BOSSIER CITY, La. — Treating diabetes often begins with lifestyle modifications, starting with a healthy diet, and Dr. Clint Wilson with Willis Knighton Health System said there are creative ways to accomplish that.
“We can do that through calorie restriction. We can do that through plant-based diet, which has a spectacular amount of research,” said Wilson. “I had one couple that wanted to lose weight together and work on their cardiovascular benefit. They moved from a dinner plate to a salad plate, and by doing that, they were able to do really well.”
Adding 150 minutes of physical activity can make a difference, as can a good night’s sleep.
“Six to eight hours minimum of sleep is going to help make sure that we do well. Watching or limiting our alcohol intake, and then stopping any kind of tobacco use,” Wilson said.
If lifestyle changes do not make the difference, then medications can.
Medication, like Metformin, can be extremely successful in not only treating diabetes, but also in preventing the progression of the disease if a person is pre-diabetic.
“We are decreasing your risk of progression to diabetes we're starting to make sure that the pancreas gets that extra help, and we can start moving that sugar into the muscle and not storing it as fat,” said Wilson. “And we can, just by starting that medicine with no other change, decrease the risk of progression by at least 30%.”
Once a person is diagnosed with diabetes, medication can help to contain it.
“We need to start thinking about not only treating the sugar number, but think about the cardiovascular implications, the kidney, the eye, all the other side effects that can happen with with diabetes and what it can lead to," Wilson said.
Once you start medication for diabetes, it takes a few months to determine if the drug and dosage are working for you.
“What we'd like to do typically is every three months or so bring you back in check some labs, check to see how your blood sugar's doing, and how you're feeling on the medicine. And the A1C will tell us a lot about where we are at that point,” Wilson said. “Depending on the number, and depending on how you're feeling, we may make an adjustment.”
When your A1C is above 9 you may need to take insulin. But there are newer medicines that could work instead.
“Both the injectable non-insulin, the pills, they're having great cardiovascular reduction. So we really try hard to get you on those, if we can, anyway, if you can tolerate them before insulin," Wilson said.
But all bodies are different. And sometimes the pancreas just quits working and insulin becomes necessary.
“You could be doing well and then at your next visit three, six months down the road, something has happened and we need to make a big change and add some insulin. It doesn't mean you're a bad diabetic and doesn't mean you've done something wrong, you can be doing everything right and it still can still happen," Wilson said.