Everyone talks about living healthier, eating smaller food portions and exercising more. But do you do it? Probably not. Then one day the doctor diagnoses you with diabetes. Now you know you have to do something, but what? It seems too complicated!

I can’t begin to tell you how often, I hear this as a diabetes educator. They have no idea what to do. I tell them to think of diabetes as a wakeup call. Basically, it means you have to start living a healthier lifestyle. What a motivator diabetes can be... and the blood sugars tell the story. So you start eating better food choices in smaller portions, you increase activity on a regular schedule and even lose weight. Now you ask yourself, “Would I have changed any of these behaviors if diabetes wasn’t part of my life?”  “I’m feeling better, have more energy and my blood sugar levels are improving….”

You now see that having diabetes is a knock at the door, but don’t wait for it. Wake up and live healthy every day!

My friend who has Type 2 diabetes just started yoga classes. She said the yoga has helped her diabetes,her blood sugars have improved plus she has lost a few pounds!

I always thought yoga only helped people relax until I read a recent study. It’s true, yoga classes may help people with diabetes lose small amounts of weight and helps keep their blood sugars in range.  The yoga used in this study was a gentle type. Of course, yoga should not replace other forms of exercise needed for weight loss. It is a nice alternative and there are yoga classes designed for older people and for those with health problems or mobility challenges.

Check your local gym or activity center to see if there are classes being held at your local hospitals or community centers.

^{http://care.diabetesjournals.org/content/early/2011/08/05/dc10-2430.abstract Accessed 9/15/2011.}

A patient recently said he had seen a commercial for a talking diabetes meter, and wanted more information. I asked if he was having difficulty reading his blood glucose results.  His answer was yes. After further discussion, I agreed that a talking meter may help but he needed to find one that matched his needs. Not all talking meters are the same.

What features are you looking for in a talking diabetes meter?

• Small sample size
• Accuracy
• Turns on with the test strip
• Fully audible meter that talks through the entire process
• Provides previous audible test results and error messages

Talking meters are a good way to maintain your independence especially when you have limited vision.

Check out the Prodigy AutoCode talking meter available at CCS Medical.

Have you ever been discriminated against for having diabetes?  I think it happens more often than most people realize. 

Recently in the news there was case where a Walgreens cashier in southern California was fired for eating a snack from the store to treat her low blood sugar.  The Equal Employment Opportunity Commission (EEOC) is now suing Walgreens. The employee had been employed there for almost 18 years with no disciplinary record, and the store knew she had diabetes.  So how can this happen?

In 1990 the original American Disabilities Act went into effect to protect people with disabilities, such as diabetes.  Part of this Act allows employees to request a “Reasonable Accommodation” which is a modification to a job or work environment that allows the employee to perform essential job functions.  Time to test your blood sugar, take medication, or treat a low, are all examples of a reasonable accommodation that can be arranged with an employer.

But wait!  I still have unanswered questions about this case.  Why did the employee choose a bag of potato chips to treat her low blood sugar?  She did pay for them after her shift was over.   But a bag of chips is not typical recommended treatment for low blood glucose especially due to the high fat content. 

Learn more about low blood sugar treatments. 

Why not choose a fast acting carbohydrate such as hard candy, regular soda, or glucose gel?  All readily available at Walgreens.  Did the employee not have the knowledge of proper treatment?  Or is there something else in the case we do not know?  

Tell me what you think about this case.   Have you ever been discriminated as a result of having diabetes?

For more information on your rights as someone with diabetes, go to the American Diabetes Association website to learn more: www.diabetes.org

1. First, learn to recognize signs and symptoms of low blood sugar.Most people feel it when their blood sugar drops below 70 mg/dL. Some people feel symptoms at higher blood glucose levels and some do not feel early symptoms at all. If you do not get symptoms, then it is important to check your blood sugar more often.  If you need a review on the symptoms or treatment of low blood sugar click here to learn more.

2. Eat the right amounts of food at the right times.  Skipping or delaying meals is one of the biggest culprits of low sugar.   Be sure to watch the timing of your meals or snacks.

3. Take the right amount of diabetes medicine or insulin at the right time.  If you take too much or take them too close together this can cause a low.  Check your eyesight, as well.  Make sure if you are using a syringe, that you are reading the dosage lines correctly.

4. Plan ahead for exercise or activity.   Check your blood sugar before, during and after.  Consider having a small snack, if needed.  Sometimes just extra activity that you did not plan for can cause low blood sugar.  I have had patients have lows from just extra shopping at the mall or painting their house and not planning ahead.

5. Carry something with you at all times to treat low blood sugar. Be sure to keep something in the car. Glucose gel or tablets work well when you have changing temperatures in the car.  Remember driving with low blood sugar is very dangerous.   

What type of glucose do you like to carry with you?   Hard candies?  Juice boxes?  Tell us what works for you.

A female coworker asked me today, if it runs in her family, will she get diabetes too?

So who is at the greatest risk for developing type 2 diabetes?

• People with impaired glucose tolerance (IGT) and/or impaired fasting glucose (IFG)
• People who are over the age of 45
• People  with a family history of diabetes
• People who are overweight
• People who do not exercise regularly
• People with low HDL cholesterol or high triglycerides, high blood pressure
• Certain racial and ethnic groups (Non-Hispanic Blacks, Hispanic/Latino Americans, Asian Americans and Pacific Islanders, American Indians and Native Alaskans)
• Women who had gestational diabetes, or who have had a baby weighing 9 pounds

Want to find out your risk? Take the Diabetes Risk Test from the American Diabetes Association:

I get this question many times from the many people I meet.  This was the case on a recent flight I took from California to Florida.  The person sitting next to me was falling asleep, with a big water bottle, told me he would need to use the restroom frequently and asked if we could switch seats. Of course my immediate thoughts were “I wonder if he has undiagnosed diabetes…..”. 

Typically health care professionals first look for signs and symptoms of diabetes.  The classic signs are increased thirst, increased hunger and increased urination.  However, sometimes you will also see weight loss, blurred vision, fatigue and sores or infections that will not heal or go away.  After this assessment, some blood work needs to be completed.

There are specific criteria for diagnosing someone with diabetes. There are number of different lab blood tests that can be used to diagnose someone.  Your doctor can use any of these 4 tests to find out.

If there are no symptoms of diabetes present with the first three tests listed above, the test should be repeated to confirm a diagnosis of diabetes and may need to be performed on a different day.

Keep in mind if you already have diabetes, there is a different set of numbers to follow for your target blood glucose range.  If you do not know your target range, speak with your physician.

^{Reference:   Diabetes Care, January 2011 34:S62-S}

^{Endocrine Practice, Vol 17 (Suppl 2) March/April 2011}