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Doctors have new guidelines for Type 2 diabetes

  • DENNIS ODA / 2017

    Mariana Gerschenson leads a diabetes research center at the University of Hawaii John A. Burns School of Medicine. There are now new guidelines, or a realignment of guidelines, for patients with Type 2 diabetes.

Mehmet Oz, M.D., is host of “The Dr. Oz Show,” and Mike Roizen, M.D., is Chief Wellness Officer and Chair of Wellness Institute at Cleveland Clinic. Email questions to youdocsdaily@sharecare.com.

QUESTION: Is it true that there are new treatment guidelines for Type 2 diabetes?

My wife was recently diagnosed, and I want to know what they are.

Lester G., Columbus, Ohio

ANSWER: Yes, there are new guidelines, or a realignment of guidelines, and there are a few things you and your wife need to talk to her endocrinologist about.

The big shift is that doctors are being told to approach their Type 2 diabetes care plan by starting with an evaluation of each diagnosed patient’s heart health, because cardiovascular disease (heart attack and stroke) is the No. 1 cause of death for people with diabetes.

While metformin remains the recommended first-line treatment for Type 2 diabetes, two other therapies are emerging as the go-to drugs for managing long-term heart health and blood glucose levels: sodium-glucose cotransport-2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists.

One caution: The Food and Drug Administration has issued a warning about SGLT2 inhibitors, because from March 2013 to May 2018, they found five women and seven men were hospitalized (one died) with what’s known as necrotizing fasciitis (flesh-eating bacteria) of the genitals (1.7 million people received prescriptions for SGLT2 inhibitors in 2017).

Going forward, a warning label will be placed on the medication. So ask the doctor about the risks and benefits for your wife.

As for the emphasis on cardiovascular health, that’s terrific. But it doesn’t depend on medicines alone!

She should make sure to get 10,000 steps daily, lose 10 percent of her body weight if she is overweight, avoid all added sugars and syrups, saturated and trans fats and highly-processed foods.

You can reverse Type 2 diabetes with a healthful lifestyle, then neither of you will have to worry about the potential side effects of Type 2 diabetes medications.

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