How can my diabetes be managed?

Q: I am a 23 years old male who has been suffering from diabetes for the last four years. I had wasted a lot of time by not consulting a doctor. Recently , I underwent blood sugar tests, which showed fasting sugar – 226 mg/dl, PP sugar – 385 mg/dl, creatinine - 0.8 mg/dl, SGPT - 59IU/L, total cholesterol – 251 mg/dl, HDL cholesterol - 49mg/dl, LDL – 177 mg/dl, triglyceride – 128 mg/dl, microalbumin Urine - <2.50 mcg/ml, creatinine urine - 61.66 mg/dl, HbA1c - 10.8% and average blood glucose - 273.64 mg/dl. My lifestyle includes fast food, untimely lunch and dinner, tea, sweet dishes, alcohol (once a week) and smoking (about 10 daily). Is it necessary to use medicines / insulin at this stage? If I maintain a steady food habit with some workout, will it be in control?

A:It is evident from the reports that your diabetes is very poorly controlled. You are also aware of the fact that this is due to your bad lifestyle. The fore most in your case is your understanding why you need to control your blood glucose levels. The first thing is awareness about your disease through process of diabetic education. The targets for control are fasting between 90-130 and PP less than 180 preferably less than 160 mg/dl. You also need to understand why is it important to control blood glucose levels? This is to avoid long term complications such as heart disease, nerve, eye and kidney involvement. Fortunately as of now your kidneys are normal. At this level of control you need to for diet therapy, exercise and oral medications. I would suggest you to meet an endocrinologist/diabetologist of your choice in your town and get counselling from a dietician as well. You will need a major change in your life style.