Posted on 11 Mar 2017 Views 10396 Comments 20
It’s a well-known fact that obesity accounts for 80–85% of the risk of developing type 2 diabetes. Because of this, it’s no wonder several of our clients have type 2 diabetes. Studies suggest that 75% of type 2 diabetics are on some form of medication or insulin (Sharma et al, 2016); the degree of medication tends to increase with disease progression over time. We thought it would be useful to provide some information about key considerations (such as for medication) for people with diabetes who are following (or considering starting) a Slim & Save programme. This article also highlights some of the new and upcoming research suggesting the role of very low calorie diets (VLCDs) in the treatment of type 2 diabetes.
This article refers to type 2 diabetes (which accounts for around 90% of people with diabetes). Type 2 diabetes is different to type 1 diabetes which is an autoimmune disease often diagnosed in childhood, and requires insulin treatment from the outset. Our programmes are not suitable for people with type 1 diabetes.
Regardless of how your diabetes is treated, it’s of paramount importance that every customer checks with their GP that their Slim & Save plan is suitable for them. We ask every first time customer to sign a declaration confirming that they have consulted with their GP via a health questionnaire before placing their first order. It’s also really important that you seek regular supervision whilst following our programmes – this may be through your diabetes healthcare professional (e.g. practice nurse) or you GP if you have other medical history that may be a concern to the safety of following a VLCD (e.g. gallstones or gout).
There are a large range of medications which a diabetic may be prescribed. Metformin and sulphonylureas are the most commonly prescribed oral diabetes medications for the first-line treatment and add-on therapy for diabetes, with metformin accounting for 90% of prescriptions for newly diagnosed diabetics needing medication. Insulin is prescribed to around 20% of type 2 diabetics. You should ensure you have a full medication review with your GP before starting a Slim & Save programme. We have included some particular information regarding some of the common medications which you may be taking:
Sulphonyureas, e.g. gliclazide, glibenclamide, glipizide, tolbutamine - following a VLCD significantly reduces blood sugars independently of weight loss (due to the minimal intake of carbohydrate experienced on the plan), meaning hypoglycaemia (‘hypo’) is likely to occur if these medications are not reduced or stopped. Discuss your medication and blood sugars with your GP or diabetes specialist nurse before commencing Slim & Save; they will probably ask you to monitor your blood sugars more frequently, in the early days at least, in order to assess the affect that following the VLCD has on your blood sugar control and the degree at which the medication dose might need to be reduced.
Insulin - following a VLCD significantly reduces blood sugars independently of weight loss, meaning hypos are likely to occur if insulin is not reduced or stopped. Discuss with your GP or diabetes specialist nurse before commencing Slim & Save; they will probably ask you to monitor your blood sugars more frequently, in order to assess the affect that following the VLCD has on your blood sugar control and the degree at which the insulin dose might need to be reduced.
Hypos are very unlikely if you take metformin only, so taking metformin should not affect your ability to safely follow the programme. You should continue taking your usual dose unless advised otherwise by your healthcare professional or GP.
Other diabetes medications, such as thiazolidinediones (glitazones) and incretin mimetics (GLP–1 agonists), e.g. exenatide are unlikely to cause hypos when used alone, but may cause risk of hypos when combined with other diabetes medications like sulphonylureas (Rizos et al, 2009; Chaplin & Bain, 2016).
Many people who are overweight or obese and/or diabetic will also be on blood pressure medications (anti-hypertensives). Losing weight, as seen when people follow our programmes helps to reduce blood pressure. Evidence suggests that a 5.1kg (11lb) weight loss results in a reduction in systolic pressure (top number) of 4.44 and diastolic pressure (bottom number) of 3.57. This works out as a blood pressure drop of approximately 1 mmHg for every kilogram (2.2lbs) lost (Neter et al, 2013). As a result, people often need their medication reduced as their blood pressure reduces. It is important be have regular checks with your GP to assess this. If you’re on diuretics, your GP may wish you to stop these before commencing the programme.
There are many medications which can normally continue to be used by people on a VLCD without any effects. These include antibiotics, anti-emetics (anti-sickness), antacids, oral contraceptives and anti-histamines. However, we do advise you to double check all medications with your GP before starting a programme.
It has always been thought that type 2 diabetes is incurable. However, there is emerging evidence to suggest that diabetes could be reversed by following a VLCD. Here are some key pieces of research that have been published over the last few years:
At Slim & Save we pride ourselves with our customer care, and our customer care team are happy to answer any questions you may have, or point you in the right direction of who you should contact. At Slim & Save, we also try to encourage all members who have reached goal to stay in touch and continue to get support either through the forum or through Facebook, email, live chat etc, so we can motivate everyone to stay at goal weight and lead a healthy lifestyle in the future.
Do you think that with the latest research showing that VLCD’s can reverse type 2 diabetes that it helps take away the stigma that a VLCD Meal Replacement Diet is a “Faddy” diet? Do you have friends and relatives who try to put you down for following a VLCD and think that its a gimmick diet etc, do you feel this enforces how effective a VLCD can be?
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