diabetes treatment
Diabetes Questions » diabetes treatment » diabetes treatment guidelines

diabetes treatment guidelines

Read and learn more about diabetes treatment guidelines. For more, visit the Diabetes website DiabetesFAQ.org

Q: Diabetes contract? Has your doctor asked you to sign one?
At the end of my regular checkup last night, my doctor told me his office had adopted a patient “contract” for diabetes patients as a motivational tool to follow all of the treatment guidelines and goals and asked me to sign it.

But the “contract” had key two paragraphs he didn’t mention, that if I didn’t comply with all the guidelines, I would be discharged as a patient, and that if I was discharged, all family members would be discharged, too. He tried to down-play the significance of the paragraphs, but it was apparent that they were what the “contract” was all about and he was pretty adamant that I should sign it, which I didn’t, took it home to read, became even angrier that he lied about the nature of the “contract,” actually an ultimatum, and continued to deny what it was for.

There has never been a question that I don’t do what I’m supposed to do, by the way.

Has anyone else been given such a thing by their doctor and coerced to sign it?
All reassuring answers so far, thanks a lot! My feeling is that this “contract” is being imposed by someone else, like an insurance carrier trying to cut its costs by coercing my doctor to get contracts or face being “discharged” from coverage.

A: since the way diabetes acts, especially type 2, that is a totally unfair “contract”!!

Most of us are not lazy, do not need to get off our butts and on to the treadmill or trail. Yes, we some of us need to lose some weight but that is not a Doctor’s option!! and neither is whether we are able to keep our glucose numbers within a certain narrow parameter.

My weight has gone from 110 to 160 with the introduction of insulin to my system!! I am definately not a couch potato!! In the past 10 years I have narrowed my food choices down to near nothing. some meat, spinach and tomato salads and apples!! This is 6 small meals per day.

I take the meds as scheduled, I eat as directed (other than eating a lot of cereals and grains) and do my walking daily.

It just doesn’t cover all the variables in a life!! I would not sign that form either!!

Suggest you terminate the doctor and find another one!! Or better still write up your own “contract” for the doctor to sign if you sign his!!

Contract will include:
no blaming patient for high glucose numbers,
no blaming patient for high blood pressure,
no blaming patient for occasional treats,
no blaming patient for bad temper,
no blaming patient for weight gain or loss,,
no blaming patient for insurance co’s lack of sending supplies.

I am sure you can write up the contract following the one from the doctor and adding these points and some more of your own.

Q: Can diabetics on insulin (not pumps) get CDLs?
Does the D.O.T. allow insulin-dependant diabetics to get their CDLs? My boyfriend was planning on getting his CDL and then he was diagnosed with diabetes. He has to take daily insulin shots. His treatment and his disease don’t really interfere with his life. So, no comas, no seizures, or anything like that. He’s heard that means he can’t drive a truck, and he’s seriously bumming. Is this true? Or is that considered discrimination? Does the D.O.T. have guidelines covering health issues for drivers? Thanks for your help!
Well, he doesnt have any “attacks” he doesn’t have seizures, or any black outs. He just does a daily shot of insulin, takes metformin and avandia. He doesn’t use an insulin pump, those guys who have “Attacks” usually rely on an insulin pump. It hasn’t progressed that far yet.

A: Check with your state DOT. rules may differ from state to state or even company to company. Trucking companies may have problems with drivers because being on the road all the time may keep him from maintaing his insulin supply, hence the side effects. Rules may differ with diabetics who are insulin dependent and diabetics who are not.

Q: Medical Benefits of Ramadan ?
Medical Benefits of Ramadan
by Shahid Athar, M.D.

Most Muslims do not fast because of medical benefits but because it has been ordained to them in the Quran. The medical benefits of fasting are as a result of fasting. Fasting in general has been used in medicine for medical reasons including weight management, for rest of the digestive tract and for lowering lipids. There are many adverse effects of total fasting as well as so-called crash diets. Islamic fasting is different from such diet plans because in Ramadan fasting, there is no malnutrition or inadequate calorie intake. The caloric intake of Muslims during Ramadan is at or slightly below the national requirement guidelines. In addition, the fasting in Ramadan is voluntarily taken and is not a prescribed imposition from the physician.

Ramadan is a month of self-regulation and self-training, with the hope that this training will last beyond the end of Ramadan. If the lessons learned during Ramadan, whether in terms of dietary intake or righteousness, are carried on after Ramadan, it is beneficial for one’s entire life. Moreover, the type of food taken during Ramadan does not have any selective criteria of crash diets such as those which are protein only or fruit only type diets. Everything that is permissible is taken in moderate quantities.

