Should I Adjust My Diabetes Medication And/or Insulin
If you are seeing many high and/or low blood sugars, are struggling with the dawn phenomenon, or are always going high or low after meals or exercise, this is the perfect time to dig deeper into the nitty-gritty of your diabetes management with your endocrinologist.
Based on your most recent blood sugar data, your endocrinologist can help you adjust your correction factor, insulin sensitivity, insulin to carbohydrate ratios, and your basal rates to help fine-tune your management.
This can be especially helpful if youve recently changed any lifestyle habits, such as your diet or exercise routine, or are pregnant or planning on becoming pregnant, in which case your hba1c and blood sugar goals may change.
Why Might I Need To Include Injectable Medication In My Treatment Plan
Many people with type 2 diabetes manage their symptoms by eating a healthy diet and being more physically active, according to the NIDDK. But some people also need medication.
Whether you need medication usually depends on how well your blood sugar or A1C levels are being controlled, says M. James Lenhard, MD, an endocrinologist and the medical director of Christiana Care Health Systems Diabetes & Metabolic Diseases Center in Wilmington, Delaware. If diet and exercise alone can no longer help you maintain healthy blood sugar levels or hit your A1C target, your doctor may start you on an oral medication . In time, you may need to change your medication, add medication, or take medicine you inject under your skin, such as an insulin or non-insulin injectable, to help control your blood sugar. Even if you dont typically take insulin, you may need it at certain times, such as while youre pregnant or if youre in the hospital with another health problem, according to the NIDDK.
Where Can I Find Motivation
Q: How can I get motivated to take care of myself?
A: Taking care of diabetes and getting through your daily to-do list along with your other responsibilities is demanding. It’s easy to understand why motivation waxes and wanes. BJ Fogg, director of the Persuasive Technology Lab at Stanford University and a leading expert on human behavior change, offers some tips to help get started:
- Move away from all-or-nothing thinking.
- Don’t judge yourself as bad or good.
- Make one tiny habit change after another. Experience success, then change another tiny habit, then another. Eventually you’ll experience “success momentum.” Fogg recommends starting by changing what you already want to change, not what you know you should change but don’t really want to.
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Do I Need To Count My Carbs How Do I Know If Im Eating The Correct Amount
Carbohydrate counting is one of the classic methods of diabetes management.
Discussing the best way for you to monitor and adjust your intake of carbohydrates, and all food groups, with your dietitian, is another key to successfully managing your diabetes.
While many people inherently think they should simply eat fewer carbs, the real key is to find the correct number of carbs and the best types of carbs for your blood sugar.
Carbs are necessary for blood sugar management and your dietitian will help you figure out how to incorporate them into your diet appropriately.
Will Taking My Medicine Correct The Glucose Level
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Different people respond differently to diabetes medications.
Ideally, after taking the medicine, within a time frame, the blood sugar level should come down. But it isnt assured. This means, relying on medicine alone isnt sufficient. Medicine will only work effectively when youre also mixing it with proper diet and adequate exercise.
So, taking medicine alone isnt guaranteed to control your diabetes. A lot of factors come into play here.
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Do I Need To Take Insulin For The Rest Of My Life
Yes. People with type 1 diabetes are not making enough insulin from their own bodies. Most people inject insulin at least four times a day. However, the insulin pump, or a continuous subcutaneous insulin infusion , is slowly replacing frequent injections as a preferred delivery system. With the pump, a new catheter is inserted every few days under the skin, and insulin is continuously infused into the body. The pump is not the final word in insulin delivery systems, and there are clinical trials underway testing both a patch and a nasal spray as possible insulin delivery systems.
How Should I Adjust Insulin Doses Before During And After Exercise
It depends on your activity level and types of activities youre doing, the ADA says. Aerobic exercise like jogging or bike riding can lower blood sugar, while anaerobic workouts like weight training can increase it. Work with your care team to develop an exercise plan and insulin regimen that works for you, and expect some trial and error. Using a continuous glucose monitor during exercise can help you determine how exercise affects you, and provide a guide for insulin dosing. In addition to adjusting your insulin, your care team can help you adjust your carb intake before and after exercise to maintain healthy blood glucose levels, Lau notes.
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What Is Diabetes And How Can I Be Tested For It
Diabetes is a condition in which your blood sugar, or blood glucose, rises to unhealthy levels. Insulin, a hormone created in the pancreas, enables glucose from your food to be transferred from blood to your cells in order to provide energy for your body. When glucose is not properly processed or if not enough insulin is created to help the processing, glucose is trapped in the blood and cannot reach your cells. The A1C test is a widely used blood test to diagnose type 1 and type 2 diabetes. If you already have diabetes, the A1C test is also used to track your blood glucose levels to help manage your condition.
