dLife TV: Gestational Diabetes, Type 2 Diabetes, and Blood Sugar Highs

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: Gestational Diabetes http://www.dlife.com/dlife_media/dlifetv/video/dlife-mail-gestational-diabetes

dLife TV: I'm Not Fat. Why Do I Have Type 2 Diabetes?

http://www.dlife.com/dlifetv/video/why-type-2

dLife TV: Why is my Blood Sugar High After a Low?

http://www.dlife.com/dlifetv/video/high-after-a-low

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 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.   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 tested my blood this morning with my sister’s glucose monitor.  It was 120.  I have diabetes, right?

A.   A home monitor provides relatively accurate information about blood sugar levels, but is not precise enough to diagnose diabetes – that must be done in a doctor’s office.  A fasting blood sugar level of 126 mg/dl or higher is considered a diabetic level, but must be repeated to confirm the results.  If your blood sugar tests higher than normal, yet not high enough to be diabetes, you may have pre-diabetes.  If this is the case, you may be able to avoid or delay its development by losing some weight and by increasing your physical activity.  Please visit your doctor to check this out.

Q.   Can people with diabetes drink tomato juice?

A.   They sure can!  Tomato juice contains very few carbohydrates (about 7 grams per 6 ounces) and shouldn’t affect your blood sugar level in any significant way unless you consume a large amount.  Today’s diabetes meal plans are far more flexible than in the past.  They allow individuals with diabetes to enjoy the foods they love as long as they are eaten in appropriate portion sizes. A dietitian can help you plan ways to add many of your favorite foods back into your day.

Q.   My father was just diagnosed with type 2 diabetes.  I purchased a few books for him, but he found them very technical and overwhelming.  Can you suggest a book that is easy to understand?

A.   I have the perfect book!  Your First Year with Diabetes uses humor and expert information to make learning about 

diabetes a breeze.  It teaches you how to manage your diabetes day to day, week to week, and month to month.  It was written by Theresa Garnero, a past AADE Diabetes Educator of the Year and…a stand-up comedian!  The book is published by the American Diabetes Association. I think your father will enjoy it and will learn a great deal.

Q.   Can massage help my diabetes?

A.   Many people believe it can.  A relaxing massage may help reduce stress, which is always a plus.  Some studies suggest that massage can also improve blood sugar levels and lessen the symptoms of diabetic neuropathy (nerve problems).  Massaging an injection site may also increase insulin absorption. 

Q.   I struggle with food portions when I eat out at a restaurant.  Is there an easy way to estimate serving sizes?

A.   Your hand is a measuring tool that goes with you everywhere you go.  Here are a few ways to use it:

• Tip of the thumb to the first knuckle = 1 teaspoon
• Whole thumb up to the second knuckle = 1 Tablespoon
• The palm of your hand = 3 ounces of cooked meat
• Tight fist = ½ cup or 1 cup for a large hand
• Loose fist or open handful = 1 cup or approximately 1 ½ cups for a large hand

*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.   Thanksgiving is almost here and my family is going to embarrass me again – they will lay out a delicious spread of homemade foods that I can’t eat, and set aside some store-bought microwaveable foods for me, their “little diabetic.”  Can you help me have a better holiday?

A.   Here are several things you can try to help everyone enjoy a better Thanksgiving:

Call the host of the dinner ahead of time and let him or her know that you appreciate their concern, but don’t require special foods.  Then use the Plate Method to take reasonable portions, so your blood glucose level stays within your target range:

• Take a standard 9-inch plate. 
• Fill one half of the plate with non-starchy vegetables.  These include lettuce, broccoli, tomatoes, peppers, celery, cauliflower, etc. 
• Limit your starch servings to ¼ of the plate.  These include potatoes, stuffing, corn, peas, etc.  Do not eat a larger portion.  These are carbohydrate-rich foods that will raise your blood glucose level.
• Fill the remaining ¼ of the plate with turkey or other protein item.
• Limit your dessert servings.  Take just a taste and move away from the buffet table.  If you can’t limit yourself, walk away before dessert is served and sit down with a cup of coffee or tea.  Or, offer to bring a diabetes-friendly dessert that all can enjoy.

I can’t stop your relatives from calling you their “little diabetic,” but I do have a suggestion that may help.  Go to www.behavioraldiabetes.org and print out copies of their Diabetes Etiquette booklet for people who DON’T have diabetes.  Pass these around to relatives who are interested in learning how to interact with people who have diabetes.  It is a great resource!

Here’s another hint that you may find helpful.  Most people respond to the tone that you set.  If you are comfortable with your diabetes, they will be comfortable too.  When your aunt calls you her “little diabetic” give her a hug and call her your “little auntie” and see what happens then change the subject. You’ll be turning it into a light-hearted joke and will, hopefully, take the sting out of the comment.  Family can be frustrating, but they do provide us with many things that we are thankful for.

Q. My boyfriend has type 1 diabetes.  His doctor said that he might not be able to have children. Is this true?

A.   Having diabetes shouldn’t affect a man's ability to have children. A very small study published in 2007 in the Journal of Human Reproduction showed that men with type 1 diabetes may have a slight change in sperm quality that could affect fertility.   All of my patients with type 1 who wanted to have children, now have beautiful families. Tell your boyfriend not to worry.

Q.   I forgot what to do when my blood sugar drops too low.  Can you print the tips again?

A.   Sure!  If your blood glucose level drops below 70 mg/dl (or below your target range), use the 15/15 Rule.  Here it is:

1. Eat 15 grams of a quick-acting carbohydrate food.  Examples include:

½ cup of fruit juice

 1 can of regular soda (not diet)

 2 teaspoons of sugar

Commercially sold glucose tablets (as directed on the label)

2. Wait 15 minutes
3. Test again. 
4. Repeat until you are within your target range or above 70 mg/dl.  Follow this treatment with a small protein/carbohydrate snack.

*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