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ADA Moderator : Welcome to ADA Live!
Today our guests are Natalie Teaff, R.Ph. and Terry Towers, R.Ph, Drug Information Specialists with Rite Aid Drug.
Thanks for being here today Natalie and Terry.
Natalie and Terry: Thanks it's great to be here. We have lots of good questions coming in from around the country.
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Grass Valley, CA: I am concerned about the potency of Lantus, Humalog and Novolog insulins. I know they are to be discarded 28 days after first opened. Does dropping on the floor (a jarring shock) or a couple of hours at say 90 degrees F change the potency? My sense is that these kinds of events affect insulin and they work better if I lower the ratio a bit, ie, take a bit more for the same amount of carbs. Thank you.
Natalie and Terry: That's a great question. You are correct that dropping the vial, shaking the vial, or leaving the vial of insulin in 90 degree weather will affect the stability of the insulin. These events will decrease the effectiveness of the insulin. However, we must recommend that if any of these events occur you must not self adjust your insulin dose and replace your supply of insulin.
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Elizabeth City, NC: I am trying to find out about Dreamfields Pasta. Have you heard of it and do you recomend it?
Natalie and Terry: We have found that Dream Fields is a type of pasta that is low in carbohydrates. The pasta is manufactured with a special fiber called inulin. We recommend that you consult with your physician and/or dietician before adding this product to you diet to determine if it is right for you.
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Abington, PA: Where does one purchase an ID bracelet for Diabetes
Natalie and Terry: Check with your local Rite Aid Pharmacy to see if they carry medical id braclets for diabetes. If they do not, they may be able to place a special order for you or have order forms available at the pharmacy for you to order one directly. You may also want to check the internet as there are several companies on the internet that offer medical id braclets for purchase.
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Graham, Texas: What is the desired fasting glucose reading for a pre-diabetic person who is aggressively following exercise and meal guidelines?
Natalie and Terry: 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. We recommend that you consult with your physcian to determine where he/she wants your target fasting blood glucose levels to be.
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Charlotte NC: I have recently had a checkup sugar test was 87 and A1C was 6.2. My home testing is now good some times but a recent test was 59 and tonight I am 210. I admit I fudged a tad but the increase is more than a tad. Is this a mormal reaction to a tiny addition of carbs for someone who is that strict? did omitting a slice of bread cause the drop to 59?
Natalie and Terry: It is not clear how much time elapsed, or how many carbs were consumed between your reading of 59 and the reading of 210. (or how long after carb consumption, you had the 210). Did, you follow the recommended routine for this level hypoglycemic event? That is: take 15 gm of a fast acting carbohydrate, then re-test in 20 minutes to insure that you were back up. (You may have ingested more carbs than you thought) Yes, the drop to 59 could have been caused by omitting a slice of bread, which is 15 Gm of carb, especially if you are using insulin and dosed based on inclusion of the bread in the meal.
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Dothan, AL: Can you please tell me the Hemoglobin A1C recommendations for children. Their was an article printed the end of last year, but I can't find it. Thankyou
Natalie and Terry: According to "Diabetes Care 28(1):186-212,2005" For children less than 6 years: an A1C between 7.5 to 8.5 is recommended. From age 6 to 12: an A1C <8.0 is recommended and from age 13 to 19: an A1C <7.5 is recommended.
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taylor mich: how come my sugar reads 145 -170 first thing in the morning, but rest of day reads 95 -120..eating small amounts..also coffee seems to raise it?
Natalie and Terry: Several things could be causing your fasting glucose to be high. If you are using insulin, you may be going low early in the morning (3 AM) and experiencing a "rebound", this is referred to as a Symogi effect. There is also a "Dawn Phenomenon" which is an unexplained rise in morning levels, generally believed to be caused by a hormonal release before waking. Doing a finger stick at 3 AM would give some insights as to what course of action should be taken. Be sure to discuss this with your physician.
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DeRidder, Louisiana: One in how many people in the general population in the United States are born with diabetes?
Natalie and Terry: There are 20.8 million children and adults in the United States (7% of the population) who have diabetes. However, only an estimated 14.6 million have been diagnosed with diabetes; unfortunately, the other 6.2 million people (about one-third) are unaware that they have the disease. Diabetes is often not present at birth. Type 1 diabetes tends to occur in children and young adults while type 2 diabetes tends to occur in adulthood (age 40 and over). However, as the number of overweight children and adolescents increases, type 2 diabetes is becoming more common in the young. We were unable to find a specific statistic stating how many people are born with diabetes.
