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How to keep diabetes under control?

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Practicing since : 2004
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I'm a 54-year-old female with hypothyroidism, type II diabetes, hypertension and obesity (5'4" and 257 lbs.) I have a demanding career with very irregular hours and meal times. I'm not really doing anything to control my diabetes except take my meds (Januvia and Metformin). I'm starting to have tingly toes and nighttime foot pain. Am I doomed or is it worth it to start taking better care of myself at this late stage. Diabetes was diagnosed in 1999. I've been on Synthroid since mid-90s. My mother was far more obese than I am and died of a blood clot at age 44 following intestinal bypass surgery. I don't know if it's psychological, but unlike most people, I do not feel good after exercise and never have. When I have dieted/exercised and lost weight, I get angry and ashamed when people start to notice and just stop. I was once in a study of the effects of exercise on diabetes and lost 27 lbs quite easily but I did not feel good about it all. I didn't regain all the weight though. Is it a psychiatrist that I need?
Posted Fri, 28 Feb 2014 in Diabetes
Answered by Dr. Saumya Mittal 1 hour later
Brief Answer: explained Detailed Answer: Hi XXXXXXX welcome to our site. I am Dr Saumya Mittal. Read your query. That is a very significant question and i appreciate your problem. I will try my best to answer your query From your query I understand that you have diabetes, possibly uncontrolled sugars, with hypothyroidism mostly controlled. First and foremost it is never too late to control sugars properly. The high sugars are supposed to be bad for all the cells in the body. They affect all the cells- neurons included. When the neurons are affected, the condition called diabetic neuropathy may develop. The problems are similar to you, like tingling, numbness etc. The best thing for control of diabetic neuropathy are control of high sugars. There are also other medicines like methylcobal, pregabalin and gabapentin that may be used for neuropathy. Despite all measures, control of sugars remains the best treatment for the problem. I would also suggest checking if the thyroid is well controlled. Because even uncontrolled thyroid can cause similar symptoms. Now for the fact about exercise and loosing weight- I don't think you should worry too much about what people think. The fact remains that the best control about sugars is from medicines like insulin and tablets (which you are taking), diet control, moderate physical exercises and loss of weight. So if people stare at you when you loose weight, let them stare. I t would be appreciative looks. And besides people will get used to your new looks sooner or later. Also, the condition your mother faced puts you at a higher risk of complications. So you should take better care of yourself. Besides, I feel that if it helps your health, people be damned. I wonder what is the current status of your sugars and thyroids, and will hope you will let me know these in your followup response. I hope this helps you. Inform the reports mentioned above so i can be of help further. Best of luck. I have given you the answer to the maximum considering the information provided. The results of the tests could further enhance my answer to you. Please do understand that some details could be extracted from a detailed history and examination. Looking forward to your return query with the details asked so that I can help you further. (If the answer has helped you, please indicate this) Dr Saumya Mittal MD Physician and Diabetician
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