The only difference between Ramadan and total fasting is the timing of the food; during Ramadan, we basically miss lunch and take an early breakfast and do not eat until dusk. Abstinence from water during this period is not bad at all and in fact, it causes concentration of all fluids within the body, producing slight dehydration. The body has its own water conservation mechanism; in fact, it has been shown that slight dehydration and water conservation, at least in plant life, improve their longevity.

The physiological effect of fasting includes lower of blood sugar, lowering of cholesterol and lowering of the systolic blood pressure. In fact, Ramadan fasting would be an ideal recommendation for treatment of mild to moderate, stable, non-insulin diabetes, obesity and essential hypertension. In 1994 the first International Congress on “Health and Ramadan”, held in Casablanca, entered 50 research papers from all over the world, from Muslim and non-Muslim researchers who have done extensive studies on the medical ethics of fasting. While improvement in many medical conditions was noted; however, in no way did fasting worsen any patients’ health or baseline medical condition. On the other hand, patients who are suffering from severe diseases, whether diabetes or coronary artery disease, kidney stones, etc., are exempt from fasting and should not try to fast.

There are psychological effects of fasting as well. There is a peace and tranquility for those who fast during the month of Ramadan. Personal hostility is at a minimum, and the crime rate decreases. Muslims take advice from the Prophet who said, “If one slanders you or aggresses against you, say I am fasting.’” This psychological improvement could be related to better stabilization of blood glucose during fasting as hypoglycemia after eating, aggravates behavior changes.

There is a beneficial effect of extra prayer at night. This not only helps with better utilization of food but also helps in output. There are 10 extra calories output for each rikat of the prayer. Again, we do not do prayers for exercise, but a mild movement of the joints with extra calorie utilization is a better form of exercise. Similarly, recitation of the Quran not only produces a tranquility of heart and mind, but improves the memory. Therefore, I encourage my Muslim patients to fast in the month of Ramadan, but they must do it under medical supervision. Healthy adult Muslims should not fear becoming weak by fasting, but instead it should improve their health and stamina.

A: That was very interesting. I worked for four years in an Elementary school as an EMT. We had many Muslim students. Being children they spent a lot of time in my office during their lunch hour complaining they were hungry and or had headaches. I felt for them, after all they are just children and felt embarrassed in front of their peers. It was very rare that any student was happy with the idea of fasting – but they all survived.

As a Catholic, I too have days of fasting and it drives my kids crazy. They too survive.

Q: please help with health questions trying to get caught up :) ?
1.Hershel is very active. He exercises every day. To determine what his caloric intake should be, Hershel needs to

A.know his body composition.
B.calculate his percentage of body fat.
C.know his activity level.
D.know his lean mass.
2.On which of the following does your daily caloric intake not depend?

A.Your BMR
B.The number of calories you need to digest food
C.Your activity level
D.Energy balance
3.Digestive problems can be caused by all of the following EXCEPT

A.overeating.
B.a specific disease.
C.a food intolerance.
D.a balanced diet
4.Which of the following is not a characteristic of a healthful diet?

A.Sound, well-balanced choices from a variety of foods
B.Following the guidelines of dietary recommendations
C.Over-the-counter diet medications
D.Eating a balanced breakfast
5.All of the following characteristics might indicate that a person is at risk for an eating disorder EXCEPT

A.an urge to throw up after eating.
B.a guilty feeling when eating sweet or fattening foods.
C.over-exercising to burn all the calories eaten.
D.liking chocolate.
6.Eating disorders

A.are usually minor and often go away by themselves.
B.often involve an unhealthy concern about body weight and shape.
C.are a normal part of growing up.
D.rarely cause serious health problems.
7.In which of the following ways are anorexia nervosa and bulimia nervosa different?

A.Anorexia nervosa is considered an eating disorder; bulimia nervosa is not.
B.Anorexia nervosa affects mostly female teenagers; bulimia nervosa
affects mostly male teenagers.
C.Nutritional therapy is an effective treatment for anorexia nervosa; it is not effective for bulimia nervosa.
D.Anorexia nervosa involves self-starvation; bulimia nervosa involves binging and/or purging.
8.When the amount of food energy taken in equals the amount of energy you use, the result is

A.a high BMR.
B.a low BMR.
C.obesity.
D.energy balance
9.Being overweight can lead to all of the following EXCEPT

A.type 2 diabetes.
B.sleep apnea.
C.certain forms of cancer.
D.personal fitness.

