Diabetes Q and A

By Janis Roszler, MSFT, RD, CDE, LD/N

Q I really try to follow my diabetes diet, but just can’t do it. Do you have any ideas that might help me?

A Your diabetes meal plan shouldn’t be a burden. If it is, meet with a registered dietitian who can redesign your plan to better fit your preferences and lifestyle. If you find that you still indulge once in a while, try to do the following:

• Learn to treat abnormal glucose levels that may result from eating foods in portions that aren’t recommended. Don’t punish yourself for veering off your redesigned meal plan! We are all human. If you make a poor food choice, forgive yourself and eat healthier at your next meal.
• Learn your A1C number. Most experts recommend a starting A1C goal of less than 7 percent with an ultimate goal of less than 6.5 percent. If your A1C level is good, an occasional high blood glucose meter reading should not be a problem. If it is too high, meet with your healthcare team to adjust your treatment plan.

Q If I have to start insulin, will I ever be able to stop?

A If you have type 1 diabetes, the answer is no – you must take insulin from an outside source because your body can’t produce any of its own. If you have type 2, it may be possible to reduce or even eliminate your need for insulin if you do the following:

• Follow a healthy meal plan. A registered dietitian who specializes in diabetes can help design a meal plan that fits your lifestyle and improves your diabetes control.
• Stay physically active. The addition of even a small amount of movement can make a significant improvement in your blood sugar control. Discuss exercise choices with your doctor before starting.
• Lose weight, if needed. You should be able to see an improvement in your diabetes control after a small amount of weight loss.

Q Is it true that pregnant women with diabetes make more amniotic fluid? I had an awful lot of fluid appear when my water broke and the nurse blamed it on my diabetes. Just curious.

A This is actually true. Women who are pregnant and have diabetes may make more amniotic fluid if their blood glucose level runs high during the pregnancy. Those who control their glucose level well will probably produce the same amount as other women.

Q I used to feel my blood sugar level drop, but can’t anymore. Can I ever get the sensation to return?

A Unfortunately, it is very common to lose the ability to feel a drop in your blood glucose (sugar) level when it runs low. This often happens to people who make a real effort to keep their blood sugar level in a very narrow range. Some experts also believe that frequent low blood sugar episodes can cause this unawareness to develop. It may be possible to get this sensation to return or to better anticipate when it may drop, by trying the following:

• Maintain blood sugar level within 80-180 mg/dl for 2-3 weeks. Many people have regained their ability to feel blood sugar lows after doing this.
• Meet with your health care team to review your daily blood sugar test results for patterns. You may be able to learn to predict when a low will occur and change your eating and/or medication schedule to help prevent it.

*This article originally appeared in 2010
** please consult with your healthcare provider before making any changes to your diabetes regimen.