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Newly diagnosed Type 2 Diabetes

 drkesari_at_work
Dr. Rajesh Kesari ( Diabetes Specialist)

Question:.I just feel horrible after being diagnosed as a diabetic, I feel as if life has to an end.

Answer: No this is not the end of the life, is is just the beginning of a new chapter in life. Calm down relaxDiabetes is not as bad as it it may seem at the first glance. Infact as long as you can control your sugar and Lipid levels, you may have a perfectly normal life.

Question:.Now that I know I am a Diabetic- from where do I start, whats the first thing I should do?

Answer:  First of all you have to understand what is Diabetes. Its a condition in the body caused by relative or absolute deficiency of the hormone Insulin, which results in raised fasting and post prandial ( After meals) blood glucose levels. High blood sugar is just one part of the story  there are many aspects of Diabetes and all are equally important. But one thing we have to make sure is control Blood sugar rigorously  keep fasting Blood glucose levels below 125 mg/dl and A1C levels below 7%.

Question:. Is it true that I have to stop taking sugar and switch over to only boiled vegetables?

Answer:  There are some things which are best to be avoided-

The food we eat can basically be divided into its basic components - carbohydrates (glucose ), fats, proteins, minerals and water. Glucose, table sugar ( sucrose), starch (corn flour) are all examples of carbohydrates. Foods may contain fats even without adding butter or oil ( invisible fat)- and some of them contain a lot of it, such foods should be avoided.

Question:. Has my weight something to do with my Blood sugar?

Answer:  If you are overweight, check your BMI. Decreasing weight would be very helpful- it would decrease blood glucose levels, decrease blood pressure, decrease total cholesterol and increase High density Cholesterol ( HDL-Good cholesterol).

Increased body weight can be caused by deposition of excessive fat in the body, even though there can be many reasons for this  like excess intake of food (fats and carbohydrates)coupled with decreased physical work, or hypothyroidism ; in diabetics this could be the sign of a condition called insulin resistance. In which insulin loses its effectiveness in controlling blood glucose levels- hence more and more of it is required to decrease the blood glucose levels after food intake, or to suppress the glucose released by liver during periods of fasting.

Theres an interesting fact about glucose and fat utilization by insulin- the more free fatty acids are present in blood the lesser would be the capability of insulin in controlling blood glucose levels, and the higher the blood glucose levels the lesser the capability of insulin to control free fatty acid levels in blood. This gives rise to a vicious cycle in which high fatty acid levels cause a further raise in glucose levels and vice versa.

Decrease in body weight as a result f reduced body fat increases insulin sensitivity- that is the effectiveness of insulin in decreasing levels of blood glucose. The same amount of insulin may  become capable of mobilizing more glucose into the cells.

Question:. Is it really necessary to do exercises as advised by my doc, isnt it possible to just add some pills in lieu for that?

Answer:  Exercise itself is a medicine, infact more effective than many tablets or injections. Exercise has manifold effects on our body- specially that of a Diabetic.  Exercise increases insulin sensitivity-lowers blood glucose, while exercising we burn calories, use excess fat and reduce weight, exercise helps in increasing good cholesterol (HDL), decreases Total cholesterol and triglycerides. Exercise improves blood flow to heart, nerves and muscles stops or decreases complications of Diabetes. But its important to know how and which exercise to do as well.

Question:. Frankly I dont feel any thing, I dont have any symptoms as such, my blood sugar was detected in a routine check-up, do I still need to be treated?

Answer:  If youve been Diagnosed as a Diabetic by your doctor and prescribed treatment, you should follow that. The reason is that Diabetes is a truly silent killer. Usually patients do not have any symptoms of Diabetes- and even those which occur are not very specific for Diabetes. By the time perceivable symptoms occur  its to late to effectively treat the damage, infact some of the complications may even mask the intolerable chest pain of a heart attack- this is why Diabetics suffer from so called silent heart attacks. Complications of Diabetes do not happen overnight- they happen over a long period of time, so its impertinent that you keep your blood glucose levels controlled at all times.

Question:.How often should I check my Blood glucose, and is it necessary to use the glucometer or I should onl;y rely on the Lab reports?

Answer: Initially blood glucose may need to be checked more often, say once in two weeks or once a month. but once your Blood glucose levels are controlled, once in every three months should suffice. Glucometer can be very helpful in deciding which foods cause a steep rise in your glucose levels and which others are being tolerated, this could serve as a good guide in choosing your diet. try checking your BG while fasting and 2 hrs after major meals. The fasting values should not exceed 125 and Post meal should preferably be below 200. There are some other Blood and other tests which need to be done periodically for all Diabetics. Blood glucose values given by glucometer are reliable for monitoring, they could be anywhere from actual to plus 20 or 30, for definitive diagnosis Lab values are more useful.