Diet and exercise play key roles in controlling diabetes

August 3, 2013 

James Lynch, M.D., FACP, Saint Joseph Primary Care Associates Tates Creek, part of KentuckyOne Health

Diabetes is a chronic condition in which blood sugar levels rise higher than normal. There are two types of diabetes, and each presents its own challenges. The most common form, type 2, represents over 90 percent of diagnosed patients and presents itself most frequently in overweight adults with a family history of diabetes.

In type 2 diabetics, the body's insulin can be ineffective. This malfunction initially causes the pancreas to create a surplus of insulin. Over time, the pancreas cannot make enough effective insulin to keep blood glucose levels normal.

Conversely, type 1 diabetes is typically diagnosed in children and young adults and occurs when the body does not produce a sufficient supply of insulin. Only 5 to 10 percent of diabetics are type 1.

Both type 1 and type 2 diabetes can have long-term health consequences. The good news is, diabetes — especially type 2 — is a disease that can be controlled by lifestyle modifications.

Diabetes is often managed using medications. However, one cannot depend solely on medications.

I recommend all of my patients attend a course on diabetes education. There, they will develop a more favorable diet for their individual condition and learn techniques such as calorie counting. While it is important to become well-educated when diagnosed, taking regular refresher courses keeps the patient proactive in dealing with the disease.

Additionally, patients who participate in diabetes education classes better manage their disease, reduce their use of medication and stay involved in their health management. This is achieved by enlisting the two most important tools for combating type 2 diabetes — diet and exercise.

The primary focus should be one's diet. Patients often eat minimally in an attempt to lower their blood sugar and lose weight. However, not eating can further exacerbate these already unregulated blood sugar levels. Patients should eat three meals and two to three snacks a day within the appropriate calorie range — focusing on a designated number of carbohydrates. Alcoholic beverages should also be minimized, as they contain many calories that are not counted.

In addition to diet, a regular exercise routine can help patients lose weight and decrease their insulin requirement.

Exercise routines do not have to be vigorous. Walking, swimming and cycling are great exercises that lower blood sugar and reduce insulin requirements.

It is vital that diabetics avoid smoking, as they are already at a higher risk for heart attack and stroke. Smoking can increase that risk and compound their disease.

As a final thought, it is important to note that there are some patients who will struggle to control their disease despite a diet and exercise modification. Those patients will require more medication therapy. While a negative connotation is often associated with the use of insulin injections, injections can be a helpful tool to manage diabetes. Some patients with type 2 diabetes believe that insulin injections are a lifelong commitment, but that is not necessarily true. Disease management can reduce the need for insulin injections.

Without proper management, diabetes can accelerate an individual's risk of heart disease, stroke, kidney disease, vascular disease and more. While some conditions cannot be controlled, diabetes fits a different mold. With the appropriate diet, exercise and medication, diabetes can be effectively managed. Patients should work toward being more dependent on their own behavior and habits to regulate their disease and control concomitant risks including: high blood pressure, smoking, obesity and elevated triglycerides/cholesterol.

James Lynch, M.D., FACP, is with Saint Joseph Primary Care Associates Tates Creek, part of KentuckyOne Health.

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