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Type 1 and Type 2 Diabetes

Program: Taking Care of Diabetes and Avoiding Complications
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Andrew Schorr:

Just so we’re clear, when somebody has a diagnosis of type 2 diabetes is it that their pancreas is just not processing blood sugars properly? Is that what it is?

Dr. Choudhury:

There are two types of diabetes. There’s a type 1 diabetes, which is basically most of the time an autoimmune-related disorder seen mostly in young patients, but we do see type 1 diabetics in older patients also, less so than younger patients. This type of diabetes does have problems with a lack of insulin. The pancreas does not produce any insulin at all. This is type 1 diabetes, and this is like I mentioned, an autoimmune disorder not related really to obesity, and this type of diabetes requires insulin.

The other type of diabetes is type 2 diabetes, which is mostly related to obesity, although some type 2 diabetics may have a family history also, but most of the type 2 diabetes that we see is obesity related. In this situation the pancreas still does produce insulin, but the insulin just does not work because of all the fat cells that there are in the body. So we call this “insulin resistance.” So type 2 diabetics do have some insulin secretion, it’s just that it’s not working.

Andrew Schorr:

So if you can decrease the amount of fat the insulin you have can do a better job?

Dr. Choudhury:

Yes, absolutely. You know weight loss will improve insulin resistance.

Andrew Schorr:

All right, well let’s go back to our story with Rick. So Rick; more than 20 pounds overweight, your wife you said was 80 pounds overweight, she made a decision to go into a program and it made a big difference for her didn’t it?

Rick:

Yes it did, drastically.

Andrew Schorr:

How much weight did she lose?

Rick:

She has lost 62 pounds since March.

Andrew Schorr:

Okay so you look at her, and what did you decide to do?

Rick:

Well I saw what she was doing and she dropped her prediabetic sugars back down to normal, dropped her blood pressure medicine, gout, and everything, and I said okay this program’s got something going. I’ll give it a try. So I jumped on board in June.

Andrew Schorr:

All right, and we’re doing this in October. How much of a difference has it made for your weight?

Rick:

I’ve dropped 24 pounds. I’ve dropped body fat percentage from probably the high 20% down to about 20-21% and just feel fantastic.

Andrew Schorr:

And how about your readings for your diabetes?

Rick:

My blood sugar with the medication, and it’s gone down a little bit on the medication, but I’m back in the normal range and a lot of that has been from the encouragement from Dr. Choudhury to watch my diet, to lose some weight, and really monitor my blood sugar. So I’ve dropped back to six small meals a day, and I’m eating real correct food and really watching to make sure there’s not a false sugar in there and a lot of carbs, and that’s what’s dropped this fat percentage down quite a bit.

Andrew Schorr:

Dr. Choudhury, Rick sounds like a poster child for somebody finally deciding to take control of their diabetes rather than diabetes controlling them.

Dr. Choudhury:

Absolutely. Rick is one of my very, very successful diabetics. He has just taken such good care of himself all by himself. I think that’s very important to have that motivation to take care of yourself first and foremost. You know the doctors are here to help you to some extent with medications and advice, but if someone is not really motivated to treat their diabetes and make lifestyle changes on their own it can be extremely frustrating for the doctor also because if they don’t change their lifestyle with the diet restriction and exercise just like Rick has done so successfully we have to somehow still treat that diabetes and those high sugars, and we have to keep using more and more medications.

That increased need for medication can really be reversed including as I mentioned insulin resistance can be reversed to a lot by just some modest lifestyle modifications, which is modest exercise and watching your diet.

Andrew Schorr:

And don’t smoke, I’m sure, don’t smoke.

Dr. Choudhury:

Of course, yes.

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