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ADA Moderator : Welcome to ADA Live!
Today our guests are Lorie Widdup and Natalie Teaff. Both are Drug Information Specialists at the Rite Aid Drug Information Center
Welcome Lorie and Natalie. Let's get started.
Lorie and Natalie: Thanks, it's great to be here, we already have some terrific questions.
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orlando, FL: I have had typeII for about 10 years. I am on oral meds, but I don't think they have been working too well. I just came in from outside after cutting down a large tree and mowing the grass. A good work out, hot and sweaty for the past 2 hours. I have not had anything to eat and just took my blood sugar. It was 268. I would think it should be much, much lower. Does this mean that my pancreas is shot and that my meds are not sufficient and that I will need to go on insulin shots?
Lorie and Natalie: I really don't have enough information to completely answer your question. First of all, it would be important to know what your blood sugar was BEFORE you went outside; your sweaty workout may have lowered your blood sugar quite a bit, but the concern to me would be that your sugar must have been extremely high before you began your work. It's not a good idea to do rigorous exercise if your blood sugar is high as adrenalin can raise your blood sugar more in the short term. I need to know the names and doses of your oral meds-there may be a lot more that can be done with your regimen before considering insulin. If the doses are maximized in a combination of oral meds and your HBA1C remains above 7%, then insulin would be a consideration. Discuss your concerns in more detail with your provider.
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Anacortes, WA: I take 500 mg of Metformin daily for type two at about 9AM. By 2 or 3 Pm each day, I am so tired I am out of energy; so much so it is compelling to lie down and rest. I fall completely asleep!. Naps are fine but there are times one can't do so. I wonder if I should try a different med or split my dose or? I drink plenty of water each day . After resting I am fine but sometimes the rest is one or two hours long! I control my diet and exercise 5 X's a week on a treadmill and weights for about 30-45 minutes. I am 69. Maybe I am just slowing down but the fatigue in the afternoon is overwhelmingly strong. Thanks, June H
Lorie and Natalie: It is true that hyperglycemia (or high blood sugar) can result in fatigue. Fatigue could possibly be a result of trying to do too much, but it can also be a result of other medical conditions in addition to diabetes. Since I don't have your blood sugars or food logs to comment on, discuss this issue with your provider. Bloodwork may be necessary to determine the cause of your problem.
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Lincoln, Illinois: Where can I send someone to get help with test strips? I have 3 clients who can't afford test strips and do not have insurance. Is there a program that helps with that expense?
Lorie and Natalie:
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Chicago, IL: My mother and I are baffled by the fact that we have normal blood glucose readings but elevated AC1? Mine is 6.7 and my Mom's is 7.2.
Lorie and Natalie: This is possible depending on when you are checking your blood sugars. Remember that the A1c is a 90 days weighted average of your blood sugars. You may have normal fasting sugars all the time and have abnormal 2-hour post-prandial (after meals) blood sugars and not know it if you are not checking your sugar at that time. I need more information about when you are checking your sugars to better answer your question.
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Laredo, Texas: I would like to have an update on diabetes risk factors.
Lorie and Natalie: Common risk factors for type 2 diabetes are: -Obesity -High cholesterol and hypertension -Giving birth to a child > 9 pounds -Being of Asian, Hispanic, Pacific Islander or Indian descent -Age -Family history -Prior history of diabetes or pre-diabetes
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Windsor, Ct: What is a normal or a good fasting Bloood Sugar level?
Lorie and Natalie: An appropriate fasting blood sugar range according to the ADA is 90-130mg/dl, although some patients tolerate sugars as low as 70mg/dl.
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Spring Texas: I was recently diagnosed with pre-diabetis and I do not know anything about normal glucose level what is normal,when is lower or when high.My doctor gave me a machine to check my glucose 3 times a week.I am very nervous and stress out. Where can I get information about all this.Should I see an endocrinilogist? Please help I am scare.
Lorie and Natalie: In order to diagnose diabetes the doctor must complete a blood test, either a fasting plasma glucose test or an oral glucose tolerance test. 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 126mg/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. It is very important to manage your blood glucose levels when you have pre-diabetes in order to help delay or prevent the progression to type 2 diabetes. If you have pre-diabetes, long-term damage may already be occurring to your heart and circulatory system. Pre-diabetes is usually treated with moderate weight loss by altering the diet and starting moderate exercise. In some cases, if caught early, weight loss and exercise can actually cause blood glucose levels to return to the normal range. Additionally, the doctor may start you on medication to help prevent the development of type 2 diabetes. For additional information on diabetes, you may wish to visit Rite Aid's diabetes website at www.riteaiddiabetes.com or the American Diabetes Association's website at www.diabetes.org. For specific information on pre-diabetes, the American Diabetes Association's pre-diabetes frequently asked questions are available at http://www.diabetes.org/pre-diabetes/faq.jsp. There is also a wealth of information on diabetes on our Rite Aid Diabetes website at www.riteaiddiabetes.com.
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Spring, Texas: Just been diagnosed with diabetes. Dr. having me test blood 4 times a day-morning before eating, and 2 hrs. after each meal. The highest blood sugar level has been 119 in the morning. Usually testing between 90 and 105. What does this mean?
Lorie and Natalie: According to the American Diabetes Association, a fasting blood glucose level for someone with diabetes should be between 90-110mg/dl. A blood glucose reading 1-2 hours after the start of a meal should be less than 180mg/dl. If the readings of 90 to 105 are your first morning readings before breakfast then it would seem that your fasting blood glucose levels are right on track with the guidelines set forth by the American Diabetes Association. It might be in your best interest to keep a diary of when you take your blood glucose levels with their values, what times you eat and what you eat so that you and your physician can see where your blood glucose levels are in relationship to what and when you eat so if you do have a high or low reading you can determine what may be the cause and adjust accordingly.
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Wellsburg, West Virginia: Can a type 2 diabetic drink lite beer? If so how many? I am taking metformin & amaryl for type 2.
