How Do You Control Diabetes?

My husband’s doctor just told him that his blood sugar level was so high that he’s diabetic. However, the doctor doesn’t seem too concerned. He gave my husband information on the phone, hasn’t recommended dietary changes other than to lose weight, and told him not to go outside barefoot. Other than cutting out sugar and alcohol, are there any immediate changes he should make?

Without knowing more about your husband, it’s hard for me to be real specific, but you and he should be aware of some general points about Type II, or non-insulin dependent diabetes mellitus (also known as NIDDM).

First, all diabetes, even mild cases, should be taken seriously and followed carefully by a physician. It has been clearly shown in recent years that careful or tight control of the diabetes delays or may even prevent the development of the severe side effects that can be so devastating. These include heart disease, kidney failure, and the eye problems that make diabetes the leading cause of blindness in this country.

I gather your husband is overweight, a very common finding in NIDDM. Losing weight would almost certainly help control his diabetes, and might even make him non-diabetic. I have had several patients who were able to lose substantial amounts of weight and became non-diabetic, by all the usual measures we use. Weight loss is notoriously difficult, however, so I think your husband needs specific help with a diet designed to produce slow weight loss, and simultaneously minimize the severity of the diabetes. You need to be involved and helpful, since I assume you eat most meals together.

A gently graduated exercise program, involving aerobic exercise, not weight lifting, will help with the weight loss. Exercise also helps to directly reduce the blood sugar.

Finally there is a blood test, called HgbA1C, or glycohemoglobin, or glycosolated hemoglobin, which provides a much better measure of diabetic control over the long term than does the blood sugar measurement, (although they tend to go hand in hand). If your husband’s doctor has not suggested frequent blood-sugar measurements at home, you might want to ask about the HgbA1C test. This might indicate that therapy with one of the many oral medications for NIDDM would be indicated.

We used to say that if humans had to pick or hunt everything they ate – as our ancestors did — no one would have NIDDM. Your husband needs to try to duplicate that state in our modern world by reducing his food intake and increasing his aerobic exercise.

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