Diabetes Questions and Answers
"I hope this web site will help connect the members of our community who have diabetes so we can support each other and gain a better understanding of our disease." Ginny Burns
Ginny Burns is a local nurse who has worked with people who have diabetes for the last 20 years. She is credited with years of dedication to the American Diabetes Association and Utah Association of Diabetes Educators. She also brings the invaluable experience of having Type 1 diabetes for 39 years which makes her a unique resource to answer your questions.
Please click here to submit your question to Ginny.
Your Questions, Ginny's Answers
Topics:
06/22/2009 -- Who to turn to for diabetes guidance
Q: Hi Ginny, I was excited to see your portion of the kutv website.
I am looking for a diabetes educator and also wondering if I should choose a doctor that's more specialized in diabetic care than my family doctor. I live in Springville and have heard about a doctor in American Fork - not remembering his name at this moment....
I have recently lost 8 pounds and I'm interested in eating according to the LDS word of wisdom. I have just looked at a Doctor Richard Bernstein book and thought I'd rather die than follow his eating plan - He said he hadn't eaten any fruit for over 25 years!
I could be pretty close to needing insulin. I don't have insurance and had to stop using Byetta because it was too expensive. I did see the ad with the info about getting an A1c test at the health department, but it looks like old info from last November. Is that being offered this month..of June.
I'm also wondering if there's anyone - like you - who could explain to me the differences in ways to deal with my diabetes. I see a lot of different choices and wonder if there's anyone who can help me find my best choices.
Sorry about all the questions. I'd be very glad to hear from you and look forward to your advice. Thanks so much, Carol
A: I think the person you thought about seeing in American Fork is Dr. Von Welch. Please call his office and make an appointment and fill out financial assistance paperwork.
Dr. Welch will be able to direct your care to the educators in the hospital, Jill and Elise, and to the Diabetes Center in Provo if you need to go there. Dr. Welch's clinic should be able to help you with medication assistance as well as a A1c test.
There are many different dietary plans you can follow, but being consistent in your carbohydrate intake is very important. Most dietary plans for people who have diabetes have patients lower their intake of refined, processed carbohydrates and use whole grain high fiber carbohydrates for their charbohydrate choices.
Dr. Welch and the educators in the hospital will be able to help you find a dietary plan that you will feel comfortable using.
Good luck to you, ginny
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03/31/2009 -- Diet Issues
Q: Ginny,
My name is Jennifer, and I'm pretty sure I have Type II Diabetes. My HgA1C was last checked two years ago, and it was 5.9. My doctor told me I'd be diagnosed at 6.0, so I haven't had it rechecked because I don't have insurance and if I'm diagnosed, I'll never have insurance. My husband's employer doesn't offer group insurance.
Anyway, I am about 40-50 lbs. overweight, and I have the basic knowledge of what I should be eating, but I don't want to. I have no desire for healthy food whatsoever. I not only have no desire for it, it sometimes makes me feel sick. I know it's backwards, and I really need to get a handle on my cravings, but they've been out of hand for about eight years and I've never been able to beat them.
I cannot do moderation. I try and I end up eating 1 lb. of chocolate or more. Chocolate is the main problem. I know I'm not healthy and I know that I need to be conscious of my eating not only for weight control, but to control my diabetes.
Can you recommend a dietician who has had experience with addictions and might not charge too much for consultations? I need to do something. Thanks.
Jennifer
A: Dear Jennifer,
You are right that you need to do something. Can you go to a clinic and get a blood test? There are low cost or free clinics that may be able to test you.
Check with the
- University of Utah Med Center at 801-581-2121;
- Maliheh clinic at 415 East 3900 South at 801-266-3700; or
- Sorenson Clinic at 855 California Avenue at 801-977-0502.
If your physician is in a clinic and you want to continue to see him/her, please apply for financial assistance. You need some information about what is happening to your body so you will know where to begin.
Sometimes when blood sugar levels are high, people become very hungry and describe the same symptoms you have described in your letter. The best place to start, I think, is to see if you have diabetes and what your blood sugar readings are. Anyone who can help you with a diagnosis will be able to direct you to a dietician.
Find out if you have diabetes first, o.k.? Remember, knowledge is power!!!
