Ask the Pharmacist Archive, Wednesday, July 3, 2008

Negar J. Haley, R.Ph., graduated from University of Pacific in 2000. She received her Certified Disease Manager (CDM) in diabetes in 2002 through NISPC and is a certified diabetes specialist for Rite Aid. In addition to her pharmacy manager position in Santa Barbara, CA, she has been a regional immunization trainer for Rite Aid since 2005 as well as an APhA certified immunizing pharmacist since 2004.

Petra Rogers, R.Ph., is a pharmacy manager in Lewiston, ID. She received specialized training in diabetes care in 2006 and is a certified diabetes care specialist for Rite Aid.

Michelle Seifert, R.Ph., Pharm.D D., is a Drug Information Specialist at the Rite Aid Drug Information Center. She received specialized training in diabetes care through the The National Institute for Pharmacist Care Outcomes (NIPCO) Diabetes Care Certificate Program.

The "Ask the Pharmacist " series is brought to you by an unrestricted educational grant from Rite Aid Pharmacy.

ADA_Moderator: Welcome to ADA Live. Today our guests are Negar J. Haley, R.Ph., Petra Rogers, and Michelle Seifer, R.Ph., Parm. D D., It's a pleasure to have all of you here today. We have a lot of questions so we're going to go ahead and get started

Guest_Pharmacists: We're very happy to be here today.
sweet_sugar: when is a patient considered glucose toxic?
Negar: I'm not exactly sure what you mean by glucose toxic. According to the fasting plasma glucose test, the normal blood glucose level is less than 100 mg/dL. Pre-diabetes is 100-125 mg/dL. A value of 126 mg/dL or above is a diabetes diagnosis and considered hyperglycemic or high blood glucose. High glucose levels anywhere above 200 mg/dL can result in serious side effects such as a coma. This is a wide range, but, maybe to answer your question, a "toxic" range.
lisa: what is the effect of diabetes with no muscle loss or no bug bite if it runs in you family. But it hurts your skin around your groin and the back of your leg
Petra__Guest_Pharmacist: It is possible that the diabetes is causing some neuropathy (nerve dysfunction due to high blood sugars), however, diabetic peripheral neuropathy generally begins with the tiny nerves in the extremities, such as fingers and toes. I would recommend speaking with your doctor regarding this situation.
Dee: Yes I would like to know why diabetes and liver disease hep c give false positives for meth
Petra__Guest_Pharmacist: I am unaware of these two diseases causing a false positive for most tests, especially for methamphetamine. I suppose, if a person had used Sudafed or another over-the-ccunter agent, which had a lower rate of metabolism due to the liver dysfunction, you might receive a false positive. I would speak with your doctor regarding any further problems you may have.
Dora: Is noticeable hair loss during the past year a concern for developing diabetes in my 21 yr old son who works out several times per week & uses protein shakes after each workout?
Negar: Hair loss is not a risk factor for developing diabetes. However, if his hair loss seems to be dramatic and quick, he really should be seen by a physician. He should also be cautious not to consume too much protein, as this can damage the kidneys. Moderation to anything is key.
Callalily: I have an area on my thigh that usually feels very numb but sometimes it feels like it is on fire and is very painful...it this a result of my type 2 diabetes?
Negar: Diabetics, especially uncontrolled diabetics, are at risk of having peripheral neuropathy. Peripheral neuropathy is pain of the nerves in the extremities (such as the thigh, leg, feet, and hands). Symptoms of this present as numbness, tingling, burning, pain and sometimes a stabbing pain. The symptoms you are experiencing may be a result of your type 2 diabetes. If your diabetes is the cause, there are medications available to help alleviate those symptoms, however, good glucose control is critical to avoid worsening of the condition. You should speak with your physician to determine if the cause of your pain is related to your diabetes or if there is another cause.
Obama_Girl_3313: Why can't we simply receive a Pancreas transplant? I never hear of people being referred for this type of treatment.
Petra__Guest_Pharmacist: The lack of suitable donor pancreases is a major obstacle in the use of pancreas transplants.
