I want to keep my fingers from looking like pin cushions (from all of the pricks). Is there any kind of hand cream/lotion you can recommend?
I want to keep my fingers from looking like pin cushions (from all of the pricks). Is there any kind of hand cream/lotion you can recommend?
My husband was diagnosed with Type 1 diabetes and we have both eaten a very healthy diet since his diagnosis. I was devastated when I went to the doctor two months ago due to weight gain, fatigue, hunger, and thirst, and I was diagnosed with pre-diabetes. My doctor told me I should folllow a low glycemic index diet. I am very frustrated because I am having difficulty finding foods that satisfy my dietary needs (low GI) and my husband's. In many cases, they seem to contradict each other. Can you offer any resources or advice to help me?
Hi! Can you explain to me what prediabetes is? I've found information on Type 1 and Type 2 but not much about pre-diabetes.
Hello! I have some questions about LADA. I was originally diagnosed as a type 2 when I was 16 but recently I went to see my endocrinologist and she believes I was misdiagnosed. My A1C levels kept going up and yet my c-peptide levels have been decreasing. I am currently on a pump and take Novolog but am curious about what will come. My endocrinologist said it is basically like type 1 except that it can take longer to fully set in, sometimes up to 6 years. Has anyone been diagnosed with this or know anything about it? My main question is does someone with this diagnoses go through a "honeymoon" period or am I in it now? Also, when one quits producing what is that like? I realize everyone is different but I would appreciate any personal experience stories.
I have been a Type 1 for 19 years now and have been on a pump for about a year. My A1C used to be horrible (13%) and I weighed a normal weight. When I finally got my A1C down to around 7% I put on about 75 pounds in 2 years. I was just wondering if anyone has lost weight while using a pump. If so, what did you do, what do you usually eat everyday, exercise, etc. Any help or suggestions would be greatly appreciated...
Hi! I just found out that I am pregnant. I've heard that insulin levels during pregnancy increase significantly. At what point during my pregnancy should I expect this to happen? -Jess
In general, during the first trimester (week 1-week 12) there is usually no need for increase in insulin doses. In fact, many women may need to decrease their insulin dose in the first trimester because of hypoglycemia. The need for more insulin is usually seen in the 2nd trimester and more so in the 3rd trimester. Some women may see as much as a tripling of their pre-pregnancy insulin doses. Remember in pregnancy, the blood glucose goals are lower than in the non pregnant state. There are actually 3 different recommendations but generally you should try to keep your fasting blood sugars between 60 and 90, premeal values less than 100 and post meal values no higher than 120 mg/dl.
If you want to get an idea of what your insulin levels during pregnancy will look like you can use the following information as a starting point to see what is considered normal (of course consult with your doctor before using this information!) Lois Jovanovic, the guru MD of diabetes in pregnancy reports that the average insulin requirement for women with type 1 diabetes is 0.7 units per kilogram of body weight in the first trimester, and increases to 0.8 units per kilogram of body weight in week 13-28, and 0.9 units per kilogram of body weight in weeks 29-34 and 1.0 units per kilogram of body weight in weeks 35-40. However, as with everything else in diabetes, no two people are the same so insulin increases should be based on blood sugar control with the stricter guidelines for the blood sugar as the goal.
Follow your blood sugars carefully doing both pre-meal and post-meal checks to assess the need for change in your insulin regimen. Ideally, your OBGYN and/or your endocrinologist can help you with these changes as well as deciding when they need to happen again based on what your blood sugars are doing.
Can you tell me the difference between Type 1 and Type 2 diabetes? Why does one type get to take pills while the other has to always take insulin?
