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  • Q&A with Australian Health Practitioners

    Borderline type 2 diabetes, do I need to go on medication?

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    Endocrinology Type 2 Diabetes
    Hi,

    Ive been told im borderline Type 2 diabetes. I am 59 years old, female and 5 KGS over weight. Currently exercising 4 hours a week. Would more exercise and a better diet help lower the sugar levels as i would like to avoid taking the medication prescribed to manage it. Any suggestions appreciated.

    Thank you Sandra
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    Chris Fonda

    Dietitian, Nutritionist, Sports Dietitian

    As an Accredited Sports Dietitian, APD and athlete (springboard diver), Chris has both professional and personal experience in sport at the sub-elite and elite level.Chris … View Profile

    A healthy diet and regular exercise can certainly help to lower your blood sugar levels (BSLs) without the need for medication. In regards to dietary changes you can make, try to swap highly processed carbohydrates (e.g. white breads, refined cereals, white rice (except basmati), cakes, and biscuits) with more wholegrain varieties, fruit, vegetables and low fat dairy.

    Try to stick to a regular eating pattern including small amounts of wholegrain carbohydrate foods in each meal to help to regulate your BSLs. Losing weight will also help you to get your BSLs under control as it is the visceral body fat (fat around your organs) that can have the potential to cause insulin resistance which can lead to type 2 diabetes.

    Its important to get individualised dietary advice and guidance from an Accredited Practising Dietitian (APD). APDs are able to convert the science of type 2 diabetes and food into practical advice tailored specifically for you. To find an APD head to www.daa.asn.au private health fund rebates may apply.

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    Dr Inna Lieb

    GP (General Practitioner)

    Dr Lieb has over 7 years experience as a GP with special interests in women's health including ante-natal shared care with the Royal Hospital For … View Profile

    The mainstay management of Type 2 diabetes before any medications are discussed is diet and lifestyle changes such as exercise. These are discussed with any patient who is overweight and is suspected or proven to have insulin resistance (pre-diabetes). These patients are advised to see a dietician/nutritionist to have a low carb, low fat, high protein diet and to exercise 30 min per day 4-5 days per week. The exercise must be rigorous with increased heart rate and increased cardiac output. In fact, it has been suggested that if you can carry on a normal conversation whilst exercising, it is not adequate level of exercise.

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    Jayne Lehmann

    Credentialled Diabetes Educator (CDE), Diabetes Educator

    As a Credentialled Diabetes Educator, I help people with type 1 or 2 diabetes to manage the physical and emotional side to feeling healthy with … View Profile

    Hi Sandra,

    Sounds like you are already doing 4 hours of exercise a week and 5kgs over weight. Well done for the exercise you have already been doing. This has probably stopped you from putting on any further weight and delayed your blood glucose level going into the borderline diabetes range - well done!  The thing with exercise is that it makes your own insulin work better. Therefore trying to increase your exercise further while also decreasing your calories and increasing low glycaemic index foods may well be enough to get your back into the non diabetes range. Exercise is like having a diabetes tablet without any of the side effects!

    One issue that can be tricky is the impact of stress on blood glucose levels because it increases them unfortunately. Give some consideration to the amount of stress you have in your life and how you are managing this because it may be that getting on top of the emotional side of your health will also help your blood glucose levels to drop. Fortunately exercise also helps to manage stress and release lovely hormones that make you feel better.

    It is really worth putting in the effort to manage your blood glucose levels now. Getting them down into the non diabetes range will give you the biggest health 'bang for your buck', so to say! It is otherwise likely that in time your levels will continue to increase until you are in the diabetes range. Taking action now will prevent or delay a diagnosis of diabetes in the future.

    Why not see a diabetes educator to help you to manage this process and provide some additional emotional support for the lifestyle changes required for a great outcome.

    All the best and good health.

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    Ashley Bigaran

    Exercise Physiologist

    I am an accredited exercise physiologist practicing in the locality of Carlton, Melbourne. My philosophy on the management and treatment of chronic and complex disease … View Profile

    The great news is that you are exercising. The key to exercise is the intensity in which you are exercising at. This can be quite an conundrum when you are trying to consider exercising more. When referring to Type II Diabetes and wanting to reduce the effects of this condition (even being borderline), the key is volume, intensity and duration. Aerobic exercise (cardiovascular exercise) is integral as you will expend energy, how you complete that comes to the specifics of the prescription. Resistance training is also of vital importance and a combination of both would assist in making changes to your body composition (body fat), increase your insulin sensitivity and also lower your blood sugar levels. 

    It would be advisable to seek the advice of an accredited exercise physiologist so that they can tailor an exercise program specifically to you needs. Find an AEP www.essa.org.au/findanaep

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