A: 1. C, 2. B, 3. D, 4. C, 5. D, 6. B, 7. D, 8. D, 9. D.

Q: For those of you who are opposed to nationalized healthcare?
Some of the comments sound like people think that anyone without healthcare coverage simply is not willing to pay for it.

However, what about families who cannot find full time jobs and have to work 2-3 part time jobs to support their families in high unemployment areas

What about employees who work for temp agencies and cannot get health insurance, or the coverage available will pay out no more than what you pay in premiums (or even less).

What about those families who must remain at home to care for family members requiring around the clock care.

What about low income families who make too much money to qualify for Medicaid, yet they are still barely above the federal poverty guidelines?

What about those who are unemployed and cannot afford the COBRA premiums (even with the stimulus plan), or worse yet, cannot qualify for COBRA.

What about those people who have health conditions that prevent them from working full time.

What about those people who require medications in order to function on a job (issues such as chronic depression, bipolar disorder, diabetes, lupus, MS) or cannot handle any type of a full time job due to medical or mental issues?

Do you sincerely feel that all of these people should just continue to go without treatment. Do you also realize that unpaid medical expenses are causing problems for medical practitioners in maintaining practices.

Do I understand that you don’t care?

A: Unfortunatley yes – look at their pathetic responses – these are ignorant people who care nothing about anyone other than themselves and their money.

Q: Medical Benefits of Ramadan ?
Medical Benefits of Ramadan
by Shahid Athar, M.D.

Most Muslims do not fast because of medical benefits but because it has been ordained to them in the Quran. The medical benefits of fasting are as a result of fasting. Fasting in general has been used in medicine for medical reasons including weight management, for rest of the digestive tract and for lowering lipids. There are many adverse effects of total fasting as well as so-called crash diets. Islamic fasting is different from such diet plans because in Ramadan fasting, there is no malnutrition or inadequate calorie intake. The caloric intake of Muslims during Ramadan is at or slightly below the national requirement guidelines. In addition, the fasting in Ramadan is voluntarily taken and is not a prescribed imposition from the physician.

Ramadan is a month of self-regulation and self-training, with the hope that this training will last beyond the end of Ramadan. If the lessons learned during Ramadan, whether in terms of dietary intake or righteousness, are carried on after Ramadan, it is beneficial for one’s entire life. Moreover, the type of food taken during Ramadan does not have any selective criteria of crash diets such as those which are protein only or fruit only type diets. Everything that is permissible is taken in moderate quantities.

The only difference between Ramadan and total fasting is the timing of the food; during Ramadan, we basically miss lunch and take an early breakfast and do not eat until dusk. Abstinence from water during this period is not bad at all and in fact, it causes concentration of all fluids within the body, producing slight dehydration. The body has its own water conservation mechanism; in fact, it has been shown that slight dehydration and water conservation, at least in plant life, improve their longevity.

The physiological effect of fasting includes lower of blood sugar, lowering of cholesterol and lowering of the systolic blood pressure. In fact, Ramadan fasting would be an ideal recommendation for treatment of mild to moderate, stable, non-insulin diabetes, obesity and essential hypertension. In 1994 the first International Congress on “Health and Ramadan”, held in Casablanca, entered 50 research papers from all over the world, from Muslim and non-Muslim researchers who have done extensive studies on the medical ethics of fasting. While improvement in many medical conditions was noted; however, in no way did fasting worsen any patients’ health or baseline medical condition. On the other hand, patients who are suffering from severe diseases, whether diabetes or coronary artery disease, kidney stones, etc., are exempt from fasting and should not try to fast.

There are psychological effects of fasting as well. There is a peace and tranquility for those who fast during the month of Ramadan. Personal hostility is at a minimum, and the crime rate decreases. Muslims take advice from the Prophet who said, “If one slanders you or aggresses against you, say I am fasting.’” This psychological improvement could be related to better stabilization of blood glucose during fasting as hypoglycemia after eating, aggravates behavior changes.

There is a beneficial effect of extra prayer at night. This not only helps with better utilization of food but also helps in output. There are 10 extra calories output for each rikat of the prayer. Again, we do not do prayers for exercise, but a mild movement of the joints with extra calorie utilization is a better form of exercise. Similarly, recitation of the Quran not only produces a tranquility of heart and mind, but improves the memory. Therefore, I encourage my Muslim patients to fast in the month of Ramadan, but they must do it under medical supervision. Healthy adult Muslims should not fear becoming weak by fasting, but instead it should improve their health and stamina.

