dLife TV: Insulin Pumps, Insulin at Night, Exercise's effect on Blood Sugar

dLife TV is all about you. Bringing you real people with real stories, as well as celebrities, cooking, and entertainment, a dLife episode gives you information and inspiration about your diabetes. Don't take my word for it- click on the link and see for yourself:

dLife TV: Will an Insulin Pump Take Care of My Diabetes?

http://www.dlife.com/dlifetv/video/joy-pape-pumps

dLife TV: Insulin at Night

http://www.dlife.com/dlife_media/dlifetv/video/insulin-at-night

dLife TV: How Does Exercise Affect My Bloodsugar?

http://www.dlife.com/dlife_media/dlifetv/video/dlife-mail-exercise-blood-sugar

For more dLifeTV, visit www.dLifeTV.com every Sunday night at 7pm ET/4pm PT

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.   Please settle this bet. I love to keep my blood sugar level as low as possible.  I mean really low, below 60, if possible. I take quite a few shots of insulin to help me do this. My mother says that this is really dangerous.  Isn’t lower better? Who is right?

A.   I have to side with Mom on this issue.  The human body isn’t meant to be at an extremely low blood sugar level.  It is even designed to release additional glucose into the system if it goes too low.  Pushing the body’s sugar level down can lead to brain damage, seizures, and possibly death.  Low is defined as 70 or below.  Please try to maintain your level above that.

Q.   I was just tested for diabetes.  My first fasting blood sugar level was high, but my 2^nd test was normal.  What should I do now?

A.   Unless you have unmistakable high blood sugar symptoms, any diagnostic test should be confirmed with a second test before making the diagnosis of diabetes. Because your second test didn’t detect diabetes, you probably fall into the pre-diabetes range. If you make a few changes in your current health behaviors, you should be able to delay or possibly avoid developing type 2 diabetes.  Here are some actions that you can take right now:

• Do some form of physical activity at least 3 days each week, (with no more than two consecutive days without any activity), and try to increase your movement throughout the day.  If you haven't exercised in a while, start with a 10 minute session and increase your daily workout by 5 minutes each week, until you reach a 30 minute goal.  A helpful book is The 7 Step Diabetes Fitness Plan, by Sheri Colberg, PhD (Marlowe & Co.)

• Meet with a dietitian to learn how to make healthier food choices. If you wish, follow the Plate Method, which is very simple to do. It uses your plate as a measuring tool and enables you to continue to eat out. The basic plan is to fill ½ of your plate with non-starchy vegetables, ¼ of your plate with carbohydrate foods, and ¼ of the plate with your protein choice.  A serving of fruit and low-fat milk can also be enjoyed.  To learn more about this meal planning tool, visit http://www.platemethod.com/downloads/4.doc

Nuts and seeds (sunflower, pumpkin, etc.) are healthy, high in calories and shouldn’t raise your BS level.  Just sprinkle chopped or ground nuts onto your cereal and yogurt, mix them into burgers and meat loaf, and enjoy them between meals. You can also enjoy diabetes-friendly snack bars and meal replacement drinks as snacks.

*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'm very skinny and I think I found a great place to inject insulin – in my breasts! It seems to work so well there.   What do you think?

A.   I do NOT recommend injecting insulin into the breast area. Insulin injections can cause scarring and lumps to develop. The breast is one area that you really want to keep lump-free. Having lumps or scarring in the breast can make it more difficult to locate malignant lumps and problems. Please consider using another location, such as your abdomen, upper buttocks or hips, the back of your upper arms, or the outer side of your thighs.   These areas have a layer of fat just beneath the skin, so they absorb insulin well.  They also have fewer nerves, so they should be more comfortable sites for you to use.
Q.   Does massage help diabetes?
A.   Some studies suggest that massage can improve blood sugar levels and lessen the symptoms of diabetic neuropathy (nerve problems).  Massaging an injection site may also increase insulin absorption. In addition, a relaxing massage may also reduce stress, which is also a plus.
Q.   I read that I can buy special diabetes snack bars that will help keep my blood sugar level from dropping while I’m asleep.  Money is tight right now.  Is there something that I can make myself instead of buying the bars?

