Vegetarians International Voice for Animals

Life with diabetes

Life with diabetes

Diabetes type 1 is a life-long condition but its progress can be slowed whilst with type 2 diabetes, it can be reversed. In both diseases, health complications can be avoided or reduced simply by adopting the correct approach.

Diabetes treatment is usually highly individual as everyone has different needs, according to their condition, the stage of development of the disease and other health complications. The classical approach to diabetes treatment is based on a combination of adjustments to diet, carbohydrate counting and medication, all of which can limit people’s personal and professional lives. Our D-Diet approach is based on a radical change in diet, requires the patient to learn how to eat and how to think about food in a new way but does not require calorie restriction or combining foods from exchange lists.

Classical approach to treatment

Healthcare professionals dealing with diabetes usually recommend diet adjustments to regulate carbohydrate intake in order to better control blood sugar levels. Because diabetes often goes hand in hand with obesity, they also recommend restricting calorie intake and appropriate physical activity.

Medication

Type 1 diabetes

In type 1 diabetes, the body doesn’t produce any insulin so insulin has to be administered in the form of injections or an insulin pump. Depending upon the presence of further complications, type 1 diabetics might also need to take cholesterol and blood pressure-lowering drugs.

Type 2 diabetes

If changes in diet and exercise don’t bring about substantial change, those with type 2 diabetes are usually prescribed oral medication to help reduce high blood glucose levels and stimulate insulin production. These drugs might be insufficient on their own to bring blood glucose under control and are therefore sometimes combined with injectable drugs called incretin mimetics, which influence the body’s glucose metabolism, stimulate the production of insulin and reduce the speed of digestion. If the oral and other non-insulin medications are not sufficient, insulin therapy is commenced. Because of the frequent presence of additional health problems, a range of cholesterol and blood pressure-lowering drugs is also taken by many type 2 diabetics.

 

Adverse effects of drugs

It is worth noting the many adverse effects of drugs used to regulate insulin sensitivity and/or production (Diabetes UK, 2008):

Name

Trade name

Adverse effects

Sulphonylureas (stimulate insulin production, increase insulin sensitivity)

Chlorpropamide

 

Hypoglycaemia, nausea, vomiting, diarrhoea, constipation, loss of appetite, abdominal pain, bloating, indigestion, weight gain, liver function problems, blood disorders, allergic skin reactions, low sodium, headaches, jaundice, tinnitus, pins and needles, increased sensitivity to sunlight, intolerance to alcohol, visual disturbances, confusion, dizziness, drowsiness, tremor, allergic reaction.

Glibenclamide

Daonil

Gliclazide

Diamicron, Diamicron MR

Glipizide

Glibenese, Minodiab

Glimepiride

Amaryl

Tolbutamide

 

Biguanide  (helps to stop liver producing new glucose, increases insulin sensitivity)

Metformin (immediate release)

Glucophage

Nausea, vomiting, diarrhoea, abdominal pain, loss of appetite, metallic taste, reduced absorption of vitamin B12, build up of lactic acid in the blood, allergic reactions, liver function problems.

Metformin (prolonged release)

Glucophage SR

Prandial glucose regulator (stimulates insulin production)

Repaglinide

Prandin

Hypoglycemia, allergic skin reactions, liver function problems, abdominal pain, nausea, diarrhoea, vomiting, constipation, visual disturbances.

Nateglinide

Starlix

Alpha glucosidase inhibitor (slows down the absorption of starchy foods from the intestine)

Acarbose

Glucobay

Flatulence, diarrhoea, abdominal pain, nausea, vomiting, indigestion, liver function problems, tissue swelling, blood disorders, allergic skin reaction, intestinal problems.

Thiazolidinediones* or Glitazones (reduce insulin resistance)

Pioglitazone

Actos

Visual disturbance, tissue swelling, weight gain, sinusitis, respiratory infection, numbness, insomnia, liver function problems, increased risk of bone fractures in women.

