By: Director of education – Jessica Cook MS, RD, LD, CDE
Learning you have pre-diabetes, diabetes or heart disease can be overwhelming, scary and depressing. It can also become confusing with TV commercials, magazine ads and friends or family providing you with information about diabetes all at once! You may want to go to the experts and get the truth!
Certified diabetes educators are often nurses, dietitians or pharmacists
that specialize in diabetes care. Their profession requires them to learn
about new foods, glucose meters, diabetes medications and diabetes research
to better assist people with management of their diabetes. Fortunately,
most insurance plans cover someone with diabetes to meet with a dietitian
and diabetes educator for a total of four times per year, sometimes including
a co-pay or deductible, to better understand how diabetes affects the
body, learn about your medications, foods that affect blood glucose readings
and how to manage blood glucose levels when exercising or when ill.
Meeting with a certified diabetes educator can help relieve your anxiety or fears about diabetes and help you understand how to better control blood glucose levels on a daily basis. Plus it will give you an opportunity to ask questions about diabetes, food, medications or symptoms. Diabetes workshops are also a great setting to maximize your knowledge about diabetes and learn in a fun, interactive group setting.
If you are interested in springing into action to learn more about diabetes and your body, do not hesitate to make an appointment with one of our certified diabetes educators today! Please call (561) 513-5100!
Thank you for taking time to read our Living Well with Diabetes March 2016 Newsletter.
By: Kort Knudson, M.D.
To reach the goal of A1c at 6.5% or 7%, we concentrate on getting plenty of exercise, watching the diet and using medication. Sometimes even after optimal control of blood sugars, there are episodes of high blood sugars or hyperglycemia, which can be frustrating.
It is common in the life of most people with diabetes that blood sugars will run somewhat high for several weeks and then go back to normal. This can occur even with no change of diet, exercise or medications. If blood sugars remain elevated more than a week or 2 weeks, then we usually change medication, but may need to return to the original regimen if the glucose spontaneously reverts back to normal.
2015 AACE Guidelines for Blood Glucose:
| Fasting Blood Glucose Levels | 70-110mg/dL |
| 2 Hours Post Meal Blood Glucose | Less than 140mg/dL |
Whenever blood sugars rise we look for other causes. We check to see if
there has been a change in lifestyle. Sometimes a minor injury such as
a sprained ankle will be enough to decrease the general activity during
the day and lead to hyperglycemia. We always review the diet. Is the patient
renovating a house or entertaining guests and eating out at restaurants
more often?
If there has been no lifestyle change we think of other causes. Many medications can raise blood sugars. The best known is steroids. They can be taken by mouth as prednisone or injected. The effects of steroids can last for weeks. They cause the liver to produce more sugar.
The statins which we use for cholesterol have been shown to raise blood sugars by a few milligrams per deciliter. In general the benefits of statins are considered much greater than the small risk of higher blood sugars and it is recommended that almost all patients with diabetes take a statin. If the patient has borderline hyperglycemia and the statin tipped the balance in to full blown diabetes than the decision whether or not to use the statin can be difficult.
Other medications which may affect blood sugar include estrogen, beta blockers, beta agonists, phenothiazines, indomethacin, levodopa, lithium, morphine, methyldopa, diltiazem, diuretics and thyroid medications. The list is much greater, so any change of medication should be suspected if the blood sugar rises for no apparent reason.
Low potassium is sometimes a cause of decrease in insulin secretion and impaired clearing of glucose from the circulation which could result in elevated blood sugars.
Patients on chemotherapy sometimes have higher blood sugars because of the chemotherapeutic agents or because of steroids that are used in the mixture of medications. Sometimes this effect is only seen when the patient is receiving chemotherapy and may go away between courses.
Hyperthyroidism has been associated with type 1 diabetes and also increased blood sugar in people with type 2 diabetes due to increased sensitivity to adrenaline, which is one of the hormones that raise blood sugar.
Stress can cause increased blood sugar when the stress hormone levels are elevated. This affect is most pronounced in the first few days of the stressful event like hospitalization or infection or trauma. Chronic stress may cause some elevation of blood sugars on a long-term basis.
Travel can be associated with high blood sugars are low blood sugars depending on whether the patient is eating more, exercising more or under stress from the rigors of travel. It is always best to check the blood sugars regularly while traveling because it is hard to know if they will rise or fall.
Even though we may not be able to always determine the underlying cause of high blood sugar, the important thing is to constantly be aware of the blood sugars and adjust lifestyle or medication to bring them back under control. If we can identify an underlying cause then we may be able to eliminate it, but many of the causes of hyperglycemia are out of our control. Meeting with a dietitian, certified diabetes educator and attending diabetes workshops, may help you to start identifying your causes of hyperglycemia with possible lifestyle remedies. If interested in scheduling an appointment please call (561) 513-5100.
By: Gail Star LCSW, CDE
Time “marches on” and have you noticed that it seems to be speeding by faster and faster these days? Therefore this may be the perfect time to start “marching to the beat of a different drummer” and “march” forward on the road to healthier living. There is no time like the present to look at habits that may keep us stuck and look to see how making just a few minor changes can help us “march” in the healthier direction.
Here are a few suggestions that may help:
These are all ideas that may make a difference in your health and how you feel. Trying one or two of these ideas can greatly help you reduce weight, blood sugars or cholesterol!
All it takes is thinking about it. Ah, there is the problem!! Who wants to think about diabetes or making changes? As much as we may not want to think of these things, please know that the mind is in control of the “march.”
Length of life is important, but so is quality of life. Blood glucose out of control can affect both. I wish I had a magic wand or a magic pill that would make diabetes go away, but there are no such things. However, the mind can create the magic to make things better. Opting to choose to take steps to modify your lifestyle can make the difference in how you can take back control of blood glucose, so that you can continue to “march” on the road of life healthfully and happily.
10:00am -12:00 P.M.
Temple Israel
1901 Flagler Drive
West Palm Beach, FL 33407
Will provide Healthy Snacks!
If interested attending this program please contact our scheduling department at (561) 513-5100 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) 513-5100. We would love to hear from you!