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What is the diet for a diabetic patient with a fractured wrist?

Dr Anju Virmani
Consultant Endocrinologist,
Sunder Lal Jain Hospital,
New Delhi

Q: My mother is 61 years old and diabetic. Her last test showed 128 (fasting) and 125 PP after breakfast. She takes glyciphage (metformin hydrochloride 0.5G) 1 tablet before lunch every day. She also takes a couple of vitamins with this. She has also gone through DST. Her reports are: Fasting blood sugar : 128 mg/dl PP blood sugar (after breakfast): 125 Glycated Haemoglobin (HbAlc) : 7.5% Urine Chemisty/Microscopy Protein: nil; Glucose: nil; S.G.:1.030; pH: 5.0; Ketones: nil; Blood: nil Microscopy: Leucocytes 0/cmm Erythrocytes 0/cmm Epithelial cell Nil General Chemisty Total Cholesterol 7.3 mmol/L Triglyceride 1.8 mmol/L HDL cholesterol 2.10 mmol/L LDL cholesterol 4.37 mmol/L Tot. chol. /HDL ratio 3.5 Sodium 130 mmol/L Potassium 4.2 mmol/L Chloride 98 mmol/L Bicarbonare 35 mmol/L Urea 5.7 mmol/L Creatinine 111 mmol/L A couple of days back she fell in the bathroom and fractured her left wrist. Doctors have advised plaster for 6 weeks. What diet should she take in normal course? How can this problem be healed keeping in mind her cholesterol level? What kind of diet can make her bones strong? Kindly suggest a diet chart for a diabetic patient.

A:Your mother's high HbA1c suggests her diabetes control needs improvement. What medication she should add depends on what her sugar levels are like (one set of F/PP values is just not enough); what her weight is, and how much she is exercising. These days we do not recommend any specific diet for diabetics: just a sensible, balanced diet which meets the individual persons needs.Keeping her fracture in mind, she should get a bone mineral density checked with the DXA scan, and also her serum calcium, phophorus and alkaline phosphatase levels. She needs to make sure she is taking regular (at least 1, perhaps 2 tablets per day) calcium and vitamin D supplements; plenty of low fat milk and low fat milk preparations, and some sun exposure to the skin. In addition, she should make sure she is walking regularly, at least 30-40 minutes over the course of a day. Once her wrist heals, she should also exercise her arms too. In addition, she needs plenty of fruits and salads, and low fat in cooking, with some reduction in fried snacks, and sufficient water. So does everyone else in your family!