Pioglitazone/Metformin

Competact

Blood disorders, visual disturbance, flatulence, weight gain, aching muscles, headaches, blood in urine, impotence, tissue swelling, respiratory infection.

DPP-4 inhibitors or Gliptins (help the hormone incretin to stay in the blood for longer time, which stimulates insulin production and reduces the amount of glucose produced by the liver)

Sitagliptin

Januvia

Hypoglycaemia, drowsiness, diarrhoea, nausea, flatulence, constipation, upper abdominal pain, tissue swelling, headaches, dizziness, osteoarthritis, arm or leg pain, allergic reactions, weight loss, loss of appetite, respiratory infection

Vildagliptin

Galvus

Hypoglycaemia, sore throat and runny nose (nasopharyngitis), tremor, headache, dizziness, weakness, constipation, weight gain, tissue swelling, allergic reactions, liver problems.

Vildagliptin/Metformin

Eucreas

Hypoglycaemia, tremor, headache, dizziness, fatigue, nausea.

Incretin mimetics (influence the body’s glucose metabolism, stimulate the production of insulin, reduce the speed of digestion and appetite)

Exenatide

Byetta

Hypoglycaemia, pancreatitis, decreased appetite, headache, dizziness, nausea, vomiting, diarrhoea, indigestion, abdominal pain, heartburn, bloating, flatulence, burping, constipation, sweating, feeling jittery, weakness, reaction at injection site, allergic skin reactions, general allergic reaction, kidney function problems, dehydration, unusual taste in the mouth, drowsiness.

Liraglutide

Victoza

Hypoglycaemia, nausea, diarrhoea, vomiting, headache, heartburn, decreased appetite, dizziness, sore throat and runny nose (nasopharyngitis), bronchitis, anorexia, abdominal pain, constipation, gastritis, bloating, flatulence, indigestion, toothache, fatigue, high temperature, reaction at injection site, kidney function problems, general allergic reaction, pancreatitis, thyroid problems.

Thiazolidinedione

*Singh et al. also found that Thiazolidinediones increase the risk of heart failure (Singh et al., 2007).

Diet

Although there are few diabetes-specific dietary recommendations from clinical practitioners, diabetics are usually recommended to consult a specialised dietician who will give them further advice based on their condition. However, most professionals are likely to prescribe a diet that limits carbohydrate and calorie intake and usually recommend cutting down on certain types of fat whilst encourage the consumption of high-fibre and low glycemic index food (Barnard, 2007; Diabetes Help, 2011; Anderson et al., 2004). This diet might temporarily improve the condition by inducing weightloss but it does not bring blood glucose levels under long-term control and, sooner or later, medication is usually needed.

People with type 1 diabetes invariably need to learn how to count carbohydrates as they base their insulin doses on the amount of carbohydrate eaten. However, recent recommendations encourage them to eat mostly foods with a low glycemic index to improve their blood glucose control (see page 20 for more information on glycemic index) and to avoid saturated fats (Barclay et al., 2010).

How well does it work?

Dieticians frequently recommend using food exchange lists, which advocate combining certain types of food at every meal, counting carbohydrates and restricting portion sizes. This kind of diet, together with medication, focuses mainly on glucose management and weight-loss but doesn’t limit animal products – the main sources of saturated fat in the diet. So, whilst it may keep blood sugar under control, it allows the body to feast on saturated fats and cholesterol and makes the kidneys work hard in coping with animal proteins.

High animal protein diets force both liver and kidneys to work harder in order to filter nitrogen products out of the bloodstream in the process of producing urine. Kidneys dilate their blood vessels to filter out protein waste – and animal protein causes greater dilation than plant protein. In addition, plant-derived proteins are lower in sulphur and demand less from the kidney’s filtration system. Moreover, fat droplets which accumulate in muscle cells remain exactly where they are and the condition gradually worsens.