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Answers to Your Diabetes Questions Cont'd

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Why did my blood sugar increase after exercising and why is my urine & water from my eyes feel sticky? I never noticed it before being diagnosed with diabetes.

Exercise usually makes your blood glucose levels go down however if your blood glucose level is high before you start, exercise can make it go even higher. Your blood sugars should be between 120 and 250 before you exercise.

Glucose is not usually found in urine. When the level of glucose in the blood is high, the kidneys will move excess glucose into the urine because it cannot properly absorb it all. This urine is characteristically sticky. It is important to inform your physician of this symptom as soon as possible.

Diabetes can cause changes in your eyes. Keeping your blood glucose levels in control lowers your risk of developing any eye diseases. You should see an eye specialist(ophthalmologist or optometrist) once a year for a complete exam. 

Joan Perlmutter, RD, LDN, CDOE, CVDOE

My husband is "pre-diabetic" but is there really such a thing? He was just given a referral slip for diabetes teaching, can he participate in the classes even though he is not on insulin?

Pre-diabetes is a condition that comes before diabetes. It means that blood sugar levels are higher than normal but aren't high enough to be called diabetes. If you have been diagnosed with pre-diabetes, you are at a higher risk of developing diabetes and should do something about it at this time. Studies show that you can prevent or delay type 2 diabetes by making changes in your lifestyle. Begin by making an appointment with a Registered Dietitian. What and how you eat is a key part of your care, the dietitian can help you figure out your food needs. The classes are for individuals who have already been diagnosed with diabetes whether or not they are on medication or insulin. 

Joan Perlmutter, RD, LDN, CDOE, CVDOE

A family member is a diabetic and seems to feel that for a snack she can eat cake and ice cream. She states that it is ok to do this as its all about the carbs... What should I say to her?

Individuals with Diabetes can consume sugar, have desserts and almost any food that contains caloric sweeteners. After you eat, your blood sugar level is largely determined by the TOTAL amount of carbohydrate you have consumed, not the source.  The source of carbohydrate does effect how fast it turns into glucose. However, it is important to remember that while foods with sugar can be incorporated into a diabetic meal plan most sweets and desserts are HIGH in carbohydrates, calories, fat and have little or no nutritional value. While these foods can be consumed, they should be considered TREATS and eaten less often in limited amounts. The American Diabetes Association suggests you limit these treats to special occasions.

Joan Perlmutter, RD, LDN, CDOE, CVDOE

I have type 2 diabetes, one year ago my blood sugar was fine. I also have neuropathy- Isn't that kind of soon to get foot pain? WIll it ever get better? I am on Metformin and watch my diet and exercise-lost 30 pounds.

First, allow me to congratulate you on being pro-active in your diabetes care by watching your diet, exercising and taking your prescribed medication. I hope your blood sugar levels are still in good control. Loss of sensation in the feet due to nerve damage is a problem for people with diabetes.Neuropathy is more likely to affect people who have had diabetes for a long time or whose glucose control is poor, however, this condition could also occur from other causes not related to diabetes. Continue to be pro-active and follow-up regularly with your physician. 

Joan Perlmutter, RD, LDN, CDOE, CVDOE
  How does exercise affect my blood glucose?  Exercise is truly one very important part of the diabetes care plan. When you exercise, your muscles work harder and use up their glucose stores for fuel. When those sources run low, glucose from the blood is used lowering your blood glucose levels. Exercise also makes muscles and other tissues more sensitive to insulin, so less insulin is needed to move glucose out of the blood and into the cells. The American Diabetes Association recommends at least 30 minutes 5 days a week. Always remember to check your blood glucose levels before exercise. It should always be between 120 and 250 before you exercise.

 Joan Perlmutter, RD, LDN, CDOE, CVDOE

My blood sugar is usually normal at bedtime around 90 but high when I wake up in the morning it is 200-300.What can I do?

There are many possibilities why your blood sugar levels are out of control in the morning. To begin with blood glucose levels at bedtime should be between 100 and 140. When you ate last and what you ate can play a large part. If and when you are taking oral medications or insulin affect this number.  Your body stores sugar inside the liver during the day and sometimes releases sugar into your blood stream when you are not eating (such as during sleep). Hormones released overnight can also cause blood glucose levels to rise. For people who don't have diabetes, the increase in glucose is offset by an increase production of insulin. For people with diabetes, this can be a problem.  If this scenario continues you should speak with your physician or Diabetes Educator. 

Joan Perlmutter, RD, LDN, CDOE, CVDOE

I read recently that epsom salts are very beneficial to aiding your body's ability to use insulin (magnesium I think it is).  It stated the best way for absorption is a bath/thru your skin but warned about unstable blood sugar levels and or blood pressure. what would be considered a safe amount?

