Such interactions across cultures often times can be difficult even in the best of situations. In many cultures, what is considered acceptable interactions in one culture often times translates as inappropriate and rude interaction in another culture. A review of the literature demonstrates there is no culturally acceptable standardized practice protocol for Advanced Practice Registered Nurse to disseminate such information to their patients. An expanded role in nursing is emerging globally in response to the need to increase human resources to achieve Universal Health Coverage UHC.
In my opinion, type 2 diabetes can be reversed with use of a GLP1 agonist such as Victoza to restore beta cell mass and significant weight loss to normal BMI.
Initially a long acting insulin such as Levemir may be required to normalize blood glucose.
Lifestyle changes certainly can control blood sugars with little to no medications but usually do not reverse diabetes due to ongoing decline in beta cell function.
If patients are motivated to make lifestyle changes, I usually encourage them to consume a lower carb meal plan, adequate protein at each meal, large volumes of low carbohydrate vegetables, and at least minutes per week of exercise a combination of resistance and cardio for maximal benefit.
These changes can decrease insulin needs, allow for weight loss, and improve insulin sensitivity. Hopefully, there will be more breakthroughs in diabetes as we learn more about the microbiome, GLP1, and other gut factors. Utilizing SMBG self monitoring of blood glucoseyou can see how different foods, as well as meals, influence your blood glucose levels.
Doing SMBG along with a writing an argument primary biliary diet and exercise is key to getting your diabetes under good control.
Type 2 diabetes can go into remission with lifestyle management. If you would like help lowering your blood glucose levels with diet, make an appointment with a Registered Dietitian Nutritionist RDN.
However we must continue these actions as lifestyle changes, not just a means to an end. The human body is incredible forgiving and will always move towards health when given the opportunity to do so. Cutting out the refined, processed starches and sugars, BG rebound into a normal range very quickly.
My experience is when people begin to be more conscious of their food intake and physical activity, which happens immediately after being diagnosed with pre diabetes or diabetes, they begin to make better food choices and cut out the foods they know are not healthy.
Most of those foods are refined, processed starches and sugars. However, in most cases, the weight comes back and weight creeps up and BG begins rising again due to the inability to sustain many of these diets. Being conscious of what we are doing gives us the opportunity to make conscious decisions in the moment and move our food choices up to the top of our priority list rather than the reaction and guilt after the moment.
Learning how to keep our diet and exercise habits at the top of our priority lists is the challenging part. Because with the speed of light, it inevitably ends back down on the bottom of our priorities. There is where diabetes hangs out and waits for us to return.
Through these adjustments their A1C improves, they lose weight, and do not require the same interventions as when they were diagnosed.
Many of my patients with several comorbidities elect to have weight loss surgery, such as gastric banding, in order to lose the amount of weight needed to improve their diabetes, blood pressure, cholesterol, and other risks that follow obesity.
Therefore, once a person has been diagnosed with diabetes they need to always check their glucose at home and follow-up with their PCP to have their A1C monitored regularly.
This is a great question that is somewhat controversial in the diabetes world. This is truly a cause for celebration.
Conversely, it must be understood that this person has an increased risk of developing diabetes if the weight gain sneaks back on. That person needs to be aware that they have accomplished an amazing achievement.I'm really pleased with these results. My total LDL-P has dropped by mmol/L and is now borderline-high, as is my LDL-C, which has .
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