselves unfortunately.

It is a systemic problem but I just don’t see help coming from the government

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bobbi21 t1_j1ebbgl wrote

If caught early possibly but thats absolutely not true once it gets going. I have type 2 diabetic patients admitted to hospital and literally not eating any food for days due to multiple factors. They still need insulin. That is the vast majority of type 2 diabetics i see.

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nowlistenhereboy t1_j1fyq2t wrote

Yes but that is not the majority of type 2 diabetics, that's just the worst 'end-stage' cases. Even later on in the disease diet and exercise can majorly improve A1c and reduce reliance on meds. Exercise causes insulin-independent insertion of glut-4 transporters in muscle cells.

Just because DM2 can't be totally cured doesn't mean we should discount the value of lifestyle changes. Yea it's hard for the patient to maintain those habits but we need to find ways to help them do it.

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ph1294 t1_j1ghl22 wrote

Not eating for 3 days with type 2 exacerbates the issue. You’re going to induce hypoglycemia, which isn’t a risk for non diabetics.

You diet control type 2 by eating a healthy portion of low glycemic index food on a regular basis until your body can readjust to the absence of glucose spikes caused by sugary foods and drinks.

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