Sugar Matters
December 7, 2007

Early diabetes management changes

Exercise and diet changes for Managing Early Diabetes-Stage 1: setting goals

This is going to be a tough topic as we head into the holiday season, especially with sweet potato pudding and black cake calling your name every time you visit somebody.

I know, I know-and all the golden apple juice too (don’t make me cry here). But please do not use the holidays as an excuse and say, “I will tackle this next year.”{{more}}

What is the number one new year’s resolution? “Too eat better and exercise more.” That’s a great resolution! In fact it is SO great, you should start it early :-).

I have noticed that one of the problems with this idea of “diet and exercise”is that there are few specific instructions given when a patient is told to “eat better”, “lose some weight” and “exercise more.”

I found that people work a lot better when they have a specific number to aim for instead of a broad vague idea.

Let’s set the scene:

You are sitting in your doctor’s office and he/she says, “Mr/Mrs. What’s-your-name, you have early diabetes, so you need to start making some changes in your life.” Please don’t just say, “Okay Doc,” and walk out, happy that you don’t have to take medication yet. The first thing you should ask is ” What changes do I have to make?” and start a discussion with your doctor.

Be specific:

How much weight should I aim to lose and over how much time? Most people can have a significant improvement in their health by losing between 7-10% of their boady weight (usually between 10-15 pounds for the average person), so I am not asking everyone to lose 50 pounds. You and your doctor should discuss your optimal weight loss, what you can reasonably aim for and set a target weight. Note: a target weight is not necessarily your ideal dream weight.

While I like to encourage people to aim high, we also need to be reasonable and start with smaller goals, which is what you determine as your target weight-the weight that will make you healthier, happier about your weight and be a reasonable goal in a defined period of time. In general, a safe goal (medically speaking) is an average of 1/2 to 1 pound of weight loss per week.

The next part of this is time. All of you out there planning crazy diets where you only drink grapefruit juice for a week-please stop. Losing 10 pounds in one week is not safe, The flip side of this is that losing 20 pounds over 7 years may not do much good for your diabetes right now. It is certainly a good trend, but may not have the effect we want at this time. Generally, the timeline for seeing the effects of dietary changes on early diabetes is about 6 months. After that time your doctor will recheck your blood tests to see how you are doing. If you have not made enough progress you may be started on medication.

Hold on fellow Vincies, this ride through diet, weight and exercise can be rough.! We’ll continue next week. Take care until then!

Anita Ramsetty, MD endodocs@endocrinehelp.com

Medical Director Endocrine Care Group

www.endocrinehelp.com