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Harriet Verkoelen

Harriet Verkoelen

Dutch Knowledge Centre for Dietitians on Overweight and Obesity, Netherlands

Title: 93% of diabetes type two patients can stop insulin treatment

Biography

Biography: Harriet Verkoelen

Abstract

Treatment of type 2 diabetes mellitus (T2DM), which is usually insulin resistance caused by metabolic syndrome, is mainly by tablets and insulin injections. The treatment protocol starts with a dietary advice which traditionally corresponds to the dietary advice of the World Health Organization (WHO). But when bloodsugarlevels are raised, diabetes medication is prescribed starting with Metformin oral tablets. When bloodsugarlevels are still raised or raise again, Sulfonylurea derivatives (SU) are prescribed in addition. When bloodsugarlevels are still raised or raise again, insulin injections are prescribed in addition. Starting with one injection of long-acting insulin per day. This can be intensified by three injections short-acting insulin per day.

Medical treatment of T2DM often comes with a side-effect which is gaining weight. The problem is that T2DM patients mostly are overweight already. Gaining extra weight by medical treatment causes more health problems. Furthermore, increasing overweight causes more insulin resistance.

Introducing the low carb lifestyle in the treatment of T2DM brings new possibilities. Less insulin is needed when eating less carbohydrates. This way patients with T2DM can postpone or even stop their medical treatment. A second  effect, most importantly, is that the patient will lose weight. This will be beneficial to their health. By losing weight bloodsugarlevels will drop, the blood pressure will also drop, and cholesterol levels will improve (HDL-C and TG). Another effect is that the patient will be less hungry.

In my own dietitians’ office the focus is on losing weight. That is why I advise the low carb lifestyle. The result was that 90% of T2DM patients was able to stop insulin injections. They all lost weight and in 80% HbA1c value improved within half a year. More studies show similar results. These findings show that the current treatment protocol of T2DM patients could be considered to change.