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ADA Moderator : Welcome to ADA Live!

Today our guests are Natalie Teaff, R.Ph. a drug information specialist at the Rite Aid Drug Information Center and Emily DeVault, R.Ph., Pharm.D. is a Diabetes Educator at the Rite Aid in Grafton, West Virginia.

It's a pleasure to have you here today Natalie and Emily.

Natalie and Emily: Thanks. It's a pleasure to be here.

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Savannah, Georgia : If you have been diagnosed as a type II diabetic and were placed on a meal plan of 45gm of carbohydrate per meal, when you lose a signigifant amount of weight (50-60lbs) shouldn't the 45gm of carbohydrate per meal be adjusted down?

Natalie and Emily: No, we need carbohydrates to give us energy, no matter how much we weight. Eating 45gm of carbohydrates per meal will help to maintain enough energy for your daily activities.

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Anniston, Alabama: If my blood sugar is elevated before I eat breakfast and I take a shot of Insulin to bring it down should I still go ahead and eat something?

Natalie and Emily: Yes, you should still eat something. You never want to skip a meal,howvever, you may want to adjust what you normally eat if your breakfast contains several carbohydrates, however you still want to include some carbohydrates in your breakfast. We recommend that you consult with your physician to determine why your blood glucose levels are elevated before you eat breakfast and what course of action would be best for your situation.

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Vancouver, WA: My father-n-law has had diabetes for a number of years and his blood sugar normally runs 120 to 140 the last 4 days it has been dropping below 90 and he gets to shaking real bad, what could be causing this?

Natalie and Emily: Several things can cause low blood sugar, including excessive exercise, not enough carbohydrates, or too much medication/insulin. Check to see if your father-in-law is eating fewer carbohydrates, or if he is having more physical activity than he is used to. Also, has he had any recent changes in his diabetes medications? Check to see if they have added any new medications or if they have increased a dose of one of his medications or insulin.

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lake elsinore, ca: if high blood pressure what medicine would be good to take?

Natalie and Emily: If you have high blood pressure and you have diabetes, there is a good class of medications to take called the ACE inhibitors. Some examples of drugs in this category are lisinopril or Zestril and Altace. There are many different drugs in this class and they can serve two functions. One, they can help to decrease your blood pressure. Two, they can help protect your kidneys from the diabetes.

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Spanish Fork, UT: There is a history of diabetes in my family, but I don't know if I have it. How do I find out without going to a doctor for a check-up?

Natalie and Emily: The only way to diagnose diabetes is through a doctor. He can do several different tests to help determine if you have diabetes. However, you may be able to find a local health fair in your area. Health fairs are usually held in malls or community buildings. Often at health fairs, nurses and pharmacists will be available to test your blood sugar. They will be able to tell you if you are at risk for developing diabetes or if it is important to schedule an appointment with your doctor soon. Also, some of the common symptoms of high blood sugar include excessive thirst, using the bathroom frequently, excessive hunger, and weight loss. If you are experiencing any of these symptoms, I would recommend going to see your doctor.

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Tulsa, Oklahoma: what is comsidered a high sugar count. I often check my sugar count but i'm not sure of the numbers

Natalie and Emily: 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 hypooglycemia). Before meals: 90 - 130 mg/dl (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) plasma/serum blood glucose reading). We would recommend that you consult with your physician to determine what blood glucose level goals are appropriate for you.

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nyc,ny: what foods have the most magnesium?

Natalie and Emily: Many foods that are high in magnesium are also high in potassium. Here is a list of foods that are high in magnesium: hallibut, almonds, cashews, soybeans, spinach, oatmeal, potato with the skin, wheat bran, yogurt, brown rice, banana, raisins, beans, and beets.

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Gresham OR: I have been recently diagnoised and took my sugar count and it came up 586. This was after exercising, which was walking. I know this isn't normal should I contact my doctor?

