As an M.D., I’m required to complete continuing education classes to keep my license. The idea is to keep us docs up-to-date with current medical procedures. I’m a bit of a research junkie, so I usually exceed the recommended hours in no time.

Well, last week I took a quiz in the clinical journal American Family Physician. This journal is kind of like the Ford Taurus of medical journals. It‘s true mainstream medicine.

Nevertheless, I need to subscribe to it. And taking their darned quiz earned me a couple of continuing ed hours. The questions are based on articles published in the journal. This month’s quiz covered all the general topics, such as splints and casts as well as heart disease and diabetes.

Testing bias hiding on every page?

The quiz was going along smoothly enough. I was feeling pretty confident in my “Ford Taurus” medical knowledge, I have to say. But then I got to question #4 and hit a road block. The question was about diabetes. Of course, diabetes has been on my mind a lot lately.

In last week’s Guide to Good Health, we looked at a new study showing that people with the highest intake of vitamin D and calcium have a 64 percent lower prevalence of ever getting the disease. Here’s the link: if you want a refresher.

In any case, the question asked, “Which one of the following medications has been shown to reduce mortality rates in patients with type 2 diabetes?”

a. Sitagliptin (Januvia)
b. Rosiglitazone (Avandia)
c. Exenatide
d. Metformin (Glucophage)

Getting answers from mainstream medicine

Any guesses which drug is the “correct” answer? Oh, pardon me. I mean which drug is the “correct” answer according to the good folks at American Family Physician?

I’ll tell you that in a moment. But first, let me point out what had me scratching my head.

You see, in my opinion, there is no right answer when the question is all wrong! The real way to reduce mortality rates in diabetics is to cure the disease, not control the symptoms with a drug.

It’s a bum question. One that makes the American Family Physician’s apparent bias toward drug solutions stick out like a sore thumb.

Well, should I have been surprised? This “scholarly” medical journal is filled cover to cover with ads for drugs. Of course their question only offers four drug answers.

Trading one problem for another

The all-mighty quiz writers tell us the correct answer is “D: Glucophage (or Metformin).
This wildly popular drug is often used as a first-line of defense for people with pre-diabetes or for people with mild diabetes. And yes—it will modestly bring your blood sugar under control. But it’s not without its downfalls.

In one clinical trial over 50 percent of the patients who took Metformin reported diarrhea as a side effect. And more than 25 percent reported nausea and/or vomiting in the same trial. Lastly, long-term use has been linked to increased homocysteine levels and malabsorption of vitamin B12.

No biggie, right?

Wrong. High homocysteine is not a small problem.

High homocysteine has been associated with increased risk of cardiovascular disease. So basically you‘re just trading one problem for another. Yes, Glucophage may help control your blood sugar. But at what cost?

The solution that works

Here’s some good news, folks. You can conquer diabetes. There are non-drug options that work.

A recent study out of Duke University examined the effects of a low-carb diet on blood sugar in diabetics. They found that 95 percent of patients who followed a low-carb diet either reduced their need for insulin or discontinued it all together after 24 weeks.

This means you’ll need to cut out all the sugar and simple carbohydrates (such as white bread, white rice, even most pasta and crackers) in your diet. Complex carbs may be okay if you’ve got pre-diabetes. But only in moderation.

Complex carbs take longer to digest and will help keep your blood sugar under control. These include whole grain/whole wheat bread, dehulled barley, millet, brown rice, quinoa, and oats. Pasta is okay as long as you go with spinach, artichoke, whole wheat, or brown rice varieties. (Make sure it’s 100% whole wheat or brown rice. Sometimes, the packaging can be confusing.)

Also, I’d try adding chromium, vanadium, B-complex and vitamin C to your daily regimen if you’ve already got type 2 diabetes or think you’re at risk for developing it.