Exercise : Best medicine for diabetics

How much exercise do diabetics need? Most guidelines recommend 300 minutes of exercise per week, which works out to around 45 minutes per day. Physical activity can be anything brisk, including walking, swimming, cycling or dancing. It also need not be at a stretch, but can be broken down into two segments in the day.

What medical consultations should I undergo? After diabetes is diagnosed or if you develop symptoms of diabetes, a referral should be obtained with an endocrinologist who is the specialist for management of diabetes and hormone disorders. Based on other symptoms and complications, you might also be referred to an eye specialist, a surgeon � if you have a non-healing ulcer, cardiologist, nephrologist or other specialist as required. You also need to follow-up with endocrinologist every three months with HbA1C and self-monitored blood glucose record every three months or even more frequently, if blood sugars are high. Blood pressure should also be checked and controlled regularly and also cholesterol and lipid levels should be controlled.

What other tests should be done? You may also need to get evaluated for kidney and liver functions, get your lipid, urine and hemoglobin and blood cell examination done, get your eyes checked for health of retina and get an ECG done. Other tests can be recommended based on your complication status. These tests need to be repeated annually.

What medications will I be prescribed? Depending on your age, blood glucose levels and other complication status, you might be prescribed diabetic drugs which (i) stimulate your pancreas to secrete more insulin (ii) ensure that your natural insulin acts more effectively (iii) slow down the absorption of glucose from food after a meal (iv) increase your satiety and reduce appetite. You can also be prescribed insulin.

I have been diagnosed with type 2 diabetes only recently and my doctor is asking me to use insulin. Is he correct? Recent research indicates that if insulin is used for a few months at the time of diagnosis, it can be subsequently stopped and the person with diabetes can be maintained with a small dose of medication, because this early insulin therapy helps the pancreas to recover and produce more natural insulin.

How do I monitor my diabetes? Usually by HbA1C levels and self monitoring of blood glucose (SMBG). HbA1C level is a measure of your blood sugar over time and this important test is done once every 3 months. The American Diabetes Association recommends an A1C level under 7%. If HbA1C is too high, changes in your diet, your exercise program, or your medicine maybe advised. Blood glucose can be self-monitored at home, as per the schedule advised by your doctor, a record maintained and shown to your doctor at every visit. It helps to keep a track of fluctuations in your blood glucose levels and can help to guide treatment. MD, DM Endocrinology

(The doctor is Consultant Endocrinologist at Ozone Hospitals, Kothapet, Hyderabad; Ph: 988564 6917)