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.   What would you tell someone who tries to stay on a diet, but cheats every now and again?

A.   Diabetes meal planning has changed a great deal in recent years.  Foods that used to be forbidden, such as sugar, can now be enjoyed in modest amounts.  As long as your A1C level (average glucose level for the past 2-3 months) is in a healthy range and you feel well, you are probably doing fine. 

If your blood sugar level is not in a healthy range, try the following:  

·       Meet with a registered dietitian to learn how to incorporate your favorite foods into your meal plan. 

·       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 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.   My doctor wants me to take insulin.  Once I start it, can I ever stop?

A.   If you have type 1 diabetes, the answer is no; your body requires insulin from an outside source because it 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.  Only a small amount needs to be lost in order to see an improvement in your diabetes control.

Q.   People tell me that they can feel their blood sugar level drop.  I can’t.  Is there something wrong with me?

A.   Many people with diabetes lose the ability to feel when their blood sugar level runs low.  This often occurs in individuals who work hard to keep their blood sugar level within a very narrow range.  Some experts also believe that frequent low blood sugar episodes can cause this unawareness to develop.  If you have “hypoglycemia unawareness” try the following:

• Check your blood sugar level more often throughout the day.
• 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 predict when a low will occur and change your eating and/or medication schedule to help prevent it.
• Always check your blood sugar before you drive a car; you don’t want to be behind the wheel when your blood sugar level is low.
• Carry carbohydrate snacks to treat surprise lows – glucose tablets, sugar packets, jellybeans, etc.
• Teach your friends, family and co-workers how to help you if your blood sugar level goes low.

*This article originally appeared in 2008

**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 

What Your Heart Really Needs

There's nothing like a Greek Salad for the health conscious- the heart-health conscious,  that is. What studies have shown is that the two biggest favors you can do for your heart is to start yourself on a Mediterranean diet and a high-intensity interval training exercise routine, today.  In a study recently released at the Canadian Cardiovascular Congress, there was shown to be a pretty big correlation between these lifestyle changes and heart health improvement in people with abdominal obesity. Some common results from sticking to this diet and exercise plan were weight loss, improved muscle endurance, and blood sugar control ( to only name a few). Also, good news for those with diabetes- those study participants with diabetes showed, on average, a 23% improvement in blood sugar levels.

To get you started, the staples of a Mediterranean diet include fruits and veggies, potatoes  beans, nuts, seeds, breads and other cereals. You can get creative, and opt for a breakfast of fat-free, plain Greek yogurt (don't have too much dairy products, though) with some berries, or some fresh veggies and hummus ( chickpea paste, typically seasoned with lemon juice, olive oil and/or garlic). Ideas for Mediterranean meals are endless, and delicious  and easy to find online, in health magazines and on TV. So, if you're the health conscious type, experimental type, or just looking for a proven and effective diet, go for it- you can only lose. 

To read more on this story ( and read some other great articles!) , visit our site at http://www.diabetesdigest.com/article/Diabetes-Headlines:-The-link-between-alcohol-consumption-and-metabolic-syndrome,-and-more/583#.Um7-NdKsgk0

Rebecca