Good luck to you, Ginny
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03/23/2009 -- Burning feet
Q: Ginny,
My husband has trouble with his feet, not horrible trouble though. He complains of them being like they are on fire on the top of them. He also says that they feel like the circulation is weird. He has a family history of diabetes, his dad takes medication for his and so does his sister. Do we need to be concerned about this problem? His shoes bother him because of the heat. Usually rubbing and massaging them helps but he is always complaining about this.
A: Yes, please be concerned about your husband's feet.
His physician can test his fasting glucose to see if his fasting glucose is 126 or higher and diabetes can be diagnosed. If the test is normal, his physician may ask him to complete a glucose tolerance test; a test that will watch what your husband's body does with 75 grams of glucose. Does your husband see a podiatrist, a specialist who deals with feet? Between your husband's physician and a poditrist hopefully some treatment will begin soon and be successful. ginny
Ginny
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03/03/2009 -- Diabetes progression
Q: Ginny,
I have read several obits lately indicating people have died from complications of type 2 diabetes, which I have had for a little over a year. I have my A1c level down to 5.8 and have lost 35 lbs. If I continue to eat sensibly and keep my Alc level in acceptable range will I avoid those complications? Or will my condition worsen?
Thank you for your info,
Judy
A: Judy, You have done a great job! Remember, the leading cause of complications (blindness, end-stage renal disease, and non-tramatic amputaions) is not diabetes. The leading cause is UNCONTROLLED diabetes.
We do not
know if your body will need more assistance, with more or different medications as time goes on, but your meter
will help you. As you test your blood sugar levels you will be able to track whether the numbers continue to be safe. If the numbers become unsafe, you and your physician will be able to decide what the next step for you should be.
Ginny
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03/03/2009 -- Possible cure for Type 1 using cancer drugs?
Q: What's the latest in the possible cure for Type 1 using the 2 already approved cancer drugs? Are there any local studies?
A: I think the two cancer drugs you are talking about are the drugs Imatinib (Gleevec) and Sunitnib (Sutent). These are drugs that block an enzyme that is believed to be a factor in autoimmune diseases. The studies looking at these drugs is being done at the University of California with mice. There is no study calling for patient participation yet that I know of.
Harvard University has been studying how to activate genes that tell cells how to transform themselves and begin working another way. They are studying how to change cells in the pancreas that make gut enzymes that help digest food and have them make insulin instead. This has also been done in mice but they think it is at least two to five years from being tried in humans.
There may be other studies, but two clinical trials that I know of who are accepting patients are:
- A drug called Otelixizumab is under investigation in the DEFEND trial. This study is looking at how the beta cells in the pancreas are destroyed by the body itself and they wonder if the drug can stop or slow down the destruction process. This study is under way in phase 3 clinical trials and they are accepting volunteers. You must be a Type 1 and have been diagnosed with Type 1 in the last 90 days. Check defend@tolerx.com or call 1-877-515-6672.
- At Massachusetts General Hospital there is a study under way by Denise Faustman, in phase 1 clinical trials, studying the Bacillus Calmette-Guerin (the TB vaccine) which seems to decrease the abnormal immune cells that attack and destroy the beta cells. Since the BCG vaccine has been used safely for about 80 years, they are busy trying to determine the doses that are needed and the possible side effects. They are accepting volunteers for future clinical trials. Look up DiabetesTrial@partners.org to email this study group for more information. Scientists are getting closer and closer to finding a solution for Type 1.
Stay healthy until there is a cure for us!
Ginny Burns RN MEd CDE
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03/03/2009 -- Foot problems and diabetes?
Q: My husband is 37 years old. He has lost a significant amount of weight lately. He refuses to go to a doctor (because he said he needs to find a good one).
He finally went to a dermatologist for his feet because he couldn’t hardly walk. They are “Really” sensitive/red dry and cracked, and can never seem to get them just right. He asked the dermatologist if it was a sign of diabetes… The doctor said NO.
He works with a lady that has had diabetes since she was 3 and tells him it is, and can be related. I also have heard it can be.
Do you think it is a sign of diabetes? She has also tested him while at work before, because she has to do hers several times, and he has scared her before with his results. Do you think you can give me a referral (recommended doctor) that takes BC/BS insurance? I am just really concerned for him. Cancer and Diabetes run in his family.
Thanks.
