Are people with
diabetes allowed to eat sugar?
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 The American Diabetes Association maintains that sugar (sucrose)
can be substituted for other carbohydrates, and included in moderation, in the context of a healthy meal plan. All forms of carbohydrate are digested to
produce sugar (glucose) in the blood, which is then used to fuel the body. Obviously, sugar does not contain the same vitamins and minerals that are
offered by other carbohydrate-rich foods like starches, fruits and milk.
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How can carbohydrate
counting help to manage diabetes?
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Carbohydrate is the part of the food that has the biggest effect on the blood sugar. Carbohydrate is found primarily in breads, grains, legumes,
starches, fruits, sugars, milk and yogurt. Carbohydrate counting is keeping track of the number of grams of carbohydrate that you eat. A registered
dietitian can assess the amount of carbohydrate that you need at meals and snacks. Eating an appropriate amount of carbohydrate at appropriate times can
help keep the blood sugars in a healthy range. For people who use insulin, or certain diabetes pills, it is especially important to balance the amount and
timing of carbohydrate with the medication. |
When I look at food
labels should I be looking at the total carbohydrate or the sugars?
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It's probably most helpful to look at the total carbohydrates since digestion turns all carbohydrates (except fiber) into sugar in the blood. The
total carbohydrate includes all of the forms of carbohydrate found in the product, such as the starch, the fiber, and the sugars. The subset listed below
the total carbohydrate tells you the grams of sugar in the product. The grams of sugar are already included in the total carbohydrates, so don't add these
numbers together! Natural sugars like lactose (from milk) and fructose (from fruit), as well as the added sugars like sucrose (table sugar), honey and
syrups, all get lumped together under the category sugars. |
Does alcohol raise
blood sugar?
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Alcohol itself is not converted to sugar in the blood. Therefore gin, rum, vodka, etc do not raise blood sugar. Alcohol is very high in calories and
these calories are easily converted to fat. Carbohydrate is what raises blood sugar and mixers such as juice or soda can add carbohydrate to the drink. A
beer has about 13 grams of carbohydrate and sweet liqueurs have sugar added. If you take insulin or certain medications you may be at risk for low
blood sugar if you drink alcohol, especially if you drink on an empty stomach or don't have adequate carbohydrates. |
If a product says it
is "sugar free" can it still raise my blood sugar?
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That depends on the other ingredients in the product. Something can be free of added sugars but still have other ingredients that supply
carbohydrate which will ultimately digest and turn to sugar in the blood. Look at the label for the grams of total carbohydrate. |
What is a sugar alcohol?
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Sugar alcohol is a class of carbohydrates that includes mannitol, xylitol, isomalt and sorbitol. These carbohydrates tend to impact the blood
sugar to a lesser extent than does sugar. However they are still a form of carbohydrate and digestion will still produce some glucose for the blood.
Products that contain sugar alcohol often claim they are sugar-free, but that does not mean the same thing as carbohydrate free. Note: sugar alcohol may cause diarrhea, gas and bloating.
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What's the best
thing to use to treat low blood sugar?
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To treat a low blood sugar you will want to eat a form of carbohydrate that is easily digested and absorbed so that the sugar will enter the
bloodstream quickly. Examples are glucose or dextrose tablets or glucose gel, fruit juice, regular soda (not diet), fruit, or a type of candy that is primarily
sugar (and doesn't contain protein or fat). Do not use chocolate bars, ice cream or cookies, all of which contain significant amounts of fat, which slows down the digestion of the sugar.
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I have type 2 diabetes and my
doctor keeps telling me to lose weight. Will weight loss really help?
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Type 2 diabetes is associated with insulin resistance. In other words, the body is not able to properly use the insulin that it makes which causes the
blood sugar to go too high. Weight loss can improve insulin resistance therefor improve blood sugar control. Exercise has a similar benefit in
improving insulin resistance. Weight loss and exercise are the cornerstone to treating type 2 diabetes. |
I have type 2
diabetes and control my blood sugar with diet and exercise. (I don't need medication). Should I eat a snack before exercising?
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Exercise does burn glucose from the blood and can lower the blood sugar. If you don't take any medication for your diabetes, then you are not at
risk for hypoglycemia (very low blood sugar) and will not need to eat an extra snack. Besides, many people exercise to help with weight loss, and if you
snack you will be burning the fuel from your snack, which means you wont be lowering your blood sugar or burn much body fat. |
How important is
blood pressure control when you have diabetes?
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A recent study called the United Kingdom Prospective Diabetes Study
showed that blood pressure control and blood sugar control were both very important in preventing complications associated with diabetes. If you have
high blood pressure you may need medication to control it. (See your physician). Other things you can do to control your blood pressure include
weight loss if you are overweight, lowering your salt (sodium) intake, exercise, quit smoking, and minimize alcohol consumption.
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How is insulin
stored?
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- Insulin can be stored at room temperature. It is good for 30 days in a cool, dry place (36 - 86 degrees Farenheit).
- Unopened bottles of insulin should be stored in the refrigerator and are good until the expiration date on the box and/or bottle.
