Balance in management of type 2 diabetes

Healthcare professionals support patients to manage insulin resistance and/or their type 2 diabetes, by balancing the pros and cons of different approaches with the individual. Reading about the imminent new oral GLP-1 has provoked consideration of this balance. It is important that prior to recommending initiation or titration of expensive medication for diabetes that all other options have been considered.

Insulin resistance increases greatly in obese patients and those who have large amounts of fat around the waist. Locally, nationally and internationally a low carbohydrate diet has demonstrated notable success in reducing obesity and healthcare professionals have observed that this approach can put type 2 diabetes into drug-free remission. Dr David Unwin's sugar charts (Public Health Collaboration, 2020) are hugely beneficial for practice. Patients can relate to the clear information demonstrating the glucose content of common foods and an approximation of how they may affect blood sugar. Surprised exclamations such as: ‘I didn't realise how much sugar is in rice’ can be heard frequently from patients and staff when viewing laminated charts on display.