Diet, exercise are cornerstones of managing diabetes

Dia­betes can be a daunt­ing diag­no­sis, but proper man­age­ment of blood sugar lev­els help patients live long, pro­duc­tive lives with min­i­mal com­pli­ca­tions, espe­cially if we catch it early.

Peo­ple with dia­betes have too much glu­cose, often called blood sugar, which can lead to prob­lems such as heart dis­ease and stroke, high blood pres­sure, blind­ness, nerve and kid­ney dam­age and ampu­ta­tions. Early detec­tion and treat­ment can pre­vent organ dam­age and reduce the risk of these complications.

In Type 1 dia­betes, the body does not pro­duce insulin, the hor­mone needed to con­vert blood sugar into energy. In Type 2, the body does not prop­erly use insulin, lead­ing to the build-up of glu­cose in the blood. Type 2 dia­betes accounts for 95 per­cent of cases.

Type 2 is almost always pre­ceded by “pre-diabetes,” in which blood glu­cose lev­els are higher than nor­mal, but not high enough to be dia­betes. In this early stage we can begin pre­ven­ta­tive treat­ment to hold blood sugar lev­els at or near normal.

Dia­betes symp­toms may include fre­quent uri­na­tion, exces­sive thirst, unusual weight loss and fatigue, but many peo­ple with Type 2 dia­betes have no symp­toms. Fam­ily his­tory, obe­sity and inac­tiv­ity are among Type 2 risk fac­tors. Blood tests that mea­sure your glu­cose level help us make a diagnosis.

Once we make the diag­no­sis, our goal is to con­trol your blood sugar level. Diet and exer­cise are cor­ner­stones of control.

Diet should fol­low Amer­i­can Dia­betes Asso­ci­a­tion guide­lines. Gen­er­ally speak­ing, it includes a vari­ety of healthy choices — veg­eta­bles, whole grains, fruits, non-fat dairy, beans, lean meats and poul­try — in mod­er­ate amounts. Your physi­cian may refer you to a dietit­ian to help you learn how to eat correctly.

Reg­u­lar exer­cise helps con­trol weight, low­ers blood sugar and mit­i­gates the risk of com­pli­ca­tion such as heart dis­ease, the inci­dence of which is four times greater among peo­ple with dia­betes. Just 30 min­utes a day of bik­ing, brisk walk­ing or even tread­ing water in the pool has myr­iad ben­e­fits. Reg­u­lar phys­i­cal activ­ity helps everyone.

When diet and exer­cise are not enough, we may need med­ica­tion to achieve blood sugar goals. Many peo­ple may require only an oral med­ica­tion for treat­ment. We have a vari­ety from which to choose. Patients with a Type 2 diag­no­sis don’t always have to imme­di­ately add insulin. The need for med­ica­tion depends on where we find patients in the dis­ease process and the effect diet and exer­cise is having.

Most peo­ple with Type 2 dia­betes need to mon­i­tor their blood sugar at home at dif­fer­ent peri­ods, typ­i­cally when they wake in the morn­ing and after they eat their largest meal. Some patients may have to mon­i­tor more often. Like many prac­tices, our office offers the equip­ment and train­ing to help you learn how to do this. Track­ing your blood sugar response to food can help teach you what to eat.

A physi­cian with exper­tise in dia­betes man­age­ment can deter­mine the sever­ity of your con­di­tion and out­line inter­ven­tions. Cer­ti­fied dia­betes edu­ca­tors, classes and sup­port groups can help you learn about man­age­ment and cope with its incon­ve­nience. Most physi­cians have refer­rals to edu­ca­tional pro­fes­sion­als and sup­port groups.

Finally, good man­age­ment requires a close work­ing rela­tion­ship with your physi­cian, who may want to see you every cou­ple of weeks at first to eval­u­ate your progress and find the right pro­ce­dures to follow.

Learn­ing to man­age dia­betes is a life­long com­mit­ment, but most peo­ple are able to become pro­fi­cient in their home care, fit it into their lifestyle and lead nor­mal lives.

Dr. Robert Gnade is a fam­ily physi­cian and active mem­ber of the Grady Memo­r­ial Hos­pi­tal med­ical staff.

Posted by Grady Memorial Hospital on Aug 2 2012. You can follow any responses to this entry through the RSS Feed. Comments can be made below.