Lorie and Natalie: Lite beer still has carbohydrates in it and depending on how much beer is consumed; your blood sugar could at first be elevated. This occurs because carbohydrates are quickly absorbed in your blood and then cause elevated blood sugar, this elevation can vary depending on how much you drink. Additionally, alcohol can cause low blood sugar levels especially if you use insulin injections or take oral medications. Therefore, you should never drink alcohol on an empty stomach, be sure to eat your meals and snacks and drink in moderation. The ADA suggests that women have no more than 1 drink a day and men no more than 2 drinks per day if you are a man. Lite beer is better than regular and there is even a low carb beer on the market that has fewer carbohydrates than the lite beer. But again, this is dependent on how much is consumed and if food was eaten with it. Additionally, some people with diabetes should not drink at all. Alcohol can aggravate some diabetes complications such as nerve damage and eye conditions. Alcohol may also interfer with the action of your antidiabetes medications, causing hypoglycemia. Consult with your physician or dietitian about adding alcohol in your meal plan. For more information on alcohol use, simply type "alcohol" into the search field on the ADA website.
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astoria. ny: do you have to check your blood sugar everyday?
Lorie and Natalie: Blood glucose (blood sugar) monitoring is the main tool you have to check your diabetes control. This check tells you your blood glucose level at any given time. Monitoring helps you find out what happens to your blood glucose when you eat certain foods, when you exercise, or when you lose or gain weight. Additionally, it helps you see what happens to blood glucose when you take diabetes medication or insulin, are sick, or are emotionally upset. Keeping a log of your results is vital. Self monitoring of blood glucose levels is the best way to know if you are reaching your goals. The more you check, the more you learn how different foods, exercise, stress, and medication affect your levels. Self monitoring of blood glucose will help you and your health care team find a diabetes care plan that is best for you. Always write down your blood glucose readings and share them with your health care team. The decision on how often to check your blood glucose and what times of the day to test is up to your doctor. It is important to follow his/her recommendations. In general, a person with type 1 diabetes should test 3-4 times a day whereas a person with type 2 diabetes should test 1-2 times a day. We recommend that you speak to your doctor to determine how often you should be testing your blood glucose each day.
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Memphis, TN: I am experiencing some strange symptoms and am worried that they may be early symptoms of diabetes. I am a 35 yr old woman (5'7
Lorie and Natalie: Common symptoms of diabetes include excessive thirst, extreme hunger, frequent urination, irritability, increased fatigue, unusual weight loss, or blurry vision. You may want to take the American Diabetes Association Diabetes Risk Test available online at http://www.diabetes.org/risk-test.jsp. For additional information on diabetes, please visit the Rite Aid Diabetes website at www.riteaiddiabetes.com or the American Diabetes Association's website at www.diabetes.org. Additionally, if you determine that you could be at risk for developing diabetes, we recommend that you speak with your doctor for an examination and appropriate testing.
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Jackson, MS: What should my blood sugar levels be when I wake up? And in the evenings before meals?
Lorie and Natalie: Blood glucose level recommendations for nonpregnant patients with diabetes vary depending on the source of the recommendation. General blood glucose level guidelines according to the American Diabetes Association (ADA) are: A1C: Less than 7% (The A1C goal for an individual patient is an A1C as close to normal (<6%) as possible without significant hypoglycemia). Before meals: 90 - 130 mg/dl Peak after a meal (1-2 hours after the start of a meal) - Less than 180 mg/dl. The new general blood glucose level guidelines according to the American College of Endocrinology (ACE) are stricter than the ADA guidelines and include: A1C: Less than or equal to 6.5% Before breakfast in the morning: Less than 110 mg/dl. Two hours after eating a meal - Less than 140 mg/dl. We recommend that you consult with your physician as to where they feel your blood glucose readings goals should be. You may find additional information on diabetes through Rite Aid's diabetes webpage at www.riteaiddiabetes.com or the American Diabetes Association (ADA) at www.diabetes.org.
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Phoenix, Arizona: I recently have acquired pain in the bottoms of my feel. It is becomming unbearable. It is very painful to walk. I told my mom about it and she said that it is a symtom of diabetes. How do I get this tested? How long will it take to get reseult? Sometime the paid shoots up my lets. How serious could this be?
Lorie and Natalie: Neuropathy is one of the most common complications for people with diabetes. Neuropathy is damage to the nerves that run throughout the body, connecting the spinal cord to muscles, skin, blood vessels, and other organs. The cause of neuropathy is unknown and currently there is not cure. There are different types of neuropathy which are classified based on if they affect one or both sides of the body, the type of nerve(s) affected, the number of nerves affected, and the parts of the body affected. Treatment is targeted at treating the symptoms associated with neuropathy. Each person is treated on an individual basis, depending on their specific symptoms. Currently, many doctors recommend that people with neuropathy closely manage blood sugar levels, exercise regularly, and maintain an ideal weight. Various medications are used to treat the symptoms of neuropathy such as pain medications (narcotics and some seizure medications), topical creams (for pain), and antidepressants (for depression, insomnia, and anxiety). Additionally, physical therapy, massage, and acupuncture have been used to help treat diabetic neuropathy. We recommend that you speak with your doctor to determine the best treatment for your specific symptoms. For additional information, you may wish to visit the American Diabetes Association website at http://www.diabetes.org/type-1-diabetes/nerve-damage.jsp or www.riteaiddiabetes.com.
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nebo,IL.: once your go on insulin as an injection can you ever get off?
Lorie and Natalie: It depends on several factors. If you are a Type 1 diabetic, your pancreas does not make insulin and you will always need insulin (either injectable and/or possibly the new inhaled insulin-Exubera). If you are a Type 2 diabetic, your pancreas is still producing some insulin and you may or may not need injectable insulin depending on your compliance with diet, exercise, and your prescribed medication regimen. Some patients who are Type 2 diabetics are given insulin because their oral medication regimen does not work well enough to maintain the A1C at a value less than 7% (the current ADA recommended value). If your A1C is slightly above 7 and your provider has maximized the oral regimen you are on, adding insulin would be a logical thing to do. With greater adherence to exercise and watching your diet more closely, it would not be inconceivable to get off the insulin. The decision to add or subtract insulin is done on an individual basis and depends on numerous factors. Discuss the situation with your provider to determine what is best for you.
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College Station TX: I have type 2 diabetes, what kind of sweeteners if any can I use?