Natalie and Emily: Hyperglycemia (high blood sugars) should be treated as soon as you detect it. Untreated hyperglycemia may lead to serious problems. It is not recommended to exercise if your blood glucose levels are over 250 mg/dl. 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. We recommend that you consult with your physician to determine the cause of your high blood sugars and treatment options.

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nc: what are normal bloodsugar ranges?

Natalie and Emily: In someone without diabetes, your fasting blood sugar should be below 100. Two hours after a meal, someone without diabetes should have a blood sugar reading below 140. Someone with diabetes should have a target fasting blood sugar between 90 and 130. Two hours after a meal, someone with diabetes should have a blood sugar reading less than 180.

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sc: Why do blood glucose readings go up and down?

Natalie and Emily: Many different factors can change our blood glucose numbers. The amount of carbohydrates that we eat, the amount of exercise we get, the diabetes medications that we take, stress, and illness can all affect our blood glucose. The goal is to find a balance between each contributing factor to help with good blood glucose control.

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Boston, MA: How does someone living alone manage their blood sugar/insulin overnight, while sleeping? My mother often has very low blood sugar in the middle of the night, and if no one is there to give her orange juice or glucose tablet...she is in real trouble. She won't go on the insulin pump...how do others manage this serious issue? I could really use some suggestions. Thanks!

Natalie and Emily: One suggestion may be to have her set an alarm in the middle of the night to check her blood sugar. If she is low at this point, she can eat a snack. We recommend having glucose tablets or a glass of orange juice sitting beside her bed so that it is easily accessible to her. She may also want to start checking her blood sugar in the evening before she goes to bed. If her blood sugar is on the lower end of normal, she may want to eat a snack (with carbohydrates) before she goes to bed. We recommend consulting with her physician about her low blood glucose episodes to determine the cause and if a change in her medication regimen is needed.

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BALTIMORE,MD: DOES DIABETES MEDICATION CAUSE A BAD REACTION WHEN MIXED WITH OVER THE COUNTER ALERGY MEDICATION ?

Natalie and Emily: There are some over-the-counter medications that you do not want to take when you have diabetes. I would suggest talking with your local pharmacist about your current medication schedule. He will be able to identify an appropriate medication for you to take given the fact that you have diabetes and knows what medications you are taking at this time.

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secaucus new jersey: i checked my blood sugar level last night at about 1am, it was 240. then i took my medication, i take insulin and pills,when i woke in the morning i checked my blood sugar again at about 9am. it was 110. my question is if my sugar is at a normal level do i take my insulin and pills or do i just take my pills or do i not take anything. i did not eat breakfast yet which will probably raise sugar levels.what is the correct thing to do????

Natalie and Emily: It is difficult to answer this question without knowing what medications/insulins you are taking. There are some medications/insulin that you only take if you are planning on eating a meal, however most diabetes medications should be taken regardless of your meal schedule. Generally speaking, if your blood sugar is normal, you still need to follow the drug regemin that your physician has prescribed for you. Your medications are working to control your blood glucose levels. We recommend consulting with your physician to determine what protocol you should follow if your blood glucose levels are too high or too low.

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bronx,n.y.: im a 41 year old man .i've been a diabetic for two years and been taking avandia for two years,should i contnue taking avandia.

Natalie and Emily: We understand your concern in light of the recent media attention that Avandia has received. However, we recommend that you consult with your physician to determine if Avandia continues to be the best medication regimen for you or if a change in your medication is warranted based on your medical condition.

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Alpharetta Georgia: When is the best time to test my blood sugar after eating? Do I need to wait an hour or more after meals?

Natalie and Emily: The best time to check your blood sugar after eating is 2 hours. At this time, your target blood glucose range should be less than 180.

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Rowlett: My husband was diagnosed with type2 diabeties. He had blood work done because he was having a bump on his head removed surgicaly. His first test was about 300. This was right before surgery. The second test they ran it was about 200. These are the only 2 blood tests ran and his doctor concluded he must have diabeties. He had no other symptoms. He has tested his blood sugar daily for about a week and they range from 118 to 154. Should'nt his doctors run further test to determine that he really has diabeties? He's afraid to eat anything. Even though he eats very healthy no drinking...the only thing he really needs to do is get more exercise. He's not overweight even. Our whole family is suffering because when he does'nt eat he gets very grumpy. Help!!!

