Diabetes and Insulin Resistance
Although this practice has been a long standing accredited affiliate of the Centre for Diabetes and Endocrinology (CDE), the practice is no longer contracted to CDE. We continue to apply evidence based guidelines to our care of Diabetic and Endocrine patients.
Patients are registered with their Medical Aid scheme Chronic Benefits to ensure access to medication, investigations, allied professional and specialist care where required.
Insights to Diabetes and Insulin Resistance
- Diabetes background https://www.mayoclinic.org/diseases-conditions/diabetes/symptoms-causes/syc-20371444
- https://www.mayoclinic.org/diseases-conditions/metabolic-syndrome
- Watch TEDX insulin resistance by Sarah Hallberg https://www.youtube.com/watch?v=da1vvigy5tQ
- TEDX “Keto” LCHF “banting” and “intermittent Fasting” talks
- See Tim Noakes https://www.thenoakesfoundation.org/wp-content/uploads/2017/02/Green-List.pdf for “only eat these food sources”. Do you think you could eat only from this list?
- Download FatSecret app or similar to benchmark the amount and nature of the calories you are eating for a week or so. To lose 1kg of fat, you need to be in a calorie deficit of 7,700 calories. This means that a daily deficit of 500 calories will take 2-3 weeks to lose 1kg. Generally, the recommended daily calorie intake is 2,000 calories a day for women and 2,500 for men.
- How grams of Carbohydrates per day? Aim for 50-150g per day
- What ratio of calories %fats:%protein:%carbohydrates? Aim for 65:30:5 ratio under professional supervision.
- “Move” – walk, jog, swim, ride a bike – every day for 30-40 minutes to start.
- Once you benefits for Diabetes are activated: Diabetic retinal screen and see a podiatrist to understand diabetic feet before complications develop
- If you google any subjects, please write “evidence” before you search for your topic, looking for links to well-known universities, Canadian, Australian and New Zealand government health sites; .org; and .edu sites.
Underactive Thyroid (hypothyroidism)
Regular monitoring and medication are key to managing this common condition. It is a Prescribed Minimum Benefit condition covered by all medical aides.
Testosterone Deficiency Syndrome (TDS)
Low testosterone is a common problem affect men from about the age of 35 years, and more common as men age.
https://www.healthline.com/health/low-testosterone/warning-signs
If you have been diagnosed with Testosterone Deficiency Syndrome (TDS), your pending results are likely to suggest a ‘usual’ type of testosterone deficiency that can be improved with testosterone supplementation in the form of Nebido (long acting) about every 4 months or so, or shorter acting Sustanon given about 3 weekly or Testosterone cypionate given between 7-14 days. There is a daily use gel, which seems to be impractical in our climate
Costs:
- Testosterone cypionate Likely to use 3-5mls per month (R3000pa)
- Sustanon 250mg About R300 every 3 weeks (about R5000 p.a.)
- Nebido Likely to use 3 per year (R7000-9000 p.a.)
- Androgel Likely to use one sachet per day (R7000pa)
Additional information:
- https://www.mayoclinic.org/diseases-conditions/male-hypogonadism/symptoms-causes/syc-20354881
- The Testosterone Guidelines (attached)
- Nebido https://www.nebido.com/prescribing-information#:~:text=Contraindications%3A,to%20any%20of%20the%20excipients.
- How to self-inject the short acting Testosterone http://www.med.umich.edu/1libr/SpinalCordInjuryProgram/IMselfInjectionTesto.pdf
Test suggestions:
- 6 weeks FBC (Full Blood Count) and Testosterone level
- 6 months Lipids
- Annual PSA, FBC
You may want to/need to consider donating blood to reduce the blood “thickness” that sometimes occurs with supplementation.