A: Your husband needs a primary care physician. Please call Blue Cross Blue Shield (BXBS) and get the names of physicians who are on your plan. You want to have him see someone who is trained to deal with diabetes. Problems with feet often occur as the glucose levels rise. Other symptoms are urinating more frequently (especially at night), feeling very hungry, losing weight, feeling very tired, having pain or numbness in your feet and feeling very thirsty.
Please make an appointment for him to be evaluated and tested.
If he is diagnosed with diabetes, a fasting glucose level 126 or higher, he may need to follow up with a specialist. Since he has BXBS he may want to call the University of Utah Diabetes Center. They will work with his Primary Care Physician to take care of your husband. Please have his glucose levels tested so he can determine what his next step should be.
Please do this right away, Ginny
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03/03/2009 -- What is Type 3?
Q: What is Type 3 diabetes and how serious is it?
Pat
A: Type 3 is a fairly new term. It generally means a type of diabetes that is mixture of Type 1 and Type 2 (the old term was Type 1.5).
Patients who have Type 1 diabetes no longer make insulin. This type of diabetes generally is considered an auto immune disease where the body destroys its own cells in the pancreas that make insulin.
Type 2 diabetes occurs when the body becomes unable to process insulin properly and becomes resistant to it's own insulin. Over 95% of the people who have diabetes, have Type 2 diabetes.
Type 3 patients are often adults or children who have Type 1 diabetes, gain weight, and develop the signs of insulin resistance, which can also include high blood pressure and abnormal cholesterol.
A report from the Children's Hospital in Pittsburgh stated about 25% of children who were diagnosed with Type 1 diabetes also had symptoms of insulin resistance. Tests can be done to determine if a patient falls more in line with autoimmune distruction or insulin resistance. Sometimes patients fall in the middle. Medications are looked at carefully to decide which would work the best. Most physicians will use the medications that will lower the glucose readings first.
Regardless of the Type of diabetes, glucose levels need to be controlled. All abnormal glucose readings can damage a body: Type 1, Type 2 and Type 3.
Please take care, Ginny
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02/23/2009 -- Future with Type 2
Q: Thanks for giving us this opportunity to ask questions!
My husband (age 57) has had Type II diabetes for about 3 years. He does everything right, monitoring all his levels, lotions his feet every day, exercises regularly, goes to the doctor every 6 months. We are improving our diet (although slowly). My question is: If he continues to maintain this schedule, what will life be like in 10 or 20 years with diabetes?
P
A: Dear P,
Your husband is doing everything right: keeping track of his blood sugar levels and his HgbA1c levels. The studies tell
us that people who keep their levels in a normal range have fewer complications. For people who have Type 2 diabetes, the big three areas he needs to watch (with the help of his physician and you) are his glucose levels, blood pressure and cholesterol. Eating well and exercising will help with all three.
Remember, complications do not generally come from diabetes, they come from UNCONTROLLED diabetes.
Good luck to you both! Ginny
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02/23/2009 --Type 2 diabetes progression
Q: Ginny: I have read several obituaries lately indicating people have died from complications of type 2 diabetes, which I have had for a little over a year. I have my A1c level down to 5.8 and have lost 35 lbs. If I continue to eat sensibly and keep my Alc level in acceptable range will I avoid those complications? Or will my condition worsen?
Thank you for your info,
Judy Hatch
A: Judy, You have done a great job! Remember, the leading cause of complications (blindness, end-stage renal
disease, and non-tramatic amputaions) is not diabetes. The leading cause is UNCONTROLLED diabetes.
We do not
know if your body will need more assistance, with more or different medications as time goes on, but your meter
will help you. As you test your blood sugar levels, you will be able to track whether the numbers continue to be safe. If the numbers become unsafe, you and your physician will be able to decide what the next step for you should be.
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02/23/2009 -- Heart disease and high blood sugar readings
Q: My husband has been diabetic for 14 years now. Recently he had a 6 by pass surgery, since then he has not been able to control his levels. We have tried different medications. But he remains high like over 400-500 maybe higher, our machine only goes to 500 then it says high. Then also he drops very low and I had to get the paremedics here to revive him. I dont know what to do.
A: Dana, please follow up with your husband's family practice or internal medicine doctor, his cardiologist and the diabetes educators that you may have met while your husband was in the hospital.
