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Is change really neccessary?



Insulin dependent, 70 year old male. Last Hgl. 6.9. Is diet change really imporant at this age? General health fine.


At any age, diet is still an important part of diabetes management. Your HbA1c is good at 6.9 now, but we don't want it to go any higher. Diabetes is a progressive disease and the more you watch your diet, the less medication or insulin you may need in the future to stay in control. Also, the HbA1c could be 6.9 because you are averaging out very low and very high blood sugars, a possible result of inconsistent food intake. Carbohydrate counting is the best way to level out blood sugars. Aim for 45-60g per meal. If you are only on basal insulin (Lantus, Levemir, NPH), try to keep the carb consistent from meal to meal. If you are on basal and pre-meal insulin, you can vary the amount of carbs per meal, but take the appropriate amount of fast acting insulin to cover it. Test your blood sugar before meals AND 2 hrs after meals and if you don't vary more than 40mg/dl, then you are taking the correct amount of insulin for the carbs you eat. Also maintain a diet low in fat and high in fruits, vegetables, lean meats and whole grains. This will help keep other areas of your health (cholesterol, blood pressure, weight) in good control.

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Response by:

Connie A Gottfried, MPH, RD, LD, CDE Connie A Gottfried, MPH, RD, LD, CDE
Case Western Reserve University