A: I am not Muslim but I do follow your writings and thank you for posting here. You are very informative. Some might grumble about your posts because it’d be a stretch to call them questions but I do believe (and hope) most would agree that it’s all ok.

Best wishes to you.

Q: Medical Benefits of Ramadan ?
Medical Benefits of Ramadan
by Shahid Athar, M.D.

Most Muslims do not fast because of medical benefits but because it has been ordained to them in the Quran. The medical benefits of fasting are as a result of fasting. Fasting in general has been used in medicine for medical reasons including weight management, for rest of the digestive tract and for lowering lipids. There are many adverse effects of total fasting as well as so-called crash diets. Islamic fasting is different from such diet plans because in Ramadan fasting, there is no malnutrition or inadequate calorie intake. The caloric intake of Muslims during Ramadan is at or slightly below the national requirement guidelines. In addition, the fasting in Ramadan is voluntarily taken and is not a prescribed imposition from the physician.

Ramadan is a month of self-regulation and self-training, with the hope that this training will last beyond the end of Ramadan. If the lessons learned during Ramadan, whether in terms of dietary intake or righteousness, are carried on after Ramadan, it is beneficial for one’s entire life. Moreover, the type of food taken during Ramadan does not have any selective criteria of crash diets such as those which are protein only or fruit only type diets. Everything that is permissible is taken in moderate quantities.

The only difference between Ramadan and total fasting is the timing of the food; during Ramadan, we basically miss lunch and take an early breakfast and do not eat until dusk. Abstinence from water during this period is not bad at all and in fact, it causes concentration of all fluids within the body, producing slight dehydration. The body has its own water conservation mechanism; in fact, it has been shown that slight dehydration and water conservation, at least in plant life, improve their longevity.

The physiological effect of fasting includes lower of blood sugar, lowering of cholesterol and lowering of the systolic blood pressure. In fact, Ramadan fasting would be an ideal recommendation for treatment of mild to moderate, stable, non-insulin diabetes, obesity and essential hypertension. In 1994 the first International Congress on “Health and Ramadan”, held in Casablanca, entered 50 research papers from all over the world, from Muslim and non-Muslim researchers who have done extensive studies on the medical ethics of fasting. While improvement in many medical conditions was noted; however, in no way did fasting worsen any patients’ health or baseline medical condition. On the other hand, patients who are suffering from severe diseases, whether diabetes or coronary artery disease, kidney stones, etc., are exempt from fasting and should not try to fast.

There are psychological effects of fasting as well. There is a peace and tranquility for those who fast during the month of Ramadan. Personal hostility is at a minimum, and the crime rate decreases. Muslims take advice from the Prophet who said, “If one slanders you or aggresses against you, say I am fasting.’” This psychological improvement could be related to better stabilization of blood glucose during fasting as hypoglycemia after eating, aggravates behavior changes.

There is a beneficial effect of extra prayer at night. This not only helps with better utilization of food but also helps in output. There are 10 extra calories output for each rikat of the prayer. Again, we do not do prayers for exercise, but a mild movement of the joints with extra calorie utilization is a better form of exercise. Similarly, recitation of the Quran not only produces a tranquility of heart and mind, but improves the memory. Therefore, I encourage my Muslim patients to fast in the month of Ramadan, but they must do it under medical supervision. Healthy adult Muslims should not fear becoming weak by fasting, but instead it should improve their health and stamina.

A: Studies conducted on Ramadan-type fasting (RTF) have shown that fasting affects human biochemistry. Such fasting results in an increase in serum lipids and uric acid, though the latter has no adverse health effects. Long term effects, such as an increase in HDL cholesterol and a decrease in LDL cholesterol, have been observed with Ramadan fasting.

A decrease in blood glucose, actate and pyruvate, has also been observed, possibly indicating alterations in metabolic activities. Basal metabolism also slows down, and fat is used more efficiently during such fasting. During fasting, the liver responds with adaptive changes in metabolic activities. The increased activities of enzymes involved in the degradation as well as the production of glucose suggest that RTF enhances nutrition and energy metabolism. There is no conclusive evidence whether the weight of an individual is affected positively or negatively by Ramadan style fasting.

Related Posts

Write a comment