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 

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