Exploiting complementary therapeutic strategies for the treatment of type II diabetes and prevention of its complications.
Impaired glycemic control in type II diabetes results from peripheral insulin resistance, hepatic insulin resistance, and a relative failure of beta cell function. Nutritional and pharmaceutical measures are now available for addressing each of these defects, presumably enabling a rational and highly effective clinical management of non-insulin-dependent diabetes mellitus. Peripheral insulin resistance, which usually responds to a very-low-fat diet, aerobic exercise training, and appropriate weight loss, can also treated with high-dose chromium picolinate, high-dose vitamin E, magnesium, soluble fiber, and possibly taurine; these measures appear likely to correct the diabetes-associated metabolic derangements of vascular smooth muscle, and thus lessen risk for macrovascular disease. Metformin's clinical efficacy is primarily reflective of reduced hepatic glucose output; this action should complement the benefits of peripheral insulin sensitizers. When these measures are not sufficient for optimal control, beta cell function can be boosted with second-generation sulfonylureas.
McCarty
M F
MF
Nutrition 21, San Diego, CA 92109, USA.
D000529:Complementary Therapies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000503:physiopathology* / Q000628:therapy*; D003925:Diabetic Angiopathies / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control*; D018752:Diet, Fat-Restricted; D004043:Dietary Fiber; D015444:Exercise; D006801:Humans; D007333:Insulin Resistance; D007502:Iron Chelating Agents / Q000627:therapeutic use; D008274:Magnesium / Q000627:therapeutic use; D008954:Models, Biological; D010848:Picolinic Acids / Q000627:therapeutic use; D012307:Risk Factors; D013654:Taurine / Q000627:therapeutic use; D014810:Vitamin E / Q000627:therapeutic use; D015431:Weight Loss
D004043:Dietary Fiber; D007502:Iron Chelating Agents; D010848:Picolinic Acids; D014810:Vitamin E; D013654:Taurine; D008274:Magnesium; C030614:picolinic acid