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October 19, 1999

Medications: Pills for Diabetes, Type 2

Question from Illinois, USA:

I weigh 260 and was diagnosed several months ago with Type�2. I am on Amaryl [a sulfonylurea pill for Type�2 diabetes] for the diabetes, and Maxzide which I am told that can raise the number in the morning. I can't seem to stick to the diet. If I could diet, I would not weigh this much. What do I do? I am so depressed over this thing. Please let me know how many carb grams are allowed. I get 7 during the day but I don't know how many grams that comes to. Thank you for taking this under advisement.

Answer:

I can hear the frustration in your note. You have asked good questions and deserve to know all you can about the management of your diabetes. My first advice would be to find a diabetes educator in your area to work through these concerns and the ongoing management of your diabetes. There are several in your state and you can find them by calling your local American Diabetes Association or calling the American Association of Diabetes Educators (1-800-TEAM UP 4) for someone in your area.

Regarding your question about carbohydrates: Carbohydrate awareness and counting is a very popular approach to food management and diabetes. In a basic 1500 calorie diet, a person would have 13 carbohydrate servings to “spend” per day. We usually advise people to split this into 3 meals, making each meal about 60 grams of carbohydrate (or 4 carb servings). Since this isn’t a lot of food, fill in with lots of green leafy veggies and a small portion of protein. By testing your blood sugar after you eat, you will be able to judge how well that amount of carbohydrate works for you and if your medicine if able to help you keep your blood sugar below 180 after eating.

Regarding your medicines: There are other diabetes medicines that are widely used throughout the world for treating Type 2 diabetes such as yours, including Glucophage and Rezulin. I would suggest you discuss these other medications with your physician and see if they would be a welcome addition to your current medicines. I would also suggest you discuss the use of an ACE inhibitor for the treatment of your blood pressure as this can help protect your kidneys from diabetes complications. The ADA recommends blood pressure be treated to reach 130/85 or below for people with diabetes.

Remember, keeping your blood sugar, blood fats and blood pressure within goal ranges is your best defense against problems down the road.

KS