Lorie and Natalie: Any of the artificial sugars are fine to use (i.e. saccharin, aspartame, sucralose, etc.). You may be more familiar with the names Sweet 'N Low, Equal, or Splenda. Since Splenda can tolereate very high temperatures it is possible to bake with it. Sugar can be used, but has a very high carbohydrate content and must be budgeted in your meal plan; stick with the artificial sweeteners.
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Cedar Hill, Texas 75101: I always here to be Diabetic you are obese or overweight, but never hear about the thin people that get Diabetes. Could you expound on this subject, because most thin people don't need to lose weight and it is a subject that needs to be discussed.
Lorie and Natalie: There are two classes of diabetes that you are seeing these differences in (Type 1 and Type 2). Type 1 diabetes is most common in children and young adults and is a result of an absolute deficiency of insulin in the pancreas. This form of diabetes results in marked weight loss because the blood sugars are so high that the kidneys dump a large amount of sugar in the urine resulting in a lot of fluid and caloric loss. Type 2 diabetes (formerly known as adult onset diabetes) used to be a disease of adults only, but is now occurring in overweight children as well. A large percentage of patients with Type 2 diabetes are overweight and the pancreas continues to produce insulin, but in much smaller amounts than a non-diabetic person. As a result, the blood sugars are usually not as extreme and a condition called "insulin resistance" develops. Patients who are overweight with Type 2 diabetes can often gain better blood sugar control with weight loss since the body can better utilize its remaining insulin. This is obviously not an issue with a Type 1 diabetic since the pancreas of these patients has no insulin to begin with. The bottom line is that if you are overweight and a Type 2 diabetic, weight loss is an important consideration in managing your blood sugar.
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Grethel Kentucky: My daughter and her 11 year old daughter both have type I diabetes. My Daughter is on the pump my grand daughter is taking several shots a day. My daughter believes that they can eat whatever they want by counting carbs and taking the amount of insulin to cover the amount of carbs. This means they literally eat whatever they want when they want. However, the child may have to take 20 or more shots a day to cover what she eats. Both my daughter and grand daughter are extremely over weight due to this belief they can eat what they want. I'm concerned they are killing themselves would you please advise. Respectfully; Ms. Akers P.S. This child is home schooled and gets little or no excercise
Lorie and Natalie: This is a tough situation for you to be in. Try talking to your daughter and ask her for your granddaughter and daughter's sake to consult with an endocrinologist and a dietician for a better understanding of carb counting, insulin usage and portion size to optimize their glycemic control.
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arbuckle ca: Why do my feet get very swollen. I have t2 diabetes.
Lorie and Natalie: Feet can swell when excess fluid accumulates in them due to the heart's inability to pump sufficiently. Heart disease is a complication of a large percentage of diabetics, therefore managing your blood sugar is an important way to manage/prevent cardiovascular disease. Of course there are other reasons that feet can swell in a diabetic patient (adverse drug reactions , poor circulation, etc.). It is adviseable to check with your provider to see what the reason could be for you; in addition, don't forget that it's a good idea to see a podiatrist on a regular basis to ensure that you are getting proper diabetic foot care.
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New Boston, Illinois: Is there any kind of object that can test eating materials to see if they are sugar free or not? If I order a fountain diet soda, I want to be sure it's a diet, so I would like some kind of tester to put into the soda to see for sure if it's diet free. I also like Popsicle Sugar Free popsicles, but how I can know for sure if they are sugar free?
Lorie and Natalie: As far as we know, there is not an indicator one can use to test foods to see or make sure the product is sugar free.
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Secaucus, NJ: My father has type 2 diabetes. Because of numerous health problems (Stroke, atrial fibrillation, high blood pressure, mechanical heart valve, pace maker and defibillator, does not have much use of left side of body) he can't take the class of drugs like Avandamet. He is taking Actos 45 Mg. His daily numbers are below 120, but his Hemogolbin A1c continues to rise (7.1)? Any suggestions?
Lorie and Natalie: Since your father is so close to the ADA A1c goal of <7%, it would seem like some dietary adjustment would be beneficial if he is not doing that already (i.e. limiting carbohydrate to 30-45 grams/ meal). Checking his blood sugar 2 hours after he eats would be beneficial to determine if he is in the 140-180mg/dl range necessary to maintain good blood glucose control. If he runs consistently high at this time despite dietary changes, adding a drug like Starlix or Prandin may be beneficial. More information is needed to determine when his high numbers occur in relation to food/fasting to choose the right drug.
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stoneham,ma: my wife is insulin dependent. had a major stroke. i am now her caregiver. since the summer has started (8o degrees) i am having a hard time keeping her counts down? is this normal? if so how do I combat? just previous to her starting to run high she was puy on asprin/dipridamole er (aggrenox). would this contribute to her higher counts? thank you
Lorie and Natalie: Any trauma, such as a stroke, may cause a person's blood sugar levels to rise. It may be that your wife's insulin requirements may have to be readjusted since her stroke. We recommend that you consult with your wife's physician to determine what insulin dosage she may require since the stroke. Also, we found that Aggrenox does not usually cause high blood sugars but it may cause low blood sugar levels.
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Los Angeles, California: I would like to know what is the glucose levels for dagnosing Diabetes. What is the normal range and what are the ranges for Type 1 & Type 2. Thank you
Lorie and Natalie: Diabetes is a condition in which the body does not properly use or does not produce insulin. Insulin is necessary for the body to process starches, sugars, and other foods into energy to be used throughout the day. The exact cause of diabetes is unknown; however, genetics and environmental factors including lack of exercise and obesity have been shown to affect the onset of diabetes. Therefore, maintaining a healthy weight and exercising may help prevent or at least delay the onset of diabetes. In order to diagnose diabetes, either Type 1 or Type 2, the doctor must complete a blood test, either a fasting plasma glucose test or an oral glucose tolerance test. 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 126mg/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. Common symptoms of diabetes include excessive thirst, extreme hunger, frequent urination, irritability, increased fatigue, unusual weight loss, or blurry vision. If you are concerned about developing diabetes, that you have diabetes, or are having any of the symptoms of diabetes, we recommend that you speak with your doctor for an examination and appropriate testing. Additionally, you may want to take the American Diabetes Association Diabetes Risk Test available online at http://www.diabetes.org/risk-test.jsp. For additional information on diabetes, please visit the Rite Aid Diabetes website at www.riteaiddiabetes.com or the American Diabetes Association's website at www.diabetes.org.