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New Orleans, La.: What is Diabetes Insipidus?
Natalie and Terry: Diabetes Insipidus is where there is excessive urination and excessive thirst, it is a condition caused by decreased action of vasopressin, or ADH (anti diuretic hormone)and should not be confused with Diabetes Mellitus, which results from insulin deficiency or resistance. More info can be found on-line, search "diabetes insipidus"
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San Diego, CA: I am type two Diabetic, I actually just found out a few months ago... I have been getting numbness on my pinky finger on my left hand and the past few days it is getting worst and I feel like my whole hand is asleep. Is this a side effect from being diabetic? should I be worried??
Natalie and Terry: While it is possible that the numbness is a result of your diabetes, there may be other factors that are contributing. Discuss this condition with your physician.
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Salem, Oregon: I get up at 4:15 AM prior to work and breakfast and go for a 25 - 30 minute walk. I take my blood sugar and it ranges from 95 to 111. On week ends I sleep in between 8:00 AM and 9:00 AM. I go for a walk to the store to get a paper and equal if not exceed my 25 - 30 minute duration. However, by blood sugur is generally 10 -20 mg higher than at my five day week day average at 4:15 AM. I have gone longer without nourishment on weekends so why the higher numbers?
Natalie and Terry: You do not mention if you are on any medication. If you are using insulin, the timing of your evening injection may contribute to the higher blood glucose on the weekends. Another possibility is that you stay up later on weekends, and perhaps snack a bit more and later in the evening. There is also a possibilty that your are experiencing the "Dawn Phenomenon" which is an unexplained increase in blood glucose in the morning. This increase is believed to be caused by a release of testosterone and appears to affect males more often than females.
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Salt Lake City, UT: I have had a sweet taste in my mouth for over a week now, a few months ago I was tested borderline for diabetes. Is this a sign of it?
Natalie and Terry: Common symptoms of diabetes include excessive thirst, extreme hunger, frequent urination, irritability, increased fatigue, unusual weight loss, or blurry vision. We recommend that you speak with your physician to discuss your symptoms for a proper diagnosis and treatment plan.
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pickerington ohio 43147: what does it mean when your body has too much insulin
Natalie and Terry: Having too much insulin is referred to as hyperinsulinemia, usually resulting from insulin resistance. This is when your bodies' insulin is not properly reducing the amount of glucose in the blood and an over production of insulin occurs. Thiazolidinidiones are drugs which help insulin work better, and are used in cases of insulin resistance.
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indep missouri: If taking chemo will that my your bloodsugar high?
Natalie and Terry: In order to determine if your chemotherapy will increase your blood glucose levels, we need to know which chemotherapy medication you are taking. Please resubmit your question to our "Ask The Pharmacist" service at www.riteaid.com with the name of the chemotherapy and we would be happy to determine if hyperglycemia is listed as a possible side effect to your specific medication.
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Aurora, Colorado: Is thee any thing like sugar free wine and liquor for diabetics?
Natalie and Terry: While we are not aware of any sugar free wine or liquor for people with diabetes, the American Diabetes Association recemmends that "If individuals choose to drink alcohol, daily intake should be limited to one drink for adult women and two drinks for adult men." (Women metabolize alcohol more slowly than men.) One serving would be defined as 15 grams of alcohol, or about 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of distilled spirits. These amounts are referred to as "light-to-moderate" intake in most research studies. Before consuming any alcoholic beverages- even on an occasional basis- please check with your physician.
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Beachwood, NJ: I've recently been diagnosed with Type II diabetes and put on a regimin that includes Avandia, Starlix and twice-daily glucose monitoring. As I understand it, Starlix (I'm on 60 mg, 30 minutes prior to each meal) boosts short-term insulin production so upon eating there is sufficient insulin in my blood to immediately begin handling the infusion of glucose. Since I test immediately before (and two hours following) meals, does not this insulin boost tend to depress the glucose level that would normally be measured prior to eating?