A.   Extend Bars were created by Dr. Francine Kaufman, a top pediatric endocrinologist and former president of the American Diabetes Association as a tasty and effective way to help prevent her patients from experiencing blood sugar lows during the night.   They contain a slow-digesting form of carbohydrate.  To make your own slow-digesting carbohydrate snack, add about   1 1/2 teaspoons of UNCOOKED cornstarch to milk, a shake or pudding. The cornstarch must be uncooked or the carbohydrate in the cornstarch will be broken down too quickly.

Q.   Its allergy season, so I started taking my annual doses of allergy medication.  I recently noticed that my blood sugar level is running higher than usual.  Do allergy medications raise blood sugar levels?

A.   You didn’t mention which medication you are taking, but if it contains an epinephrine-like drug such as ephedrine, pseudoephedrine, or phenylephrine, it can raise your blood sugar level.  If it does not contain this, the physical stress of living with allergies could be the cause. Your blood sugar level will often climb when your body is stressed in any way, emotionally or physically.

Q.   I recently read an article on the Internet that recommends eating raw celery as a way to lower blood sugar levels.  I’ve never heard this before.  Is it true?

A.   No reliable research shows that raw celery can lower blood sugar levels.  Be wary of information that you read on the Internet, especially if it isn’t posted on a reliable website by accepted medical experts.  Here are a few health websites I recommend:

Americanheart.org

Cartoonmd.com

Consumerlab.com

Dearjanis.com

Diabetes.org

Eatright.org

dLife.com

jdrf.org

joslin.org

medlineplus.gov

WebMD.com

*This article originally appeared in 2009

**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.   Can you suggest a few holiday gifts for someone who has diabetes?

A.   Sure! Here are several diabetes-friendly gift ideas:

• Exercise videos or a health club membership. 
• A massage.
• A bicycle or other piece of exercise equipment.
• A romantic date that includes dinner plus a night of dancing or tickets to a show.
• Assorted low carbohydrate snacks and a diabetes-friendly cookbook arranged in a new piece of cookware.
• A selection of relaxing music CD’s. 
• Slippers and a robe.  Choose slippers that have solid soles as people with diabetes must protect their feet from cuts and other injuries that invite infections. 
• A new diabetes book. 
• Make a donation in your friend’s honor to the International Diabetes Federation’s Life for a Child Program.  This program supports the care of close to 1100 children with diabetes in more than 18 countries worldwide.  Their website is www.lifeforachild.idf.org

Q.   I get a flu shot every fall.  A friend told me she got a pneumonia shot also.  Do I need that too?

A.   According to the American Diabetes Association, people with diabetes are three times more likely to die from pneumonia than those without diabetes.  You can take a pneumonia shot anytime during the year.  A single shot will protect most people for their entire lifetime.  Ask your doctor if a pneumonia shot is right for you.

Q.   Can I ski while wearing an insulin pump?  What if I fall?

A.   Your pump can definitely join you on the slopes.  Pump cases are made from a plastic similar to the type used for motorcycle helmets.  They tolerate bumps quite well, so you needn’t worry about taking a fall. You can also purchase a comfortable holder from your pump company, so your pump will stay on securely. 

Athletic activity requires an adjustment in insulin delivery rate as exercise usually lowers blood sugar levels.   Also, very cold or windy conditions may intensify the blood-glucose lowering effect, so monitor your blood sugar level often.

Some experts recommend the following:

• Reduce your mealtime boluses by 10-30% for all-day or intense skiing and snowboarding.
• Reduce your basal insulin rates by 25-50% for the entire day.
• If needed, eat 10-15 grams of additional carbohydrate per hour.

Q.   Who discovered insulin?

A.   The discovery of insulin is a great story.  The year was 1921.  In a poorly equipped, long-forgotten lab in Toronto, Canada, Dr. Frederick Banting and Charles H. Best began their research.   They were given about eight weeks to prove Banting’s belief that the pancreas contained a magical substance that could prevent diabetes.  Using the money from the sale of Banting’s car, the researchers started their work.  The first few weeks were terribly disappointing.  Finally, as the seventh week approached, a breakthrough happened.  Banting isolated the “anti-diabetic factor” and demonstrated its ability to lower blood sugar in diabetic dogs.

Banting was awarded a Nobel Prize for medicine with Dr. John J. MacLeod, who provided the research lab.  Upset that his associate, Charles Best, had been slighted, Banting shared his Nobel Prize with him.  Later, Banting was knighted by the Queen and became Sir Frederick Grant Banting.  In 1922, Banting and Best became associated with Eli Lilly and the commercial production of insulin for human use began.

*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