You may not have to take any medications yet or you may have been prescribed diabetes medication or insulin. You might feel that it is all still too confusing and that it would be very helpful if somebody just gave you more tailored advice and the latest research developments in diabetes.  Learning to manage your diabetes takes time, patience and effort. Anita has an over 16 years of experience working as Diabetes Dietitian in the NHS clinis, research and privately and can work with you to develop a tailor-made dietary and lifestyle programme and advise about all you need to know about your medications and much more.

Anita will help you to develop a diet/lifestyle plan that may reduce your risks of diabetes complications. She will help you with carbohydrate awareness, structured blood glucose monitoring, weight loss, insulin dose adjustment, explanation of the mode of action of different diabetes medications, interpretation of the blood test results (e.g. HbA1c, blood cholesterol, thyroid functions, liver functions, kidney functions).

Here are examples of some of the Anita’s Research in Type 2 Diabetes, but please see her Research page for more info.

PUBLICATIONS

PRESENTATIONS

at the International conferences:

Bowes A, Begley J, Heart T & Kerr D “The sustained reversal of type 2 diabetes by intensive lifestyle intervention at diagnosis”. 6th World Congress of Prevention of Diabetes and its Complications, Dresden, Germany, Apr 2010.

Bowes A, Begley J Heart T, Painter H, & Kerr D “Effect of Intensive Lifestyle Intervention on Glucagon Like Peptide-1 (GLP-1) Levels in Patients with New Onset Type 2 Diabetes.” 69th American Diabetes Association conference, New Orleans, USA, Jun 2009.

Key finding: This study showed that 2/3 of the patients with new onset Type 2 Diabetes who took part in the GLP4Health Lifestyle Programme, reverted to normal blood glucose tolerance or pre-diabetes state.

This study recruited 22 people newly diagnosed with type 2 diabetes who took part in the Lifestyle change programme “GLP4Health”. 16 months later the patients underwent the Oral Glucose Tolerance Test (diagnostic test for the Type 2 Diabetes), which confirmed that two thirds of the people who took part in this study, showed blood glucose levels below the WHO 1999 criteria for the diagnosis of diabetes. All except of one patient remained off the diabetes medications. The improvement in blood glucose levels were directly related to the magnitude of the weight loss achieved.

TYPE 2 DIABETES OVERVIEW

According to Diabetes UK, 1 in 20 of us have diabetes, there are over 100,000 people newly diagnosed each year and up to half a million of us have the condition but don’t yet know it.

Type 2 diabetes cases have increased from 0.2 million to 2.6 million in the last 50 years. Genetics play a role in the development of type 2 diabetes, however, such an increase cannot be attributed to genetics alone. The experts believe that the rise is most likely attributed in the most to diet, obesity and sedentary lifestyle.

Figures suggest that the risk of developing the condition increases progressively the heavier you become. Obese people are up to 80 times more likely to develop Type 2 diabetes than those who maintain a healthy weight.

HAVE YOU JUST BEEN DIAGNOSED WITH TYPE 2 DIABETES?

You might be feeling frustrated or angry or just scared. From our clinical experience we can reassure you that diabetes doesn’t have to stop you from leading the life you want. Nor does it mean you’ll have other serious health problems in the future. With careful management you can control the condition and ensure it doesn’t control you. Many of our patients continue to stay healthy, active and live a full life many years after the a type 2 diabetes diagnosis.

When you were diagnosed, your GP probably referred you to an education programme for people newly diagnosed with type 2 diabetes, who then explained the most important aspects of managing your condition.

You may not have to take any medications yet or you may have been prescribed diabetes medication or insulin to keep your blood glucose level stable.

Learning to manage your diabetes takes time, patience and effort. You might still feel that there is too much information and it is all still too confusing and that it would be very helpful if somebody just gave you more tailored advice. At ACE Diets we can work with you to develop a tailor-made dietary management and lifestyle programme and answer all the questions you may still have about your type 2 diabetes.

*ACE diets is not a replacement of the care you are currently receiving from your Doctor and your Diabetes Care Team, but a complimentary private service to enhance your existing knowledge of the condition and its management.

ARE YOU MANAGING DIABETES WITH DIET ONLY?

Most of the patients who have followed the GLP4Health programme (please visit our Research page) have been managing their diabetes for many years without any medications and living a completely healthy, happy and symptom free life. At ACE Diets we can help you to keep on track with your diet and lifestyle. We can help you to stay motivated and positive and support you on each step of your journey.

*ACE diets is not a replacement of the care you are currently receiving from your Doctor and your Diabetes Care Team, but a complimentary private service to enhance your existing knowledge of the condition and its management.

ARE YOU TAKING DIABETES MEDICATIONS?