Natalie and Terry: Starlix is designed to begin working approximately 30 minutes after taking and is taken 30 minutes before meals to coincide with normal production of insulin by the pancreas. It is possible that you may metabolize the Starlix slightly faster than average, and if you are concerned about this affecting your pre-meal blood glucose, you could do the finger stick 10 to 15 minutes before eating (15 to 20 minutes after the Starlix).
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Saan Antonio, Texas: I have developed a rash on my hands and my left arm and both legs go numb and feel like they are burning?
Natalie and Terry: We are unable to determine what the rash on your hands and left arm is and recommend that you consult with your physician for proper diagnosis and treatment options. However the numbness in both of your legs may be neuropathy which 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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Fortlauderdale ,Florida: Who founded American Diabetes Association
Natalie and Terry: The American Diabetes Association (ADA) was founded in 1940 and is the nation's leading nonprofit health organization providing diabetes research, information and advocacy. The ADA conducts programs in all 50 states and the District of Columbia. You may find out more about the ADA under the "About Us" section of their website at www.diabetes.org .
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Oviedo Florida: My name is Norberto, my question is I am taking Vytorin for cholesterol can this medication increase my sugar level? I am really concern about having diabetes. I love to eat rice with beans. Its this a bad choice for me? Pleae help me. Thank you
Natalie and Terry: Keeping your LDL cholesterol levels within acceptable ranges is very important to people with diabetes, Vytorin shows no indication that it will raise glucose levels. If you test your bg levels 2 hours after eating your rice with beans, you will know how it affects your sugar level. Portion size is an important consideration when eating anything.
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New Marshfield, Oh: I have a FBS of 104 and a 2 hour of GTT of 121. Do I need medication? If so which group?
Natalie and Terry: 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. Only your doctor can diagnose you with diabetes. Depending on what your diagnosis would be, your doctor will need to decide on the most appropriate treatment. We recommend that you contact your doctor to discuss your lab results.
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san antonio texas: what is considered normal blood glcose levels in healty people?
Natalie and Terry: The normal fasting blood glucose level should be less than 100 mg/dl in a healthy individual.
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Coimbatore. TamilNadu: My fasting blood sugar level is 107.7 mg/dl. Am I at risk of developing diabetes? What are the ways to prevent getting diabetes?
Natalie and Terry: A fasting blood glucose of 100 to 126mg/dL would be considered as pre-diabetes, and this would be one risk factor towards diabetes. Eating healthy and engaging in a good exercise program (maintaining a healthy weight), keeping your blood pressure in normal range and keeping cholesterol numbers in normal range are all factors in keeping risk for diabetes at lower levels
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Pleasant Garden NC: Should my grandma have a tempature of a 102.0 with Diabeties and have weezing and chest pain? She just found out she had Diabeties..
Natalie and Terry: Your grandma should not have a temperature of 102, whether she has diabetes or not. She should be checked by her physician to determine the reason for the high temp and the wheezing and chest pain.
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St. Louis, Missouri: What happens when a type 2 diabetic eats items made with sugar?
Natalie and Terry: When a person with diabetes eats someting containing sugar, the blood glucose level will go up, this is the same thing that happens when the person with diabetes eats any carbohydrate (sugar is a carbohydrate). usually sugar containing products are higher in calories, and if weight is a problem, then one should watch the calorie intake. If the person with diabetes is counting carbs, and wants to eat something with sugar, be sure to include those carbs in your count.
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Atlanta, GA: My husband is a diabetic and has heart problems so has very poor circulation. He is always cold. I have seen the heated mattress pads in stores and wondered if they would be safe for him? They show that different settings can be used but I know people with poor circulation and diabetics have to be careful. Thank you.
Natalie and Terry: You are right when you state that people with diabetes have to be careful not to apply heat or cold to their extremities. A condition known as diabetic neuropathy can cause a person to have a lessened perception of heat, cold, and/or pain and may cause burns to the skin without the patient knowing it is occurring if heat or cold is applied. We do not recommend using a heated mattress cover or electric blanket. Consult with your husband's physician to determine what treatment options are available to alleviate your husband's cold extremities.
