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  Chat Transcript
Open Q & A - Dr. Rajamani, February 26, 2013

 Dr. Rajamani @ Unity:
 Welcome to the Unity Diabetes Online Community! I’m Dr. Rajamani, an endocrinologist at the Unity Diabetes Center, and I’ll be hosting today’s chat. We’re glad you could join us today. I’m excited to answer all of your diabetes-related questions.
 Dr. Rajamani @ Unity:
 Hi lucyblue and SyddyBee! Welcome to the online diabetes chat.
 Dr. Rajamani @ Unity:
 I was looking at the forum and there were a lot of interesting threads posted there.
 lucyblue:
 Hi Dr Rajamani! Would you be able to tell me about what I should do for exercise? I like to walk but it's hard to do in the winter. Is it ok if I take a break from exercise now and start walking again in the spring? I do notice my blood sugar is better in the summer months.
 Dr. Rajamani @ Unity:
 lucyblue, I'm glad you like to walk and I do too. Walking outside in the winter can be rough. Are you able to walk inside your home?
 lucyblue:
 Well I think I could, never thought about that.
 Dr. Rajamani @ Unity:
Some people like to walk up and down the stairs but that can get boring. I think one of the ways to help exercise is to turn on your favorite show and maybe watch that while you walk or ride a stationary bike. 
 lucyblue:
 That's a good idea, what is a good amount of time to walk for?
 Dr. Rajamani @ Unity:
 If you are some one who likes the outdoors, it really is nice to get outside when it is not terribly cold and walk when everything is quiet.
 Dr. Rajamani @ Unity:
 You could walk for any amount of time that you are comfortable. If you like to walk you may want to walk about 15-30 minutes daily. 
SyddyBee:  
 Do you have any suggestions for household items to use as equipment if we don't have traditional workout equipment?
 lucyblue:
 OK, that I can do. Maybe after dinner. Thanks for the ideas
 Dr. Rajamani @ Unity:
 I like a step ( inexpensive!). Just be careful that you don't fall off things.
 dbhattac12345:
 Does type 2 diabetes get worse with age?
 SyddyBee:
 Thank you!
 Dr. Rajamani @ Unity:
 Hi dbhattac12345. Type 2 diabetes can progress so that many people who initially require tablets may require the use of medications such as insulin.
 Dr. Rajamani @ Unity:
 dbhattac12345: There is a lot of research being done to try to find out what contributes to progression of type 2 diabetes and what can be done to slow or reverse this.
 dbhattac12345:
 What are best times to take the blood glucose reading if I do it twice a day and what should be a reasonably good reading?
 Dr. Rajamani @ Unity:
 The best times to take the readings are sometimes related to the medications you use. If you are not on any medications and are otherwise under good control you may need to monitor only occasionally. If you are on tablets most people would recommend 1-2 x daily usually before BF abd sometimes before the largest meal or 2 hrs after the largest meal.
 Jane@Unity:
 What other physical activity besides cycling and walking are beneficial?
 Jane@Unity:
 Does Type 2 ever regresss even after you follow a program, i.e. can you ever get rid of Type 2?
 Dr. Rajamani @ Unity:
 The targets can vary as to what the blood glucose should be. You try to aim as close to normal in the morning ( Normal is 60-100) So AM BG near 100 is good. Later in the day I tend to aimn for less than 150 after meals. The lowe you aim the higher the chance of low blood glucose.
 Dr. Rajamani @ Unity:
 Hi Jane@unity: I think you should exercise with any thing that suits you. Type 2 diabetes can regress: This occurs more commonly in the early phases when you are very careful with food intake and exercise regularly. Getting to a good body weight helps this process. In early diabetes following 30 minutes of exercise daily and being careful with foods can help prevent progression
 Dr. Rajamani @ Unity:
 Following gastric bypass surgery some patients do not need many of the medications they previously used.
 dbhattac12345:
 What is a gastric bypass surgery? Can you please elaborate a bit.
 Dr. Rajamani @ Unity:
 It is a procedure that is done so that the food you eat is delivered right to the intestine bypassing the normal process of going through the stomach and small intestine first.
 Dr. Rajamani @ Unity:
This causes patients to lose wight as the food is not absorbed through a large portion of the intestine first and does not come in contact with the digestive enzymes . 
 Dr. Rajamani @ Unity:
 The way that diabetes improves is entirely not clear and some researchers think that this is related to hormones in the intestines called "gut hormones"
 Dr. Rajamani @ Unity:
 That’s all the time we have for today. I’ve really enjoyed our conversation and hope that I was able to provide some insight for you. If we didn’t get to your question today or if you think of another question later on – feel free to jump into the conversation in the forum, or submit a question using our “Ask an expert” feature. Be sure to join us for our next chat Tuesday, March 12 at 8 p.m. – an open Q&A session with Elva Parker, C.D.E. and Megan Alchowiak from the Kidney Cares. Elva and Megan will answer all of your diabetes questions and will share information on kidney health.
 
 
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