title: Exploiting complementary therapeutic strategies for the treatment of type II diabetes and prevention of its complications.
abstract: 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.
authors.affiliation: Nutrition 21, San Diego, CA 92109, USA.
authors.forename: M F
authors.initials: MF
authors.lastname: McCarty
mesh_terms: 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
chemical_list: D004043:Dietary Fiber; D007502:Iron Chelating Agents; D010848:Picolinic Acids; D014810:Vitamin E; D013654:Taurine; D008274:Magnesium; C030614:picolinic acid