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gastonia, NC: Hi, My name is april and I feel a may have symptoms of type 2 diabetes but I'm young and I don't have insurance or enough money right now for a doctors appointment. I have always been very thin and I have mood swings that seem to be cured on occasion by sugar or protein. I feel very tierd after I eat sometimes. I also used to get very moody in the mornings and heard that this was a symptom of hypoglycimia, and could be cured by having protein as soon as I wake up and after trying it and having success I felt I could confirm having hypoglycemia. My question is, is there a way to test myself over the counter for diabetes? Thank you for your time, April
Natalie and Terry: Type 2 diabetes occurs when a person experiences high blood glucose levels, or hyperglycemia. Hyperglycemia may be caused by eating too much, lack of physical activity, illness, stress, the body not having enough insulin, the body not being able to use the insulin present, skipping medicine, or exercising less than usual. Symptoms of hyperglycemia include confusion, drowsiness, rapid breathing, fruity breath odor, increased urination, unusual thirst, low blood pressure, high levels of sugar in the urine, blurred vision, fatigue, headache, nausea, difficulty concentrating, or changes in mental status. On the other hand, hypoglycemia is when blood glucose levels drop below 70 mg/dL this condition is called hypoglycemia. Hypoglycemia may be caused by exercising, skipping meals, too much medication or insulin, drinking alcohol on an empty stomach, or changes in your schedule. Symptoms of hypoglycemia include shakiness, dizziness, inability to concentrate, headache, sweating, hunger, fast or pounding heart, fatigue, paleness, weakness, fainting, sudden moodiness or behavior changes, tingling sensations around the mouth, clumsy or jerky movements, and poor or blurred vision. If your blood glucose drops very low you may develop slurred speech, confusion, seizures, combativeness, or pass out. There is a home A1C test that you can do at home and send to a designated lab on the package to get the results. An A1C test gives you a 3 month picture of what your blood glucose levels were. We still recommend though that you consult with your physician to determine the cause of your symptoms and to get proper treatment options. To help prevent hypoglycemia, eat meals and snacks on a regular schedule and test your blood glucose levels frequently. Ask your doctor how often you should check your glucose levels. It is important to know the symptoms of hypoglycemia and treatment options in order to prevent worsening hypoglycemia.
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Peoria Arizona: My 40 year old son was recently diagnoised with type 2 diabetes and he is havin a hard time adjusting to his Metformin and the Doctor recently added another medication to it and now he is having dizziness and nausa feeling really lathargic and his sugar is still 300 what can he do?
Natalie and Terry: Gastrointestinal adverse effects, including anorexia (loss of appetite), nausea/vomiting, abdominal discomfort, dyspepsia (upset stomach), flatulence (gas), diarrhea, and dysgeusia (metallic taste)are seen in about 30% of patients taking metformin and usually tend to decline with continued use and can be lessened by starting out with lower doses of metformin. You do not mention what other medication your son is on but either way, we would recommend that he be reevaluated, blood glucose levels of 300 are not within the recommended guidelines and may be causing his dizziness and lethargy.
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niagara falls, ny: my level is 130, am i able to have 2 or 3 beers 1 or 2 times a week
Natalie and Terry: Alcohol contains carbohydrates which can at first elevate blood sugar levels. 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. 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. 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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Burlington, NJ: Is Type 1 diabetes an autoimmune disease?
Natalie and Terry: Yes, Type 1 diabetes is an autoimmune disease for which there is not a cure.
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churchville.pa: my blood sugar is usual between 105 (the lowest)-140(after meal).I don't take any prescription medication yet-only cinnamon water exstract and supplement called Diamaxol.I try to keep low carb diet,don't use sugar or any sugar substitute.I am 52 years old,my weight is 150 lbs,height 5'6'.My question is-can i stick to the same routine?
Natalie and Terry: It would appear that your current routine is controlling your blood glucose levels. Continuing with a healthy eating and physical activity program, and continuing to monitor your glucose levels would be appropriate. One danger is to become too complacent, losing the control that you have. Congratulations on your success, and keep up the good work.
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Gaffney, SC: My son, who is 18 years old, has been having some symptoms of diabetes so I tested his BS last night (his dad is diabetic). His BS was 157. This morning I tested a fasting fingerstick BS and it was 135. Should I make him an appt. with a MD asap?
Natalie and Terry: Since one risk factor for diabetes is heredity, and since the finger sticks that you have done, are above the normal range, it would seem wise to have your son checked by your physician for follow up.