Petra__Guest_Pharmacist: --MayoClinic.com
Petra__Guest_Pharmacist: A pancreas transplant offers a potential cure for type 1 diabetes, but it's not a standard diabetes treatment. Often, the side effects of a pancreas transplant are more serious than the diabetes. If your diabetes treatment plan is working, a pancreas transplant isn't likely a better option. But if your diabetes can't be controlled or you have serious diabetes-related complications, a pancreas transplant may be worthwhile.
Obama_Girl_3313: If you are spilling urine and you tell your doctor what steps should he be taking to help you?
Negar: There are many things that can be spilled into the urine such as glucose, ketones, proteins, etc. The treatment will depend on what is in the urine and what diagnosis that may signify. We recommend that you speak with your physician to determine exactly what is in your urine and what tests he/she is planning to perform in order to diagnose the problem.
casey: My father has pre-diabetes. Yesterday, he ate a cinnamon biscuit from BoJangels and for supper he ate a waffle with syrup and bacon. Last night he had a bad chill, was disoriented, was extremely thirsty, then wet the bed and floor because he felt extremely nervous and was afraid to get up (he has recently had a hip replacement). He is on aggrenox, simvastatin, and recently started finasterid. I wonder if his "attack" was because of the sugar or could it be the finasterid?
Negar: His symptoms are not likely due to the finasteride. The 3 classic symptoms of diabetes are drinking too many fluids (his symptom of being "thirsty"), eating too much and urinating too much. His thirst might have been due to elevated blood glucose levels. The only way to really rule out if his sugar level was elevated during this time would be to self monitor his sugar levels. Hopefully he has a blood glucose meter. If he does not, get one. Empower him to know his sugar levels. This can explain a lot of symptoms. I can not express how important it is for him to get in touch with a nutritionist. Food plays an integral and powerful part to glucose control. His choice of foods are not the best. He should be eating more vegetables and not so many carbs. He can have carbs, but portion control is important. What he eats will make a big difference in delaying the progression of his pre-diabetes to diabetes. Without knowing what his glucose level was it is hard to know for sure, however, disorientation is a common symptom of elevated glucose levels. Empower your father and yourself, get him a blood glucose meter (test up to 8 times a day) and set up an appointment with a nutritionist.
Smarty: My question is does diabetes may affect leg muscles? Coz I am having cramps in my leg
Negar: Diabetes does not directly affect leg muscles. However, diabetics are more prone to poor blood circulation and therefore more prone to muscle aches and cramps. The key is good blood glucose control (90-130 mg/dL before meals and less than 180 mg/dL one to two hours after the start of a meal). If your glucose levels are within a good range, it may be something else. Are you taking any other medications? Anything for cholesterol? If your glucose levels are not within a good range, then achieving good glucose control may help alleviate some of those discomforts. If the symptoms do not improve, we recommend that you speak with your physician to explore other potential causes.
omai: my mom takes glucotrol and she has type 2. she exercises, diets and able to keep her blood sugar level under control. however, for the last 3-4 days, even with medication, her readings are up and down from 120 to 220. after a short walk, it went down but then she got lightheaded and the level went up again to over 200. is it possible for someone to get so used to the medication that it's no longer effective? and if yes, should she see a doctor soon to changer her diabetic medication?
Negar: It is important to note, in the past 3-4 days, has she been more stressed than normal, been eating differently, is she sick or has she checked to see if her meter is working appropriately by testing with a control glucose solution? Be cautious to evaluate if there is anything different going on before jumping to conclusions quickly.
Negar: However, over time, anti-diabetic medications such as glucotrol will not adequately control blood glucose levels and it is recommended to either increase the dose or add on another oral medication. It is not so much that she is used to the medication, rather it is the natural progression of diabetes. Yes, I would recommend she be seen by her physician to assess if either there is something else going on or quite possibly increase the dose of the glucotrol or add on another anti-diabetic medication.
jean: Does diabetes cause dark specs under your feet?
Petra__Guest_Pharmacist: Diabetes may cause a number of foot complications, mostly due to neuropathy. Most podiatrists and physicians recommend daily inspection of your feet. I think this is a topic you should discuss with your physician, so that they may better assist you with this problem.
