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

Q.   I want to start using an insulin pump, but my insurance won’t pay for one.  I spotted a pump for sale on eBay the other day.  Is it safe to buy one from there?

A.   Please do not get a pump from eBay!  I’m a fan of that site, but it isn’t the place to purchase important medical equipment. A pump provides a life-saving service. One that is advertised on eBay, which is an online flea market, could be used, reconditioned, damaged, sold as new when it isn't new at all, etc. A pump should be purchased from a reliable source. Many people who are initially turned down by their insurance carrier are often accepted later.  Have one of the pump companies contact your insurance company on your behalf.  They may be able to turn things around for you.

Q.   Yesterday, my emotions were all over the place.  I’m comfortable and then suddenly feel like crying.  Does this happen often with diabetes?

A.   Mood swings can be caused by a variety of different things including stress, medications, and blood sugar swings. To see if your blood sugar level is the cause, test it during one of your emotional moments and see if it is within your target range. To help maintain your blood sugar level in a healthy range, stay physically active, take your diabetes medication as directed, don't skip meals, and choose foods that have a lower glycemic index value.  The glycemic index ranks the effect that foods may have on blood glucose levels; high values may cause a more rapid rise, and lower values may have a slower, gentler effect. In the past, the glycemic index was highly unreliable, but the University of Sydney has compiled a more reliable list that is posted at (glycemicindex.com).  Discuss additional treatment options with your health care team.

Q.   The weather is getting really strange.  Please help me prepare for the upcoming hurricane season.  You gave us a list last year.  Can you please repeat it?

A.   I’m in Florida, so I’m getting ready too.  To prepare for rain, storms, power outages, or evacuation, follow the general recommendations suggested by your local government – keep cash on hand in case ATM machines stop working, fill your car’s gas tank, secure important documents in watertight bags, etc.   To care for your diabetes, place at least a two-week supply of the following items into a watertight container or bag:

• Prescriptions
• Emergency numbers
• Syringes and insulin pen needles
• Alcohol swabs
• Insulin pump supplies
• Test strips, lancets, and lancing device
• Extra glucose meter and pump batteries
• Low blood sugar treatment snacks-glucose tablets, hard candies, juice boxes, cans of regular soda, etc.
• Glucagon emergency kit to treat severe insulin reactions
• Other medications

Keep extra insulin in the refrigerator.  If you lose power, your fridge should remain cold for several hours.  After that, transfer the insulin into a cooler with ice packs, but don’t allow it to touch the ice.  Once opened, insulin can remain at room temperature for about a month, but will spoil at temperatures higher than 86 degrees.

*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.   Can the weather affect a person’s blood sugar control?

A.   Yes, it can. Some people find that they need an insulin increase in the winter and a decrease in the summer.  We don’t know why this happens, but it may be related to the fact that some blood vessels dilate in warmer weather, which increases the delivery of glucose in the body.  If your diabetes control seems to be related to changes in the weather, check your blood more frequently and work with your health care team to adjust your diabetes care plan to better meet your changing needs.

Q.   I wear an insulin pump and recently started having an embarrassing problem. Right after I participate in sexual activity, my blood sugar level shoots up to the 300's.  Why does this happen and what can I do about it?

A.   Any form of physical activity, including sex, needs an adequate amount of insulin or your blood sugar level may go high. Your pump infusion set may be moving out of place during your activity. If it is doing this, you won't get the insulin that you need and your blood sugar level will go high. Try moving your infusion set to another area or secure it with special tape. Tape samples should have come with the pump supplies. If it didn’t,  you can contact your pump company and order some.

Q.   School is starting again.  Are there any special scholarships for students with diabetes?

A.   The childrenwithdiabetes.com website lists scholarships and financial aid information on its website. There aren’t a great number of options, but you may find an opportunity that fits you. Bayer Healthcare offers an annual college scholarship to incoming freshman who seek a higher education at an accredited four year university, college, technical or trade school. Check childrenwithdiabetes.com for additional information. 

Q.   What is the carbohydrate content of whiskey?

A.   Whiskey, vodka, bourbon, gin, scotch and rum do not contain carbohydrates.  But that doesn’t mean they should be consumed without care.  Alcohol can cause a rapid drop in blood sugar levels.  Studies showed that people with diabetes who ate food with a moderate amount of alcohol were able to limit the effect the alcohol had on their blood sugar level.  Here are some ways to safely include alcohol in your life:

• Eat something while consuming alcohol.  The additional food helps blunt the hypoglycemic (low blood sugar) effect of the alcohol.
• Don’t imbibe if your blood sugar level is low or you have a history of alcohol problems.
• Limit your intake to a safe amount. The American Diabetes Association suggests that men with diabetes drink no more than 2 alcoholic drinks per day and women with diabetes consume no more than one drink per day.  A serving of alcohol is approximately 12 oz of beer, 5 oz of wine or 1.5 oz of distilled spirits like whiskey and vodka. 
• Wear medical identification.  Symptoms of low blood sugar often resemble drunkenness.  If your blood sugar drops and you have alcohol on your breath, those around you may assume that you are intoxicated and won’t get you the medical assistance you require.
• Discuss your use of alcohol with your health care team to see if it is an appropriate choice.

*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