Q: Why do doctors suggest that people with diabetes drink lots of water?

A: Water is necessary so that we will continue to be hydrated and not get dehydrated. When blood glucose levels are running high, there is a tendency to become dehydrated. Plus, drinking water helps with our kidney function. It is healthy practice to drink 6-8 glasses of water per day.

Q: My understanding is that blood glucose levels should go down after exercising. My glucose levels go up after exercising. What could be causing this?

A: Blood glucose levels usually do go down after exercise, providing that the body has adequate insulin on board for glucose utilization.

If your blood glucose level is greater than 240-250mg/dL before exercising, the exercise will make your blood glucose go higher. Exercise can affect your blood glucose up to 48 hours afterwards.

During exercise, if glucose levels are lower before exertion, the body will pull from stored glycogen (stored glucose in liver and muscles) which is released to provide energy. Usually after 20-30 minutes of exercise these glucose reserves are used. So, if you test immediately during exercise you may see a rise. Or if the exercise is an increased stress on the body, you will see a slight rise in levels. After a sustained duration of exercise, usually, you will see a decrease.

Meal time/composition prior to exercise; Medication schedule: peak times of medications; Blood glucose levels before, during and after exercise.

By evaluating the above parameters, you may be able to assess what is causing the increase after exercise.

Q: I try to follow the "exchange" type of weight management. How can all the new "fat free" and "sugar free" foods be figured into this type of a diet?

A: I would recommend that you see a registered dietitian who can help you with the specific questions you might have regarding the use of fat-free and sugar-free foods in a meal pattern for your husband. When I see patients with these kinds of questions, I refer them to the nutrition panel of the foods. You need to be looking at the total number of grams of fat, protein, and carbohydrates in that particular food. Remember that a serving of meat or meat substitute has 7 grams of protein, a serving of fat has 5 grams of fat, and a serving of carbohydrate has 15 grams of carbohydrates. From this you should be able to figure out if one serving of the particular food falls into the protein category, fat category, carbohydrate category, or a combination of two or three categories. Also, remember that most fat-free foods have more carbohydrates added for flavor, and that most sugar-free foods have more fat added. Both will usually have more sodium added to enhance the flavor so you need to look at sodium content.

Q: Can I cure myself of Type 2 diabetes with diet and medication?

A: At present, Type 2 diabetes cannot be cured. However, diabetes can be controlled with a combination of a healthy meal pattern, healthy activity level, self-monitoring of your blood glucose and, if necessary, oral medication. [Ed. note: With good diabetes management you can significantly reduce your risk of diabetes complications. Please discuss your options with your health care team. They will work with you to find the right combination to help you lead a healthy life with Type 2 diabetes.]