Kara: Does diabetes cause a person to have hot flashes or raise the body temp., where they are hot most of the time?
Petra__Guest_Pharmacist: I have not seen a correlation between diabetes and increased internal body temperature. If you are currently going through menopause, or living in a hot, humid climate, this may cause you to feel warmer.
rids: hi i wanred to about diabetes in indian people
Petra__Guest_Pharmacist: According to the World Health Organization, India is the number 1 ranked country in the world for the highest numbers of estimated cases of diabetes. China is listed as number 2 and the United States is number 3.
Lee: hello I need to know why sugar level goes down that fast, and I can not say anything utill my sugar is too low people arround me will find out
Petra__Guest_Pharmacist: Depending upon the severity of a reaction, blood glucose levels can drop rapidly. It is important to try to identify the first signs and symptoms, including: hunger, weakness/shaking, blind spots, sweating, confusion. If you first start to feel these symptoms, try to let someone know immediately. Also, it is important to carry candy or glucose tablets with you at all times. They also now make an oral spray which has very fast action. Even if you are unsure if you are having low blood sugar, it wouldn't hurt to take a couple of tablets or sprays and check your blood sugar.
TRISH: Do you know anything about the medi-fast diet for diabetics is it ok for type 2 diabetics to use
Negar: I am not fully aware of the medi-fast diet. However, any quick fix diet is not a safe diet. The key is good nutrition, exercise and everything in moderation. A quick fix is just that...a quick fix. Lifelong lifestyle modification is the key to a long and healthy life. It would be best to speak with your physician and a dietician/nutritionist for assistance determining a diet appropriate for you.
sldr64: I am a type 1 diabetic taking gabapentin 600mg for neuropathy. I take it at 8am, noon, 5pm and 10pm. I am also prescribed ranitidine 150mg tid. Due to it's suspected interaction with gabapentin, please advise the best time of day to take. Thank you in advance, SLDR64
Negar: Yes...antacids can decrease absorption of gabapentin. It is best to take the gabapentin at least 2 hours after the antacid. Therefore, here is a schedule I can recommend:
Negar: Gabapentin 8:00 a.m.
Negar: Ranitidine 10:00 a.m.
Negar: Gabapentin 12:00 p.m.
Negar: Ranitidine 3:00 p.m.
Negar: Gabapentin 5:00 p.m.
Negar: Ranitidine 7:00 p.m.
Negar: Gabapentin 10:00 p.m.
Negar: Unfortunately, it is a little challenging, however, in order to maximize the effets of your medications, this is the best way. In the event, another medication is added, be aware this may alter.
admiral: If they have discovered that during bypass surgery the Type 2 symtoms disappear in most patients why has no one came up with a drug to acomplish whatever this surgery's affect had on the body
Guest_Pharmacists: Well, it is nearly impossible to create a medicine that only allows you to eat about 1/2 cup serving per meal. The rapid amount of weight loss usually allows a patient with newly diagnosed type 2 symptoms to maybe waylay the disease for a number of years. However, weight loss is a key way to help stop glucose intolerance. Unfortunately, there is no miracle pill for this.
gorillamom: my son is 40 and has had type 2 diabetes since his twenties......he always has sores on the back of his calves....one leg looks to be a purpleish color......what does this signal is occurring......he as past history of sores on the bottom of his foot.....been out of work for two wks at a time.....he also has to use viagara....thanks for discussing this matter with me
Negar: Especially in uncontrolled blood glucose levels, blood circulation is a big concern. Elevated sugar levels causes a cascade of problems, of which one is poor circulation, especially to the extremities, such as leg and feet, which may be the reason for the purpleish color. With good blood glucose control, this can be reversed. Foot care is critical in diabetics, as this is the region of the body furthest from the heart, and proper foot care is imperative. Foot care means washing with soap and water and physically looking at both feet (bottom of feet,toes and in between toes) to see for any cuts, sharp edges or ingrowns daily. Proper moisturizing with creams should be applied daily (there are plenty of diabetic creams available at your pharmacy). Nails should be filed down to avoid any hangnails or ingrowns that can possibly cause infection. Viagra is not an uncommon medication prescribed for diabetics, and again, this is due to poor blood circulation due to elevated glucose levels. Think of it like placing sugar on fruit to make jam. Over time, the sugar makes the fruit turn into a jam. Elevated sugar in the bloodstream makes it difficult for the blood to effectively flow, causing difficulty achieving an erection.
scared_mom: What can an infant with type 1 diabetes eat and what can't they eat.