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Rochester Hills, MI 48309: My husband has type 2 diabetes. He has swelling in both legs. Could this be from the medication he is taking for diabetes? He is taking Actos and glucoplase(spelling).
Lorie and Natalie: We have found that Actos may cause peripherial edema (swelling of the arms and legs). We recommend that you consult with your husband's physician to determine if the swelling is being caused by the Actos or if futher examination of the situation is warranted.
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Williamsville Mo.: where is the best places to inject the insulin
Lorie and Natalie: The most rapid absorption of insulin occurs when the insulin is injected in the abdomen followed by the back of the arms, thighs, and buttocks. Remember to rotate the sites of injection to avoid poor absorption of the insulin which could result in a change in blood sugar control.
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torrance california: when checking blood suger what should the numbers read
Lorie and Natalie: A patient who doesn't have diabetes should have a fasting blood sugar less than 100mg/dl and a 2 hour post-prandial (after meals) reading of <=140mg/dl. Patients who have been diagnosed should have target ranges (as recommended by the ADA) of 90-130mg/dl (fasting) and <=180mg/dl 2 hours after meals. Optimal bedtime readings for diabetics should be around 100-150mg/dl.
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Fresno, Ca: where can a person get record books for keeping their record of readings? How much do they cost?
Lorie and Natalie: Many manufacturers will give them to you for the asking. On the back of your blood sugar meter there should be a toll-free number for the manufacturer. Call them and see if they will send you some free log books.
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Roxbury, CT: I just came home from having a three hour glucose tolerance test and feel very wiped out. What reactions should I be concerned about?
Lorie and Natalie: You shouldn't have to worry about "reactions" per se. You feel tired because you have challenged your body's ability to recover from high carbohydrate loads over a 3 hour period (and experienced 3 phases of "carbohydrate crashing"). You could compare this feeling of "wiped out" to the feeling you would have if you consumed a large quantity of "junk food" in 3 hours and just didn't have the energy to do anything. Your body will recover and you will not have any lasting reactions.
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Suwanee, Georgia: Is Type2 Diabetes irreserable? Even in mild cases.
Lorie and Natalie: Type 2 diabetes is manageable, but once the diagnosis is confirmed, you will always have the disease. "Mild cases" that you are referring to are really cases of "borderline" or "prediabetes" which can often be managed by diet and exercise alone. Since Type 2 diabetes is genetic, those patients who have it will always be at higher risk than the general population; the disease itself is not reversible, but through diet, exercise, and appropriate medication (if need be), Type 2 diabetes can be managed.
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nigeria, plateau: what is are the main causes of diabetes
Lorie and Natalie: The exact cause of diabetes is unknown; however, genetics and environmental factors including lack of exercise and obesity have been shown to affect the onset of diabetes.
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lavergne,tenn: I have just been diagnosed Type 1 diabetic, and I am a vegetarian. Can I still be vegetarian with diabetes?
Lorie and Natalie: Yes, you can be a vegetarian and manage Type 1 diabetes. It is important to recognize those foods that are high in carbohydrate vs. those that are not (i.e. potatoes, corn, peas, some beans, etc.) have a higher potential to raise your blood sugar than foods that are lower in carbohydrate (i.e. eggs, cheese, peanut butter, non-starchy vegetables like tomatoes, cauliflower, broccoli, etc.). Since managing type 1 diabetes requires some proficiency in carb counting to determine the amount of insulin you need prior to a meal, you should meet with a dietician and/or purchase a booklet from the American Diabetes Association or your local bookstore to familiarize yourself with the various food groups.
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barstow ca..: does diabetes type 2 cause men to lose their sex drive completley? if so what can help?
Lorie and Natalie: According to the American Diabetes Association, men with diabetes are twice as likely to experience erectile dysfunction as men without diabetes. There are medications by prescription to help with erectile dysfunction. We recommend that you discuss your concerns with your physician who can determine what is causing your problem and determine the appropriate course of therapy for you situation.
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wellington, florida: Hi I heard an oral insulin should be avalaible soon. Any idea as of when? And would someone taking a high dosage of insulin daily (about 60u) be able to take it? Thank You.
Lorie and Natalie: There is a new insulin for inhalation that has been approved (Exubera) and should be available sometime this summer. It is a short-acting insulin that would be used to control blood glucose spikes after meals and would be used in place of rapid or short-acting insulin given before meals. It will not replace longer acting insulins and cannot be used in patients who smoke, have breathing conditions (i.e. asthma, COPD), or in children at this time.
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Townsend, MA: Im a 56 year old male and i am concerned that I may have diabetes. What should I kbe lookingout for?
Lorie and Natalie: Diabetes is a condition in which the body does not properly use or does not produce insulin. Insulin is necessary for the body to process starches, sugars, and other foods into energy to be used throughout the day. The exact cause of diabetes is unknown; however, genetics and environmental factors including lack of exercise and obesity have been shown to affect the onset of diabetes. Therefore, maintaining a healthy weight and exercising may help prevent or at least delay the onset of diabetes. In order to diagnose diabetes the doctor must complete a blood test, either a fasting plasma glucose test or an oral glucose tolerance test. 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 126mg/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. Common symptoms of diabetes include excessive thirst, extreme hunger, frequent urination, irritability, increased fatigue, unusual weight loss, or blurry vision. If you are concerned about developing diabetes, that you have diabetes, or are having any of the symptoms of diabetes, we recommend that you speak with your doctor for an examination and appropriate testing. Additionally, you may want to take the American Diabetes Association Diabetes Risk Test available online at http://www.diabetes.org/risk-test.jsp. For additional information on diabetes, please visit the Rite Aid Diabetes website at www.riteaiddiabetes.com or the American Diabetes Association's website at www.diabetes.org.
