Managing Blood Sugar Fluctuations and Weight Loss in Diabetes - Internal Medicine

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Managing blood sugar fluctuations and weight loss in diabetes can be a complex issue, especially when considering the interplay between medication, diet, exercise, and individual metabolic responses. Based on your description, it appears that you have been proactive in managing your diabetes through lifestyle changes and medication. However, the persistent weight loss and blood sugar fluctuations you are experiencing warrant a closer examination.


Understanding Blood Sugar Fluctuations
Blood sugar levels can fluctuate for various reasons, including dietary choices, medication adherence, physical activity, stress, and even hormonal changes. The fact that your fasting blood sugar levels range from 100 to 140 mg/dL and postprandial levels can spike to 200-240 mg/dL indicates that your blood sugar control may not be as stable as desired. The HbA1c levels between 6.1% and 6.7% suggest that your average blood glucose levels are within the acceptable range for many individuals with diabetes, but the fluctuations can still pose risks for long-term complications.


Medication Considerations
You mentioned taking "泌樂寬" (likely referring to a medication like Metformin or a similar agent). While these medications are effective for many, they can sometimes lead to gastrointestinal side effects or may not be sufficient alone for optimal blood sugar control, especially if your body is not responding as expected. If you are experiencing significant fluctuations despite medication, it may be worth discussing with your healthcare provider the possibility of adjusting your dosage or exploring additional medications that can complement your current regimen.


Dietary Factors
Your current diet, which includes salads and bread, may lack sufficient carbohydrates and protein to maintain stable blood sugar levels. While salads are healthy, they may not provide enough calories or nutrients to support your energy needs, especially if you are losing weight. Consider incorporating a more balanced diet that includes whole grains, lean proteins, healthy fats, and a variety of fruits and vegetables. This can help stabilize blood sugar levels and support weight maintenance.


Exercise Routine
Your exercise routine of walking every two days for 30-40 minutes is a positive step towards managing diabetes. However, consistency and intensity matter. You might want to consider increasing the frequency or duration of your workouts, or incorporating strength training, which can help improve insulin sensitivity and support weight management. Aim for at least 150 minutes of moderate-intensity aerobic activity per week, along with muscle-strengthening activities on two or more days per week.


Monitoring and Support
Regular monitoring of your blood sugar levels is crucial. Keeping a log of your blood sugar readings, dietary intake, and physical activity can help identify patterns and triggers for fluctuations. Additionally, consider working with a registered dietitian or a diabetes educator who can provide personalized guidance and support.


Conclusion
In summary, the combination of medication, diet, and exercise plays a critical role in managing diabetes and maintaining a healthy weight. Given your ongoing weight loss and blood sugar fluctuations, it is essential to have an open dialogue with your healthcare provider to reassess your treatment plan. They may suggest adjustments to your medication, dietary changes, or an enhanced exercise regimen to help stabilize your blood sugar levels and support your overall health. Remember, managing diabetes is a dynamic process that often requires ongoing adjustments and support.