Natalie and Emily: The doctor's have made a diagnosis of diabetes based on the fact that he has had two blood glucose readings above 200. Someone without diabetes typically has a fasting level (or a level in the morning before eating) of less than 100. Two hours after a meal, someone without diabetes typically has a blood glucose level of less than 140. When someone is first diagnosed with diabetes, it can be very scary to eat certain foods. I would recommend going to the American Diabetes Association website for some information on portion sizes and foods high in carbohydrates. You may want to see if there is a dietician in your area that he would meet with to help in this transition. You are also absolutly right about the exercise. Exercise is one of the best things that we can do to help control our diabetes. Exercise itself can actually lower out blood glucose readings. I would suggest talking with his doctor about an appropriate exercise regimen.

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Deltona, FL: My husband & I both have type 2 diabetes; He is disabled because of heart disease, stroke, dementia, high blood pressure, etc.; I have insurance coverage through my employer which also covers my husband; Additionally, he also carries Medicare because of his disabilities; Neither company covers benefits for eyeglasses and/or eye exams; We both need both eyeglasses & an eye exam, but can't afford it; Is there any help for low income diabetic patients to receive glasses?

Natalie and Emily: We are not aware of any national programs to help diabetes patients receive eye care/glasses. However, there may be some programs in your state that can help you. We recommend talking with eye doctors in your area and/or your local health department, they may be aware of progams available to help with the cost of eye exams and eye glasses.

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NORFOLK ,VA.: I AM TAKING A DRUG CALLED GLUEMETZA AND I DON'T KNOW ANY THING ABOUT IT. CAN YOU TELL ME SOMETING ABOUT THIS DRUG, AND HOW IT SHOULD BE TAKen AND WHAT DOsage?

Natalie and Emily: This medication, also known as metformin, is used along with a diet and exercise program to control high blood sugar in people with type 2 diabetes (non-insulin-dependent diabetes). This medication is usually taken by mouth, once daily with the evening meal, or as directed by your doctor. This medication must be swallowed whole. Do not crush or chew the tablets. Drink plenty of fluids while taking this medication. Nausea, stomach upset, diarrhea or metallic taste may occur initially as your body adjusts to the medication. If stomach symptoms recur later (after you are on the same dose for several days or weeks), tell your doctor immediately. A late recurrence of stomach symptoms may be due to lactic acidosis. Inactive parts of the drug may be passed in your stool as a harmless soft mass that may look like the original tablet. This is normal for this drug.

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Carmi, IL: I take Lantus and an actos/metformin combo for my type 2 diabetes, and have questions about using the Lantus. My daily dose gradually increased from 20 units to 30, taken at bedtime, but even with that my bs readings in the evening were high (between 240 and 300), and sometimes low (75) in the morning. With my doctor's permission I have starting splitting the dose to 1/2 at bedtime and 1/2 after lunch. I've seen better control (105 am and around 100 before supper and late night) and been able to reduce the overall dose back to 20-24 units. Have you seen this in other patients? Would I be better to take half my dose at breakfast and half after supper, to correspond with my meals? My doctor recommended a bedtime snack, such as a glass of skim milk, to keep my bs level up overnight. I'm taking a total of 1700mg of metformin and 30 of actos--should this be lowered?

Natalie and Emily: It is hard to determine exactly what medications and dosages you should be on without following you as a patient and seeing your blood glucose log book. However, the medications that you are taking are very common and you appear to be at very safe doses. Some patients have had better success with taking the Lantus twice daily. This is not recommended to all patients and should be discussed with your doctor before starting. As far as the timing of your Lantus doses, I would try to keep them 12 hours apart. You can determine what times are the easiest for you to remember to take the Lantus. You do not have to correspond the Lantus with your meals however. Lantus is an insulin that works in our body over several hours. It does not act like a short-acting insulin that needs to be taken with regards to meals. A bedtime snack at night should be a good idea if you are having problems keeping your blood sugar up while you are sleeping. Make sure that you snack contains carbohydrates.

