Ask the Experts

Take a Step in the Right Direction to Treat Diabetes

dr. michelle l. abis
Michelle L. Abis, MD
More about Dr. Abis

What is diabetes?

Diabetes is a lifelong disease that is manifested by abnormally high levels of sugar in the blood. It is usually caused by decreased production of insulin by the pancreas and/or decreased sensitivity of cells to the action of insulin. Diabetes is a common disease and, if left untreated, can lead to multiple complications that may affect the eyes, the heart, the nerves, and the kidneys. Diet and exercise are the cornerstone of treatment of this disease. Medications are indicated for some people, but diet and exercise are still necessary to maintain ideal sugar levels.

Why is exercise so important for diabetics?

Exercise has been shown to improve control of sugar in people with diabetes. It can reduce the Hemoglobin AIC, which is the average sugar level in three months, by approximately 0.5-0.7 percent.

Exercise is also effective for weight loss or maintenance of optimal weight, which is important in achieving blood sugar control. Exercise will also improve other health issues that are often associated with diabetes, such as high blood pressure and high cholesterol.

What types of exercise are best?

Aerobic exercise, resistance training, and high intensity-low volume exercises have been shown to help improve blood sugar levels in diabetics. One hundred fifty minutes of moderate aerobic exercise, such as brisk walking, per week is recommended. For people who don’t have any contraindications to resistance training, such as the use of weights, it would also be good to do these exercises two times per week.

People who have been sedentary should start with a gentle exercise program and increase the duration and intensity of exercises gradually. Prior to starting any exercise program, it would be advisable to consult with your physician.

How does nutrition help diabetics keep their sugar levels in check?

Following a diet is very important in controlling blood sugar levels in diabetics. The overall sugar levels are affected by how much and what is eaten. Carbohydrates are one of the main source of energy and it is found in bread, pasta, grains, dairy products, fruits, and vegetables. Carbohydrates have a direct effect on the levels of blood sugar. Increased carbohydrate consumption leads to higher sugar values. How much carbohydrate a person needs per day varies depending on level of activity and medications being used, among others. One can start with limiting carbohydrate intake to 30 to 45 grams for meals and 15 to 20 grams for snacks and adjust accordingly based on the sugar levels.

Controlling one’s diet to include reducing caloric intake, is also crucial to weight loss and maintenance of optimal weight. Obesity increases the risk for diabetes, and weight loss has been shown to improve sugar levels by increasing the sensitivity of cells to the action of insulin. An initial weight loss of 5 to 10 percent in an overweight person has been proven to improve sugar, cholesterol, and blood pressure.

Are certain foods more helpful?

Carbohydrate counting and portion control is important in meal planning for diabetics. Another consideration is the glycemic index of the carbohydrate being consumed. The glycemic index (GI) of a carbohydrate containing food, is a measurement of how much it raises the blood sugar. A high glycemic index food raises blood sugar more than a medium or low GI. When planning a meal based on GI, low or medium GI foods are usually preferred. A high GI food can be combined with a low GI food to balance the sugar levels. The total amount of carbohydrates and not just the GI of food being eaten should be considered in meal planning for diabetics. In addition to controlling the type and amount of carbohydrates consumed, a healthy diabetic diet should include foods that are high in fiber, low in saturated and trans fat and cholesterol, and low in sodium.


Dr. Michelle L. Abis is Board Certified in Internal Medicine. She has been practicing Internal Medicine since 1994 and has been in the Hudson Valley for the past 16 years.


Northern Dutchess Hospital
Health Quest Medical Practice
31 Springbrook Park
Rhinebeck, NY 12572
845-876-4432
TTY /Accessibility: (800) 421-1220
www.healthquest.org/primarycare


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