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Summerville SC: My husband and my brother both have Type 2 diabetes (both onset within the past 3 years). My husband is 68 and his is controlled by diet, exercise & Glucophage twice a day and he maintains an A1AC of 4.8. My brother (age 47), is on 5 oral medications throughout the day and cannot control his sugar even with diet (it hovers between 300-750, with problems w/sight, extreme weight loss, neucrophy, and is now being tested for possible mild stroke because of a sudden problem w/walking and speech. His A1AC stays at a minimum of 10.7. What exactly is an A1AC blood test & what does it measure in the blood? I'm not sure how concerned to be with this number but the doctors seem very concerned. Thank you for your time & consideration.
Lorie and Natalie: An A1c or HbA1c is an abbreviation for hemoglobin a1c and is a blood test that your provider will perform every 90-120 days to assess your blood sugar control for that period of time. A portion of the glucose in your bloodstream attaches itselt to a protein on your red blood cells and remains there for the life of the cell (about 90 days). The amount is expressed as a percentage and should optimally be less than 7% to be at minimal risk for diabetes related complications. An A1c of 6% corresponds to an average 90 day blood sugar of 135mg/dl; every 1% increase translates into another 35mg/dl increase in the blood sugar (i.e an A1c of 7% would mean an average sugar of 170mg/dl; 8%-205mg/dl, etc.) Your brother's A1c of 10.7% means he is averaging 270-305mg/dl, which exceeds the goals set by the ADA for optimal diabetes control. Insulin would be the next logical step for him since the oral medications cannot bring him to goal and he is obviously suffering from diabetes complications.
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Moultrie, GA.: My Grandpa has Type 2 Diabetes,and I would like to know if it is okay to eat tortillas daily?
Lorie and Natalie: Balanced nutrition is extremely important in managing blood glucose levels. Your grandfather may eat tortillas daily however he must understand how eating them will affect his blood glucose levels and adjust accordingly. It is recommended to eat three meals a day plus small snacks in between and at bedtime can prevent extreme fluctuations in blood glucose. Fifteen grams of carbohydrate equals one serving. General guidelines for carbohydrate intake are 3-5 servings of carbohydrate (45-75 grams) per meal and 1-2 (15-30 grams) servings of carbohydrate per snack. The American Diabetes Association recommends that people with diabetes follow an individualized meal plan based on their lifestyle to manage diabetes and weight. If your grandfather has not already, we recommend that he speak with a registered dietician to help develop a meal plan that is appropriate for him. We also recommend that he view information from the National Diabetes Information Clearing House at the following website: http://diabetes.niddk.nih.gov/dm/pubs/eating_ez/index.htm or http://diabetes.niddk.nih.gov/treatments/index.htm He may also visit www.riteaiddiabetes.com for extensive information on meal planning and food choices.
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Berkeley, CA: Recently when I eat candy I get sleepy! Am I a border line diabetic? Will a Glucose test determine my status?
Lorie and Natalie: Diabetes is a condition in which the body does not properly use or does not produce insulin. Insulin is necessary for the body to process starches, sugars, and other foods into energy to be used throughout the day. The exact cause of diabetes is unknown; however, genetics and environmental factors including lack of exercise and obesity have been shown to affect the onset of diabetes. Therefore, maintaining a healthy weight and exercising may help prevent or at least delay the onset of diabetes. In order to diagnose diabetes the doctor must complete a blood test, either a fasting plasma glucose test or an oral glucose tolerance test. 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 126mg/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. Common symptoms of diabetes include excessive thirst, extreme hunger, frequent urination, irritability, increased fatigue, unusual weight loss, or blurry vision. If you are concerned about developing diabetes, that you have diabetes, or are having any of the symptoms of diabetes, we recommend that you speak with your doctor for an examination and appropriate testing. Additionally, you may want to take the American Diabetes Association Diabetes Risk Test available online at http://www.diabetes.org/risk-test.jsp. For additional information on diabetes, please visit the Rite Aid Diabetes website at www.riteaiddiabetes.com or the American Diabetes Association's website at www.diabetes.org.
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HOUSTON, TX: WHY AM I LOSING WEIGHT AND CAN I SAFELY INCREASE MY MEDICATION?
Lorie and Natalie: We can not determine why you are losing weight. We recommend that you consult with your physician to determine why you are losing weight. We do not recommend altering your medication dosages (increasing or decreasing) except on the advise of your physician.
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Kent, Alabama: What is target range for blood glucose levels in adults with type II diabetes and adults without diabetes? Harry Naile, dictu@eezznet.com
Lorie and Natalie: ADA target goals for diabetes management include a fasting plasma glucose (FPG) of 90-130mg/dl, a 2-hour post-prandial glucose (after a meal) of <180mg/dl, and bedtime glucose of 110-150mg/dl. Patients are considered non-diabetic if FPG is <100mg/dl and 2 hour post-prandial glucose is <140mg/dl.
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Hagerstown, Maryland: I am 55 yrs. old and have been diabetic for 19 yrs. Insulin dependant for about 13. currently I have been have issues with high afternoon glucose readings and suggested to my Dr. that we might try Byetta. My request rec'd a No response. Stating that Byetta was for individuals that were recently diaganosed and not for those that have been diabetic as long as I have. Would I benefit from adding byetta to my current treatment?
Lorie and Natalie: Byetta is not just for patients who have recently been diagnosed with diabetes; in fact, the drug is FDA approved as additive therapy for people with Type 2 diabetes who have not achieved adequate blood sugar control with metformin, a sulfonylurea (drugs such as glyburide, glipizide, and glimepiride) or a combination of both. What your doctor may be concerned about is that the drug is currently not approved for use in patients using insulin and some other oral diabetes medications. Your high afternoon readings may be resolved by adjusting your carbohydrate/insulin amounts. Start keeping a food diary (grams of carbohydrates) and units of insulin necessary to maintain your 2 hour post-meal readings <=180mg/dl. If this is confusing to you, ask your doctor to refer you to a diabetic educator who can help you get on track.
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JACKSONVILLE, IL: WHAT IS HbA1c (%)
Lorie and Natalie: HBA1C, or glycosylated hemoglobin, is a weighted average of your blood sugar (measured as a %) for the past 90-120days. Your provider will therefore normally have your blood work checked 2 to 4 times/year depending on your blood sugar control. The American Diabetes Association (ADA) recommends a level of <=7% for optimal diabetes control.