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Union City, California: A recent study says Glaxo's Avandia Raises Heart-death Risk. Actos is in the same family of drugs, so is there reason to believe that Actos may also raise the heart death risk?

Natalie and Emily: Currently there is no literature suggesting that Actos is associated with the same risk of heart problems seen in patients taking Avandia.

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Carencro, LA: Is late-onset diabetes the same as Adult Type 2 diabetes? Thanks

Natalie and Emily: Type 2 Diabetes has also been referred to as late-onset diabetes or non-insulin dependent diabetes. Very few people now refer to type 2 diabetes as "adult onset" because we are now seeing children develop type 2 diabetes.

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Baltimore, Maryland: I had GDM, when I was pregnant with my son. Now,I have type II diabetes. What is my son's risk of having diabetes?

Natalie and Emily: Diabetes is hereditary. Because you have diabetes, your children are at an increased risk of developing diabetes later in life. My suggestion is to start educating your son now on proper diet and exercise. This may be very beneficial in the future as far as preventing or delaying the onset of diabetes.

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Costa Mesa, CA: Why does my blood sugar go up at night with no intake of food. At bed Time I take my blood sugar and it registers 90. When I wake up in the morning I take my blood sugar and it is 105. this is a consistent result, different numbers, but the same relationship, lower at night and higher upon rising. My morning should be my fasting blood sugar. Thanks

Natalie and Emily: 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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RIVERTON: where does diabetes emerge from. where does it start?

Natalie and Emily: Diabetes is a disease that involves an insufficient supply of insulin produced from the pancreas. In type 2 diabetes, your body may still be producing insulin, however the insulin that you are producing is either not working correctly, or you are not producing enough insulin.

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Flushing, Ohio: When is the best time to take Acto/Met(15mg/500mg BID) One hour prior to Byetta(10mcg. BID) or one hour following? I am currently taking it one hour after breakfast and dinner. Meals are taken within one hour of the injection. Other meds are Lisinopril, HCTZ, asprin, and Lipitor. Thank you.

Natalie and Emily: If you experience nausea when taking this medication, it is best to take it with meals to decrease some of the symptoms. It can be taken without regard to the Byetta.

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Edmond, OK: I just found out that I'm Diabetic. I used to think I was low on potassium when my legs ached at night, but now I wonder about those leg ackes at night? Could this be caused by my Diabetes?

Natalie and Emily: The leg pains that you are experiencing may be related to your diabetes. Some patients will experience something called diabetic neuropathy. Some of the common symptoms of diabetic neuropathy are pain, numbness, and tinging in the feet, legs, hands, and arms. However, the pain that you are having could also be due to low potassium or a disease called Restless Leg Syndrome. I would recommend going to see your doctor for a full physical to help you determine what is causing your pain.

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Rohnert Park, CA: I was just diagnosed with diabetes the other day. My doctor said that I am going to have to lose some wieght and control what I eat. My question is Does diabetes ever go away? Can blood tests show the insulin levels are ever normal again? Or is this something that I will have for the rest of my life? Thank you Carolyn M

Natalie and Emily: Unfortunately there is not a cure for diabetes.There are, however, many treatment options, including, diet, exercise, weight loss and medications to help control diabetes and keep your blood glucose levels within normal range.

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woodstock ga: I was told by someone at work that if you dont regularly take your insulin it causes your pancreas to detoriate and therefore give off a really bad odor. I was told this because i have someone at work that smells really bad and we are trying to find out the reason

Natalie and Emily: There is no literature to suggest that this is true.

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san jose, ca: my doctor has me taking niacin. will that have any effect on my blood sugar level?

Natalie and Emily: Niacin can possibly cause hyperglycemia or elevated blood sugar. We recommend monitoring your blood sugar to determine if the niacin is causing your blood glucose levels to fluctuate and let your physician know the results.

