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October 11, 2001

Type 2

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Question from Ft. Myers, Florida, USA:

I have had type 2 diabetes for five weeks, my hemoglobin A1c is 7.2%, my fasting blood sugars are 170-190 mg/dl [9.4-10.6 mmol/L], and I have been taking Glucotrol for a month. A physician told me that an ACE inhibitor and Actos [pioglitazone] would be better than my current pill and went on to say that Xenical alone could “cure” me with a 1000 calorie diet.

Answer:

I would suggest you ask your physician what he means by the statements you are repeating. In the end, the best result is the one which lowers your blood sugars. Whether one is better than the other is not clear. Some have advantages and some have disadvantages.

Xenical is a medication which has to be taken for a lifetime in order to decrease/maintain weight loss. Weight loss is a primary therapy in the treatment for type�2 diabetes, but not everyone loses enough weight to “cure” diabetes.

I also suggest you receive more education regarding these issues. A good start would be to attend classes held by a local diabetes education team. You can find the nearest education group by contacting your physician, your local hospital, or your local American Diabetes Association affiliate.

JTL

[Editor’s comment: ACE inhibitors are generally used to treat hypertension and early kidney disease. Unless you are showing signs of these, it would seem to be inappropriate treatment at this stage.

SS]

[Editor’s comment: I was confused whether the physician who told you these things was just an acquaintance giving an informal opinion, or a physician who is providing you with medical care. If the doctor is only an acquaintance who doesn’t know your situation in detail, he/she would be guessing what might be best for you. On the other hand, if he/she is actually your doctor, you should ask for clarification, and a referral to a diabetes program.

WWQ]