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Preventing Type 2 Diabetes

Can drugs prevent the onset of type 2 diabetes? One class of drugs shows promise, but it has its drawbacks.
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The traditional medical approach to diabetes is simply to manage it after it has been diagnosed. Because there isn't a cure, the emphasis is on keeping blood sugars as close to normal as possible -- usually with exercise and weight loss coupled with medication -- and dealing with complications as they arise. But while this sort of treatment can allow people with diabetes to have full and relatively normal lives, it doesn't get at the root causes of the illness.

Thomas Buchanan, MD, professor of medicine at the University of Southern California, believes this is precisely why the thrust of diabetes treatment needs to be changed.

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Taking Care of Your Diabetes Every Day

The four things you have to do every day to lower high blood sugar are: 1. Eat healthy food 2. Get regular exercise 3. Take your diabetes medicine 4. Test your blood sugar. Experts say most people with diabetes should try to keep their blood sugar level as close as possible to the level of someone who does not have diabetes. This may not be possible or right for everyone. Check with your doctor about the right range of blood sugar for you. You will get plenty of help in learning...

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"Typically, in diabetes treatment, the whole focus is on blood sugar," says Buchanan, who is also director of the clinical research center at the Keck School of Medicine. "But people aren't thinking enough about the actual disease that's causing the problem."

To address this issue, Buchanan led the Troglitazone in Prevention of Diabetes (TRIPOD) study, which treated women at risk of developing type 2 diabetes with a class of drugs called glitazones or thiazolidinediones, or more commonly, TZDs. The results were dramatic: The drugs were apparently effective in preventing the onset of the disease.

Given that an epidemic of type 2 diabetes may be on the horizon -- due primarily to the increasing levels of obesity in the U.S. and around the world -- preventing diabetes is an urgent public health priority. TZDs could be part of the solution.

TZDs and the TRIPOD Study

Unlike some drugs used to treat diabetes, the main strength of TZDs as treatment doesn't lie in their ability to directly boost insulin production or lower glucose levels. Instead, TZDs work on a different level by affecting the beta cells in the pancreas.

For the body to use blood glucose as energy, beta cells secrete the hormone insulin. As insulin circulates throughout the body, it attaches itself to individual cells; once the insulin is attached, the cell becomes receptive to glucose and absorbs it, providing itself with energy. In many people developing type 2 diabetes, the body becomes less sensitive to insulin -- a condition called insulin resistance -- making the absorption of glucose from the bloodstream more difficult.

The pancreatic cells respond by producing more insulin to make up for this resistance. While the beta cells may be able to produce enough insulin to keep blood glucose at normal levels for a time, the increased production of insulin eventually may take a toll. The beta cells may become compromised and their ability to produce insulin will diminish, causing insulin deficiency. The body will become less capable of processing blood sugar, blood sugar levels will rise, and type 2 diabetes can follow. About 70 to 80 million Americans are estimated to have insulin-resistance syndrome and 17 million have type 2 diabetes.

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If the level is below 70 and you are experiencing symptoms such as shaking, sweating or difficulty thinking, you will need to raise the number immediately. A quick solution is to eat a few pieces of hard candy or 1 tablespoon of sugar or honey. Recheck your numbers again in 15 minutes to see if the number has gone up. If not, repeat the steps above or call your doctor.

People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.

Congratulations on taking steps to manage your health.

However, it's important to continue to track your numbers so that you can make lifestyle changes if needed. If you are pregnant always consult with your physician.

Your level is high if this reading was taken before eating. Aim for 70-130 before meals and less than 180 two hours after meals.

Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.

One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.

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