Petra__Guest_Pharmacist: Infants up to 4-6 months should be given breast milk or formula only. Solid foods should slowly be introduced into the diet, one at a time. Infants are at particular risk for hypoglycemia causing problems to the developing brain. Therefore, it is important to have a well devised meal plan to follow. Often times the ADA exchange system is used to help teach families the effects of foods on the infant’s diabetes. A caloric level will be established based on the child’s growth status and diet history. We recommend that you speak with your child’s pediatrician and a dietician to establish a meal plan that is appropriate for your child.
Dino: My brother in law was diagnosed with type 1 diabetes at age 3, he is now 30. Can having diabetes at such a young case him have poor judgment with common sence because the area of the brain which handles common sence has not developed properly?
Petra__Guest_Pharmacist: If his diabetes had been extremely uncontrolled (lower than 80 or greater than 270) for periods of time, it has been shown in studies that cognitive ability can be impaired (such as math ability, etc). At this time, I believe, it would be difficult to determine if his long-standing diabetes were the cause, or if the inability to control current blood sugars may be the cause.
breezy: what causes blood-glucose levels to be elevated in my 7 yr old
Negar: There are many possible reasons for elevated blood glucose levels in children including the child’s weight, eating too much, not exercising, being ill, stress, forgetting medication, hormones (such as growth hormone), etc. If sugar levels tend to be higher than normal, adequate screening should be done.
vintner: Is there a link between diabetes and memory loss
Negar: Because diabetes is known to damage blood vessels that supply the brain, there have been studies suggesting diabetics have an increased risk with memory problems. More research is needed to confirm this possible link.
Irene: My husband has diabetes and is doing just wonderful. He was first prescribed glucophage and did exremely well on it. Problem was he is a lean man and he was losing weight, about 15 lbs he should not have lost. He is 5'11 and usually weights 160-164. He was placed on Actos and was great on that as well and gained back the lost weight over time and was back to 160. I am concerned about Actos. Actos is know to cause edema. He has none in his limbs but - he has an enlarged heart, did not know this prior to diabetes. Our concerns with actos was mentioned to the endocronogist and he just put him back on glucophage. Well, in 5 weeks his has already lost 5 lbs. My worry is this - if placed on actos, could this possible, not cause, but be a contributor to the enlarged heart? He has never had high blood pressure or cholestrol. Drs call him an inigma!! I am just concerned about the edema with Actos. Thank you,
Negar: This is the recommendation when it comes to Actos...prior to initiating Actos, make sure he has maintained a steady weight consistently. Once achieved, Actos 15 or 30 mg can be initiated. If more than 5 pounds is gained within a week period, it is advised to discontinue Actos, wait one month and reinitiate. If after another try of Actos, weight gain is seen (5 pounds in a 1 week period), Actos is not recommended for the patient. Actos is probably not a contributor to the already existing enlarged heart.
katie: I currently take Humalog 3x a day between 18 to 23 units each time. I also take Lantus 38 units 2x a day. When I test, the results are rarely under 300. Is there a cap on how high of a dose I can take? Does my doctor have much "wiggle room" with increasing the insulin? Is there something else I should be considering to help lower my blood sugars? Thank you
Negar: There is not a cap on the dose. What I would suggest is you see a nutritionist to evaluate if you are dosing appropriately based on the foods you eat. This can make a big difference. There is "wiggle room" and you may want to get together with your doctor after a good solid week of logging your levels 4-5 times a day, at least, to adjust your dose. 300 is not a safe number. With a good diet plan and appropriate dosing schedule based on the foods you eat, you can overcome this high number.
cathy: how does one find the right doctorfor treating type 2?
