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September 5, 2006

Hyperglycemia and DKA, Weight and Weight Loss

Question from Peoria, Arizona, USA:

I am 6 feet tall, 340 pounds with bad knees. I work out four or five days a week on a treadmill for 20 minutes, then about 90 minutes of weights and 20 minutes on a bicycle. I know I am not pushing my self hard on the aerobic part, but I am doing 1.7 miles per hour on the treadmill and a lot faster on the bike. My heart rate is about 107 to 115. I am doing what my knees can take. They are getting stronger. I have a 57 inch chest, 21 inch biceps, and a 60 inch waist. On weights, I do five sets of everything from arms to legs. I cannot lose weight and people say it is because I am a diabetic and, of course, my favorite muscle is heavier than fat. I try to eat right and not a lot. I eat pork, chicken, and vegetables. If I start using whey products and workout supplements, will that help me or make things worse? I know I have to watch my sugar all the time and. In the morning, before breakfast, it averages 135 to 150 mg/dl [7.5 to 8.3 mmol/L]. At 2:30 p.m., my blood sugar ranges from 98 to 115 mg/dl [5.4 to 6.4 mmol/L]. At 9 p.m., it ranges from 70 to 95 mg/dl [3.9 to 5.3 mmol/L]. My body produces sugar while I am asleep. Right after a workout, my blood sugar. is usually over 200 mg/dl [11.1 mmol/L], but the doctor says that is to be expected. Is this correct?

Answer:

You have several questions. First, you ask about the use of protein and whey supplements. At this point, I believe you need additional consultation from physicians who know you best. You have multiple reasons to lose more than just trivial amounts of weight. I do not think that these nutritional changes will be enough to allow you to lose the amount of weight you want. You need a comprehensive review of your diet, your cardiac status, and a detailed discussion of the therapies that have been studied. Your body mass index, an index of how much fat tissue your body contains, is high and has negative impact on your exercise performance, cardiac status, and your diabetes. The whole spectrum of therapies need to be discussed. These include the choices of diet, exercise, medications, and bariatric surgery. You may be doing a good job with your exercise, however, I believe it needs to be quantitated more completely to get an idea of how much this impacts your status. Your situation is too complicated to use anecdotal treatments. As far as your blood sugars following exercise, it should be noted that exercise can temporarily increase blood sugars. However, within minutes to hours, blood sugars should fall as a reflection of the use of sugar stores within muscle that need to be replenished. Please note that your overall blood sugar needs to be evaluated with a test called a Hemoglobin A1c. This gives you an average blood sugar with one test result that reflects the previous three months.

JTL