Before I address the question “what is diabetes,” you first have to understand a little basic physiology. When we eat food whether we have diabetes or not our bodies break down that food first by us chewing and then enzymatic breakdown into component parts of carbohydrate, protein and fat and then into glucose. When the glucose level in our bloodstream rises, a message is sent from our brain to our pancreas basically saying, “Hey, pancreas, we’ve got a bowl of cereal and a banana coming down the pike!” The pancreas then secretes insulin which goes to our cells and acts like a key opening the door to the cell which allows the glucose (sugar) to go into the cell. In that way insulin basically allows us to use the food we eat for energy. It is a negative feedback system that works just like an air conditioner. When the temperature in your house goes up, the AC kicks on and when the temperature drops, the AC shuts off. In diabetes, this system of checks and balances of the glucose level is not working right. In type 1 diabetes, it is an absolute insulin deficiency. The brain sends the message to the pancreas reporting the incoming glucose rise, but the pancreas is unable to respond appropriately, either makes no insulin or not enough to do the job. People diagnosed with type 1 diabetes must take insulin injections to cover what their pancreas is not making or they would perish from starvation. In type 2 diabetes, the brain sends the message to the pancreas and the pancreas secretes insulin but the body does not use the insulin appropriately. It basically ignores the insulin. This is called insulin resistance. It is the hallmark feature of type 2 diabetes. It’s similar to getting a new key made for your door and the key goes in the lock but is unable to turn the lock. In Type 2 diabetes, there are medications available that help the body with its insulin resistance. These pills help the body use its own insulin better. Exercise and weight loss also improve insulin resistance. People with type 1 diabetes cannot take these pills because they do not make any or enough insulin.
Typically, Type 1 diabetes is diagnosed at an earlier age than type 2. Individuals often lose a lot of weight before diagnosis because their bodies are starving since they do not have any or enough insulin. There may or may not be any family history of diabetes. Type 1 diabetes is an autoimmune disease so there may be family history of those types of other autoimmune diseases such as thyroid disorders or rheumatoid arthritis.
Type 2 diabetes is typically diagnosed later in life. There is almost always a family history of diabetes and the person typically is overweight. Also African Americans, Hispanic Americans and Native Americans are at higher risk for developing Type 2 diabetes.
The etiologies and treatment of Type 1 and Type 2 diabetes are different but the bottom line is still the same. Blood sugar levels are above normal and should be treated to restore euglycemia (a.k.a. normal blood sugar). The treatment in Type 2 diabetes usually starts with diet and exercise with the emphasis on weight loss. Medications (pills) are usually added with the goal of improving insulin resistance and thus normalizing blood glucose. There are several types of pills on the market for Type 2 diabetes and they each affect a different region of the body, again with the hope of improving blood glucose. If these medications do not get the person’s blood sugar to goal levels, then insulin injections may be added.
In Type 1 diabetes, the only treatment is insulin. A regimen should be created with the healthcare provider to replace the insulin that the body no longer makes. The regimen ideally should match the person’s body’s needs and the food he/she eats.
No matter which type of diabetes you have, you should educate yourself about it so that you can understand what treatment plan your healthcare team may prescribe for you. Get to know your body and its responses to medicines, diet and exercise so you can explain your situation to your healthcare provider. Remember that the goal of therapy in diabetes is to have as close to normal blood sugars as possible and to feel good.
Since I did not get a specific question for this week, I’ve decided to share with you a thought or two about living with diabetes. As I go through the weeks and months at my job, where I see anywhere from 20 -30 people living with diabetes a week, there is one thought that keeps coming back to me “ We are all unique individuals.”
This quality makes working with and living with diabetes the challenge that we all know! I find that many of my patients want a cookbook answer to their diabetes but unfortunately this does not exist. All that we have are guidelines and places to start when it comes to therapies and treatments for diabetes. A lot of people get very upset because they figure there must be a fix all answer. In my mind, this is actually the beauty and certainly the challenge of living with diabetes. What we are given is an opportunity to get to know our bodies so much more than anyone else. What happens when I exercise…what happens when I walk my dog versus when I run for an hour? What happens when I eat Kripy Creme donuts versus brown sugar cinnamon Poptarts? For a lot of us, diabetes is just a huge pain because the answers to these questions may seem too burdensome to discover but I think that we should embrace our diabetes and try to learn as best we can all the nuances of our diabetes. By putting in the time and effort, you can learn so much and learn to live well with diabetes. Keeping track of what your blood sugars do when this or that happens helps to give you insight. Listening to and asking others with diabetes is helpful but again, we are all unique and our bodies may have a different response than our best friend. Once you learn some of these things, you may be better equipped to deal with various situations and fine tune your regimen to suit that particular situation. Believe me I am not trying to be a ”Polly Anna” because I know too well that diabetes can throw you a curve ball despite your best efforts. When that happens, you may have to chalk it up to “the nature of the beast” and keep on trying. We are approaching “World Diabetes Day” on Nov 14th. Instead of thinking about what a bummer it is, embrace it and get to know your body showing the world that we all can live well with diabetes.