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McKee, KY: I'm an overweight diabetic successfully controling my blood sugar, but not my weight with diet only. How can I loose weight safely?
Lorie and Natalie: A good diabetes management program consists of a good balance of appropriate medication, diet, and exercise. Since I don't know your medical history, consult with your doctor about the types of exercise that is appropriate for you. General ADA guidelines suggest 30 minutes of aerobic activity five days/week, but this may not be appropriate for you.
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Langley WA: I was told that 90 to 120 are the nomal blood sugar values,is this correct?
Lorie and Natalie: It depends on who you are talking about and when the blood sugars are taken. A normal fasting blood sugar for a non-diabetic is less than 100mg/dl. A fasting sugar greater than 100mg/dl is a "red flag" for impaired fasting glucose (IFG) or diabetes depending on how high the number is. Fasting numbers ranging from 101-125mg/dl is indicative of IFG or "prediabetes." Fasting numbers >=126mg/dl measured on more than one occasion is diagnostic of diabetes. Target fasting sugars for diabetics range from 90-130mg/dl according to the ADA. With that said, 90-120mg/dl is a good fasting blood sugar range for a diabetic, but is high for a non-diabetic if the blood sugar is >100mg/dl.
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Lampe, MO: The nurse said the Hemogloblyn test should range 4-6 and mine was 8.9 How bad is that, she said it was high.??? High compared to what? What's BAD?
Lorie and Natalie: Patients who are not diabetic have A1C's around 4-5. A1C's that creep toward a 6 usually indicate impaired glucose tolerance (or "borderline diabetes" as some say). An A1C of 6 translates into an average blood sugar of about 135mg/dl. For every 1% increase in the A1C, the blood sugar average increases about 35mg/dl. This means that if your A1C is 8.9, your average blood sugar is roughly 240mg/dl. The American Diabetes Association (ADA) recommends an A1C of <=7% to minimize the incidence of diabetes complications. With that in mind, your A1C is about 2% higher than what it should be.
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stone mountain, ga: I just took a blood test and I can not remember what it was called. It helps the doctor determine if you are a diabetic and it measure your average insulin in your body you have to take it every 3 mths, I think. What is this blood test called?
Lorie and Natalie: This blood test is called an HbA1C or A1C for short and it doesn't measure the average insulin in your blood, but does measure the % of glycosylated hemoglobin in your blood. This is an average 90-day % of sugar attached to your red blood cells and should be <7% according to ADA practice guidelines.
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Flint Michigan: what are the important measurements and their relative range of
Lorie and Natalie: Reference ranges for blood sugars are as follows: -Fasting sugars are good in the 80-130mg/dl range -2 hour post meal blood sugars should be <180mg/dl -Bedtime blood sugars should range from 100-150mg/dl -A1c should be <7%
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Boston, Massachusetts.: My son, a 27 yr old diabetic, is visiting . He woke this morning unable to control his limbs. I tested his blood sugar and the level was 50, I gave him glasses of orange juice until he felt that he had the ability to move on command. I am extremely scared , he lives alone. Is there a connection between low blood sugar and loss of movement? Thank you, Karen Owens Linehan
Lorie and Natalie: It sounds like your son was experiencing severe signs/symptoms of hypoglycemia (low blood sugar). This can include trembling/shaking, sweating, pounding heart, fast pulse, tingling in arms and legs, weakness, headache, etc. It would be a very good idea if he could see a diabetes educator who can help him understand the relationships between diet, exercise, and medications to help him prevent episodes such as this from happening; especially since he lives alone. It is also important to know how to manage such episodes (3 to 4 glucose tablets, 2 tablespoonfuls of raisings, 4 to 6 ounces of fruit juice or non diet soda, or 8 ounces of milk followed by a half a cheese or peanut butter sandwich if a meal is more than an hour away). As you can see, loss of movement or weakness can occur with extremely low blood sugar-see that your son is educated by someone soon.
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Alvarado, Texas: Why would blood sugar count be consistently high in the morning on first arising and before breakfast? Can this be prevented?
Lorie and Natalie: There are several factors that can contribute to elevated fasting blood sugars. One obvious reason would be eating late at night or going to bed with a blood sugar that was elevated to begin with. Depending on your level, and whether or not you take diabetes medications in the evening, the fasting sugar can still be elevated. Another reason for elevated fasting am blood sugars is the nature of type 2 diabetes itself. Remember that diabetics do not have enough insulin in the pancreas to keep blood sugars down; however, the liver, which is a storage place for sugar, will continue to dump glucose into the bloodstream overnight. Since the pancreas does not answer with an equal amount of insulin, blood sugars are elevated. Hormonal influences from cortisol, glucagon, and adrenalin (the Dawn Phenomenon) in the middle of the night also contribute to elevated fasting am blood sugars.
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Newark, NY: I was diagnosed with Diabetes 2 a year ago. I've been successful in losing weight, lowering cholesterol and excersing, but it hasn't helped. I'm now on Metformin (1000 MG daily). Since I started taking it, my glucometer readings are the highest I've ever had. Why?
Lorie and Natalie: I think I could give you better information if I knew your HBA1C at diagnosis and now, and what kind of blood sugars you are getting (both now and before Metformin). Another thing you should consider is, is your meter giving you true readings? Do you have to code the meter? Do you use control solution when you get a new box of strips? Does it measure plasma or whole blood? Most meters have a toll-free number on the back of them. Call the maufacturer if you feel you need assistance in determining if your meter is working correctly. Also, do you take the Metformin is split doses (500mg at breakfast and supper)? This may also give you better blood sugar control depending on when your readings are elevated. Keep a blood sugar log and a food diary if you aren't already and discuss your concerns with your provider.
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Venice fl.: what can happen if a diabetic misses one or more of their insulin injections?
Lorie and Natalie: Obviously the blood sugar levels will be elevated the next time they are checked. Symptoms of fatigue, headache, frequent nighttime urination, etc., may also occur depending on the level. Getting the blood sugar under control the rest of the day will also be a challenge since less carbs need to be consumed and/or more insulin will need to be taken to try and stay at your glucose targets. It is always best to stay in the habit of taking insulin injections as directed by your provider for optimal management of your diabetic condition and to minimize risk of complications.
