September 24, 2002
Daily Care
Question from San Diego, California, USA:
I’m 30 years old, weigh 195 pounds, and eight weeks ago I was diagnosed with type 2 diabetes. I have been exercising really hard (twice a day — a half hour after lunch and an hour before dinner) and eating a very low carb/low sugar diet. In the last six weeks, I have lost 12 pounds and my blood sugar readings are 100-150 mg/dl [5.6-8.3mmol/L], so I know I am making progress. My ultimate goal is to lose the weight, make the changes to my diet, and hopefully stay off of medication for the rest of my life. Given my age and a lot of motivation to adhere to a strict diet and exercise regimen, these are my questions:
Will I at some point start to need medication?
Will my pancreas stop producing insulin (progressive deterioration?)
Will losing another 25 pounds bring my fasting blood sugar down?
Are there any dietary recommendations you can make so that I can control my fasting blood sugar?
I sometimes see an aberration in my readings (quite high) on the days when I have a cold or battling a viral infection of some sort. Is this normal?
Do over the counter medications like Tylenol significantly affect my blood sugar levels?
Answer:
You certainly do have a lot of questions and that makes me wonder why you don’t go see a diabetes educator to learn more about diabetes and how to control it. The sooner type�2 diabetes is diagnosed, the greater the chances it can be controlled initially through diet and exercise, but over time, you can expect to take medication, first by mouth and later on, insulin injections. This is because type 2 diabetes is a chronic and progressive illness and eventually you will have less and less beta cells to make insulin. Your fasting blood sugars are too high and that concerns me because it increases your risk of complications. You may need medication now to help you bring it down while you continue to lose weight. The high blood sugars when you are sick with a viral infection are expected and temporary.
I suggest you go back to your endocrinologist to talk about ways to lower your morning blood sugars and ask for a referral to a diabetes educator and/or dietitian to discuss meal planning in detail.
JS