The medications are used to lower the blood sugars---they match up with everything that makes the blood sugars go up---illness, stress and carbohydrates. If at times he is very high and then drops very low, there isn't a good match. Please meet with his doctors and the diabetes educators to learn more about what the medications are doing and how you can make better matches with the food he is eating.
Is there a diabetes clinic close to you? Please call for an appointment right away.
Please let me know how everything turns out. We want to make sure the blood sugars become lower and much steadier.
Ginny Burns
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01/27/2009 -- Gestational diabetes
Q: Hello Ginny,
I am 8 months of pregnancy. They found Gestational diabetes I have. Could you please let me know about special diet what I should use during last 9th month?
Thank you very much!
Respectfully, Olga
A: Olga, What did your doctor tell you to do? Did they want you to see a dietician? Did they want you to test your blood sugar levels?
It is best to see a registered dietician to help you design a diet that will help the higher than normal blood sugars that you are having but still provide your growing baby with the calories and nutrients that he/she needs. The dietician will also recomend the correct number of calories for you. It usually turns out to be about 2,200 to 2,500 calories a day if you are of average weight. If you are overweight the dietician may ask you to lower the amount of calories.
The dietician will teach you how to balance your diet. Diets are very individual but usually about 10-20% of the calories come from protein (meat, eggs, cheese, fish); less than 30% of the calories come from fat and the rest of the calories come from carbohydrates (bread, rice, fruit, milk, cereals ect). The dietician will teach you how to choose the healthiest carbohydrates.
In addition to the diet, your doctor may ask you to exercise 3-5 times each week to help control your blood sugar levels too.
To make sure the diet and exercise are working, your doctor may ask you to test your blood sugar at the clinic or use a blood sugar meter at home. It is important to know what these blood sugar numbers are! If the numbers remain high even after you change your diet and add exercise, your doctor may ask you to take insulin. Not many women need to take insulin but the blood sugar levels must be normal in order for you to have a healthy baby. Your doctor may need to monitor you and your baby more closely during these last few weeks. They may do ultrsounds, non-stress testing and/or other fetal movement charting. The doctor will be checking to see if the baby is growing normally. Most women are able to have a normal labor and vaginal delivery but some doctors will deliver the baby earlier or may suggest a cesarean section if the baby becomes too large.
After delivery, your doctor will also check to make sure your blood sugar level have returned to normal. It will be important to check again at the baby's six week check up and every 1-3 years to make sure your blood sugar levels are still normal.
Please contact your doctor right away and ask: Do I need to see a dietician? Should I exercise? Should I test my blood sugar? It will be important for the health of your baby!
Good luck, Ginny
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12/19/2008 -- Cold/Flu medication for diabetics
Q: Hi Ginny,
My name is Mike Walters (age 67) and I have been a type 2 diabetic for 6 years now. I have recently pick up a cold and can not shake it. I have been able to find Diabetic Tussin cough syrup, but unable to find Diabetic Tussin cold and flu tablets. I have been to all of the stores & pharmacies within a 10 mile radius of my home in Kearns and the only thing I can find is Cold-Eze which is a tablet that you have to let dissolve in your mouth and you have to take one every hour. (very inconvenient). My question is, do you know of any stores/pharmacies in the Salt Lake Valley that actually stock a regular supply of diabetic items (cold/flu meds, vitamins, testing supplies, etc.)?
Most of the stores I have been in stock only a token supply and it is mostly creams, sugar free snacks and maybe a bottle or two of Diabetic Tussin cough syrup. When I questioned some of them about their meager display, their response is there is not a big enough call for those items and they end up having to get rid of some items due to expired expiration dates. Yet right across the aisle is three shelf's of at least 20 brands of cold & flu medications which you know are not going to all be bought before the expiration dates. I wish the neighborhood grocery/super market stores would realize that there are a lot of diabetics in the world and we get colds also and we don't want to have to running to our doctor to get medication just for a cold. I would like to be able to buy something off of the shelf for 8 or 9 dollars, rather the paying the doctor for a visit and paying for a prescription.
Thanks for letting me bend you ear.......................Mike
A: Mike, I was so interested in your comments, I began to search for answers and comments about cold medications too. Just as you did, I called many pharmacies and diabetes supply stores in the Salt Lake Valley. The answers I received were very similar to the answers you received---there isn't enough of a demand so often the supplies become outdated and must be thrown away. There is generally a minimum amount the stores must order from large suppliers and if the supplies are not sold by a certain date, they must be thrown away. Most pharmacies, large or small, can not afford to lose any money.
