Can You Lower Your Need for Diabetes Medications?
By: Jessica Hrdlicka MS, RD, LD/N, CDCES
Many of our patients with diabetes take medications to control blood glucose levels. When blood glucose levels remain high despite medication use, dosages may need to be increased in order to lower blood glucose levels effectively. Our physicians at Palm Beach Diabetes and Endocrine Specialists (PBDES) also provide other services to help patients lower blood glucose levels without increasing medications! What is the secret to lower blood glucose levels without medication increase? Diabetes Education.
Here at PBDES we have a full team of certified diabetes educators to teach patients easy steps to lowering blood glucose levels without medication increases. Most insurance plans cover 2 visits every year with a registered dietitian, 2 visits every year with a certified diabetes educator and Group classes on healthy eating and blood sugar management every year!
Our education team has helped countless patients lose weight, reduce blood glucose levels, reduce medication use, feel better and some patients have even discontinued medication use with basic lifestyle changes. At PBDES you have your very own diabetes care team all year round to keep you motivated, successful and healthy! So why not make an appointment with one of our diabetes educators to learn ways to reduce blood glucose levels easily, safely and without extra medication!
For more information on diabetes management, chronic kidney disease weight loss and nutrition or to schedule your CGM Class call 561-659-6336 ext 8012 to schedule an appointment today. Please enjoy our March 2025 Living Well with Diabetes Newsletter!
What is Dawn Phenomenon?
By: Kathyrn Reynolds, M.D.
The dawn phenomenon is the early morning (typically 2 AM-8 AM) rise in blood sugars caused by a surge of hormones that counteract the effects of insulin. These include epinephrine, cortisol, growth hormone, and glucagon (hormone produced by the pancreatic alpha islet cells which increase blood glucose). People with diabetes do not have normal insulin responses to adjust for this. In addition, people with type 2 diabetes have an inappropriate increased production of glucagon, which signals the liver to break down glycogen stores into new glucose. As a result, people with diabetes may commonly see their morning fasting sugars rise.
High morning sugars may also be caused by an insufficient dose of insulin or oral medication the night before, or due to late night carbohydrate consumption. Here are some strategies to try to combat the overnight blood glucose increase due to the dawn phenomenon:
- Limit the amount of carbohydrates eaten with dinner and try to avoid bedtime carbohydrates
- Eat dinner earlier in the evening
- Physical activity after dinner (for example walking)
- Possible adjustment of oral medication and/or insulin
- Use of an insulin pump to match insulin delivery to physiological requirements
- Rule out the possibility that AM highs are rebound following overnight lows. Try testing blood sugar around 2-3 AM to make sure glucose is not dropping during sleep, as a compensatory release of stress hormones can cause the subsequent elevation of glucose
New Tandem Control IQ + Technology Update
By: Ines Cobo RN, CDCES
Tandem Diabetes just announced on March 19th, 2025, their newest technology Control IQ+ in their Tandem Mobi and t:slim X2 Insulin Pumps.
With this update , users will be able to update their pump software via Tandem Source. In the next few weeks users will receive an email notification letting them know that a software update in now available, the software update is Version 7.9.
Additional Activity Settings
Control-IQ+ technology includes optional activity settings that adjust the range of treatment values.
Temp Basal Rate
Temp Basal Rate option to personalize insulin delivery for changing needs during automation.
Extended Bolus
The only system with an extended bolus, up to eight hours, during automated insulin delivery.
Sleep Activity
Uses a narrower and lower range of treatment values to help guard against lows and highs while sleeping.
Exercise Activity
Uses a narrower and higher range of treatment values to help guard against lows during activity.
Summary of New Features:
Before You Update
You must complete the required online training in your Tandem Source platform account before you can initiate the pump software update.
Choose a convenient time when you have supplies on hand and can stop all insulin delivery. You will need to disconnect your infusion set during the update process and load a cartridge to resume insulin delivery.
If you would like help with your Tandem pump settings, infusion set, bolus strategies, carb counting and to receive a personalized pump back up plan please call 561-659-6336 ext 8012 to schedule an appointment with one of our diabetes educators today!
Check Out our New CGM Classes!
Freestyle Libre Class
West Palm Beach Location
Temple Israel 1901 N. Flagler Drive
West Palm Beach, FL 33401
Tuesday April 8th 10am-12pm
Dexcom Class
West Palm Beach Location
Temple Israel 1901 N. Flagler Drive
West Palm Beach, FL 33401
Tuesday April 15th 10am-12pm
Healthy Meal Planning Class & Pre-Diabetes Sessions are available! Join our classes to stay motivated & feel great in 2025!
Healthy Meal Planning & Weight Loss Class
West Palm Beach Location (Virtual or In Person!)
Temple Israel 1901 N. Flagler Drive
West Palm Beach, FL 33401
Tuesday May 13th 10am-12pm
Boynton Beach Location
6056 Boynton Beach Blvd.
Boynton Beach, FL 33437
Tuesday April 15th 10am-12pm
Pre-Diabetes Class
West Palm Beach Location (Virtual or In Person!)
Temple Israel 1901 N. Flagler Drive
West Palm Beach, FL 33401
Tuesday May 20th 10am-12pm
If interested attending this program please contact our scheduling department at (561) 659-6336 Extension 8001 today!
At Healthy Living with Diabetes we want to ensure that you are satisfied with all services received. We also would like your input on educational workshops that you would like us to offer, information you would like to read about in Healthy Living with Diabetes Monthly or feedback on any workshop that you may have attended. You can contact the director of education personally by email jcook@PBDES.COM or leave a message at (561) 659-6336 ext. 8012. We would love to hear from you!