Negar: An endocrinologist specializes in diseases of the endocrine system such as diabetes. If you can not find one in your area, check with your primary care physician or even your local pharmacist. Pharmacists can be a great resource to direct you to a diabetic specialist.
chat: Are the normal blood glucose levels for a child, 8 years old, the same as an adult?
Guest_Pharmacists: Blood glucose levels should be maintained as close to “normal” (70-100 mg/dL) as is safely possible. The ADA has established blood glucose goals for young people with type 1 diabetes. Although there are no national recommendations, it may be reasonable to use the same values for patients with type 2 diabetes. An 8 year old child should have levels between 90-180 mg/dL before meals and 100-180 mg/dL at bedtime/overnight. It is important to note that the blood glucose goal must be individualized for the specific patient. You should consult a physician to determine the goal that is most appropriate for your child. In children, blood glucose levels can be more erratic. You must take extra care with these patients, as their sugars can raise or lower more quickly.
sarma: When your blood sugar gets low and you eat a candy bar, why does your blood sugar drop again?
Petra__Guest_Pharmacist: Depending on the severity of the hypoglycemic reaction, the candy bar may not have been enough sugar. This could explain why your sugar continues to drop. If the candy bar does raise your blood sugar effectively, your body's natural release of insulin is slow, but does kick in, and will lower your blood sugar again.
Tim: Why when fasting do I have a low reading but, in the am it is higher?
Petra__Guest_Pharmacist: There are both simple and complicated explanations for this occurrence. Fasting blood sugars (after not eating for 8-10 hours) will be your lowest readings of the day. In the morning, after breakfast, your body has had a chance to process food, your sugars start to rise. If you have not eaten in the morning, and your sugars still run high, it is a little more complicated. Your body releases steroid-based hormones in the morning which cause you to be awakened in the morning. The release of these hormones can increase your blood sugar as well. If your blood glucose levels continue to be high in the mornings, you should contact your physician for an evaluation.
Tim: Why does diabetes cause erectial dysfunctioning?
Negar: Poor blood circulation leads to erectile dysfunction. When sugar levels are not well controlled, the extra sugar causes damage to nerves and blood vessels leading to poor circulation, which can cause difficulty achieving an erection.
BETTY: WHAT DOES A1C MEAN?
Negar: The Hemoglobin A1C level estimates your average blood glucose level over the past 2-3 months. Hemoglobin is found inside red blood cells and functions to carry oxygen all over the body from the lungs. Hemoglobin will link up with sugars such as glucose if they are present in the blood. If diabetes is uncontrolled, you will have too much sugar in the blood. The extra glucose will link up (glycate) with the hemoglobin inside the red blood cells. The more glucose in the blood the more glycated the hemoglobin is and the higher the percentage of A1C in the blood. The A1C test is an average of your blood glucose control for the past few months. The red blood cells do not unlink from the glucose and only when the red blood cell dies, after about 120 days, does that "memory" of the high blood glucose go away. Therefore, as your blood glucose levels fluctuate and your red blood cells die and new ones are created by the body the A1C level varies and reports the average over the past few months. A person who does not have diabetes will have an A1C of around 5%. Hemoglobin A1C levels less than 7% are beneficial to people with diabetes because they have been associated with decreased rates of long term complications such as eye problems (retinopathy), kidney problems (nephropathy), and nerve problems (neuropathy). In general, the recommended goal for a non-pregnant patient with diabetes is an A1C less than 7%. (The A1C goal for an individual patient may be an A1C as close to normal (<6%) as possible without significant hypoglycemia.) However, this goal may vary from person to person. We recommend that you speak with your physician or diabetes educator to determine exactly what your A1C goal should be.
cencalvllygrl: I wqanted to know how often should a person be checked for diabetes
Negar: If you are overweight and age 45 or older, you should be checked during your next routine medical office visit. If your weight is normal and you're over age 45, you should ask your doctor during a routine office visit if testing is appropriate. For adults younger than 45 and overweight, your doctor may recommend testing if you have one or more risk factors for diabetes or pre-diabetes. These include having high blood pressure, low HDL cholesterol and high triglycerides, a family history of diabetes, a history of gestational diabetes or giving birth to a baby weighing more than 9 pounds, belonging to an ethnic or minority group at high risk for diabetes, or being fairly inactive. If your blood glucose levels are normal, it is recommended to be screened every 3 years. If you are diagnosed with pre-diabetes, you should be screened for type 2 diabetes every 1-2 years after your diagnosis.