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chgo, il: please discuss how to deal with uninformed personel at school. My daughter is 10, has had type 1 for 2 1/2 yrs. The gym teacher got up on parent/teacher night and said the major cause of juvenile diabetes was inactivity and obesity. This was to a crowd of 600. I wonder how to deal with teachers and parents who subconscientiously think she is to blame for the extra time in monitoring her.
Natalie and Terry: Unfortunately, there are many people who are uninformed on diabetes. You might approach your school board of education and request that they schedule some informational seminars on diabetes for the teachers and aides. There are many school districts throughout the country that have made this type of program mandatory. The most important thing, however, is that you and your daughter realize what is important in maintaining control, and do not get frustrated with the uninformed public. Good Luck.
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Columbia, SC: My sister, 67 - typically a happy, well-balanced, stable person - is 'morbidly obese' by her own definition. A medical transciptionist, her lifestyle is extremely sedintary and her eating habits are horrendous - centering around 'hidden' candy bars and cookies. Rather suddenly she has become a totally different person - driven by hate and fury - a radical change noticed by everyone. She has been told by her doctor she is a candidate for diabetes - but none of us dare ask her present status. My question is this: Is it possible that diabetes could trigger this kind of change in a person who continues this destructive lifestyle?
Natalie and Terry: Hypoglycemia, low blood sugar, and hyperglycemia, high blood sugar, in someone who has diabetes may cause changes in personality. We highly recommend that you try and talk to your sister and/or her physician with your concerns. There could be many different scenarios as to why your sister has undergone such a drastic change in her personality and it is in your sister?s best interest to obtain a proper diagnosis and treatment soon as possible.
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DENVER, CO: WHAT TESTING METER SHOULD I PURCHASE. I JUST GOT THE NEWS AND I AM SO CONFUSED.
Natalie and Terry: There are many different kinds of glucometers on the market today. The bottom line in picking out which one is best for you is preference. Some characteristics to think about before choosing the right one for you include: ease of use or number of steps required, testing time or speed, amount of blood required, display size, size and weight of meter, when and how to calibrate, meter cleaning requirements, cost of meter, cost of strips, cost and ease of replacement batteries, memory and ability to download, ability to use alternate site testing, plasma versus whole blood values, effect of altitude and finally customer support from the company). You can check the FDA website on the discussion of glucose monitoring at http://www.fda.gov/diabetes/glucose.html#3. Another website is: http://www.americandiabetes.com/supplies/meters.htm
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cold lake albeta: Please tell if there is any swelling caused by diabetes? I have swelling in my one foot on and off and there is diabetes in are family. I have not been to a docotor about the diabetes as of yet.
Natalie and Terry: 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. We are not aware of swelling as a symptom of diabetes. 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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inverness fl: Can pain increase you blood sugar?
Natalie and Terry: Stress can cause blood sugar to rise, and pain may be the cause of some degree of stress. Infection can also cause blood sugars to rise, and if your pain is from an infection, then your blood sugar will be higher.
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Ashton, Maryland: I had a strange and worrisome episode today. I was getting into my car after grocery shopping and couldn't get in fast enough. I felt faint and weal. I sat in my seat with my head on the steering wheel. My legs felt weak, hands were tingling and shaking and I felt really faint. I perspiring heavily. I decided to try and drive home which is only a 12 minute trip. I drove very slow and with my flashers on because I still felt the same. I had part of a baguette I'd bought in the grocerky store. And then water. And then M & Ms. I still didn't feel better so I pulled off of the road and thought if I could rest a few minutes I'd feel better. I did not. I continued home. As soon as I got there I had to lay down. I was craving the M & Ms and hate handfulls. It took a couple of hours or resting before I felt better. Now I'm exhausted.
Natalie and Terry: You are describing a hypoglycemic event, where your blood glucose drops below 70mg/dL. Whenever you have this type of feeling you should check your blood sugar. If you are low, take 15 to 30 grams of a fast acting carbohydrate (not chocolate) 1/2 glass of orange juice, 1/2 can of regular soda, 3 to 5 glucose tablets, 5 to 7 life savers. Then re-test your blood sugar in approximately 15 to 20 minutes to verify that you are coming back up, if not back above 70mg/dL repeat the process. You should never go lie down to see if the feelings will go away. Try to determine why you went low: did you take medication (ex. insulin) and not eat; Did you have more physical activity than normal. When you determine why you went low, you can be better prepared to prevent it from happening.
