Top Doctors: Diet, exercise and diabetes

Cutting calories and walking around the neighborhood once a day won't reduce the effects of every disease. But for people with diabetes, these fairly simple acts can have a major impact and may even send the illness into remission.

How can this be? Here's what you need to know:

1. LIFESTYLE CHANGES CAN HAVE A BIG EFFECT

"Many individuals with diabetes underestimate the power of diet and exercise in helping control their blood sugar," said Dr. Kenneth H. Hupart, chief of the division of endocrinology, diabetes and metabolism at Nassau University Medical Center in East Meadow. "Regular exercise and a healthy diet can help achieve consistency of glucose control and improve overall health."

Sometimes it can do more. Dr. Marie Gelato, an endocrinologist and professor of medicine at Stony Brook University Medical Center, said, "Diet and exercise can help patients decrease medication dosage and in some instances eliminate the need for medication."

2. EXERCISE HELPS FOR MORE THAN JUST A FEW MINUTES

"Exercises such as walking, swimming or cycling lower blood sugar not only while someone is exercising, but throughout the day," Hupart said. "Thirty minutes of aerobic exercise on most days is what it takes to achieve this benefit." However, he said, consult with your doctor before launching a new vigorous exercise program, especially if you haven't been exercising or if you have heart problems.

Gelato explained that exercise works for people with diabetes by making the body more sensitive to insulin, which processes blood sugar. "When you exercise, you make insulin more effective and able to lower blood sugar," she said.

3. A FEW POUNDS CAN MAKE A DIFFERENCE

A loss of 5 or 10 pounds can have a significant impact in terms of easing diabetes, Gelato said. "I just tell people to get started and get out there," she said. "Even if you walk 10 minutes, it's better than not walking 10 minutes. And hopefully you increase it."

Gelato remembers one patient who told her, "I cut down what I was eating and shook my booty." The woman lost 35 pounds and improved her diabetes numbers.

4. GET TESTED TO MONITOR YOUR PROGRESS

"Some patients need to monitor their blood sugar levels, and they will notice an improvement in their glucose control pretty rapidly" if they're dieting, exercising or both, Hupart said.

"Those who take insulin or other medications that stimulate insulin release may develop low blood sugar and will need to lower their medication doses as diet and exercise continue," he noted.

For diabetics who don't need to monitor their blood sugar frequently, Hupart suggested asking their doctor about a hemoglobin A1c test. "It's a terrific marker for the average control of blood sugar during the past three months, and people who are taking charge of their diabetes care with these kinds of lifestyle changes should be aware of their own A1c levels," he said. "A number less than 7 percent is terrific, and some doctors strive for numbers that are 6.5 percent or lower."

5. BENEFITS OF DIET AND EXERCISE DO HAVE LIMITS

Diet and exercise won't cure diabetes, Gelato warned. However, it can force it into a form of remission, and that can potentially continue as long as the person keeps dieting and exercising, she said.

Hupart added that diet and exercise also won't cure some of the chronic complications of diabetes, such as eye disease, kidney disease and nerve damage.

"However," he said, "you can still alter the course of the progression of these health issues that result from diabetes."

Endocrinologists, diabetes & metabolism specialists

Today is the seventh installment of a 26-week series in which Newsday presents Castle Connolly's list of top Long Island doctors.

