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Diabetes

Can walking improve prognosis of diabetes?

05/12/2009

Question:

Respected Sir,

I am from India having BP taking Atenolol 100 Losartan 100 Indapamide 1.5 Amlodepine 10 mg. Dose of Atenolol is due to problem of tachycardia and missing beats which is under control with the atenolol.

I have normal lipid profile, normal thyroid function Creatinine 0.98 Blood urea/uric acid/homocystein/Lp(a)/PSA X Ray chest normal. 2D echo is normal with 65 EF Dystolic dysfunction and sever concentric LVH TMT normal with 9 METS and negative for IHD Renal doppler normal. Abdominal sonography normal with Grade 1 fatty liver ...

I am obese. I am having impaired glucose Fasting blood glucose remains 110 around whereas post prandial is 100. my HbA1c is 7.1.

My dr suggested metformin 500 mg once daily after lunch. My mother died at the age of 59 because of diabetes and BP ( Diabetic coma) My query is I have started walking for 6 kilometers for 70 minutes in the early morning. I am a vagan, non alchoholic non tobacco chewer non smoker. Can my walking will improve the HbA1c level and fasting glucose or should I start metformin ? Why fasting is little higher than post blood sugar whether walking will improve the glucose tolerance I am male-51 years Two brothers have HBP Sister has BP+DM Can U explain me my problem for my education I shall be very much obliged to receive your guidance I am encouraged to ask because of your quality repsonse and humane approach Thanx in advance

Answer:

The walking is terrific - keep it up - but I would probably do both, as long as you tolerate the metformin and do not have a contra-indication to its use.  If your A1c is a valid 7.1% then that is more likely to be diabetes than simply impaired fasting glucose.  The combination of exercise, careful nutrition and metformin has been shown to slow the progression of diabetes more than any one measure alone.

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Response by:

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