Many pharmacists stated that there is a worry that active ingredients (the ingredients that treat the symptoms) or inactive ingredients (the ingredients that don't have any treatment value but are fillers or give a flavor) in the medications may affect patients with diabetes. If there is even a slight chance that patients will be harmed, the company will print on their labels that their product is not for patients who have diabetes. How can we decide which ones may be O.K.??? Our physicians can be the ones who can help us decide. I know it is expensive, but you want the best advice you can find to choose products that will help you and not harm you.
After checking with several Internal Medicine physicians and Eye, Ear, Nose and Throat specialists, there does seem to be a very simple procedure that may help stuffy noses without using any medication. A recent article by Pynnonen, Mukerji, Kim, Adams and Terrell found that saline irrigation or nasal washing was more effective that a saline spray. A patient I spoke to also uses this procedure to help with his stuffy nose that he gets at times from allergies. This procedure is not done frequently in the United Stated, but it seems to be gaining in popularity. Check with your physician to see if this simple procedure can be done safely at home to relieve some of the symptoms you get when you have a cold.
Thanks Mike for your very interesting letter.
Good luck to you, Ginny
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12/17/2008 -- Vegetarian and diabetes diets
Q: Dear Ginny,
Kindly tell me any website where I could get access to diet planning of diabetes patients. In the meantime, kindly send a menu for 1400 caloric vegetarian menu with 40% CHO, 40 Fat and 20 Protein.
Dr. Shankhdhar
A: Dr. Shankhdhar,
There are several on line sites that you can direct patients to learn about vegetarian diets. Try www.MayoClinic.com, www.Veggie123.com and for a free diet www.SparkPeople.com. A book can be ordered from the American Dietetic Association "Becoming Vegetarian" for $5.00. It is difficult to just send a diet plan without knowing what type of vegetarian diet your patient is looking for.
- Are they Lacto-ovo Vegetarian: eating mostly plant foods but also eating eggs and dairy?
- Are they Lactovegetarian: eating no meat, no eggs but eating dairy?
- Are they Vegan: eating no animal proteins or animal by products?
- Are they just avoiding red meat?
I would direct your patient to a registered dietitian to be sure they obtain the diet they prefer and obtain a well rounded diet so the nutrients that are at times missing in a vegetarian diet are present: calcium, Vitamin B12, Iron and Zinc.
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11/25/2008 -- Prediabetes concerns
Q: Hello! I found this Q&A board through Diabetes Daily.
This past January I was told that because my fasting BS was 104 and my A1C being 6.4% that I have early adult onset diabetes. It was quite a shock because I don’t fit the typical profile. I am and always have been the ideal weight for my height, exercised all my life, eaten sensibly and avoided desserts (except small portions occasionally).
My GP informed me that at some point he would put me on medication. Three months later my A1C decreased to 6.1% and my doctor was pleased and merely stated that I should keep on doing what I have been doing. I’m sure you hear this all the time. I did cut back on my carbs and that must have explained the decrease in the A1C reading I did fail to mention that no one to my knowledge had diabetes in my family. In my excitement that my A1c was lower, I didn’t ask my GP about medication and he didn’t mention it at that particular visit.
I have a few questions………….is it possible that I may never get diabetes, how do I keep from losing weight if I cut out so many carbs I’m already compensating by eating walnuts, Omega peanut butter and using more olive oil in cooking, and should I see an endocrinologist for better information?
I am checking my BS upon waking, before meals as well as postprandial. The lowest reading I had was 83 and the highest 120 after a meal.
Any information you can send me is appreciated.
I am female and 59 years of age. My total cholesterol is 220, but the breakdown numbers are good and the reason it’s high is because my HDL is so high, which is a good thing:
- HDL = 120
- LDL = 87
- Triglyceride = 64
Thank you in advance for your response.
A: It sounds like you are doing everything right for your body! The changes you have made have given you glucose readings that are in the normal range. It is important to control your diabetes when it is in the very early stages in order to help prevent any possible complications. We don't know why some people develop Type 2 diabetes when there is no family history and weight is normal. It is not something that you have caused.