Wife_concerned: My husband is in pain in one leg and he is hurting badly, what can I do?
Negar: If the pain is significant enough, he should be referred to a physician for an evaluation. It could be a multitude of things. Diabetics are very prone to having peripheral neuropathy (nerve damage in the extremities). But there are treatment regimens available to help alleviate the pain.
vllygrl: My question is, can diabetes come on suddenly? For example one month you are tested and are fine and the next you come down with diabtes.
Petra__Guest_Pharmacist: No, diabetes does not come on that quickly. Over a period of months to years, cells in the body build a resistance to insulin. As those cells become resistant, the body releases more insulin to a higher concentration in the bloodstream, so that the body's cells will be aware. This increase in insulin production over time causes the pancreas to wear out more quickly. Because this is not a fast process, it can take years for diabetic symptoms to appear. However, symptoms show themselves as soon as blood glucose levels start to rise. That's why it seems that diabetes comes on so quickly.
Jr: i am 14 and 5'6 tall i took a blood test and it came out 105 am i at risk of diabetes?
Petra__Guest_Pharmacist: In order to diagnose diabetes the doctor must complete a blood test, either a fasting plasma glucose test (FPG) or an oral glucose tolerance test (OGTT). The results will determine if you have pre-diabetes, diabetes, or are normal. The fasting plasma glucose test measures the blood glucose level first thing in the morning after a person does not eat (fasts) overnight. The fasting plasma glucose test defines pre-diabetes as blood glucose levels between 100 and 125 mg/dl and diabetes as blood glucose levels at 126 mg/dl or above. The normal fasting blood glucose level would be less than 100 mg/dl. The oral glucose tolerance test measures blood glucose levels first thing in the morning after a person fasts and then again 2 hours after the person ingests a drink that contains glucose. With this test, pre-diabetes is defined as the 2-hour blood glucose level between 140 and 199 mg/dl and diabetes as the 2-hour blood glucose level at 200mg/dl or above. The normal 2 hour blood glucose level would be less than 140 mg/dl. Self monitoring test kits are not designed to diagnose diabetes. We recommend that you have your physician run either a FPG or OGTT to confirm any suspicions you may have. You may also wish to take the ADA's Diabetes Risk Test on their website at http://www.diabetes.org/risk-test.jsp
mercy: i am 34 yr old,diagnosed diabetic a year before when i was 4 mnth pregnant,doctor adviced me to take insulin. after delivery i stopped taking insulin. now my fasting BG is 100 +. but below 120. what i have to do?
Guest_Pharmacists: Your level is in the pre-diabetes range for fasting blood glucose. If you are still a few months post-pregnancy, the levels might still come down as you lose weight or get more active. If the numbers remain high or start to rise and you are eating a healthy diet and getting exercise, I would recommend that you contact your doctor. It may be possible to try an oral antidiabetic agent instead of going back to insulin, however, this will depend on the agent and if you are breast-feeding. Speak with your doctor to determine what is the most appropriate treatment for you.
mercy: how type 1 diabetes can be manged without insulin?
Negar: Currently, type 1 diabetes can not be managed without insulin. Type 1 diabetics pancreas do not have the ability to produce insulin to sustain normal blood glucose levels. Dietary and lifestyle modification are critical to management as well.
tom: is there a place where i can get help with a diabetes test kit and test strips i have no insurance and make verry little money
Petra__Guest_Pharmacist: Most companies offer incentives for free glucose monitors. However, the cost of the strips are the most expensive cost. Most companies charge approximately $1 per strip. Rite Aid offers a lower-cost alternative, TruTrack, which charges only $0.40 to $0.50 per strip. If you are only testing a few times per week to once per day, this is the most affordable approach.
Murphy: I take Lantus injections 25 units in the morning and 20 at night. My sugar runs around the same numbers as if I am not taking any? Is my body rejecting the insulin and what do I do about it? I follow a very strict diet but that has not helped either.
