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Question:

I have a great concern for my brother, who lives in a small town in New Mexico. He has been diagnosed with diabetes recently, and has lost considerable amount of weight and energy over the past year. His new doctor has put him on a low dosage pill and was given a blood monitor. He registers now at 300 mg/dl and the fatigue was so overwhelming that he had to go back to the doctor. The doctor doubled his dosage, and now his sugar level is 350 mg/dl and his legs are aching more.

I wonder since there is no diabetic diet involved, and my brother is afraid to eat anything with sugar, how long does it take to really see any progress? With his job, as a branch manager, who travels quite a bit with a dairy, he will have to get some kind of help.

The doctor didn't feel he had to worry about any kind of diet, but I have been reading up on diabetes, since he is 58 years old, and guess it is the diabetes that older people get, that a monitored diet is the most effective.

Is there any kind of help that you could advise??? He is still suffering from his feet hurting so bad and his legs aching, and the really tired feeling.

Answer:

For people with either Type 1 or with Type 2 diabetes, it is my very strong opinion that meal planning, preferably by a Registered Dietitian who also is a Certified Diabetes Educator, is paramount in obtaining improvement in control and symptoms. For example, if your brother were still drinking sugar soda pop, a simple switch to sugarfree soda pop would go a long way towards helping. There are many dietary concepts that would help him to control his blood sugar better, especially since he's traveling a lot, and it's unfortunate that his physician hasn't stressed the importance of meal planning.

Your brother could ask his physician for a referral (or perhaps call a hospital during one of his trips out-of-town, and ask to talk to the Coordinator of the Diabetes Education program) to arrange to see a dietitian.

Most diabetes pills should show a favorable effect on blood sugar control within a few days; the exceptions are metformin and acarbose, both of which are deliberately started at very low doses to avoid gastrointestinal upset.

WWQ

Additional Comments from Dr. Lebinger:

Most individuals 58 years of age develop non-insulin dependent diabetes which can often be treated with diet alone or a combination of diet and oral mediation (though sometimes insulin is necessary). Occasionally, however, people this age can develop insulin-dependent diabetes, which requires insulin in addition to diet to control the blood sugars. If your brother is losing weight without dieting, he might have insulin-dependent diabetes and need insulin. Ketones in the urine would be an strong indication that he needs insulin.

If your brother has not seen an endocrinologist, I suggest that he see one.

TGL

Original posting 24 Dec 96
Additional comments added 28 Dec 96

  
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Last Updated: Tuesday April 06, 2010 15:08:52
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