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Cave Creek, Az: My husband is an insulin diabetic and has been experiencing lows lately. I read sometime ago that their was a watch type bracelet that could monitor your readings all day and night. Have you heard of it? Where could I buy one?
Natalie and Terry:
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Massachusetts: I'd like to know why some people have to go on insulin after having taken diabetes pills and some people don't. I thought a person on pills always at some point had to take insulin.
Natalie and Terry: Meal planning and physical activity are usually the initial concerns for treatment of diabetes, when this no longer controls the disease, oral medications may be started. In some instances the oral medications fail, and this is when insulin is initiated.Diabetes is different for everyone, and the course of treatment is determined by how each patient is responding to his/her current therapy. It is true that a large majority of people with diabetes will eventually need insulin therapy, but is not a forgone conclusion.
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Columbus, OH: What are the specific numbers for testing fasting and non-fasting.
Natalie and Terry: 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 (5.0-7.2 mmol/l) (plasma/serum blood glucose reading); peak after a meal (1-2 hours after the start of a meal) - Less than 180 mg/dl (less than 10 mmol/l). 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 (less than 6.1 mmol/l)--(plasma/serum blood glucose reading) Two hours after eating a meal - Less than 140 mg/dl (less than 7.8 mmol/l)--(plasma/serum blood glucose reading) We recommend that you consult your physician to determine what specific goals are appropriate for you.
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DELTONA, FLORIDA: I RECENTLY HAD A SEIZURE WHEN MY SUGAR LEVEL DROPPED TO 58. MY USUAL LEVEL RUNS AROUND 150. HOW OFTEN SHOULD I CHECK MY SUGAR LEVEL AND WHAT TIMES DURING THE DAY? I WANT TO PREVENT ANOTHER SEIZURE BY MONITORING MYSELF AS OFTEN AS NECESSARY. THANK YOU. FRAN TODD
Natalie and Terry: 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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Oviedo, FL : I was diagnosed a few months ago and I am very compliant with my diet & medication, but I still have low blood sugars where I get shakey and feel so weak I can hardly stand up. I have lost 13 pounds and still need to lose some more. I have cut sugar completely out of my diet. I also sometimes experience blood sugars over 200 & 300 and feel very sleepy and tired. Is this normal as your body adjust to the medication? Any suggestions please. Thank you.
Natalie and Terry: It does take some time and practice to reach the goals that you set for yourself. You must remember that testing is very importatant when first trying anything new. When you have symptoms of hypoglycemia, you must do a finger stick, ingest a fast acting carb, and re-test 15 to 20 minutes later, to insure that you are coming back up, then ingest something like 1/2 peanut butter sandwich to keep your levels up. You have to remember, also, that sugar is not the culprit, but any carb in excess will contribute to higher glucose levels, you may be ingesting higher levels on those occassions when your levels go to 200 and above. (Feeling tired is one symptom of hyperglycemia). Congratulations on you recent weight loss, keep in mind that you should not try to lose more than 1 or 2 pounds per week.
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murfreesboro, TN: I was just diagnosed with diabetes a couple months ago and am controlling my diet and taking Glipizide. I have had considerable hair loss the last couple weeks and was wondering if this is because of my diet or just because of the diabetes in general. And if there is anything I can do to stop it. Thank you.
Natalie and Terry: Diabetes may cause hair loss (alopecia). We recommend that you consult with your physician about your hair loss for a proper diagnosis and treatment options.
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Boca Raton, Florida: How long does the insulin, my son is on Novalog and Novalin last once opened and if refrigerated?
Natalie and Terry: Novolog and Novolin will last 28 days after being opened, whether refrigerated or not. Novolog 70/30 will last 14 days after opening
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columbia sc: does being diabetic affect a woman sexual desire?
Natalie and Terry: According to the American Diabetes Association, "Sex is an important part of life and relationships. But diabetes can affect a woman's sex life. Some women with diabetes have less interest in sex because of depression. Or high blood glucose levels can make some women feel tired all the time. Or perhaps intercourse is painful because of vaginal dryness. Problems with having sex aren't a normal part of getting older and don't happen to all women who have diabetes." Don't be afraid to talk to your physician about your diabetes affect on your sexual desire. They are there to help you with all your health issues.