Often, the first medication of choice is Metformin. Your physician may not have thought you needed to start this medication, or any other, because the glucose readings looked like they had improved. Your lifestyle changes have helped control the diabetes. Be sure and stay in touch with your physician and continue with your follow up appointments so you can keep track of the glucose readings to see if you need medication.
If you do need medication, you have not failed!!! Remember diabetes is a progressive decline in beta cell funtion (beta cells are our cells that produce insulin) and often over time your body may just need some extra help. Your glucose readings will let you know if any medication is needed. You want to have a healthy diet, healthy weight and feel physically strong. If you are too hungry and your food intake is too small, please see a diabetes dietician who will help determine a carbohydrate, fat and protein intake that will work well for you. You are doing such a good job!!!
Ginny
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10/27/2008 -- Lips Tingle
Q: Why do your lips tingle when your blood glucose is low?
A: Nerves thoughout the body are often irritated when glucose levels are low. Sensory facial nerves can be affected and some reported symptoms have been with eyes, with twinkling lights in the periphery or colors that become vivid; ears with buzzing in the ears or loss of hearing; with cheeks that tingle or itch; and lips and/or tongues that tingle or become numb.
I asked several endocrinologists if they noticed specific low glucose readings when these symptoms occurred and they didn't. The numbers that have been reported from patients have ranged from 10 to 90mg/dL. It was very individual and seemed to often depend on how fast the glucose levels had fallen. The endocrinologists felt that the faster the readings fell the greater the occurance of symptoms. Numb tongue and lips, rather than just tingling, were associated with the lower readings however. If these are symptoms that you experience, be sure and test your glucose levels right away and treat quickly.
Thanks for the great question! Ginny
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10/16/2008 -- Family History & Diabetes Prevention
Q:My father developed Diabetes in his late 40s. I'm approaching my 40s and want to avoid this disease if possible. Is there anything I can do to be proactive in preventing Diabetes? To what extent is genetics a major contributing factor in developing Type II diabetes?
Thanks,
Dave
A:Dave,
Having parents or siblings with Type 2 does put you at a greater risk of developing Type 2 Diabetes. Being proactive now may help you prevent diabetes from developing. If you can, check with your primary care physician and see if you have had a fasting blood sugar test during a recent visit. If not, see if you can have this very quick test done. The fasting blood sugar should be below 100. If it begins to rise, it is a signal that something is happening.
The American Diabetes Association tells us that if the fasting blood sugars are between 100 and 125, this is considered prediabetes. It means you have not been diagnosed with diabetes -- the fasting glucose would have to be 126 or higher -- but you are certainly headed in that direction. It is often very helpful to learn where your fasting blood sugar is standing.
The best way to prevent diabetes is to make several important lifestyle changes.
- Start to exercise and become active (check with your physician first if you have any health problems that would prevent you from becoming active).
- Try eating smaller healthier meals (Try using higher fiber foods like whole grains, fruits and vegetables and try to eat less fried or high fat foods).
- If you need to, try to lose 5-10% of your current body weight and it will take a tremendous amount of pressure off your system.
Good luck to you!
Ginny
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10/3/2008 -- Dessert & Diabetes
Q: I am a type 2 diabetic. I currently am managing my diabetes with oral medicine. My numbers are currently between 90 – 126. if I increase my exercising would I be able to have a piece of cake or pie? I would also limit my carbs that day.
Kathy
A: Kathy,
It sounds like you have been giving this some thought. Your medication and exercise routine are helping your body handle the carbohydrates you are eating. Since the glucose readings are so very good, it sounds like there is a good balance in what you are doing. How many grams of carbohydrates are you eating per meal? Remember, cake and pie are carbohydrates too and they can be substituted for other carbohydrates in a meal if you choose.
For example--- You might want a piece of pie for dessert after dinner (a slice of pumpkin pie, about 1/8 of a pie has about 30 grams of carbohydrates). If you usually have 45 grams of carbohydrates for dinner, you could have chicken, salad and green beans with a biscuit (a 2 and 1/2 inch biscuit is about 15 grams of carbohydrates) and then use the remaining 30 grams of carbohydrate for your piece of pie. Generally a piece of fruit pie, with 2 crusts, has about 45 grams of carbohydrates. If you choose a piece of fruit pie, you would need to substitute the fruit pie for all the carbohydrates in our sample dinner.
