than 13 million Americans suffer from diabetes. Around 700,000 of them
have insulin-dependent diabetes, the rest have non-insulin-dependent
diabetes. According to estimates by the American Diabetic Association,
6 million residents of this country who have non-insulin-dependent diabetes
do not know that they have the disease. As a rule, these are people
beyond age 40 who are overweight and, unfortunately, have the gene for
diabetes. Up to a certain point in life, a person with diabetes is almost
completely unaware of it. He/She is active, with no problems working.
But then, however, an at first inexplicable weakness suddenly appears
along with fatigue, excessive thirst, weight loss or gain, frequent
urination, constant feelings of hunger, irritability, nausea, bladder
infections or bruises or wounds to the skin or gums that appear from
time to time and take a long time to heal. Other symptoms of diabetes
may be excessive sleepiness, darkened vision, constant itching, a ringing
in the ears or a loss of feeling in the hands or feet. The cunning of
diabetes is in this latent period, is that the symptoms are not apparent.
A woman who has diabetes during her pregnancy may give birth to an underweight
baby, and men sometimes lose their sexual potency. This disease has
no equals (with the exception of AIDS) when it comes to its underhandedness
and destructive effects. Diabetes is difficult to manage. It is for
good reason that doctors call it "crazy diabetes" - this definition
best characterizes the disease. Many suppose that any doctor is qualified
to diagnose the extent of the illness and to prescribe the type of medication
required, whether insulin or pills. After all, a blood test should suffice.
But is that really the case? In fact, the methodology for treating insulin-dependent
diabetes significantly varies from the treatment for non-insulin-dependent
diabetes. There are many cases where it is not necessary right away
to prescribe injections or pills, even if blood sugar levels are higher
than normal. Indeed, it is possible to reach a level that corresponds
to the norm or is at least close to it with the help of a precise balance
between the content, the quality and the volume of food, exercise and
medication. In other words, it is possible to prevent increased blood
sugar or its excessive reduction by precisely observing a balance between
diet (what and how you eat), exercise (how much you train) and prescription
medication (insulin or tablets). Each part plays its role in raising
or lowering blood sugar levels. It is very important to remember that
in many cases one can only normalize sugar levels with the help of intelligent
nutrition and exercise, without resorting to medication.
IS THE ROLE OF DIET?
Eating raises the level of sugar in the blood. This
is why medical analysis of what, how much and when you eat is so important
for your diabetes-control efforts. And if you really want to achieve
your diabetes treatment goals, you will need a nutrition plan that has
been specifically developed for you. In our office this task is met
with the help of a special computer program. I emphasize this, because
it is just as important to create a nutrition (and exercise) plan which
takes into account illnesses associated with diabetes as it is complicated.
This is job, which can't be done without a computer. That's not just
a sign of the times; it's an essential requirement. A nutrition plan
consists of instructions, which will tell you how much, and what kind
of food products you should eat each time you sit down at the table
or when you are literally grabbing a bite "on the run" (as
a snack). This plan prescribes an appropriate nutrition schedule and
eating habits, including those products which you find most satisfying.
If you are overweight, the diet plan also prescribes losing weight SLOWLY.
IS THE ROLE OF EXERCISE?
It has been clinically tested and proven that exercise
lowers blood sugar, often to normal levels. Exercise, therefore, is
an indispensable element of the treatment of diabetes. Exercise works
to stimulate tissue metabolism, the utilization of sugar in the body
and its uptake in the muscles. When we talk about exercise, we have
in mind any sort of physical activity which, however, is not a part
of our everyday or work routines. We emphasize this because we often
hear from our patients: well, you know, I'm sweating all day, I get
tired, there's no energy left for exercise. It's up to you to decide
how to proceed with your diabetes. We'll just say that exercise after
the work day is a hundred times more useful than when conducted against
a background of absolute rest. First, it reduces fatigue, because it
switches the organism to another kind of work, and second, because it
puts a load on the heart, the lungs, the endocrine system and the muscles,
which are not so active during other forms of everyday or productive
activity. Exercise may be therapeutic, but it can also be harmful if
it is not appropriate for you. We do not advise people who suffer from
diabetes to experiment on their own in the search for effective exercise
methods. It would be better to come into our office once or twice for
consultations. There are specialists here who will not only develop
a program specially for you, but also teach you how to go about exercising
the right way. By the way, selecting an exercise system and defining
the required, but still safe level of physical exertion for a diabetic
is an extremely complex process. It is only possible to complete this
task here in the office where we can rigorously control blood sugar
levels. In this way you won't have any problems in the future using
the whole program of exercise and training on your own. The integral
exercise system may be oriented toward reducing body weight, if this
is necessary. It will certainly be a requirement for the many who have
IS THE ROLE OF MEDICATION?
Insulin lowers the level of sugar in the blood. People
with the first type of diabetes (insulin-dependent) must take insulin.
For the second type of diabetes, tablets, which lower blood sugar, may
be prescribed. If you take insulin or medication or both, it is very
important to take the correct dosage and at the right times. When it
comes to these issues, the experience and qualifications of the doctor
who prescribes the medication, as well as the regimen for their use,
are essential. One should never change the type or amount of medication
prescribed by a doctor on one's own.
WHAT IS THE RELATIONSHIP BETWEEN DIET, EXERCISE AND MEDICATION?
As we have shown, all three elements, i.e., diet,
exercise and medication, influence blood sugar levels. Too much or too
little of any one of these elements can shift those levels away from
the norm. If you take insulin or tablets, the quantity of each dose
is defined in accordance with the volume of food intake. If you eat
more than the medication is able to neutralize, your blood sugar may
be unduly elevated. But if you don't get enough food, blood sugar may
be excessively reduced. Insulin quantities and the dosages of your prescriptions
should be coordinated with your physical exercise regimen. Your nutrition
plan, for example, might include a snack before a regular exercise session.
Or, if you need to engage in exercise or some other form of extended
physical exertion without having had time to plan the activity ahead
of time, then grab a bite to eat before you start exercising or working.
you succeed in formulating an anti-diabetes program, you will be able
to avoid occasional health problems while maintaining the proper balance
in your life. And that is all by itself an excellent investment in your