What To Do Next
To take us back to where we started, diabetes can be overwhelming. Sometimes when were overwhelmed we dont know where to start, which way to turn, or which questions to ask to start to get our bearings.
At this point, you are armed with seven questions to ask your dietitian about your diabetes to start moving in the right direction.
If you have a dietitian you are working with, great! Use these questions to guide your sessions.
If you are in need of a dietitian to be your guide to managing your diabetes, we are here to help. The OnPoint Nutrition team will help you address these seven points, and so much more, to help you manage your diabetes and optimize your health.
To get started with one of our dietitians today, schedule your free consultation where you can learn more about us and we will learn more about you!
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What Foods Should I Eat Before And After Exercise
Q: What are the best foods to eat before and after exercising?
A: Foods that contain carbohydrate are quick and easy to digest for energy. “Eat foods like bread, crackers, pretzels, dry cereal, 100 percent fruit juice, or sports drink with calories,” says Gary Scheiner, CDE, an exercise physiologist and owner of Integrated Diabetes Services near Philadelphia. But if weight loss is a goal and you aren’t at risk of hypoglycemia, just drink water-ditto for after exercise. Unless your workout was particularly exhausting or lasted several hours, you don’t need food. People who take insulin and are physically active should consult their health care provider about how to adjust insulin dosages.
How Does Exercise Fit Into My Healthy Lifestyle Plan
Exercise helps to control blood sugar levels, helps manage diabetes.
When you exercise, your body uses the glucose circulating in your bloodstream. This brings down blood glucose levels, which is beneficial for your body.
Now, this doesnt mean that your dietitian is going to tell you to start lifting super heavy weights daily or start training for a marathon. Instead, you and your dietitian will work together to set goals around exercise and develop an exercise plan that works for you.
This might mean going for a walk a few days each week, signing up to take a class at a local gym, or trying an at-home strength training workout. The best part is, it all depends on you and what is realistic for you.
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Why Isnt My Type 2 Diabetes Treatment Plan Working As Well As It Used To
Many people with diabetes think they need to explore new treatments because what theyre currently doing isnt working, and thats true, Beaulieu says. For example, you may notice that your blood sugar or A1C levels are rising, even though you eat a healthy diet, exercise frequently, and stick to your doctor-prescribed treatment. This could be because your type 2 diabetes is progressing, youve developed a complication, or another medication youre taking is interfering with your diabetes treatment, among other potential causes. If you make additional diet modifications and exercise more but your A1C still continues to rise, it might be time to talk to your doctor about a change.
Questions To Ask Your Endocrinologist
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As a person living with diabetes, you know its important to see your doctor regularly, and that includes seeing a diabetes specialist called an endocrinologist.
The frequency of these types of appointments varies but they usually follow a quarterly hba1c test.
Typically, people with diabetes see their endocrinologist at least once a year for follow-up on management, bloodwork, and to renew prescriptions for medications like Metformin or insulin. To make the most of these appointments, its best to be prepared.
This article will outline 10 important questions to ask your endocrinologist the next time you have an appointment.
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Will My Diabetes Ever Go Away
Q: Can I get rid of diabetes? Will it ever go away?
A: Once you are diagnosed with type 1 or type 2 diabetes, you have it for the rest of your life. To stay healthy, keep your blood sugar, blood pressure, and cholesterol under good control. To do so, eat healthy, be physically active, and take your prescribed medications. Also get the tests and checks you need to detect complications early and treat them aggressively.
Q: How often should I replace my glucose meter?
A: The only reason to replace your meter is if you determine it is not working correctly with its strips. To check, use the control solution that comes with your meter. “It’s an essential monitoring supply that many people don’t know about or use,” says Janine Freeman, RDN, CDE, a member of the American Association of Diabetes Educators Board of Directors.
Are These Side Effects Related To My Medication
If youre taking new medications, you may experience new side effects. You might feel dizzy or have digestive problems or a rash. Your doctor can help you figure out if these are from your medications and advise you on how to treat them. If youre starting on medications that can cause low blood sugar, be sure to ask your healthcare team what symptoms to watch out for, and what you need to do if you do experience low blood sugar levels.
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Can I Enjoy My Life And Eat My Favorite Foods While Managing My Diabetes
Dietitians dont want you to give up everything you know and love to manage your diabetes. Your dietitian wants you to enjoy your life and eat the foods you love but do so with your diabetes in mind.
Eating cake on your birthday isnt a thing of the past. Enjoying a glass of wine isnt off-limits.