From my research into this topic I learned there has been little medical research done on the effectiveness of Epsom Salts on relieving symptoms of Diabetes. Epsom salt is magnesium sulfate which is absorbed through the skin. People with high blood pressure, heart problems or diabetes should consult their personal physician prior to using. Epsom salts can cause a severe drying of the skin, making the skin more fragile and this is something Diabetics want to avoid. When reading any health articles in magazines or online please make sure the sources are reliable.  Joan Perlmutter, RD, LDN, CDOE, CVDOE
Can diabetes be cured? 
Once you are diagnosed with diabetes, you will have it for the rest of your life. Although you can not cure diabetes be assured that with the help of your healthcare team, you can treat your diabetes, take charge of it and control it. There are a number of ways to keep your diabetes in control, including following a meal plan, checking your blood glucose levels, staying or becoming active, getting regular check-ups and taking medications, if necessary.

Joan Perlmutter, RD, LDN, CDOE, CVDOE

What if your blood sugar is 111?

If you have already been diagnosed with Diabetes a blood sugar level of 111 is within normal range whether the reading was taken fasting or 2 hours after a meal. If you have not been previously diagnosed, two fasting blood sugar levels greater than 100 and less than 126 classify you as pre-diabetic. Pre-diabetes means that your blood sugar levels are higher than normal but aren't high enough to be called diabetes. Even if you have pre-diabetes, you may be able to delay or prevent diabetes. If you have pre-diabetes you can and should do something about it. Talk with your physician or member of the health care team on the steps you should be taking.
Joan Perlmutter, RD, LDN, CDOE, CVDOE 

I have diabetes for four years and the morning readings have always been from 115 -120 until a few weeks ago. Now they are 136-149 ever day.  What should I do?

If you haven't recently changed your eating or exercise habits which could alter your numbers then a call to your physician is suggested to appraise him or her of the situation. 

Joan Perlmutter, RD, LDN, CDOE, CVDOE

How does lisinopril protect my kidneys? 

Your kidneys are your body's filter units. They work 24 hours a day to rid your body of toxins that your body makes or takes in. Toxins enter the kidney by crossing the walls of the small blood vessels, called capillaries, along its borders. Diabetes can cause changes in the small blood vessels. They can become blocked or leaky. The most important thing you can do to prevent kidney disease is to keep your blood glucose levels under control. A special type of Blood pressure medication, called  ACE Inhibitors, lisinopril being one, is usually prescribed, even if your blood pressure is normal, to decrease the rate of progression.  Your physician or pharmacist are excellent resources for more specifics. 

Joan Perlmutter, RD, LDN, CDOE, CVDOE
I've was diagnosed with Diabetes Type 2 diabetes about a year ago and started taking Metformin. However my doctor recently put me on Lantas because my A1C level was 9.8. I had been following a rigid diet and lost 15 lbs in the past 3 months. If I'm doing all the right things why is my blood sugar still high?

Congratulations on your weight loss. Have you seen any changes in your blood sugar numbers since starting on the Lantus? Your previous medication, the metformin, doesn't make the body produce more insulin and your body was probably not producing enough on its own to get the sugar out of the blood stream into the cells. You stated you were following a rigid diet, not knowing what that actually consisted of makes it difficult to assess why your blood sugars are out of control. Consistency and appropriate portion sizes of carbohydrates at meals are important in getting your blood sugar levels in control. If you havent met with a dietitian yet, I highly recommend you do. She can work with you and help you get your Diabetes under control.

Joan Perlmutter, RD, LDN, CDOE, CVDOE

I have type 11 diabetes and have had it for about 15 years. I am currently experiencing numbness in all of my toes as well as the balls of my feet. Is this cause for concern?  Your risk for nerve damage is greater because you have diabetes. The small blood vessels that feed your nerves can become blocked and cause poor circulation. The feet and legs are commonly affected. Numbness is a common symptom as is pain and a tingling sensation.  You should contact your physician whenever you experience changes in your physical being. 

Joan Perlmutter, RD, LDN, CDOE, CVDOE
I just got diagnosed never sure what to eat can I have any sugar? It is hard to find food without any sugar.
As a newly diagnosed Diabetic it is always a good idea to meet with a Registered Dietitian. Learning how and what to eat is an essential part of mananging your diabetes. The dietitian will provide you with an individualized meal plan, adjusted to fit your lifestyle, so you consume the right kinds and amounts of food. Foods are made up of carbohydrates, proteins and fats. Carbohydrates affect your blood sugar levels the most. Carbohydrates turn into sugar but they are the main source of fuel for our bodies as well as provide essential vitamins and minerals and therefore necessary in a healthy diet. The amount of carbohydrate you need depends on your age, weight, activity and medications you may be taking. Sugar and sweets are OK to include once in a while but keep in mind they often contain lots of carbohydrates, calories, and fat with very little nutritional value. 

Joan Perlmutter, RD, LDN, CDOE, CVDOE

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