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Mississauga, Ontario: I was wondering if you ever heard of the drug Tranacety. I heard it was for diabetes and it would take the place of the incelin.If you could send me information on this drug i would deeply appreiciate it thanks.

Natalie and Emily: We have tried to look up information concerning the drug "Tranacety." However we can not find any information on this drug. If there is another way of spelling this drug, please resubmit your question to our "Ask the Pharmacist" option at www.riteaid.com and we will be happy to further research with the new spelling.

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hyderabad,Andhrapradesh: respected Doctor, Myname is srilaxmi, i got married 1yr back but after marriage i came to know that my husband is having sugar before marriage only, my doubt is whether i get diabetes and if i get pregnancy will my child also get diabetes,pls doctor pls guid me ,i dont know wht type of diabetes my husband is having. awaiting for your reply. with regards, srilaxmi

Natalie and Emily: Diabetes is not a disease that you can give to someone. You can not get diabetes by being around someone, however it is hereditary. Your children will be at an increased risk for diabetes but it does not mean that they will have diabetes.

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Bangalore,Karnataka-India: Iam 28 yrs of age and newly diagnosed as type1, presently iam taking insulin 4 times a day,Can my dosage be reduced after sometime?

Natalie and Emily: Insulin dosages can be adjusted over time depending on many factors including weight loss, response to the insulin, etc. However, we can not determine if your dosage can or can not be adjusted. We recommend that you consult with your physician to determine how your medication regimen is working and if your dosage may be adjusted over time.

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Andover Hampshire UK: I have type 2.Can you explain why about once a week on average I feel as if every scrap of energy has left my body and I feel I could literally lie down and die, there is no fight left in me. It is a physical,not mental sympton. My diabetes is managed well and my Dr can offer no explanation. It does not coincide with any marked change in blood sugar levels. The feeling wears off slowly but I have to force myself through it.

Natalie and Emily: Like your doctor, I do not think that I can give you an exact answer without getting more information from you. Diabetes can cause drowsiness and fatigue at times. I would suggest trying to get an adequate amount of sleep at night to try and help the symptoms. If you do not feel that it is related to your diabetes, you may want to talk to you doctor about other possible causes of of this exhaustion.

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Jamaica, NY : Hi, what are the symptoms of both hypergycemia and hypoglycemia? Thanks.

Natalie and Emily: Unfortunately there is not a set list of symptoms that you will definately see if you are experiencing hyperglycemia or hypoglycemia. Each patient presents differently during episodes of high and low blood sugar. With hypoglycemia, some of the common symptoms inlcude shaking, fast heartbeat, sweating, dizziness, anxious, hunger, weakness, headaches, and being irritable. With hyperglycemia, some of the common symptoms include extreme thirst, frequent urination, dry skin, hunger, blurred vision, drowsiness, and decreased healing. This is not a complete list and you may experience other symptoms of high and low blood sugar. You may want to visit our website at www.riteaiddiabetes.com and the American Diabetes Association's website at www.diabetes.org for more information on hyperglycemia and hypoglycemia.

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Atlanta, GA: I am a 39 year old female, diagnoses with type II in 2005. I began taking Byetta a little over a year ago with excellent results (my A1C went from 9.9 to 6.2 in three months). I also began watching my carb intake very closely. In less than 6 months I lost 50 pounds. I did slip a little over the past four months and have paid the price. My FSBS went up to 138. I gaines 21 pounds back. I was not taking my medication nor being strict with my diet. 3 weeks ago I began taking my Byetta again and restricting my carb intake. 2 weeks ago I began working out 5 days a week (I walk on the treadmill at a brisk pace for 25 minutes plus a 5 minute cool down plus slowly I am adding weight training). I give you all this information because I am considering a change to Januvia. I am still considered morbidly obese (my BMI is now 48.1, which is down from 51). Would this medication change be advised?