Petra__Guest_Pharmacist: Lantus is a slow-release insulin, which releases about 1-2 units per hour. This controls your basal insulin rate, which doesn't keep your sugars in the appropriate range after eating a meal. If your sugars are running high after meals, Lantus is not always enough. Talk with your doctor to see if this dose of Lantus is the correct dose for you. It may be necessary to adjust the Lantus dosage or add on a fast-acting insulin to use for mealtimes.
anitra_Lee: Does metformin cause kidney failure?
Petra_Guest_Pharmacist: No, metformin does not cause kidney failure. However, this medication is processed and excreted through the kidneys. For this reason, when diabetic patients undergo any surgical procedures, doctors will ask patients to stop taking their metformin until a few days after surgery.
Amy: I have to urinate often and I have had periodic blurred vision for the past ten years. I do not have a family history for diabetes and I excercise and eat right. Should I get tested? Could this be type I ?
Negar: If you are genuinely concerned, get tested. It is an easy test to evaluate whether or not you are diabetic or not. It could be type 1 or type 2. Increased urination and blurred vision are two common symptoms of diabetes. If this has been going on for 10 years, probably not type 1, but just to make sure, get tested. That is the sure best way to find out.
nag: what is the definition of Diabetes
Negar: According to the Merriam-Webster dictionary, diabetes is a "variable disorder of carbohydrate metabolism caused by a combination of hereditary and environmental factors and usually characterized by inadequate secretion or utilization of insulin, by excessive urine production, by excessive amounts of sugar in the blood and urine, and by thirst, hunger, and loss of weight".
Bobby: Should a diabetic get pedicures?
Petra__Guest_Pharmacist: It is absolutely essential for diabetics to take good care of their feet!!! However, you must make sure that the pedicurist is reputable. Many have specialized training for treating diabetic patients. If you do have a regular pedicure, have the pedicurist avoid trimming nails and calluses, and never go if you have any cuts or sore areas on your feet.
tunes: what is a good level for your blood? I took mine this morning & it was 105
Negar: 105 is great! General blood glucose level guidelines according to the American Diabetes Association (ADA) for nonpregnant patients with diabetes are 90 - 130 mg/dl before meals and less than 180 mg/dl peak after a meal (1-2 hours after the start of a meal). The guidelines according to the American College of Endocrinology (ACE) are stricter than the ADA guidelines and include less than 110 mg/dl in the morning before breakfast and less than 140 mg/dl two hours after eating a meal.
lore: is CHOLEST OFF good for T2 women using 21units Lantus at bedtime plus novolog before meals and 2000mg Metformin per day?
Petra__Guest_Pharmacist: If your total cholesterol is over 200, and your LDL (bad cholesterol) is over 100, I believe Cholest OFF could be a good choice to start with a cholesterol medication. Phytosterols have been shown to help bring down high cholesterol levels. There is no interaction between Cholest OFF and insulins or metformin. I would recommend having your cholesterol levels checked, then rechecked after 6 months of taking Cholest OFF. If your levels don't start to decrease, it might require further pharmacological treatments, such as a statin, niacin, etc.
KcJazzie: What should one do if there blood sugar level is 51?
Negar: 1 cup of milk ,1/2 cup of apple juice, 1/2 cup of orange juice, 3-4 glucose tablets, 5 chewed lifesavers, 6 jelly beans, 1 box or 2 tablespoons of raisins, 1/2 cup of regular non-diet soda, 1 & 1/2 tubes of glucose paste, 3 packets or 1 tablespoon of sugar
Negar: Hypoglycemia (low blood sugar) is considered blood glucose levels less than 70 mg/dL. If there are symptoms of dizziness, fatigue, disorientation, hunger, chills, sweats or tired/exhaustion which can occur when levels are 51 mg/dL consume one of the following:
Negar: Wait 15 minutes, self monitor blood glucose (SMBG) and assess glucose level. If still low (less than 70 mg/dL), have one of the above again and reassess in 15 minutes. Additionally, if your next meal is not within 2 hours, eat a snack such as 1/2 sandwich or crackers with peanut butter or cheese.
mariee67: Is there any proven medical evidence that black coffee is of benefit to diabetics?
