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Managing diabetes

Q: I am 33 years old and found to have diabetes in August 2001. In the beginning I used to take Daonil, one in the morning and one in the evening. I lost at least 4 kg weight and now I am on Amaryl 1 mg for the past three months and I have gained only 1 kg during this period. My blood sugar values for the last three months are F-82 mg/dl, PP-96 mg/dl (02.04.02). Then Daonil was stopped and I was put on only diet restriction. On 01.05.02 F-162 mg/dl, PP-194 mg/dl. Since then I am on Glimtide 1 mg and asked to take Bitmiac one per day for 30 days and Diapro powder in milk. I have gained 1 kg weight in this month. On 04-06-2002 blood sugar was F-129 mg/dl & PP-212 mg/dl. and since then till today I am on Amaryl 1 mg. On 13-07-2002 my blood sugar was F-136 mg/dl, PP-168 mg/dl; on 22-08-2002 F-127 mg/dl, PP-173 mg/dl. On 21-08 2002 I had taken random sugar at 4 PM, it was 243 mg/dl. I feel my sugar in the evenings may be high. In the evenings I feel tired and lose concentration/interest in work. Can I take up regular morning walking? Please advise me the proper diet to gain weight. Am I really on a proper dose of medicine? On any day is there any symptoms that will lead to high blood sugars? I am normally an active person. These days I really feel there is nothing sweet in life and am rather disgusted with life. In the morning if I plan to go for a movie or to meet a friend, by the evenning I lose interest. Please advise me. Has diabetes attacked me at an early age?

A:Diabetes can occur at any age. From your description, it does seem that your blood sugars are poorly controlled, and that may account for the tiredness, lack of interest, depression, and inability to maintain a somewhat higher weight. You need to be in regular touch with a competent diabetologist, who will guide you on how to achieve and maintain good control of your diabetes, weight and general health, as well as how to prevent the complications which can occur with diabetes. You do not have to live in a big city for this: once the basic workup has been done, you may need to visit the diabetologist only 3-4 times a year. I would also suggest you visit diabetes.org, which is the site for the American Diabetes Association, and carefully go through the section on STANDARDS OF CARE. You may also find diabetes.com, which is meant for lay people, useful. As far as walking is concerned, you can and should certainly go for walks: they will help you control your diabetes, gain muscle and therefore weight,and reduce stress. However, you should walk within the current limits of your tolerance, i.e. do not walk so much that you exhaust yourself. It would be a good idea for you to have a glycosylated hemoglobin (hemoglobin A1c) test done. This would give information on the average blood glucose over the last 3 months and would help your doctor to plan out further treatment.

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