Friday, June 13, 2008

Should type 2 diabetes be treated less aggressively?

The other day I blogged about the findings that hypoglycemia actually increases a type 2 diabetic's risk for heart attack. Since doctors have been operating under the assumption that lowering a type 2 diabetic's blood sugars would lower the risk for heart attack, now there's an article questioning whether the disease should be treated less agressively.

In my opinion, that depends on what your definition of "aggressive treatment" is. Too often, I think type 2 diabetes is treated with drugs — pills to make the body more sensitive to insulin, and sometimes insulin injections to supplement what the body makes on its own. Personally, I think an aggressive treatment for type 2 diabetes should attack the root of the problem: usually obesity, diet, and lack of exercise.

Many cases of type 2 diabetes can be reversed with proper diet and exercise — in other words, by losing weight and eating right. Since I think the chance of heart disease in diabetics is probably linked more to these factors than to high blood sugars, I doubt this kind of approach would make heart attacks more likely. I'm guessing it's the drugs that are causing the lows, which in turn are connected to a greater risk of heart attack.

Of course, not all cases of type 2 diabetes are caused by obesity, diet, and lack of exercise. Some people's bodies develop a resistance to insulin as they age that is unrelated to their lifestyle. However, in light of the epidemic that type 2 diabetes is becoming, I would say a large percentage of the cases are a result of America's couch potato trend.

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