Case Study

  • (Q) I have Type 2 diabetes
  • I have Type 2 diabetes, and I recently started taking metformin after controlling my blood glucose levels with diet and exercise for nearly five years. Recently I’ve been seeing all kinds of reports on TV and in newspapers and magazines about how weight loss has cured people’s Type 2 diabetes. I am about 10 pounds overweight. Would losing those 10 pounds cure my diabetes?

    It’s unlikely that losing 10 pounds
    It’s unlikely that losing 10 pounds would cure your diabetes, but it might make it easier to control. Excess fat, particularly in the abdominal area, is believed to increase insulin resistance, or to interfere with how your body uses the insulin it makes. Losing excess abdominal fat can lower insulin resistance.

    The drug that you’ve been prescribed, metformin, is unlike many other drugs used to treat diabetes in that it may help you to lose some weight. Meal plan, and exercise plan that encourage weight loss and, even more important, help you maintain a healthy weight.

  • (Q) Regular mealtimes
  • I have had Type 2 diabetes for two years. I find it hard to cook for just one person, and because I work part time and go to college full time, I also have trouble finding time to cook. In addition, I’m often not hungry until about 4 PM. Is it really that important for me to eat breakfast and lunch? If so, what are some easy meals to prepare for one person?

    It’s unlikely that losing 10 pounds
    Choosing healthful foods and eating regularly are two of the most important diabetes self-management actions you can take. Spacing your food intake throughout the day will help keep your blood glucose level in the near normal range.

    Consuming a large amount of carbohydrate all at once is likely to cause high blood glucose after eating, and not consuming any carbohydrate for long stretches of time can make you more likely to develop hypoglycemia(low blood glucose). Both extremes are hard on your body and your brain.

    Skipping meals slows metabolism, which promotes weight gain. And waiting for extreme hunger before eating can make it more likely that you will experience a feeling of exhaustion once you do eat, making it harder to function generally.

    Lastly, if you let yourself get too hungry, you are more likely to make less healthful food choices. Because your body wants to get calories in as fast as possible, you may crave high-fat, high-sugar foods.

    There are many different ways to make small meal, here is one of example. Buy large packages of frozen, non-starchy vegetables such as broccoli, green beans, and spinach. A small portion of these can easily be removed and micro-waved at lunch or dinner time.

  • (Q) I used NPH insulin for years
  • I used NPH insulin for years and was able to buy it at any pharmacy without a prescription. More recently I switched to insulin glargine(brand name Lantus) and, to my surprise, was told that I couldn’t buy a bottle without a doctor’s prescription. Why is a prescription necessary for glargine but not for NPH?

    Lantus, along with Levemir
    Lantus, along with Levemir, Humalog, NovoLog and Apidra, are all need prescription to buy. Regular and NPH insulin are no prescription require to buy from long time ago. Recently there are many insulin analog on the market, those insulin analogs have small differences that change the speed with which they are absorbed in the body. A person who was switching from human insulin to analogs and who was not aware of these differences could easily inject the analogs at the wrong time and end up with high or low blood glucose.

    Requiring a prescription for insulin analogs is a way to ensure that people have been informed about the proper administration of these medicines before using them. Each insulin analogs or traditional human insulin have had advantages and disadvantages each other so that the patient need well recognize those are difference.

    It is worth mentioning that while Regular and NPH insulin generally do not require a prescription in the United States.