ENDOCRINOLOGISTS, DIABETES & METABOLISM SPECIALISTS

Dr. John Aloia

1300 Franklin Ave., Ste. ML6

Garden City; 516-663-3511

Dr. Michael Balkin

191 E. Main St.

Huntington; 631-549-2525

Dr. Anjani A. Bhatt

871 E. Park Ave.

Long Beach; 516-889-8853

Dr. Rachelle N. Bitton

2 Pro Health Plaza, Floor 2

Lake Success; 516-390-5760

Dr. Howard A. Brand

2500 Nesconset Hwy., Bldg. 3C

Stony Brook; 631-751-2400

Dr. Harold E. Carlson

Stony Brook Univ. Med. Center

Dept. Medicine

Div. Endocrinology & Metabolism

26 Research Way

East Setauket; 631-444-0580

Dr. Seth G. Friedman

560 Northern Blvd., Ste. 207

Great Neck; 516-466-6165

Dr. Marie Gelato

26 Research Way

East Setauket; 631-444-0580

Dr. Leonard V. Gioia

53 Brentwood Rd., Ste. E

Bay Shore; 631-666-6275

Dr. Alan Goldenberg

East End Endocrine Associates

189 Main Rd.

Riverhead; 631-288-7120

Dr. Jeffrey H. Gordon

3 School St., Ste. 306

Glen Cove; 516-759-2420

Dr. Martin Greenfield

2 ProHealth Plaza

Lake Success

516-608-6823

Dr. Kenneth H. Hupart

Nassau Univ. Medical Center

Div. Endocrinology

2201 Hempstead Tpke.

East Meadow; 516-572-4848

Dr. Jonathan Kaplan

1000 Northern Blvd., Ste. 240

Great Neck

516-829-0802

Dr. Steven Lomasky

242 Merrick Rd.

Rm. 403

Rockville Centre 516-536-3700

Dr. Paul Margulies

444 Community Dr.

Ste. 312

Manhasset 516-627-1366

Dr. Lawrence E. Shapiro

1300 Franklin Ave.

Ste. ML6

Garden City 516-663-3511

Dr. Ashok N. Vaswani

901 Stewart Ave.

Ste. 204

Garden City 516-739-0414

Dr. Stuart Weinerman

2800 Marcus Ave.

Ste. 200

Lake Success 516-708-2540

Dr. Craig B. Wexler

285 Sills Rd., Bldg 15. Ste. D

East Patchogue; 631-758-5858

CLINICAL GENETICISTS

Dr. Martin G. Bialer

1554 Northern Blvd., Ste. 204

Manhasset; 516-365-3996

Dr. Joyce Fox

1554 Northern Blvd., Ste. 204

Manhasset; 516-365-3996

Dr. David B. Hyman

48 Route 25A, Ste. 205

Smithtown; 631-862-3620

Dr. Margaret McGovern

Stony Brook Univ. Med. Center

Pediatrics HSC Bldg.

Fl. 11, Rm. 020

Nicolls Rd.

Stony Brook; 631-444-5437

REPRODUCTIVE ENDOCRINOLOGISTS

Dr. Steven H. Brenner

2001 Marcus Ave.

Ste. N213

Lake Success 516-358-6363

Dr. Richard A. Bronson

2500 Nesconset Hwy. Bldg. 23

Stony Brook; 631-246-9100

Dr. Daniel J. Kenigsberg

8 Corporate Center Dr.

Melville; 631-752-0606

Dr. Michael L. Lydic

Reproductive Specialists of NY

2500 Nesconset Hwy. Bldg. 23

Stony Brook; 631-246-9100

Dr. David L. Rosenfeld

Div. Human Reproduction

Ambulatory Bldg.

300 Community Dr.

Manhasset; 516-562-2229

How they were picked

Castle Connolly Medical Ltd. is a health-care research and information company founded in 1991 by a former medical college, board chairman and president to help guide consumers to America's top doctors and top hospitals. Castle Connolly's established survey and research process, under the direction of a doctor, involves tens of thousands of top doctors and the medical leadership of leading hospitals.

Castle Connolly's physician-led team of researchers follows a rigorous screening process to select top doctors on both the national and regional levels. Its online nominations process -- located at castleconnolly.com/nominations -- is open to all licensed physicians in America who are able to nominate physicians in any medical specialty and in any part of the country, as well as indicate whether the nominated physician is, in their opinion, among the best in their region in their medical specialty or among the best in the nation in their medical specialty.

Careful screening of doctors' educational and professional experience is essential before final selection is made among those physicians most highly regarded by their peers. The result -- Castle Connolly identifies the top doctors in America and provides the consumer with detailed information about their education, training and special expertise in their paperback guides, national and regional magazine "Top Doctors" features and online directories. Doctors do not and cannot pay to be selected and profiled as Castle Connolly Top Doctors. (Newsday is not part of the selection process.)

Physicians selected for inclusion in this "Top Doctors" feature may also appear as Regional Top Doctors online at castleconnolly.com, or in one of Castle Connolly's Top Doctors guides, such as America's Top Doctors® or America's Top Doctors® for Cancer.

To see the whole list . . .

Who else is on the list of Top Doctors? More than 6,000 listings are in the New York Metro Area edition of "Top Doctors," published by Castle Connolly Medical Ltd. The softcover list price is $34.95. For more information, go to castleconnolly.com, or call 800-399-DOCS.