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nyc, ny: why would blood glucose level be high first thing in the morning (before breakfast)and then drop thru out the day? No carbs were consumed for dinner the night before.
Natalie and Terry: We have found that some patients do have high before-breakfast blood glucose levels because of hormones that are released in the early part of sleep (called the Dawn Phenomenon). Typically, the blood glucose level rises between 4 AM and 8 AM. Check your blood glucose level in the middle of the night (around 3 AM). If your blood sugar is high, you may be experiencing the dawn phenomenon. If it is low, it may be a rebound hyperglycemia (high blood glucose) causing your high blood glucose levels in the morning. This occurs if you have low blood glucose levels at night and your body is releasing hormones as a defense mechanism against low blood sugar. It would be best to consult your physician for proper diagnosis and treatment.
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Rowland hts., Ca.: My best friend has type 1 diabetes and has cut back on taking her insulin because she noticed she loses weight when she doesn't take it. she went from a size 10 to a size 4 in about 3 months. is that healthy? she also drinks a lot of alcohol. what can that do to her liver being a diabetic? i am really concerned.
Natalie and Terry: First and foremost, a person with Type I diabetes needs insulin in order for their body to process glucose in the body. When there is not insulin to accomplish this, hyperglycemia, or high blood glucose will occur and untreated hyperglycemia may lead to serious problems. Short term (days to weeks) hyperglycemia can lead to increased urination, increased thirst, weight loss, blurred vision, fatigue, nausea, and can also lead to many fungal and bacterial infections. More serious complications include diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic nonketotic syndrome (HHNKS). Diabetic ketoacidosis (DKA), also known as diabetic coma, occurs when the body lacks insulin and breaks down fats for energy. When this occurs the body produces ketones which can be found in the urine. Ketoacidosis occurs when the body does not get rid of all the ketones in the urine and they build up in the blood. This is a life-threatening situation and needs immediate treatment. DKA is associated with blood glucose levels from 200-2,000mg/dL. Symptoms of DKA include unexplained blood glucose greater than 250mg/dL, fruity smelling breath, dry mouth, nausea, vomiting, fever, abdominal pain, low blood pressure, shortness of breath, dehydration, increased heart rate, shock, and coma. Medical assistance is needed from hospital staff. Treatment includes insulin infusions, fluid replacement, and potassium replacement. Hyperosmolar hyperglycemic non-ketotic syndrome (HHNKS) can be life-threatening and is associated with blood glucose levels greater than 600mg/dL. Symptoms of HHNKS include dehydration, excessive thirst, low blood pressure, glucose in the urine but no ketones, hallucinations, sensory deficits, rapid eye movements, paralysis on one side of the body, loss of vision in half of the visual field, seizures, and a partial or total loss of the ability to comprehend spoken or written language and express ideas. Medical assistance is needed from hospital staff. Treatment also includes fluid replacement, potassium replacement, and insulin infusions. Long term (years) hyperglycemia can lead to coronary artery disease, skin breakdown, infections, peripheral vascular disease which may lead to amputation of limbs, loss of vision, numbness and tingling in the extremities, feet problems, skin ulcers, joint problems, and kidney problems. Extremely high blood glucose readings are a medical emergency and require medical assistance. Please let your friend know that skipping her insulin is a very dangerous practice and she may be putting herself at risk for serious health problems.
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ADA Moderator : The GlucoWatch is a non-invasive monitor that is worn on the wrist like a watch and may be used as an adjunct to a glucose meter. It works by an extremely low electric current that pulls glucose through the skin. This device is not designed to replace a regular blood glucose meter. The GlucoWatch is used to detect trends and track patterns in your glucose levels such as hyperglycemia and hypoglycemia. A standard glucose meter still needs to be used to confirm results. You would need a prescription written by your physician to purchase the GlucoWatch. More information regarding the GlucoWatch can be found at www.glucowatch.com or by calling 1-866-459-2824.
That's it for today. Thanks so much for taking the time to be here Natalie and Terry.
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. Our guest will be Rite Aid pharmacists and diabetes specialists at 1:00 p.m. ET November 2, 2006. See you then.
Natalie and Terry: Thank you and ADA for the opportunity to help folks understand diabetes just a bit better.
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