When taking multiple medications, it is particularly important to ensure that your diet is well-balanced and is adequate in essential vitamins and minerals and helps you to maintain a healthy weight. At ACE Diets will can give you a more detailed understanding of the action of different diabetes medications you are taking and explain how they affect your weight and diabetes management. We can help you to optimise your diet and lifestyle, which in turn will enhance the action of your medications or even help to reduce the amount of medications you need. We can help you to get motivated to make the changes and support you at each step of your journey.

METFORMIN

Metformin lowers insulin resistance. It makes the tissues more responsive to insulin, and this lowers the sugar levels. Metformine may also help you to lose weight. Blood levels of vitamin B12 can decrease in some people who take metformin. B12 deficiency increases the chance of developing painful neuropathy.

Metformin starting dose is 500mg twice/day, increasing to 1gm twice/day. There is a slow release form that can be used once daily. Side effects may include nausea (feeling sick), diarrhoea, loss of appetite, and the presence of a metallic taste in your mouth.

GLICLAZIDE, GLIPIZIDE AND OTHER SULFONYLUREAS

Sulfonylureas act on the pancreas to make it release more insulin. Sulfonylurea medicines can cause weight gain. As it makes the pancreas to release more insulin, low blood sugar is the most common side effect.

DPP-4 inhibitors (e.g.Sitagliptin, Alogliptin, Vildagliptin, Saxagliptin)

It can be used in addition to metformin, glitazone, or sulphonylurea, lowering the HbA1c by 0.5%.

Side effects are uncommon. As with some other oral blood glucose lowering drugs. It is weight neutral.

GLP-1 agonists (e.g. Exenatide, Liraglutide, Dulaglutide, Lixisenatide)

These are relatively new drugs. They are Glucagon-like peptide-1 (GLP-1 )analogues. GLP-1 is a naturally occurring peptide hormone, released from the gut after eating. GLP-1 stimulates insulin release, reduces glucagon release (this stops the liver making glucose), delays stomach emptying, and stops hunger feelings.

  • These medications have a double action: they aid glucose level reduction and weight loss.
  • They help you to reduce your appetite. You will notice that you are satisfied with a lot smaller portions and you are less hungry between the meals. It doesn’t cause hypoglycaemia (low blood glucose)
  • An average lower HbA1c reduction is 1%.
  • An average weight loss of about 7lb for each of the first 2 years.
  • Main side effect is nausea/sickness, but many patients prefer to stay on them as it helps to lose weight.

 

SGLT-2 inhibitors (e.g. Dapagliflozin, Emphagliflozin, Canagliflozin)

SGLT2 Inhibitors work in the following ways:

  • Reducing the amount of glucose being absorbed in the kidneys so that it is passed out in the urine.
  • Reducing the amount of glucose in your blood.

 

*ACE diets is not a replacement of the care you are currently receiving from your Doctor and your Diabetes Care Team, but a complimentary private service to enhance your existing knowledge of the condition and its management.

ARE YOU ON INSULIN THERAPY?

Insulin seems to make most people put weight on. Diet and exercise becomes even more important. Type 2 diabetes is partly caused by resistance or lack of responsiveness to insulin. This resistance mostly depends on the amount of your body fat. As your body weight and fat mass increases, the more insulin you need. On the other hand, the more body fat you lose, the less insulin resistance there is, and the less insulin you need (whether natural or injected), and the better the control of the diabetes.

At ACE Diets we can help you to lose weight and adjust your diet. We can guide you in your blood glucose monitoring and insulin adjustment. We will help you to keep motivated and together with you we will tailor the diet and lifestyle that suits you.

You might be prescribed one of the following insulin regimens:

Once daily long acting insulin Levemir (detemir) or Lantus (glargine).

When insulin is prescribed for the first time it is usually once- daily long acting insulin Levemir (detemir) or Lantus (glargine). You have probably titrated your dose of the insulin until fasting sugars are controlled.

Multiple dose insulin regimen (basal bolus): Long acting insulin Levemir or Lantus & quick-acting insulins Humalog (lispro) or Novorapid (aspart) or Apidra.

If the once daily injection didn’t achieve the target HbA1c and glucose levels, you might been prescribed multiple dose insulin (MDI, basal bolus regime, flexible insulin regime). The quick-acting insulins are used for meals, and are generally given just as you start (or occasionally during or immediately after) a meal/snack.

*ACE diets is not a replacement of the care you are currently receiving from your Doctor and your Diabetes Care Team, but a complimentary private service to enhance your existing knowledge of the condition and its management.


If you are living in Dorset or Hampshire around Poole, Bournemouth, Christchurch, Verwood, Ferndown, Dorchester, Ringwood, New Forest or Southampton, I would recommend to book face-to-face consultation. People who live further a field or just prefer to have consultation at the comfort of their home, can book a Skype, FaceTime or phone consultation.