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Diabetes

Diabetes and brisk walk

03/13/2009

Question:

Respected Sir, I browswd several responses of yours which are of high educational quality and very meaningful. I am hypertensive on Metoprolol 100 Micardis 80 and Norvasc 10 and Lozol 1.5 Last month I had a health check up in which lipid profile,homocystein,urineanalysis Hemogram,liver and Renal function tests were normal But my fasting blood sugar was 118 and HbA1c was 7.7. Renal doppler was also normal S Creatinine was 1.1 My intern suggested me to repeat it after one month My HbA1c was 7 and S Creatinine is 1.5 which is high. He asked me to start Metformin 500 after meals. My mother was diabetic.

My age is 53 years from India My query is without starting a metformin 500 mg is it possible to bring down the HbA1c by a speedy or brisk walk for 30 minutes and sugarless items. Further, what should I do to reduce creatinine level. I seek your guidance as a part of diabetes awareness rather than treatment recommendtaion. My GTT( glucose tolerance test) was done 2 months back which revealed decreased glucose tolerance.As humane approach and nobility is reflected in your responses I am sure I shall get guidance from you sir Thanx in anticipation

Answer:

It doesn't make sense to me that the creatinine should rise that much over 1 month in a relatively stable person; also you haven't described what was done that would explain that brisk a drop in hba1c - I don't know whether those are real changes or unreliable results.  if the creat. is really 1.5, then metformin would not be recommended.  It is possible to substantially improve BS control with exercise, as long as intensity is sufficient and frequency maintained - hard to predict magnitude of effect.

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Response by:

Robert M Cohen, MD Robert M Cohen, MD
Professor of Clinical Medicine
College of Medicine
University of Cincinnati