Q & A from Janis Roszler, MSFT, RD, CDE, LD/N

Q. I'd like to give a holiday gift to my friend with diabetes. Any ideas? 

A. Here are a few items that make great gifts:

• Diabetes-friendly cook books. 
• A diabetes identification bracelet. Here are two websites that sell unique styles:
• www.laurenshope.com - This site carries crystal, sterling and gold-filled beaded bracelets and gives a portion of the profits to the Juvenile Diabetes Research Foundation.
• www.nicolejohnson.com  - This is the website of Nicole Johnson, former Miss America and host of dLife TV.  It offers an elegant design that Nicole helped create.
• An exercise video or gift certificate to a yoga class.
• Workout-related items, including a gym bag, towel and water bottle.

You can always make a donation to a diabetes organization.  Here are a few:

• American Diabetes Association (www.diabetes.org)
• dLife Foundation (www.dlifefoundation.org)
• Joslin Diabetes Center (www.joslin.org)
• Juvenile Diabetes Research Foundation International (www.jdrf.org)

Q.   I’d like to donate blood.  Does having diabetes disqualify me from doing this?

A.   Having diabetes should not prevent you from giving blood, as long as you feel well at the time that you donate.  However, if you used any bovine-derived insulin produced by Novo Nordisk in the early 1980’s, you may not be eligible to give.  The concern is that the beef content of this insulin may have introduced certain elements into your blood that make it inappropriate to share. Please discuss your eligibility with your local American Red Cross office or local blood donation center.  Giving blood truly saves lives.  I plan to do it this month and hope all of you will too!

Q.   How much should I weigh?

A.   Here is an easy way to estimate your desired body weight:

For women:

1.  Measure your height.
2. For the first 5 feet, give yourself 100 pounds.
3. For each inch over 5 feet, add an additional 5 pounds.
4. If you have large wrists, which indicate a large frame, add an additional 10%.
5. If your wrists are slender, which indicate a small frame, subtract 10%.
6. For a medium frame, add nothing to your total.

Example:  Joan is 5 feet 4 inches.  She adds 100 pounds plus 20 pounds, which equals 120 pounds.  She has a large frame and adds 10% (12 pounds).  Her desired weight is 132 pounds.

For men:

1.  Measure your height.
2. For the first 5 feet, give yourself 106 pounds.
3. For each inch over 5 feet, add 6 pounds.
4. If you have a large frame, add an additional 10%.
5. If you have a small frame, subtract 10%.
6. For a medium frame, add nothing.

Example:  Marc is 5 feet 10 inches.  He adds 106 pounds plus 60 pounds.  He is medium framed and should weight about 166 pounds.

Remember, the weight that you calculate is just an estimate.  Your personal need may be different.  Review your answer with your health care team.

 *This article originally appeared in 2007

**please consult with your healthcare provider before making any changes to your diabetes regimen.

- For more great articles by Janis Roszler, visit the e-version of our magazine at walgreensdiabetes.com 

Q & A from Janis Roszler, MSFT, RD, CDE, LD/N

Q.   I really try to follow my diabetes diet, but just can’t do it.  Do you have any ideas that might help me?

A.   Your diabetes meal plan shouldn’t be a burden.  If it is, meet with a registered dietitian who can redesign your plan to better fit your preferences and lifestyle.  If you find that you still indulge once in a while, try to do the following:

• Learn to treat abnormal glucose levels that may result from eating foods in portions that aren’t recommended.
• Don’t punish yourself for veering off your redesigned meal plan!  We are all human.  If you make a poor food choice, forgive yourself and eat healthier at your next meal.
• Learn your A1C number.  Most experts recommend a starting A1C goal of less than 7 percent with an ultimate goal of less than 6.5 percent.  If your A1C level is good, an occasional high blood glucose meter reading should not be a problem.  If it is too high, meet with your healthcare team to adjust your treatment plan.

