Endocrinology (including Diabetes)/sugar

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Question
Hello,
   I am 63 and diagnosed last year as diabetic (blood sugar 145-150 etc).  I also have gastroparisis and the doctor has me on Metheltrexate and put me on Medforman.  Since then my blood sugar has been normal.  I asked the doctor to take me off Medforman and he said "Why do you think your blood sugar is normal?"  He had no advice about weight (which is normal) or stopping sugar.   So I have been eating a lot of candy and cake and my blood sugar is normal.  My diabetic friends say I should not eat sugar even if the bs is normal. I also asked the doctor about if I should get a glucometer and he had no advice.   What do you think?

Answer
Don,
  Your diabetes may be well controlled at the moment, but since you did have elevations before you went on medications, there's no reason to try to "overeat" your medications.  Diabetes never really goes away fully, and if your meds start working less well or your lifestyle puts a bigger burden on your insulin needs, your blood glucose can certainly start increasing.  Also, it's not just the AM blood glucose that matters; how high your glucose spikes after meals can also affect whether you develop complications over the long haul.  Even if your AM values are good, eating a lot of candy and cake may cause big spikes after you eat them that you just aren't measuring.  For that reason, it may be good to get a glucometer and check for yourself the effects of eating different things and exercising.  Checking before and an hour after eating can catch those post-meal spikes.  Metformin is likely just keeping your AM blood glucose levels under control, nothing else.  I do have lots of info about making healthy lifestyle changes to help manage blood glucose levels without a lot of medications on my web site and blogs (www.shericolberg.com), so feel free to read those as well.  Sheri

Endocrinology (including Diabetes)

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Sheri Colberg, PhD

Expertise

I am an exercise physiologist with a PhD who specializes in diabetes--as such I CANNOT answer general questions about other endocrine problems as I am neither an expert in all areas of endocrinology nor am I a medical doctor. My expertise lies in answering questions about diabetes (of any type) and physical activity, so please limit your questions to those areas. I can help you if you want to begin exercise or if you're already a diabetic athlete, and I am prepared to respond to questions about physical activity to which even your diabetologist may not know the answer. I can give suggestions about changes in your diabetic medications that differing types and intensities of exercise may necessitate, but I will have to refer you to your regular health care team to get final approval to make such changes. I can also answer questions about physical fitness, exercise metabolism, prediabetes reversal, and prevention of type 2 diabetes and diabetic complications.

Experience

I have both personal and professional experience in the areas of diabetes and exercise/physical activity. On a personal level, I have had type 1 diabetes since 1968, and I have been an avid exerciser since I was a child. Professionally, I have been conducting clinical studies on diabetes and exercise since 1992, largely with funding from the American Diabetes Association. I am also the author of 8 books related to diabetes, exercise, and more: The Diabetic Athlete (2001), Diabetes-Free Kids (2005), The 7 Step Diabetes Fitness Plan (2006), 50 Secrets of the Longest Living People with Diabetes (2007), The Science of Staying Young (2007), Matt Hoover's Guide to Life, Love, and Losing Weight (2008), Diabetic Athlete's Handbook (2009), and Diabetes? No Problema! (2009).

Organizations
I am a Fellow of the American College of Sports Medicine, a professional member of the American Diabetes Association (and professional volunteer for the ADA), and a former member of the Board of Directors of the Diabetes Exercise & Sports Association.

Publications
I have published research and review articles in the following journals and magazines: Diabetes Care, Diabetes, Journal of Diabetes & Its Complications, Diabetes Self-Management, Medicine & Science in Sports & Exercise, Journal of Applied Physiology, The Physician and Sportsmedicine, Journal of Clinical Investigation, International Journal of Obesity, FASEB Journal, The Diabetes Educator, Journal of Physical Education, Recreation, and Dance, Clinical Exercise Physiology, Clinical Diabetes Reviews, Insulin, ACSM's Health & Fitness Journal, Biomechanics, On the Cutting Edge, Diabetes Technology & Therapeutics, Microvascular Research, Drug Benefit Trends, ACSM Certified News, Diabetes Health, SportEX Health, Diabetes Focus, Diabetes In Control, dLife-For Your Diabetes Life, Pediatrics for Parents, and My TCOYD (Taking Control of Your Diabetes) Newsletter. I have also been interviewed in myriad other magazines, such as Men's Health, Men's Fitness, Diabetes Forecast, Countdown Magazine, Joe Weider's Muscle & Fitness, Health, Tidewater Parent, Barron's News, Diabetes New Day, and Newsweek International.

Education/Credentials
I have an undergraduate degree (1985) from Stanford University, a Master's degree in exercise physiology (1987) from the University of California, Davis, and a Ph.D. (1992) from the University of California, Berkeley, in the same field. I also spent two years in an NIH-funded postdoctoral research position in endocrinology (studying obesity, diabetes, metabolism, and exercise) at the University of Pittsburgh School of Medicine (1993-1994).

Awards and Honors
Fellow, American College of Sports Medicine (FACSM) - 1996 Old Dominion University Darden College of Education Young Investigator Grant Award 2003 Honor Society of Phi Kappa Phi, Old Dominion University Chapter 2004-Present Great Women of the 21st Century by the American Biographical Institute 2005 Edition Old Dominion University Darden College of Education Largest Research Grant Award 2006 Old Dominion University Darden College of Education Publications Award (for greatest number) 2006 Saint Louis University, The Max K. Horwitt Memorial Lecture Distinguished Lectureship Award 2008 Old Dominion University Darden College of Education Publications Award 2009 Old Dominion University Darden College of Research Grants Award 2009

Past/Present Clients
I have consulted for numerous groups, including Can-Am Care, Numera|Social, California Commission on Peace Officer Standards and Training(about candidates with diabetes), Animas Corporation (an insulin pump company), Therasense, Inc. (makers of the Freestyle blood glucose meters), Council of Healthcare Advisors, and the City of Chesapeake (Virginia) Health Department.

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