Petra__Guest_Pharmacist: Study results on the benefits of coffee vary. Some studies have shown that drinking coffee may lower the risk of developing type 2 diabetes. However, the amount of coffee needed for this benefit has not been firmly established. Currently, it looks like heavy coffee consumption is needed to show benefit. Other studies suggest that coffee may contain chemicals to lower blood glucose levels or increase your resting metabolism rate. However, none of these findings have been confirmed. Study opinions also vary on whether decaffeinated coffee is as beneficial as caffeinated coffee or what type of coffee is beneficial (i.e. brewed or instant). In patients diagnosed with diabetes, studies show the potential benefit seems less likely. Caffeine can increase blood glucose levels, lead to dehydration, increase blood pressure, and have effects on the kidneys. Until all the studies are completed and the results are analyzed, I would recommend drinking coffee in moderation and monitoring your blood glucose levels for alterations if you have diabetes.
tony: was recently tested for diabetes and tested 50 what does that mean am i at risk
Negar: I assume this was a fasting plasma glucose test result. The fasting plasma glucose test measures the blood glucose level first thing in the morning after a person does not eat (fasts) overnight. It defines pre-diabetes as blood glucose levels between 100 and 125 mg/dl and diabetes as blood glucose levels at 126 mg/dl or above. The normal fasting blood glucose level would be less than 100 mg/dl. You are well below this level at 50 mg/dL. This is actually considered hypoglycemic (low blood sugar). You would not be considered to be a diabetic.
tony: what does it mean when you test 50 for bloodsugar levels
Petra__Guest_Pharmacist: A reading of 50mg/dL is fairly low for diabetic patients. Hypoglycemia (low blood glucose level) is considered less than 70 mg/dL. When a diabetic's sugar drops to 50 or below, they might experience a reaction, which includes symptoms such as shaking, weakness, dizziness, blind spots, etc.
chocolate: I have headaches and sometimes sick at my stomach. Could this be from sugar?
Negar: If you are a diabetic, test your blood sugar. Hopefully, you have a blood glucose meter, and if you don't have one, get one. Headaches and nausea can be a sign of either high or low blood glucose levels. If it is within the recommended range (ADA recommends 90-130 mg/dL before meals and less than 180 mg/dL one to two hours after the start of a meal), then it might be due to something else. Empower yourself by testing. It can be a great way to answers and fast. If you are not a diabetic, too much sugar can cause headaches and stomach aches. So remember, everything in moderation.
thirdday: Hi, My husband is 46 years old. He has severe swelling in his foot. he has seen a specialist who found nothing wrong. He was given Naproxin for the swelling and told to try and stay off his foot as much as possible. He has never had a blood test . his foot has continued to swell even more even with the medication. could it be diabetes?
Negar: The only way to know for sure is for him to get tested and screened appropriately. A swollen foot not improving is not a typical symptom for diabetes.
pk78: how often should you change out meters?
Negar: There really is no recommendation for how often to change meters. If a particular meter works and you are happy with it, stick with it. There are a lot of options out there, and the key to what meter to choose or keep is the one you will use. Again, so long as it works, you don't need to change. Sometimes, meter companies will phase out a meter and the test strips for an upgraded model. In this circumstance, you will need a new meter
gil: i would like to know the signs & symtomes of early on set of diabetes
Negar: Common symptoms of diabetes include excessive thirst, extreme hunger, frequent urination, irritability, increased fatigue, unusual weight loss, or blurry vision.
ADA_Moderator: That is all we have time for today. Thanks so much for taking the time to be here. Thanks to all of you who joined us by asking great questions or by just tuning in. If you wish to continue any of today's discussions please feel free to visit the ADA Message Boards
ADA_Moderator: Keep up to date with all the ADA Live events and reference the archives here. We hope you found this interesting and informative and that you'll join us again next time here at ADA Live. Our guest will be Rite Aid Pharmacists and diabetes experts, will discuss and answer your questions on all aspects of diabetes at 1:00 p.m. EDT Thursday, August 7, 2008. See you then.