Frequently Asked Questions:
- How can I prevent or delay the development of type 2 diabetes?
- How often should my medication regimen for diabetes change?
- What should I do when my blood glucose level is too high?
- What should I do if my blood glucose level is too low?
- Can you help me with research related to diabetes?
- How do I become a certified diabetes educator?
- Where do low income families go for diabetes supplies and medications?
- How do I choose the best diabetes doctor?
- How should I prepare for pregnancy if I already have diabetes?
How can I prevent or delay the development of type 2 diabetes?
It is important to understand the risk factors for developing type 2 diabetes:
- Family History of Diabetes
- History of Gestational Diabetes or having a baby >9lbs
- Advanced Age
- Black, Hispanic, Indian and Asian Race
Addressing the modifiable risk factors for diabetes is the best way to prevent or delay the development of type 2 diabetes. For most people, lifestyle changes that promote healthy eating and regular physical activity can promote weight loss and may lower risks for developing type 2 diabetes.
It is important to have blood glucose regularly checked each year. If you feel that you are at higher risk for diabetes or if you have a strong family history of the disease, home monitoring systems may be a good idea as well.
It is important to consider needed lifestyle changes before and after a diagnosis of diabetes. Consistency with healthy meal planning and regular physical activity can improve one’s chances of developing diabetes, but can also help with controlling related conditions such as high blood pressure and cholesterol.
How often should my medication regimen for diabetes change?
Because diabetes is a progressive disease, regimens that worked well in the past may not always be the best solution for the present. Your diabetes health care team should monitor Hemoglobin A1C levels every 3 months and review blood glucose logs frequently to assess your current treatment. It is important to achieve target blood glucose levels to prevent or delay complications of diabetes. If blood glucose levels are not at goal, a medication change may be needed.
There are many options for oral diabetes pills and insulins. It is important to understand the specific actions of each medication. Many of these treatments should be evaluated and adjusted frequently.
You are a very important member of the healthcare team. Work together with your physician to find the right regimen for treating your blood glucose levels. Remember that eating healthy and physical activity are also important aspects of a good treatment plan.
What should I do when my blood glucose level is too high?
There are many reasons why blood glucose levels become elevated. It is important to know what blood glucose levels should be at all times of the day (before meals, after meals, etc) to properly gauge elevated blood glucose. People that check blood glucose more frequently often catch changes in glucose values more quickly. If this is the case and you notice that your blood glucose levels are gradually rising or are higher than they used to be, contact your healthcare team. Consider any recent changes in eating, stress levels, activity level, illness, infection or medications that may be contributing to higher blood glucose values.
Note that over eating, decreased activity, decreased or missed medication, stress or any kind of illness or infection can cause blood glucose levels to rise. Storing insulin or blood glucose test strips improperly could greatly affect the glucose value as well.
If left untreated, hyperglycemia can cause severe problems. The following are signs and symptoms of high blood glucose:
- Unusual Thirst and/or Hunger
- Frequent Urination
- Blurred Vision
- Dry, Itchy Skin
- Cuts or sores that heal slowly
- Decrease in appetite, possible nausea or vomiting
Use the following steps to treat hyperglycemia:
- Take diabetes medication
- Drink water or other sugar free fluids
- Identify possible causes
- Walk or mild physical activity unless glucose > 300 mg/dL or as health care provider advised.
- Check glucose frequently to assure they are returning to normal level.
- Notify your diabetes doctor if blood glucose is averaging over 200 mg/dl for a week or more.
- Patients with type 1 diabetes experiencing high blood glucose should also be encouraged to check ketones. If ketones Moderate or Large patient should contact healthcare team immediately.
What should I do if my blood glucose level is too low?
Most people with diabetes will experience low blood glucose, or hypoglycemia at some point. Hypoglycemia is a sudden drop in blood glucose levels caused one or more of the following: too much diabetes medicine, increased physical activity, missing a meal or drinking alcohol with no food. Symptoms of hypoglycemia can be experienced at many blood glucose levels, but is defined as blood glucose less than 70mg/dl.
Symptoms: Mild – In the early stages of hypoglycemia you may feel all or some of these sign and/or symptoms
|Fast or pounding heartbeat||Dizzy|
|Sweating or hot||Numbness or tingling around mouth & lips|
|Nervous or excited||Blurred vision|
Symptoms: Moderate – If the reaction is not treated, the symptoms will progress to:
|Slurred or slow speech||Poor coordination|
Symptoms: Severe – If the reaction is not treated, and your Blood Glucose continues to fall, you may pass out or develop convulsion.
|Unresponsiveness||Not able to waken|
It is important to check blood glucose if possible when you experience symptoms of hypoglycemia. To treat hypoglycemia correctly, first take in 15 grams of a fast-acting carbohydrate. Examples as follows:
|1/2C (4oz) andy type regular juice||6-7 hard candies|
|5 sugar cubes||3 glucose tablets/td>|
|1 small box of rasins||8 os. skim milk|
|60z regular soda||4 tsp granulated white sugar|
Wait 15 minutes and recheck blood glucose. If blood sugar is not above 70 or you still have symptoms, repeat treatment. If it will be an hour or more before your next meal, have a 15 gram carbohydrate snack.