A quick check of your glucose two hours after eating will let you know how your body handled the carbohydrates. You should be able to choose the carbohydrates you would like to eat at each and every meal. If you need to learn more about carbohydrate counting and making substitutions check with a diabetes dietician.
Everyone feels like a little dessert at times---even people who have diabetes! With a few adjustments you should be able to have dessert and keep the glucose readings in your range.
Good luck to you, Ginny
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10/2/2008 -- Ideal A1C Level
Q: I've heard that the ideal A1C number is lowering (below 6.9%) and that the formula for calculating the percentage of sugar in the blood is now different. Is this true? What should my goal be?
L
A: L, the way the test is changing will be how it is checked in the lab. Our results will be showing us an average blood sugar that is associated with the HgbA1c % (Glycosylated hemoglobin). This should make more sense to us as the number will relate more to what we usually see on our meters. The labs that run my tests have a normal range of 4-6%.
Some labs have different normal ranges so check your number with what the normal range that your lab uses. Generally the closer our %s are to the normal range, the better off we are. 6%-7% is generally seen as the safest range for patients with diabetes. The closer you are to normal, 6%, generally the better your diabetes control.
The closer to normal is better but WITHOUT HYPOGLYCEMIA.
Ginny
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10/2/2008 -- Continuous Glucose Monitor vs. Insulin Pump
Q:Ginny,
I have had type 1 diabetes for 18 years, using an insulin pump for 13 years, and now am investigating a continuous glucose monitor. What are the advantages and disadvantages of shifting to this system? Is it a closed loop system?
thanks very much
Laura
A: Laura, There are 3 continuous glucose sensors out on the market and all have advantages and disadvantages: DexCom 7, Navigator and Minimed. There may be others that will have appeared on the market since I have written this letter, but these are the big 3 in the market place today. The advantages is that they all show you results of your blood sugars every minute or every 5 minutes.
I have worn each one and love knowing how my glucose levels are rising and falling during the day and night. The amount of information you can see is amazing. The disadvantages is having another item on your body besides your pump. They vary in size and calibration needs so be sure and check out what you think of each system. 2 sensors, DexCom and Navigator, do not connect with pumps directly but will have ways to overlay the results with different insulin pump information that you can download from your pump. The sensor made by MiniMed sends glucose information to their MiniMed pumps, but it is not a closed system. You still need to look at the results and tell the pump what to do. Check out the web site of each sensor so you can see them for yourself.
The results are amazing and I love wearing this type of device. If you see an endocrinologist, ask if you can wear one on a trial basis or meet with one of the representatives at his office. Check with your insurance company as the coverage is getting better and better. Good luck!!
Ginny
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9/15/2008 -- Shoes & Diabetes
Q: Ginny, I have had Diabetes for over 40 years and have been one of the luckier ones, my older siblings both died from complications of having diabetes. My sister never even knew, my brother passed away after 25 years with it.
My question is where is a good and reasonably priced place to purchase a good pair of shoes that work well for a Diabetic who has some problems with finding a shoe that fits and is comfortable to walk and even stand in?
Thank You,
Don
p.s. I have been a pump for over 15 years. (works great)
A: Have you gotten any guidelines from your podiatrist for what you need? There are some specialty shoe stores that will help with shoes for diabetic feet but I think the best place to start may be a diabetes specialty store that also sells shoes. Check in the phone book and call to make sure you find a store that you feel will help you with your special issues.
Very few of our insurance companies in Utah cover specialty shoes but a few do, so be sure and check with your insurance policy to see if there is any coverage. Medicare does cover but you will need a prescription; Medicare will cover 80% of the cost. Generally a pair of specialty shoes will cost $130 to $150. Be sure and discuss the cost with the store you are checking with to see if they provide any assistance for someone paying cash or can help with a payment plan.
I know shoes may be expensive, but it is so very important to take care of our feet! Three cheers for you wearing a pump for 15 years!!!
Ginny
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For more information, please contact:
Grant Sunada, Media Liaison
Utah Diabetes Prevention and Control Program
PO Box 142107
Salt Lake City, UT 84114-2107
Phone: (801) 538-6896
Fax: (801) 538-9495
E-mail: gsunada@utah.gov
This Utah Department of Health web site is designed for informational and educational purposes only. It is not intended for diagnosing or treating a health problem or disease. It is not a substitute for professional care. If you suspect you have a health problem, contact your health care provider.
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