Natalie and Emily: Since you seeing positive results from Byetta, we would recommend not changing medications. We am very impressed with your commitment to losing weight and exercising. A proper diet and a scheduled exercise regimen will also help to bring your blood glucose numbers down. We recommend that you discuss your concerns with your physician to determine if Januvia is an option based on your current medical condition.

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perth amboy, nj: What would be the total carbohydrates on a daily basis for a person weighting 116 pounds. (female)

Natalie and Emily: According to the American Diabetes Association, "The balance between the amount of carbohydrates you eat and insulin determines how much your blood glucose level goes up after meals. This means you need to know what foods have carbohydrates and how many carbohydrate servings to eat to keep your blood glucose within the target range." Each person has different needs and it is advisable to consult with a dietician to help you decide how many carbohydrate servings you should eat at meals and snacks based on how carbohydrate foods affect your blood glucose.

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Sharjah, UAE: Hi, I am from India, 50 yrs old and have just now diagnised as diabetic. Fasting sugar 110, but 2 hrs after glucose intake is 280. Smoker. 2 weeks ago I was cooking - cutting tough meat with knife, kneading frozen chicken mince, etc. Next day had slight pain on upper thumb by the side of the nail towards the forefinger. Started swelling and paining more so went to doctor after 10 days. Dr. put some gel to soften the skin overnight and tried to puncture / cut next day, without anaesthetic to take out pus. Except a bit of blood, nothing came out. Taking anti-biotics and applying bacterial ointment. Today swelling has increased even in front of the upper thumb, feels a bit different in touch. What to do? Am a senior IT Manager, with family, and feeling very very worried.

Natalie and Emily: Unfortunately, one of the side effects of elevated blood glucose levels is increased healing time. We recommend consulting with your physcian about the slow healing time to determine if additional treatment options need to be considered.

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Kuala Lumpur: I'm a young adult whom is just got the Type 1 diabetes. I would like to know if there's any percentage that this disease can be cured totally?

Natalie and Emily: Unfortunately there is no cure currently for diabetes. However, because of many recent developments in diabetes managment, we are able to treat diabetes and slow the progression of the disease.

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portland ,. oregon: my test for glucose is 250 and i eat low carbs what can i do for keep low than that.

Natalie and Emily: There are several ways to help lower your blood glucose level. Exercise is an excellent way to help decrease your levels. If exercise and diet alone are not helping, you may want to talk to your doctor about starting a medication for diabetes. However, if you begin a medication for diabetes, it is still very important to continue eating a healthy diet and exercising.

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oronto: what are the bad vegetabels

Natalie and Emily: There are no "bad" vegetables, however 3 vegetables are known to have carbohydrates. These include: corn, peas, and potatoes. You can still eat these vegetables, however they should be considered a "Starch" in your meal, such as pasta, bread, or rice.

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Farmington, N.M.: I am 11 years old and think I have type1 diabetes but rarely visit a doctor and don't know how to tell anyone. I have ay least 4 of the symptoms regularly. Can you help me tell somebody?

Natalie and Emily: It is ok to tell your parents or any family members if you might be sick or think that you might have diabetes. Tell them what symptoms you are having and that you know that those might be symptoms of diabetes. Have someone take you to the doctor or to the hospital and then can tell you if you have diabetes. Diabetes can be very serious and you want to get help if you have the disease.

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wenatchee washington: my mother has diabetes, and recently went into a angry rage, i have never seen her so out of control and seeming so angry. is this someting someone having diabetes does?

Natalie and Emily: Irritability, anger, and confusion can be symptoms of low blood sugar. If this happens again, I would recommend testing her blood sugar to determine if it is low.

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elizabeth nj: if i have diabetes then what can i eat

Natalie and Emily: This is a very complex question, however to put it simply, it is very important to watch how many carbohydrates you are eating daily and to control your portion sizes. We recommend talking with your doctor and/or a dietician to help you determine how to account for what you eat and how it may affect your blood glucose levels.

