“Just some positivity right in your face!” is how GP Sebastiaan van Beek begins his presentation of a case on LinkedIn.1 This description of the enormous health improvement of a diabetic patient is certainly positive. In just three months, the HbA1c drops from 121 to 46 and the non-fasting blood glucose value normalizes from 30 to 5.8.
What is going on here? The patient in question radically changed course and started swimming, eating structured food and going for a brisk walk. For DOQ.nl, Jaap Kroon, diabetes staff physician at primary care organization PoZoB in Veldhoven, responds to this case: “I immediately wondered whether I could explain this enormous improvement from the cause of type 2 diabetes. I expect that this patient has a too high BMI. and waist size. In these people, insulin resistance is usually one of the main factors involved. If you then abruptly reduce your excessive intake of carbohydrates, for example via soft drinks, you can achieve such a sharp drop in your blood glucose level.”
“The discussion is mainly about whether you should divide patients into five groups at the time of diagnosis or whether a classification into the two most important groups will suffice”
Stafarts diabetes Jaap Kroon
Subtypes
Kroon is a strong advocate of subtyping diabetes, as not every patient has the disease for the same reason. Classic is the difference between type 1 and type 2 diabetes. In 2018, a group of Scandinavian researchers published their analysis of a cohort of newly diagnosed patients.2
They discovered
2023-05-24 08:07:41
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