At our clinic, we mainly provide complex care for type 2 diabetes patients. An essential part of diabetes care, as with the management of obesity, is a good lifestyle, which includes healthy eating guidelines and an emphasis on active leisure time exercise. A healthy lifestyle also helps to reduce body weight, and the indirect calorimetry available in our clinic can provide important information for this.

Type 2 diabetes develops mainly as a consequence of an unhealthy lifestyle, usually due to insulin resistance associated with obesity.

In addition to the choice of personalised drug therapy, modern diabetes care involves the combined management of other co-morbidities, mainly cardiovascular and renal.

A good long-term metabolic status helps to prevent both the so-called minor complications specific to diabetes (eye, kidney, nervous system) and the major complications (coronary artery disease, stroke or lower limb artery stenosis).

In order to achieve adequate blood glucose levels in the long term, we place great emphasis on continuous glucose sensor readings when designing a personalised drug therapy. These are part of the daily care at the MIND clinic.

It is now clear to us, based on the results of several international studies, that the progression of type 2 diabetes can be reversedand even normal glucose metabolism can be restored if weight is effectively reduced. As the success of this process depends on a number of factors, we will consult you in a personal consultation to assess the likelihood of achieving this in your case.

Sometimes, particularly in the case of long-standing diabetes, we can simplify the complex treatment regimen used, for example by switching back from multiple daily insulin therapy to once-daily or once-weekly injections of blood glucose-lowering medication. In this case, too, we need to consider several factors to assess the chances of success.

We also care for adult type 1 diabetics who are not on insulin pumps.

It is important to know that the disease can be prevented and even reversed!

The energy balance of our body is determined by the following parameters:

1. Basal metabolic rate: the amount of energy needed to keep the body functioning at a basic level (without physical activity) - the basic minimum needed to maintain vital functions when we do not do any activity for 24 hours, i.e. lie down, do not move, do not eat

1. Total metabolism: the amount of energy needed for basic metabolism plus the energy needed to carry out our daily routine tasks (there can of course be huge variations between individuals). It also includes the amount of energy needed to digest and process the food we eat

Both basal metabolism and total metabolic rate vary widely and are highly individual. When we want to lose excess weight, one of the most important pieces of information is to know and assess our individual body's basal metabolic rate.

Knowing this, it is possible to make appropriate changes to our daily calorie intake in order to lose weight and ensure that the weight loss that has started does not stop prematurely before we have reached our target weight.

The most reliable way to measure our basal metabolic rate is currently indirect calorimetry, which accurately calculates and quantifies the amount of oxygen we inhale and carbon dioxide we exhale. InBody body composition monitors also give you a basal metabolic rate, but they calculate it according to a formula from your fat-free body weight as determined by the machine. This may be realistic for the average individual, but for overweight people it is often misleading, under- or over-calculated.

If we can accurately determine our basal metabolic rate with indirect calorimetry, we can more effectively change our diet or the intensity and frequency of our physical activity to achieve the desired result (weight loss in the case of overweight).

Indirect calorimetry also provides other important information. We can also tell, from the so-called respiratory quotient, to what extent our body relies on burning sugars or fats when it needs energy.

The latter is extremely important if you want to lose weight, for example. In cases where, even with intensive lifestyle changes, there is no change or very slow weight loss, the respiratory quotient can help us to identify the cause of this dominant sugar burning. In this case, with the help of a dietician, we need to change our diet so that our body focuses on burning fats instead of sugars.

At the moment, indirect calorimetry is the only tool that can help us do this and give us real information about our metabolism.

HOW IS THE TEST DONE?

The test, which is carried out using the state-of-the-art COSMED Q-NRG machine, developed and market-leading in Europe, takes 10-12 minutes in total. It requires minimal intervention and is not at all stressful for the participant.

There are two options: lying down, in complete relaxation, breathing in and out for about 10 minutes under a transparent plastic dome, which provides the most accurate data. Testing through a mouthpiece (roughly like a snorkel or the part of a diver's snorkel that fits in the mouth) also gives accurate data, and is best recommended if someone is uncomfortable with testing under a dome.