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ASK THE DOCTOR

by Wesley W. Wilson, MD

NOTE: If you have any questions for "Ask the Doctor," please send them to the Voice editorial office. The only questions Dr. Wilson will be able to answer are the ones used in this column.

Wesley W. Wilson, MD, has retired as an Internal Medicine practitioner at the Western Montana Clinic in Missoula, Montana. Dr. Wilson was diagnosed with type 1 diabetes in 1956, during his second year of medical school. He remains interested and involved in diabetes education for patients and professionals.

Q: I'm 31, and have had type 2 diabetes for about seven years. I've been overweight and underactive most of the time, but now I'm regularly exercising. I know if I build up muscle, it will help keep my blood sugars where they belong. My question: What about those "muscle growth supplements" marketed on TV and at the gym? Will they help? Will they mess with my blood sugars? Are they safe for a diabetic like me?

A: It's the exercise, not the size of your muscles, that counts!

Type 2 diabetes develops as a result of several factors: Insulin resistance, and a reduced ability to produce maximum insulin. "Insulin resistance" describes the findings in persons with type 2 diabetes, in which there is less insulin action or effect, even though the level of insulin is high -- at times possibly even higher than in "normal" persons. The insulin is present, but it is not doing its job. As a result, more insulin is required to maintain normal blood sugar. Insulin resistance is seen with overweight, lack of exercise, infections, pregnancy, excess cortisone, and the anabolic steroids some athletes and bodybuilders use to build muscle.

Your job (I know you've heard this before) is to exercise and lose weight, to reduce insulin resistance.

Your question brings a question from me: How have your exercise and weight loss affected your blood sugar test results? Have you lost weight? Are you exercising regularly? Are you testing your sugars more often, now that you are exercising and watching your diet more carefully? Often, medicine given to control high blood sugar must be reduced, or even stopped, once the patient "gets the word," and really works on activity and diet.

Changes in activity level, infection, pregnancy, or change in other medicine may require an increase in frequency of blood testing, to watch for blood sugars that are too low.

In conclusion, don't take stuff to grow your muscles; do keep on with the old-fashioned diet and exercise method of controlling blood sugars. If you start feeling "funny," check your sugar again -- you could be having low blood sugar.