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Woodside, NY : What's the normal range for type 2 diabetes after one eats meals. And how long do you have to wait until one tests oneself? My sugar levels run from 150 to 187.
Lorie and Natalie: It is best to wait 1-2 hours after the start of a meal to test your blood glucose levels. A normal reading for a non-pregnant person with diabetes, according to the American Diabetes Association, should be less than 180mg/dl when tested 1-2 hours after the start of a meal.
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Corpus Christi, Texas: What shall I do if my husband, a type 2 diabetic, has sugar level of 395?
Lorie and Natalie: If your husband's level is running that high, I would contact his physician immediately for evaluation. It would be a wise idea to keep a food diary as well and see a dietician with diabetes credentials for better management after the physician has made necessary adjustments in his medication.
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Culpeper, Virginia: I have recently started taking Cinnamon pills to help me manage my type 2 Diabetes. I have had type 2 for approx. 9 years. I am a 49 year old mail. I weigh 240 pounds. I take glucophage 100 mg twice a day, avandia 4 mg and lantus insulin 35 units. Can you advise dose for cinnamon pills since they come in varring amounts.
Lorie and Natalie: We have found conflicting reports stating whether or not cinnamon is beneficial for the treatment/management of diabetes. Cinnamon is considered a "natural" or "herbal" product and the manufacturers of these products are not required to undergo the FDA (Food and Drug Administration) approval process to demonstrate their safety and effectiveness. The FDA only regulates the package labeling, prohibiting a product from making claims that it is intended to diagnose, treat, cure, or prevent a disease nor is there a recommended dosage for the management of diabetes. We recommend that you consult with your physician before adding any "natural" or "herbal" product to your daily regimen.
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fredonia,ny: I'm a Type 1 diabetic, how low can my blood level go to cause death? I can get pretty low, what about a blood level of 20 and severe seizure-like behaviors?
Lorie and Natalie: There are different thresholds of blood sugars that can feel "low" to patients with diabetes. The ADA recommendation for an optimal fasting blood sugar is 90-130mg/dl, although many patients feel fine with readings below 90mg/dl. In general, many patients (diabetic or not) experience symptoms of low blood sugar (shakiness, rapid heartbeat, headache, etc.)when their blood glucose levels drop below 70mg/dl. As a Type 1 diabetic, you are prone to more frequent episodes due to having to administer insulin. It is adviseable to keep your blood sugars above 70mg/dl to lessen the likelihood of severe episodes of low blood sugar (hypoglycemia). The more frequent the episodes become, the longer your body will take to recognize these symptoms, which can be a very serious thing. You do not want to have readings of 20mg/dl and experience seizure like behavior for obvious reasons. Consult with your provider to assess your insulin regimen and your eating habits; eating on a regular schedule will help prevent this situation.
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WARRENTON, GA: I was recently diagnosed with diabetes and am having problems with severe fatigue. The Dr. has placed me on medications and I feel I'm eating the right foods, but to no evail. What can I do?
Lorie and Natalie: Severe fatigue is a symptom of diabetes and should begin to resolve as your blood sugars come closer to the normal range (fasting sugar: 90-130mg/dl; 2 hour post-prandial sugar < 180mg/dl). Some medications such as Avandia and Actos may take 3-4 weeks to realize an appreciable drop in blood sugar. Other medications such as Metformin, glimepiride, glipizide, glyburide, etc. will work sooner. I would have your diet assessed by a dietician to ensure that you are eating appropriate foods, and I would consult with your doctor or pharmacist with specific questions about your medications to determine when you should expect to see a difference in your symptoms.
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ridgewood, nj: Is there any connection with eczema of the hands and feet and type two diabetes?
Lorie and Natalie: It is a known fact that patients with Type 2 diabetes are predisposed to dry skin (probably due to impaired circulation); however, having eczema does not necessarily put patients at higher risk for diabetes. As a diabetic, it is important to moisturize your skin after bathing to prevent cracking (especially on the heels). Controlling your blood sugar will minimize diabetes-related dry skin conditions, but you may still have eczema. Be sure and contact your doctor if you notice areas on your skin that are not healing properly.
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Independence Missouri: What is normal blood glucose level for someone who doesn't have diabeties?
Lorie and Natalie: A normal fasting blood sugar for a non-diabetic patient is <100mg/dl. A normal blood sugar for this patient two hours after eating is <140mg/dl, and a normal HBA1C for this person is 4-6%.
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TORONTO CANADA: I s memory loss a symptom of diabetes in adults? romania1ca@yahoo.com
Lorie and Natalie: Memory loss and decreased comprehension skills may be more prevelent in older persons with diabetes. It has been shown that with good blood glucose control, older persons with diabetes scored much better on the thinking and memory tests after achieving better glycemic control.
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Maumelle AR: IN detail, why do steroid shots for pain/arthritis cause high blood sugars for at least a day? I have to monitor my blood sugars every two hours and the resulting reading warrants dosages of Humalog insulin three to four times my usual sliding scale for four or more blood glucose readings.
Lorie and Natalie: Steroids may cause high blood glucose levels in individuals with diabetes due to increased peripherial insulin resistance from the steroid. The steroids may also increase gluconeogenesis, which is is the generation of glucose from noncarbohydrate sources and with long term use, promotes glycogenolysis, the breakdown of glycogen to glucose. All of these processes lead to increased blood glucose levels.
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Myrtle Beach, South Carolina: Before going to bed last night, I noticed that the skin between my last two toes had opened up. I am so recently diagnosed with type 2, with good BG levels. What is the best way for me to treat this disorder. I normally live in New Mexico where it is very dry. I have been here in S. Carolina for just three days where it is very hot and humid.
Lorie and Natalie: We are unable to determine what is causing your skin to crack open between your toes. We recommend that you consult with your physician for a proper diagnosis and treatment option. Proper foot care is very important in those with diabetes. According to the American Diabetes Association, "Inspect your feet every day, and seek care early if you do get a foot injury. Make sure your health care provider checks your feet at least once a year - more often if you have foot problems. Your health care provider should also give you a list and explain the do's and don'ts of foot care. Most people can prevent any serious foot problem by following some simple steps." For more information on foot care and prevention you may also visit the American Diabetes Association website at http://www.diabetes.org/type-2-diabetes/foot-care.jsp for more information.
