Key Topics Covered
- Type 2 diabetes is an inability to effectively removed glucose from the blood. Due to either or both insulin resistance or limited capacity for the pancreas to produce enough insulin.
- If Type 2 diabetes is not managed well, it can lead to an increase in cardiovascular issues, chronic kidney disease, eye problems, peripheral neuropathy.
- All carbohydrates (CHO) break down into glucose in the blood. Sugar is a type of carbohydrate. Sugar (High GI CHO) breaks down into glucose faster than complex carbohydrates (Low GI CHO). Therefore, spikes blood glucose levels (BGL) faster than complex carbohydrates would.
- Protein can be converted to glucose. Therefore, protein can raise BGL.
- Fat can indirectly raise BGL. This is because it can take over the role that protein and carbs can do, allowing more protein and carbs to be available, in turn, spike BGL.
- Decreasing body fat can decrease insulin resistance and might also improve the ability of the pancreas to put out insulin.
Remission or Management?
- Remission – When BGL markers stay in the non-diabetic range without any medication for 6 months.
- Excluding those who manage their diabetes through a low-carb diet. Though their biomarkers may appear in range, once they perform a glucose tolerance test or consume CHO again, their sugars will most likely spike again.
- Unless the low CHO diet was used during a weight loss phase. Which decreased excess body fat, improving insulin sensitivity.
- Remission is rare and difficult to achieve.
- Direct trial had 149 non-insulin-dependent people with diabetes go through standard model of care in the UK in their control goroup. Only 4% went into remission in the 12 months.
- For remission to occur, 2 significant steps must happen:
- Significant decrease in body fat – to increase insulin sensitivity.
- Building muscle – increase insulin sensitivity.
- Managing BGL (HbA1c) – Exercise + reduction of calorie and CHO intake.
HbA1c – Long term measurement of average BGL. Based on Red bloods Cells, which have an average lifespan of 3 months.
- Metformin – Improve insulin sensitivity and ability for pancreas to put out insulin. There are minimal downsides to taking metformin.
- Therefore, in order to achieve remission, clients would have to come off metformin to meet the definition.
- Modest weight loss – 5-10% reduction in weight has shown to improve outcomes of Type 2 diabetes.
- Moderating CHO intake – Spacing CHO consumption evenly across the day. Usually 30-45g CHO for meals and 15-30g CHO for snacks.
- Moderating Glycemic Load – Aiming to consume predominantly Low GI sources.
Medicare In Australia
- Individuals who have a chronic disease, such as type 2 diabetes will receive 5 medicare sessions per year. These can be allocated to any allied health professional. Each session equates to $55.10, therefore if the health professional chooses to Bulk Bill, that session will be covered. If the health professional chooses to charge more, the client will just have to pay the gap.
Check out Podcast 33 – Part 2 of Exploring Non-traditional Approaches to Managing Type 2 Diabetes to learn more.
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