A Medwatch reader sent in a question asking about how a diabetic can lower their blood sugar. Here is the response from Dr. David Trachtenbarg, MD, Methodist Family Medical Center.

There are 3 main ways to lower the blood sugar.

a) Diet and exercise. Exercise lowers the blood sugar when exercising and in the long run increases the effectiveness of the body's insulin. Avoiding meals that are high in sugar and losing weight will also help diabetes. Diet and exercise are particularly helpful to prevent diabetes or when diabetes is present, but the sugar is close to normal.

b) Oral medications will lower the blood sugar by stimulating the pancreas to make more insulin, decreasing the amount of sugar made by the liver or increasing the effectiveness of the body's insulin. These are most effective when combined with diet and exercise and when the sugar is running less than 200 mg/dl without medication. Oral medications are not effective if patients have insulin dependent diabetes (also called type 1 diabetes).

c) Insulin is the most effective medication to lower the blood sugar and is needed when the sugar is running high with oral medications or inpatients with type 1 diabetes. Insulin should always be combined with diet and exercise and is sometimes used with oral medications in non-insulin dependent diabetes (also called type 2 diabetes).

The best treatment for you needs to be determined by working with your physician. The details of a good diet and exercise program are best learned by working with your diabetic educator and medical nutrition therapist who are certified in treating diabetes.

Dr. Trachtenbarg is board-certified in family practice and geriatrics. He has a special interest in the management of diabetes. Dr. Trachtenbarg sees patients at Methodist Family Medical Center.