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Grass Valley, California: What is the average length of time for a type II to get Gastroparesis, with a fair control of blood sugars? I'm 52, have been diagnosed 7 years, and feel that I'm too young to have this very painful stomach complication.
Lorie and Natalie: We were unable to locate a time frame for when gastroparesis could occur after being diagnosed with diabetes. According to the American Diabetes Association, "Gastroparesis is a disorder affecting people with both type 1 and type 2 diabetes, where the stomach takes too long to empty its contents. It happens when nerves to the stomach are damaged or stop working. The vagus nerve controls the movement of food through the digestive tract. If the vagus nerve is damaged, the muscles of the stomach and intestines do not work normally, and the movement of food is slowed or stopped. Just as with other types of neuropathy, diabetes can damage the vagus nerve if blood glucose levels remain high over a long period of time. High blood glucose causes chemical changes in nerves and damages the blood vessels that carry oxygen and nutrients to the nerves." You may want to consult with a gastroenterologist and endocrinologitst for treatment options for your condition.
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Houston, Texas: What should a person without Diabetes sugar level be after eating? What about a person with pre-diabetes/diabetes?
Lorie and Natalie: Two hours after eating blood glucose levels for a person who does not have diabetes should be less than 140mg/dl. If a person has been diagnosed with prediabetes their blood glucose levels two hours after a meal should be between 140 and 199 mg/ld and a person with diabetes is usually over 200mg/dl. You must understand that a person who may have prediabetes or diabetes, with diet, exercise, and medication can get their blood glucose levels under control and have normal readings of their blood glucose levels. We recommend that you consult with your physician about your concerns and have them run either a fasting plasma glucose test or an oral glucose tolerance test to determine if you have diabetes.
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Houston, TX: If my A1C home test I take once every three months indicates my Mellitus is totally under control......don't you think that measuring my glucose level three times a day is superfluous???
Lorie and Natalie: An A1c test measures the average blood glucose levels over a 3 month peroid and gives you an overall picture of how your glucose control has been. Daily blood glucose testing gives you a pinpoint, at that time, blood glucose level reading that can help you to correct a high or blood glucose level. While each has its importance separately, together they give you better control and snapshot view of how your blood glucose control is working and both are equally important in your blood glucose control.
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lansing, ill 60438: please help me solve this problem, have diabetes # 2 average reading is 120-140. also on diet, also excercice, however have neuropathy very bad. refuse to take neurotin, had a treatment with anodyne no results. is this situation permanent or do you have any suggestionm,, also take amaryl, glucophage. thank for your help. anita
Lorie and Natalie: Treatment of neuropathy is targeted at treating the symptoms associated with neuropathy. Each person is treated on an individual basis, depending on their specific symptoms. Currently, many doctors recommend that people with neuropathy closely manage blood sugar levels, exercise regularly, and maintain an ideal weight. Various medications are used to treat the symptoms of neuropathy such as pain medications (narcotics and some seizure medications), topical creams (for pain), and antidepressants (for depression, insomnia, and anxiety). Additionally, physical therapy, massage, and acupuncture have been used to help treat diabetic neuropathy. We recommend that you speak with your doctor to determine the best treatment for your specific symptoms. For additional information, you may wish to visit the American Diabetes Association website at http://www.diabetes.org/type-1-diabetes/nerve-damage.jsp or www.riteaiddiabetes.com.
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topeka, ks: Hello, I have type II diabetes. I have had it for almost 3 years now. Recently I have been having muscle spasm's in my right eye. Is this a sign of a more seriuos problem or am I just tired. Could you tell me if this is common.
Lorie and Natalie: Muscle spasms in your eyes are not necessarily related to poor blood sugars. Blurry vision, seeing "spots", etc. are often typical of blood sugar fluctuations. It is always best to see your eye doctor annually when you have diabetes, so I would explain your symptoms to him and let him evaluate your condition.
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CHEYENNE WYOMING: WHAT ABOUT USING METFORMIN WHEN YOU HAVE HEPATITIS C....I AM USING IT AND HAVE FOR 3 YEARS NOW...BUT MY COUSIN WHO TWO WEEKS AGO WAS DIAGNOSED WAS NOT GIVEN THE OPTION. HIS DOCTOR SAID SHE DOESN'T PRESCRIBE METFORMIN TO HEP C PATIENTS..FOR FEAR OF LACTIC ACIDOSIS. BOTH OF US HAVE HEP C. dgoard@hotmail.com
Lorie and Natalie: The liver is an important for clearing accumulated lactic acid from the body. In a person with liver disease, including hepatitis, there is a possibility of decreased lactic acid removal from the body, which could be a problem in someone that is on metformin. Metformin may cause a buildup of lactic acid as a side effect. We recommend that you consult with your physician about your concern with being on metformin with your current condition.
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ADA Moderator : There are many pharmaceutical companies that offer prescription assistance for patients without insurance coverage. The Partnership for Prescription Assistance (PPA) is a new program created to help qualifying patients without prescription coverage obtain medications at a reduced price or free of charge through public or private programs. Their mission is to increase awareness of patient assistance programs and boost enrollment of those who are eligible. You may contact the PPA by phone at 1-888-4PPA-NOW (1-888-477-2669) or though the internet at www.pparx.org. Additionally, there is a card called Together RX which allows qualifying patients to save on certain prescription medications. This card is made possible through a coalition of pharmaceutical companies. To enroll, you may call 1-800-865-7211 or enroll online at www.Together-Rx.com. Finally, you may also contact the manufacturers of your medications directly in order to obtain information about available patient assistance programs. In order to provide you with the name and phone number of the manufacturer, we would need the name of the strips that the patient uses in order to provide the correct telephone number. Please resubmit your question with the name of the test scripts to our Ask The Pharmacist link at www.riteaid.com and we will be happy to provide you with the manufacturer's telephone number.
Those are all the questions we have time for today. Thanks so much for being here Lorie and Natalie.
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.
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. Rite Aid Pharmacists and Diabetes Care Specialists will be with us next at 1:00 p.m. EDT August 3, 2006. See you then.
Lorie and Natalie: It was a pleasure. Thanks for having us.
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