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greenwood, mississippi: i am a 18 year old male. i weigh about 130 lbs and i am 5'7''. i sometimes get light-headed and/or dizziness and when i eat something that is sweet such as chocolate it goes away. do i have diabetes and if so which type?

Natalie and Emily: It is hard for me to answer this without having other information. I would recommend talking with your doctor about getting a fasting blood glucose to determine if you might be at risk for diabetes.

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hyderabad andhra pradesh: is serum creatine of level l.8 normal or is it the sign of diabetic nephropathy if so what is the treatment available in india

Natalie and Emily: A normal serum creatinine is 0.6 to 1.2. I would recommend talking to your doctor in India about the steps to help improve your renal function.

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atlanta, georgia: I have had other people I know with the same problem, yet the physician does not seem to think the Metformin is the cause. Does long term use of Metformin cause your liver enzymes to be elevated and essentially cause liver damage. I think it does because when I come down from 2000 mg. to a smaller dose, my counts are lower. My last test I was 76. Thanks.

Natalie and Emily: I can not find any research to support that metformin causes your liver enzymes to increase. However, if someone is experiencing liver or hepatic disease, they should not take metformin.

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DUBAI - UNITED ARAB EMIRATES: what is the right time and duration of walking is good for a diabetic (type 2). * Immediately after Dinner or in the eveninng? * Half'n hour of brisk walking or more?

Natalie and Emily: We are more concerned with the amount of walking that you do, rather than the time of day that you exercise. Everyone exercises at a different rate and it is very important to talk with your doctor before starting an exercise program. In general, exercising 30 minutes a day 3 to 4 times a week is adequate. However, keep in mind that this is not a safe amount for everyone and it is important to determine the amount of exercise that you can safely handle.

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Easton, Pennsylvania: What is normally the amount of sugar--in grams--to keep healthy and to avoid pre-diabetes or diabetes itself. I have just been diagnosed pre-diabetic and I would like to know the limits of sugar for me. I do consume as much sugar free food as possible, but I know carbs turn into sugar and I don't know how to guage my intake of sugar. Thank you, Carol Propsner

Natalie and Emily: Carbohydrates are vitally important to look at when we are discussing diabetes. With pre-diabetes it is important to start counting your carbohydrates that you consume each day. Discuss with your doctor and/or a dietican to determine how many carbohydrates you should consume per day. Remember to read all food labels for their carbohydrate content. Foods that contain carbohydrates include starchy foods such as pasta, bread, and rice, some vegetables such as corn and peas, all fruits, and milk products. Be cautious with the sugar free foods because they do tend to contain a large amount of carbohydrates.

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Penn Valley, Ca: Eight months ago my gluclose reading was 91. In April of this year it was 114. Can your gluclose level be normal one day and then rise up to another level over weeks. I am concerned that I could get diabetis and have taken action to lose weight( I weigh 158) 5'6. I do however walk 3 1/2 miles a day and do heavy aerobics and weigh lifting every other day. Is there a way to beat this before it becomes a health issue. Thank you.

Natalie and Emily: Diabetes is often very gradual in nature. You may see slight increases in your glucose over a period of time. If you feel that you are at risk for diabetes it is very important to continue exercising as you are doing. However, with exercise, we also need to instill a healthy way of eating. I would suggest watching your carb intake and sugar consumption. Talk with your doctor about any materials they may have on a special diet plan to follow.

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irvine, california: I have a family history of diabetes. I think I may have it, as well. Are hives and/or itchy skin a symptom?

Natalie and Emily: Dry skin can be a symptom of high blood sugar, which could be related to your itchy skin. However, having dry skin does not mean that you have diabetes. Other symptoms of high blood sugar include excessive thirst, frequent urination, and tiredness. If you feel that you may have some of these symptoms, I would recommend going to your doctor. he can do blood work to determine if you have diabetes.

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ADA Moderator :

That's it for today. Thanks so much for taking the time to be here Natalie and Emily.

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 guests will be Rite Aid Pharmacists and Diabetes Care specialists at 1:00 p.m. ET Thursday, July 5, 2007. See you then.