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February 7, 2003

Diagnosis and Symptoms

Question from Sinking Spring, Pennsylvania, USA:

I am 47 years old, about 5 feet 6 inches tall and weigh 237 pounds, and I see the doctor for a variety of ailments (high cholesterol, hypertension, gastric reflux, six protruding disks, tendonitis, arthritis, neurogenic bladder, anxiety/panic attacks and depression). My blood sugars are always in bold with "High" written next to them, and the doctor just tells me I need to lose weight. Exercise is not an option as even a short walk results in pain and numbness in my leg. I drink regular sweetened iced tea and Coca Cola, and my starch intake is moderate. What kind of diet should I follow to lose the weight? My last fasting blood sugar was 149 mg/dl [8.3 mmol/L]. Do I have diabetes? When I try to get off the sugared drinks and diet I shake, heart pounds, I get nervous and sweaty and I have severe mood swings.

Answer:

I would recommend that you first try to eliminate (or reduce) the amount of regular soda and sweetened tea. A lot of people don’t realize how much sugar/carbohydrate is in regular soda — 15 teaspoons of sugar per 20 ounce soda. Next, I would recommend that you schedule an appointment with a registered dietitian who specializes in diabetes meal planning. He/she can individualize a meal plan that meets your caloric requirements (for weight loss), which in turn may decrease your insulin resistance and improve your sugars. If you have questions regarding your diagnosis of diabetes, please consult with your physician. There are specific guidelines for diagnosing diabetes.

JMS

[Editor’s comment: If the fasting blood sugar was done in a lab, then you appear to have diabetes — see Classification and Diagnosis of Diabetes Guidelines. If your physician isn’t willing to discuss this diagnosis with you, and the implications or having diabetes, you should ask for a referral to a diabetes team.

SS]