Help! I began feeling sick and when I checked my temperature, I realized that I have a fever of 102. I also have diabetes. What precautions should I take?
Answer Needed Urgently,
Here are a few things you should keep in mind when faced with illness and diabetes:
1) Always take your diabetes medications. Illness may cause an increase in blood sugar levels.
2) Test blood sugar more frequently. For those with type 1 diabetes, check every 4 hours and those with type 2 check 2-4 times per day
3) Drink extra water or caffeine free sugar free fluids (8oz.every hour when awake)
4) Try to eat the usual amount of carbohydrate. Soft foods or liquids may be easier to consume.
5) If having difficulty eating, try drinking 15 grams of carbohydrate every hour.
6) Test for urine ketones every 4 hours (if you have type 1)
7) OTC meds and prescription meds may contribute to hyperglycemia
Foods for Sick Day Management if you can’t or do not feel like eating that contain approximately 15 grams of carbohydrate
4 oz. juice (1/2 cup)
1 cup Gatorade
½ cup regular soda
½ cup regular gelatin
½ cup unsweetened applesauce
1 slice toast
6 saltine crackers
1 cup soup
½ cup sugar free pudding
When do you contact your Physician?
1) Fever >100 degrees for 24 hours
2) Persistent hyperglycemia (>300 mg/dl)
3) Persistent diarrhea (for more than 8 hours)
4) Vomiting and unable to take fluids for over 4 hours
5) Sick longer than 24 hours
6) Severe abdominal pain
7) Difficulty breathing
8) Moderate to large ketones ( type 1)
9) Other unexplained symptoms
We all get sick at one time or another so it is a good idea to be prepared as best you can. Get your flu shot every year. Wash your hand a lot particularly if you work in situations with a lot of people who may be bringing their “bugs” in to the workplace. Good Luck and Be Well !
I am taking an antibiotic a doctor prescribed for my cold-like symptoms and my sugar keeps going low. Why is this happening? and What should I do?
If you are prescribed antibiotics, monitor your blood sugar more carefully as there can be varying responses. Some will see no change in numbers but again it is important to keep a careful watch as others may find increases or decreases. I did find a study out of Canada that reported that the antibiotic Tequin (gatifloxacin) caused a fourfold increase in the risk of being treated in the hospital for low blood sugar but also an even higher risk of high blood sugars. Typically, Tequin which is manufactured by Bristol-Myers Squibb is used to treat respiratory infections, urinary tract infections, and bladder infections. If you have been prescribed this medication, pay extra attention to your blood glucose. In this particular study, this low blood sugar side effect did not appear to apply to other antibiotics in the same class as gatifloxacin (which belongs to the fluoroquinolones). This study was published in the New England Journal of Medicine because of its public health implications.If you have Type 2 diabetes and are taking a sulphonylurea such as Amaryl, glipizide, Glucotrol, etc., you also need to be aware of the possible low blood sugar side effect of certain antibiotics. These antibiotics include chloramphenicol, tetracycline and the sulphonamide group.In all cases of being sick, make sure the physician you are seeing for this issue is aware that you have diabetes and knows what medicines you are taking before he/she prescribes you any additional medication. Also, make sure to monitor your blood sugar more often when sick and/or taking medication because of potential high or low blood sugar. Just like almost everything else in diabetes, we are all individuals and our responses to certain medications are going to vary from person to person. Given the time of year, let’s all go out and get our flu shot! Be well!
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