Q.   If I have to start insulin, will I ever be able to stop?

A.   If you have type 1 diabetes, the answer is no – you must take insulin from an outside source because your body can’t produce any of its own.  If you have type 2, it may be possible to reduce or even eliminate your need for insulin if you do the following:

1.  Follow a healthy meal plan.  A registered dietitian who specializes in diabetes can help design a meal plan that fits your lifestyle and improves your diabetes control.
2. Stay physically active.  The addition of even a small amount of movement can make a significant improvement in your blood sugar control.  Discuss exercise choices with your doctor before starting.
3. Lose weight, if needed.  You should be able to see an improvement in your diabetes control after a small amount of weight loss.

Q.   Is it true that pregnant women with diabetes make more amniotic fluid?  I had an awful lot of fluid appear when my water broke and the nurse blamed it on my diabetes.  Just curious.

A.   This is actually true. Women who are pregnant and have diabetes may make more amniotic fluid if their blood glucose level runs high during the pregnancy.  Those who control their glucose level well will probably produce the same amount as other women.

Q.   I used to feel my blood sugar level drop, but can’t anymore.  Can I ever get the sensation to return?  

A.   Unfortunately, it is very common to lose the ability to feel a drop in your blood glucose (sugar) level when it runs low.  This often happens to people who make a real effort to keep their blood sugar level in a very narrow range.  Some experts also believe that frequent low blood sugar episodes can cause this unawareness to develop.  It may be possible to get this sensation to return or to better anticipate when it may drop, by trying the following:

• Maintain blood sugar level within 80-180 mg/dl for 2-3 weeks.  Many people have regained their ability to feel blood sugar lows after doing this.
• Meet with your health care team to review your daily blood sugar test results for patterns.  You may be able to learn to predict when a low will occur and change your eating and/or medication schedule to help prevent it.

*This article originally appeared in 2010

** please consult with your healthcare provider before making any changes to your diabetes regimen.

- For more great articles by Janis Roszler, visit the e-version of our magazine at walgreensdiabetes.com 

Q & A from Janis Roszler, MSFT, RD, CDE, LD/N

Q.   I recently went to a restaurant and ordered a diet drink.  The waitress accidentally brought me a regular soda and boy did I have problems with my blood sugar level after drinking it!  How can I keep this mistake from happening again?

A.   Here are a few suggestions that may help:

1. If possible, watch the serving staff pour your drink.
2. Ask the waiter to place a slice of lemon in your diet soft drink. This request makes your order is a bit unusual, so the waiter must give it a bit more attention as he or she pours it into the glass. 
3. When riding a plane, request the can, so you can be certain that you are getting a diet beverage.  If they refuse, tell them that you have diabetes and have a medical need.
4. Take a sip or two before enthusiastically drinking your entire beverage; you may be able to taste the difference.
5. Carry a bottle of visual glucose test strips that change color when sugar is present.  If it changes color when you dip it into your drink, your beverage is not a diet one.

Q.   I think I’m starting to enter menopause. What kinds of diabetes-related changes can I expect to see?

A.   You can expect the unexpected. As your hormone levels start to change, your blood sugar control may become a bit unpredictable.  Test frequently and you should be fine. Hormonal swings can create symptoms that resemble blood sugar swings. If you think that your BS level is low, test it before you take a high carbohydrate snack. Your feelings may have nothing to do with your blood sugar level.  If you treat a blood sugar low that isn't really there, your level will climb and you will gain weight. Exercise regularly and stay active.

Q.   This is a sensitive subject.  I wear an insulin pump. Lately, after being intimate with my spouse, my blood sugar level shoots way up into the 300’s.  Why do you think this is happening?

A.   This same problem happened to a patient of mine. She discovered that her pump infusion set was moving out of place during sexual activity.  When this happened, she stopped receiving insulin and her blood sugar level went high.  Not everyone wears a pump during intimacy, but some find that they need the insulin.  If you don’t have enough insulin in your system when participating in any physical activity, your blood sugar level may climb. Try moving your infusion set to another area on your body or secure it better with special adhesive tape. Contact your pump company to order some.

