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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Can Diabetes Be Managed Only By Diet Control And Exercise?

I`m 51 years old and quite fit. On my 50th birthday I was diagnosed with type 2 diabetes. At my doctor`s request; I started with 3 metformin tablets a day; one per meal. When I returned from my trip to Europe and having taken my metformin; we did an A1C test. I was at 16!!!! even with the metformin. Now granted I drank and ate to my hearts content but I had never been that high...I was pre-diabetic for a number of years before that. Then I decided to go vegetarian for the summer, finish my meds and increase my gym attendance...I went down to an A1C level of 7.3!!!! My question...can one not manage their diabetes through diet and exercise alone? I admit my last result was 8.4...but I realise that food abuse was to blame. My numbers during the day are fine but it`s in the morning that I`m often between 8 and 10.0....dawn phenomenon ...I`m really opposed to going back to metformin but my doctor insists upon it. And btw...I have no symptoms whatsover and feel great! In fact I`m healthier than I was in my 20s...My last physical showed straight A`s ....except of course my A1C reading...so what do you think Doc?
Fri, 30 May 2014
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Diabetologist 's  Response
Hi, I had gone through your query and understood your concerns.

In Diabetes, when diagnosed newly, first diet and exercise is tried for 2-3 months.
If that doesn't help in controlling, then medications with anti diabetic drugs like in your case is prescribed depending on the sugar levels. Once a particular dose is set to control your sugar levels, then that particular dose is continued until sugar levels are controlled.

When initially started, after week or two when the sugar levels are controlled, you can take treating doctors advice and stop or reduce dose and see. If the sugar levels again bounce back as in your case, then no option, you need to continue the medication. Now you check the sugar levels and consulting treating doctor you can decide the dose.

In long standing diabetes, Diet and exercise will supplement but doesn't replace the medication in controlling diabetes

The food and life style changes to follow are:

Small and frequent rather than heavy meals at a time.
High fibre diet, green leafy vegetables, fruit.
Cut down the processed food. White bread, doughnuts, white sugar, pizza should be completely avoided.
A 40 minute physical activity every day like morning walk, evening walk or a visit to the gym or swimming pool.


Hope this guides you. For any other queries you can write to us. we will be happy to help you. Thank you.
Dr Phanindra Dulipala
Diabetologist.
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Can Diabetes Be Managed Only By Diet Control And Exercise?

Hi, I had gone through your query and understood your concerns. In Diabetes, when diagnosed newly, first diet and exercise is tried for 2-3 months. If that doesn t help in controlling, then medications with anti diabetic drugs like in your case is prescribed depending on the sugar levels. Once a particular dose is set to control your sugar levels, then that particular dose is continued until sugar levels are controlled. When initially started, after week or two when the sugar levels are controlled, you can take treating doctors advice and stop or reduce dose and see. If the sugar levels again bounce back as in your case, then no option, you need to continue the medication. Now you check the sugar levels and consulting treating doctor you can decide the dose. In long standing diabetes, Diet and exercise will supplement but doesn t replace the medication in controlling diabetes The food and life style changes to follow are: Small and frequent rather than heavy meals at a time. High fibre diet, green leafy vegetables, fruit. Cut down the processed food. White bread, doughnuts, white sugar, pizza should be completely avoided. A 40 minute physical activity every day like morning walk, evening walk or a visit to the gym or swimming pool. Hope this guides you. For any other queries you can write to us. we will be happy to help you. Thank you. Dr Phanindra Dulipala Diabetologist.