- 5 crackers with peanut butter or cheese
- Small fruit
- ½ sandwich
Can you help me with research related to diabetes?
It is important to gather information regarding diabetes from trusted internet sites. The following are examples of reputable sites that can help answer some questions. Because each person with diabetes has specific needs unique to their situation, it is recommended to seek personal medical and educational advice from your healthcare team. Information may found on web-sites might be too broad and not best address individual needs. Our web site has some information about diabetes. Other websites that could be helpful include:
www.diabetes.org (the website of the American Diabetes Association)
www.cdc.gov (the website for the Centers of Disease Control)
We wish there was time to personally help every student who seeks our input, but we simply cannot. Our primary goal at this time is getting information for our patients, and we do not have the ability to answer the many requests we receive.
How do I become a certified diabetes educator?
The following information is according to the National Certification Board for Diabetes Educators:
The Certification Examination for Diabetes Educators is designed and intended for health care professionals who have defined roles as diabetes educators, not for those who may perform some diabetes related functions as part of or in the course of other usual and customary occupational duties.
Certification is a voluntary testing program used to assess qualified health care professionals’ knowledge in diabetes education. It is an evaluative process that demonstrates that rigorous education and experience requirements have been met. The purpose of the NCBDE certification program is to conduct certification
activities in a manner that upholds standards for competent practice in diabetes education.
Objectives of the certification program are:
- to provide a mechanism to demonstrate professional accomplishment and growth
- to provide formal recognition of specialty practice and knowledge at a mastery level
- to provide to consumers and employers validation of demonstrated dedication to diabetes education
- to promote continuing commitment to best practices, current standards and knowledge
The CDE credential demonstrates that the certified health professional possesses distinct and specialized knowledge thereby promoting quality of care for persons with diabetes. Certification is voluntary and is not required by law for employment in the field, although some agencies may use board certification as a basis for employment, job promotions, salary increases and other considerations.
The cost of managing diabetes appropriately can be a burden for all people with diabetes. When cost become a greater issue it is important to work with your health care provider to find the most cost-effective plan. There are many generic oral diabetes pills, types of insulin, and cheaper testing supplies available. It is important to not stop medications, but to speak with your health care team. Many pharmaceutical companies offer assistance plans to help with the cost of medications. It is also important to remember physical activity, healthy eating, and weight loss can also improve blood glucose and may potentially lower or decrease the need for medications.
Diabetes is a chronic disease that affects many body systems and if left untreated can cause many severe complications. The good news is that research shows by achieving ideal blood glucose levels, complications of diabetes can be prevented. It is important to receive education from your physician or health care team on how to achieve target blood glucose levels. Many lifestyle aspects such as eating habits, physical activity, stress levels, ability to monitor blood glucose, work schedule, etc can affect blood glucose levels and your overall diabetes control.
Proper treatment of diabetes involves much more than receiving prescriptions for your medications. Because diabetes is a progressive disease, treatment for diabetes must be followed closely, and blood glucose logs should be consistently evaluated by your physician or health care team.
Finding a physician who makes you feel comfortable, known and educated is very important. It is also encouraged to seek diabetes treatment offered by a multi-disciplinary team that includes physicians, nurses, dietitians, etc in order to receive comprehensive treatment and thorough education for how to live with diabetes. Many places like Diabetes America have certified diabetes educators to offer your overall diabetes education.
If you have diabetes and are planning on becoming pregnant, it is very important to achieve blood glucose control prior to conception. As always, it is recommended to discuss with your diabetes team 3-6 months prior to conception to begin the proper preconception care. Assessments at this time should include patterns of blood glucose, history of DKA, problems with hypoglycemia, weight and blood pressure, urinalysis, Hemoglobin A1C tests, and review of any complications of diabetes to eyes, nerves, kidneys, etc. Most physicians will recommend an A1C value of 5.5% prior to conception.
Blood glucose control before pregnancy and during early pregnancy helps to prevent birth defects.
- Organs such as the heart and neural tube are formed by six to eight weeks of pregnancy.
- If your Diabetes has been poorly controlled, you may miss the opportunity to decrease the risk of birth defects.
- Well controlled Diabetes may decrease risk for birth defects form 17% to 3-5%; the same as women who do not have Diabetes.
- Uncontrolled Diabetes may also lead to higher risk for miscarriage during the early weeks of pregnancy.