Q.   I think I’m developing diabetes.  My doctor says that my fasting blood sugar level is fine, but my blood sugar level is running higher than normal (at least 200) after meals.  Is it possible to tell if I have diabetes by checking my after-meal blood sugar level?

A.   I’m impressed! You are on the right track.  A person’s fasting blood sugar level is usually the LAST level to show a change as type 2 diabetes develops.   Unfortunately, it is often the only level that is checked by health care professionals. Many people who are diagnosed with type 2 diabetes discover that they probably had it for many years before it was finally identified by their physician. You are catching a growing problem nice and early.  Bring this information to the attention of your doctor or see an endocrinologist (diabetes specialist).

*please consult with your healthcare provider before making any changes to your diabetes regimen.

- For more great articles by Janis Roszler, visit the e-version of our magazine at walgreensdiabetes.com 

Q & A from Janis Roszler, MSFT, RD, CDE, LD/N

Q.   The winter killed my skin!  It is red, chapped and itchy.  What do you suggest?

A.   Here are several suggestions that may help:

• Use plenty of moisturizing lotion or cream to relieve the itch that often comes with dry skin.  It can help heal the irritation and cracking, and also prevent future damage from occurring.
• Drink plenty of water to stay hydrated.
• Keep your blood glucose level in a healthy range.  A high level can cause the skin to become dehydrated and slow healing. 
• Wear gloves while the weather is cold.
• If the irritation continues, see your doctor or dermatologist for additional guidance.

When you have diabetes, it is important to protect your skin from injury as cuts can invite the development of an unwanted infection.  Hang in there.  The weather should be improving soon!

Q.   I keep chocolates in my home in case my blood sugar drops.  A friend told me that people with diabetes shouldn’t eat chocolates. Why not?

A.   People with diabetes can enjoy most foods, including a small amount of chocolate, if it fits into their daily meal plan.  But chocolate is not the best food choice when managing hypoglycemia (low blood sugar). The fat in the chocolate slows down its absorption, so it won’t raise your glucose level as quickly as other foods will.  If that’s all you have handy you can use it, but it isn’t ideal.  When treating a low blood glucose level, use the 15/15 Rule:

1.  Eat 15 grams of a fast acting carbohydrate, such as those listed below.

2.  Wait 15 minutes

3.  Test again

4.  Repeat if needed

The following items contain approximately 15 grams of carbohydrate:

½ cup (4 oz) of fruit juice

Half a can of regular (not diet) soda

2-5 Glucose tablets (check label)

Two tablespoons of raisins

5-7 hard candies

Your blood sugar level will begin to rise before the unpleasant feelings disappear, so don’t keep eating or drinking until the feelings go away.  That will cause your glucose level to climb too high and may cause you to gain weight.

Q.   I was just diagnosed with type 2 diabetes.  I’m so ashamed. Do I have to tell people I have it? 

A.   First, let’s tackle your feelings of shame.  You did NOT cause your diabetes.  Diabetes is a complex condition that can be triggered by certain lifestyle behaviors, such as weight gain and inactivity, but you must inherit the potential to get it.  You are also not alone.  23.6 million Americans have diabetes and 57 million have pre-diabetes, which means they are on their way to developing it. The good news is that you can now take steps to become healthier.  Attend a diabetes class and learn how to make better food choices, achieve a healthy weight, and feel better than you have felt in a long time.

As for telling people, your medical health is a personal issue.  Share your diabetes information with those who can support you and help you in an emergency. If you believe someone will make fun of you or make it more difficult for you to care for your health, don’t say a word. 

*This article originally appeared in 2010

**please consult with your healthcare provider before making any changes to your diabetes regimen.

- For more great articles by Janis Roszler, visit the e-version of our magazine at walgreensdiabetes.com