Lifestyle modification in the Treatment of NIDDM: do we really need it? April 9, 2019

  Lifestyle modification consisting of diet combined with aerobic exercise can be effective for controlling NIDDM and reducing risk factors associated with macrovascular complications in both men and women. The program was far more effective in controlling the disease in patients taking no medication or oral agents compared with patients taking insulin. These results stress the need for early emphasis on lifestyle modification in the treatment of NIDDM.
Diet and Exercise in the Treatment of NIDDM: The need for early emphasis
by R James Barnard, PHD, Tiffany Jung, MPH and Stephen B Inkeles, MD, MPH
Copyright © 1994 by the American Diabetes Association
 http://care.diabetesjournals.org/content/17/12/1469

        This is publication from 1994. Only in 1980 a new classification of diabetes was developed. Diabetics were divided on types, NIDDM - non insulin dependent diabetes mellitus, and IDDM - insulin dependent diabetes mellitus. Every year, according to CDC, 80,000 diabetics perished. From 90% to 95%  of all diabetic population are NIDDM. According to CDC every year 80.000 diabetics perished due to untreated or uncontrolled diabetes. How many diabetics type 2 modified their lives since 1980 when a new classification took off and insulin as primary medicine was taken out of diabetics medical box? 
       Every one do know very well that diabetes type 2 is obesity induced type of diabetes, 100% preventable with life style modifications.  Also it is very well known that early intervention give best result. The question is, why level of sugar in blood is not vital? With this test easy to do in every clinic the myth that obesity and too much sugar in diet will be broken. Not would be but will be. Why? Because of there are millions of diabetics who are not diagnosed with diabetes. They do have elevated level of sugar but deal with problems without ADA guidance. 
      According to medical publications diabetics type 2 gone less then 10 years after being diagnosed with diabetes type 2. Really, those who do not go to clinic in much better situation then those who were diagnosed with diabetes at the crisis in their lives. Every one has crisis in lives. At that time level of sugar in blood going dramatically up, sometimes even critically up. At this time Med Pro go fishing. When we are fished we do not have choice, we are on hook. We trust in MD, and do what we were told to do. We skip deeper and deeper into condition when secretion of insulin reduced. With treatment and every life style modification more and more beta cells destroyed. Finally, there is no way to escape. Just time to schedule appointment to St. Peter. 

Medical charts obtained from 4,587 participants in a lifestyle modification program were screened for patients with NIDDM. A total of 652 patients was identified, and their responses to the 3-week program were analyzed.

     3 week program will show best results. Every one can fast 3 weeks. For this time when diabetic fasting, level of sugar will go down. The result of these studies confirmed, this claim is true. Now,for how long these modifications will last? How soon blood sugar will go up or down? What happened after 3 weeks? At first life style modification suggest that once modifications were done, there are some time when no other modifications are needed, right? If we modify our house it last for many years till another modifications are needed. Modifications demand extra efforts and extra money. They cannot be constant. If it is constant then it is not modifications but simple life style.
     We do something  in our house every day, or week, or year. It is just constant re-decoration, or simple cleaning. We bought a new souvenir and placed it on the spot which was free or taken by some other staff. But it is not modifications.
      So, what after 3 week life style modification? Would level of sugar stay down after modifications of life style done?

Fasting glucose level was reduced from 10.0 to 8.45 mmol/l, and 71% of 197 subjects taking oral hypoglycemic agents and 39% of 212 taking insulin were able to discontinue their medication.

       Sorry, if it is NIDDM then why this diabetic discontinue to take insulin? Insulin should not be in treatment regime in first place. 
     10 mmol/L  is 180 mg/dl and according to ADA it is not diabetes at all. The level of sugar to be diagnosed with diabetes type 2 must be over 200 mg/dl. 8.45mmol/L is 150 mg/dl. It is not so difference between these two numbers. Just season, Summer or Winter, and all differences will be balanced. In Summer readings are lower, in Winter readings are higher, regardles of any modifications in life style.
    The claim that oral agents were discontinued is also does not support the claim that life style modifications were needed. It is oral agents which were not needed. As soon as Metformin and SU were stopped, diabetic start to recovery. Weight will go down. Level of sugar in blood will dropping. If at this time the crisis why sugar went up  solved, illness or trauma, or other stress issue started to ease, level of sugar would return back to normal. Or may stay elevated but not so dramatically to lead to severe complications. 

Of the 243 not taking medication, 76% reduced their fasting glucose levels to ≤ 7.84 mmol/l.

          Another trick by ADA. Are those 76% sick or they are not?  If they are sick or ill, then why they do not take medication? If they are not ill or sick then what is the point in fasting glucose level discussion? BTW, fasting glucose level is very floated level of sugar. Take fasting at 6 am and at 9 am, and reading will be different. So, which fasting level do they present was reduced?
      It is well known that level of sugar in blood depend on meal we eat. This is why all those discussion about fasting. At the same time, the level of insulin secretion depend not on meal but on the ability beta cells secret it. It is more constant and not so easy to change from healthy to sick level. Why ADA never check up level of insulin secretion?
     If insulin secretion would be prime concern in diabetes therapy then there is no need to modify life style. Any life style modifications lead to decrease in insulin secretion, negative outcome of medical intervention. To have positive outcome, tail placed before horse, and now all in the order: Med Pro do their best, but stupid diabetics type 2 still eating.
      Well, I prefer to be stupid diabetic then be smart corpse. I am opposite to modify my life style.

via Ravenvoron