Diabetes in the perimenopausal/menopausal woman
Dr.Sharad Kumar, Endocrinologist, Lucknow
Q: When should a woman start testing for impaired glucose tolerance test in the absence of any symptoms.
A: In Indian population, it would be best to start testing for impaired glucose tolerance test after the age of 35 years of age. If the findings are normal, screening every 3 years would be ideal.
Q: If a woman is shown to have diabetes and she is either put on diet, medicines or insulin, how often should she undergo testing for diabetes?
A: Generally, the treating physician is the best judge on how often to test for glucose control, but if the presenting symptoms do not suggest any urgency, testing blood glucose level every 20 to 30 days would be ideal.
Q: How often should Hb1Ac be tested in maturity onset diabetes?
A: Once the glucose levels have reached normal levels, then every 3 months or so.
Q: What are the dietary advices to be given to a diabetic woman if she is lean?
A: To avoid simple sugars, avoid too much of saturated fats and maintain normal body weight.
Q: What are the dietary advices given to a diabetic woman if she is obese?
A: Same as for all diabetic woman stressing the importance of maintining ideal body weight.
Q: If there is normal control of the glucose levels, is it necessary to look for elevated serum creatinine levels to rule out diabetic nephropathy or ophthalmic check up to rule out diabetic retinopathy?
A: Screening for possible complications of diabetes should start at the beginning of diagnosis of diabetes and yearly thereafter, irrespective of glycemic control.
Q: What are the indications to look for complications of diabetes?
A: Should be looked for in every patient of diabetes.
Q: What are the oral antidiabetic drugs available for treatment of maturity onset diabetes?
A: Several groups are now available, Starting from Metformin, sulphonylureas,Pioglitazone,Alpha glucosidase inhibitors,DPP IV inhibitors,Bromocriptine.
Q: Can a diabetic woman take Hormone replacement therapy?
A: Yes, but with due precautions.
Q: Should a diabetic woman routinely take Vitamin B tablets?
A: Not necessary.
Q: Should diabetic women be given omega=3 fatty acids or other antioxidants routinely?
A: Not necessary.
Q: Are there medicines to decrease absorption of carbohydrates from the diet? If so are
They helpful in management of diabetes?
A: Alpha glucosidase inhibitors do decrease the DIGESTION of Carbohydrates and not absorption.
Q:Should we routinely give statins to patients with diabetes .
FAQs answered by Dr.Sharad kumar,