Instead of simply trying to cut these things out, you and your dietitian will work together to figure out how you can enjoy the things you love without causing crazy spikes in your blood sugar.
Be open and honest with your dietitian about the things that are important to you so they can help you build a lifestyle that works for you.
What Do I Need To Look For On Nutrition Labels
Looking at a nutrition facts panel can be confusing. So many words and so many numbers, but you may not be sure what they all mean.
Your dietitian will help you decipher these labels so you know what is in the foods you are eating and how they will affect your blood sugar.
Additionally, your dietitian can help you set guidelines around what to look for, how to know if a food is a good choice, and how to compare multiple foods based on their nutrition facts.
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Things To Ask A Diabetic Patient
Its important to be detailed when taking patient history to get a good picture of what is going on. For every type of patient, there are specific sets of questions that need to be asked. During our rotation, we learn to follow patients, present our patients to our attending physicians, and observe our attendings examen the patients. For every rotation, there will be times when our attendings will ask us a question about our patient to which we would realize that we had forgotten to ask that particular question during the patient interview or check for that particular sign in the physical exam. We would reply, I did not ask, and subsequently, we would then be given a lesson about the importance of detail. Its all a part of the rotation learning experience, and after enough mistakes, eventually, doing a history and physical would become second nature to us.
Ive had my fair share of incomplete histories, and because of this, I decided to personally make a list of the basic things I will ask or look for whenever I see a patient with a certain condition, like diabetes. Besides the basic interview questions , here is my list of other specific things to make sure to ask for in a diabetic patient:
Will I Need To Continue Taking Other Diabetes Medications Such As Pills
For most people with type 2 diabetes, metformin, which comes in pill form, is the oral drug theyll take at least to start. Metformin is designed to regulate the amount of blood sugar released by your liver, but it doesnt help your body produce more insulin, according to the National Library of Medicine. Thats why your doctor may keep you on your oral medication as you transition to an injectable, Lenhard notes. This is called combination therapy. Eventually, you may stop the oral drugs and use only injectables, depending on how well your body produces insulin, according to the nonprofit Beyond Type 2.
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How Can I Lose Weight
Q: Why is weight loss so important? What’s the best way for a person with type 2 to lose weight?
A: Weight loss is vital, particularly just after a diagnosis of type 2 or prediabetes. Weight loss increases insulin sensitivity, allowing cells to more effectively use the insulin the body continues to make. Losing just 1020 pounds can accomplish a boatload of benefits. Among them are improved blood sugar, blood pressure, and cholesterol levels and possibly taking fewer medications or lower doses. To lose weight slowly and steadily, change your lifestyle. The pounds you keep off over time are the most important to living a long life.
What Can I Do If I Dont Experience The Warning Symptoms Of Low Blood Sugar
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Low blood sugar, or hypoglycemia, affects different people differently. While there are common symptoms weakness, fatigue, tingling in the fingers not everyone with type 1 diabetes will experience them, according to Diabetes UK. This is especially true for people who have had the condition for a long time. More frequent blood sugar testing, or the use of an insulin pump or continuous glucose monitor can help. You should also work with your healthcare team, who may adjust your blood sugar targets to help avoid episodes of low blood sugar, notes the ADA.
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What Can I Eat With Type 1 Diabetes
You can eat just about anything and everything, notes Lau. Really, its about learning to balance meals and finding foods that are healthy for you. As processed foods tend to increase blood sugar more rapidly, its best to avoid them, or at least try to limit consumption, Lau adds. Work with a registered dietitian or CDE to develop an eating plan that works for you.
How Can I Adjust My Care Between Visits
Seeing the doctor and asking them questions consists of less than 1% of the time you live with your diabetes, and you need to know what to do on the fly if you have an issue.
Say youre sick and need to vastly increase the amount of insulin youre taking or training for a marathon and are suddenly extremely insulin sensitive.
This is the ideal time to ask your endocrinologist when and how you can adjust your insulin doses and corrections factors yourself, versus when they would be more comfortable guiding you through any necessary changes.
Its also helpful to know how available your doctors office will be. Can you contact them between visits for quick guidance or advice? Do they answer the phone on weekends? Do they email, text, or use a patient portal? How can you reach them in an emergency?
These are all great questions to ask and something youll definitely need to know for optimal care.
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I Feel Fine Do I Still Need To Worry About My Diabetes Condition
If your blood sugar level is more than what your doctor has set the target for, you have every reason to care about it. As mentioned, diabetes is a progressive disease. Depending on your age and condition, it might not cause any short-term complications.
But it sure is damaging your overall health, which would become evident and fatal in the long-run. Hence do not just focus on how you feel, instead note what your glucose monitor reads.