- Once opened, an insulin bottle that is kept refrigerated is good for three months or one month if it has not been refrigerated
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Has my insulin
gone "bad"?
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- Don't use Regular insulin if it becomes cloudy in appearance and / or is expired.
- Don't use NPH or Lente insulin if it becomes clumped or crystallized, or if the bottle becomes frosted, or if it is expired
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What if my insulin
needs to be changed?
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- Changes in type and/or source of species may result in the need for a change in dose.
- Any change of insulin should be made only under medical supervision.
- What about mixing insulins?
- Regular and NPH - inject immediately after mixing.
- Regular and Lente - inject immediately after mixing. It is best not to mix and store for later use.
- Regular and Ultralente - mix and inject within 5 minutes or inject the Regular and Ultralente in two different injections. Be consistent with your choice.
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How do I dispose of syringes?
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- Throw out immediately after use into an opaque, puncture resistant, (heavy duty) non-breakable container such as a detergent container.
- Syringes should not be recapped before disposal.
- It is not necessary to break the needle and in general is not recommended. If you desire to do this, you need a device specifically for this purpose. These can be purchased in a pharmacy.
- When the container is near full, it should be covered, taped and thrown out according to local and state medical waste rules.
- To decrease the chance of another person using your syringe after you dispose of it, separate the plunger from the barrel.
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Can I reuse my
syringes?
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Syringes should only be used once because the sterility of a reused syringe cannot be guaranteed. However, for some patients it appears to be safe and
practical. If based on the evaluation of your educator, multiple uses of your syringe is acceptable, it should not be for more than one day and this procedure should be followed:
- Store syringe at room temperature
- Recap needle when not in use
- Do not wipe the needle with alcohol
- Keep outside of syringe clean and dry
- Flush syringe with air to prevent the needle from clogging
- Discard if needle is bent or dull or if it has come in contact with any surface other than skin
- Discard if the calibrations are difficult to read from wear
- Be sure to check your skin around your injection site for unusual redness or signs of infection.
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When was the last time my hemoglobin A1c was tested?
What were the results, and what did they mean?
How often does my physician do such testing?
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This test measures the level of blood fats in your blood. People with
diabetes are prone to higher levels of blood fats in their systems -- which puts them at increased risk of heart and blood vessel disease. You should
have these tests done at least once a year. Your levels of HDL (so-called good fats) should be greater than 45. Your levels of LDL (so-called bad fats)
should be less than 100, and your triglyceride levels should be under 200. If you have heart or blood vessel disease, these levels may have to be even
lower to prevent more problems. If your test results don't fall in these ranges, your physician should be referring your to a dietitian for help with lowering
the overall fat content in your diet, and help in losing weight, if that is a problem. Improved blood sugar control may also improve your blood fat
levels, so if your blood sugars are non under control, you will need to work on this. Your health care team should also encourage you to begin an
exercise program -- and should recommend an exercise tolerance test before you embark on an exercise program if you are over age 35 or have any
diabetes complications. If you have any diabetes complications, your team should be referring you to an exercise specialist (usually an exercise
physiologist). These are usually the first courses of treatment for a lipid problem. They may also prescribe lipid lowering medications, if you have found that these changes aren't having the desired effect.
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When was the last time I had a "lipid profile" done?
What were the results and what did they mean?
How often does my physician do such testing?
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Hemoglobin A1c (HbA1c) is a measure of diabetes control over the
past 2-3 months. The Diabetes Control and Complications Trial, completed in the 1990s, showed that tight blood sugar control can conclusively lower the
risk of certain diabetes complications. Your physician should be ordering an HbA1c test at least 2-4 times per year. Ideally your results should be below
7.5, or even at or below 7. If your results are over 7.5, and are running consistently closer to 8.0 or above, your physician and health care team
should be discussing with you potential changes in your treatment plan to improve your diabetes control, because your risks of developing diabetes
complications are higher. If you are suffering frequent low blood sugar (hypoglycemic reactions)
, you health care team should be discussing possible changes in your treatment plan to lower your risk of low blood sugars while keeping your HbA1c as low as safely possible |
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How frequently should I be testing blood sugars at home?
What should my target blood sugars be?
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Patients and their physicians should work out an individualized testing program that works well for them. For patients who are not on insulin, we still encourage daily blood sugar monitoring at least twice a
week. Patients on insulin should be testing their blood sugars at least four times per day, (before meals and at bedtime). Additional testing should be
done before and after exercising, and if you feel like you are having a low blood sugar. Normal fasting blood sugars for a non-diabetic are under 126
mg/dl. Although people with diabetes can't be expected to hit these target levels all the time, blood sugars that are over 180 in a person with diabetes
are considered high. Your treatment plan may need adjustment if your blood sugars stay above this level for a period of time. If your physician
recommends higher target goals for blood sugars, ask why. There may be circumstances associated with your overall medical condition -- such as
frequent hypoglycemic reactions, an inability on your part to be able to identify low blood sugars, etc. -- why a higher target is better>
For you. For information on target blood sugar goals at various times during the day. |
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