Dr. Bernstein's Diabetes Solution by Richard K. Bernstein

Author:Richard K. Bernstein [BERNSTEIN, RICHARD K.]
Language: eng
Format: epub
Tags: HEA039050
ISBN: 9780316191739
Publisher: Little, Brown and Company
Published: 2011-10-31T16:00:00+00:00

WHO IS A LIKELY CANDIDATE FOR INSULIN-SENSITIZING OR INSULIN-MIMETIC AGENTS?

Generally speaking, these agents are natural choices for a type 2 diabetic who despite a low-carbohydrate diet cannot get his weight down or his blood sugars into normal ranges. The blood sugar elevation may be limited to a particular time of the day, it may be during the night, or it may entail a slight elevation all day. We base our prescription on the individual’s blood sugar profiles. If even on our diet, blood sugar exceeds 160 mg/dl at any time of the day, I’ll immediately prescribe insulin and won’t even attempt to use these agents, except perhaps to eventually reduce doses of injected insulin. If your blood sugar is higher upon arising than at bedtime, we’d give you the sustained-release version of Glucophage (Glucophage XR) at bedtime. If your blood sugar goes up after a particular meal, we’d give you rapid-acting Glucophage about 2 hours before that meal. Since food reduces the possibility of diarrhea from this agent, we might give it with the meal. If blood sugars are slightly elevated all day long, we might use alpha lipoic acid and evening primrose oil on arising, postlunch, and postdinner. It should be noted, however, that the ISAs are considerably more effective than insulin mimetics in lowering blood sugars.

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