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Managing Diabetes: Eating Right & Staying Active

Dana Artinyan & Trina Herrejon August 17, 2011 1:00 PM This chat has ended. Thank you for participating.
Catherine (Moderator) - 12:50 PM:
Welcome! Today’s chat: Managing Diabetes: Eating Right & Staying Active will begin shortly. Please start submitting your questions and Dana Artinyan, RD, LDN, & Trina Herrejon, RD, CDE will begin answering them as soon as we get started. While you are waiting for the chat to begin, feel free to visit the Diabetes Section to obtain more information about managing diabetes. We will do our best to answer all of your questions, but because this is such a popular chat, not all questions may be answered in the time allowed. Your understanding is greatly appreciated.

Prasanna (Chicago, IL) - 1:02 PM:
What fruits are recommended for daily consumption?

Dana Artinyan & Trina Herrejon (NorthShore):
All fruits and vegetables offer benefits. There isn't necessarily one that we would recommend over others. The most important is get a variety in your diet. However, certain fruits may be higher in natural sugars, so watching your portion size is key.

Rogel (Chicago, IL) - 1:04 PM:
I have Nuropathy in both feet and left hand, What in your opinion is the best and most effective medication for it ? Is there a cure for Nuropathy ?

Dana Artinyan & Trina Herrejon (NorthShore):
If your neuropathy stems from inadequate blood glucose control or diabetes, the best course of action is to improve your blood sugar control. Better blood sugar control may slow down the progression of neuropathy but may not reverse it. If you are controlling your blood sugars and are still having pain, talk to your doctor regarding medications to help control the pain.

David (Mount Prospect, IL) - 1:06 PM:
I am unable to perform in the bedroom and cannot keep an erection for more than 3-5 minutes even while taking a dose of Viagra. A friend tells me that is a symptom of diabetes. Can this be right? I'm only 38 years old and would hate to think my sex life will be struggling for the rest of my life.

Dana Artinyan & Trina Herrejon (NorthShore):
Yes, ED can be symptom of diabetes. First, have your doctor conduct a blood test to determine whether or not you have elevated blood sugars. If you do have diabetes, you would want to talk to your endocrinologist regarding your blood glucose control to determine if this is impacting your symptoms. Your doctor may also refer you to a urologist to determine if there are other issues and/or to find you the right medications. Please talk to your doctor regarding any ED medications as they may interfere with other medications or they may not be appropriate in light of other medical conditions.

Stephen (Naperville, IL) - 1:08 PM:
I have had adult onset diabetes for about the last ten years. I am very overweight, 6'4". 370. Just in the last week my pinkie and the next finger on my left hand feel as though they are asleep, the tingling sensation that you get. Half of my middle finger has it too. My wife thinks I pinched a nerve so I am not worrying but a diabetic co-worker said it could neuropathy. This feeling is constant and does not go away at all and it seems to be getting stronger. What do you think?

Dana Artinyan & Trina Herrejon (NorthShore):
Because you have had diabetes for 10 years and neuropathy can be a symptom of diabetes, it could be neuropathy that is causing your symptoms. However, the only way to know for sure would be to assess your blood glucose control with your endocrinologist. If your doctor suspects that it may in fact be neuropathy, he/she will most likely refer you to a neurologist.

Daniel (Chicago, IL) - 1:12 PM:
What is the best way a diabetic on medication which is controlling my sugar levels lose weight, my goal is to get off the medication or at least reduce the amount of pills.

Dana Artinyan & Trina Sprengelmeyer Herrejon (NorthShore):
The best way to lose weight and to control your blood sugars is to eat a healthy, well balanced diet and to exercise regularly. Losing 5-10% of your total body weight can dramatically improve your blood sugar levels. If you are taking a medication that can cause low blood sugars and you are having to continually treat those low blood sugars with carbohydrates, this can make weight loss difficult. Talk to your doctor if this is an issue in order to prevent lows caused by medications.

Meredith (Darien, IL) - 1:16 PM:
Does hot weather affect my high blood sugar? Also do emotions raise my blood sugar, how can I control this for type 1 diabetes ?

Dana Artinyan & Trina Sprengelmeyer Herrejon (NorthShore):
Stress, both physical and emotional, can raise blood sugars. If you feel that this is a constant problem, seek out the help of your doctor, who can refer you to the appropriate person. Other variables, including weather changes, may affect your blood sugar. In hot weather, you may be more dehydrated, which could cause your blood sugars to be high. Be sure to stay adequately hydrated to help prevent this. Also remember to store your insulin at the proper tempterature (between 32 and 85 degrees F). This will ensure that your insulin works effectively.

Sarah (Chicago, IL) - 1:24 PM:
My daugher has been a type 1 since Nov. 2008 and her A1C's are still above 11. I know Lantus isn't supposed to peak but after I gave her her injection, i had her check her sugar every 15 min for 1 hr.and her BGL dropped from 124 to 99 with the first drop by 15 min. of 14 pts.and the remaining 15 pts over the next 45 min. Our endo won't consider a pump until her A1C is below 9.0. Won't getting on a pump be more beneficial as it would eliminate the lows from the Lantus and provide a more balanced

Katrina Herrejon (NorthShore):
You can have well controlled blood glucose levels or poorly controlled blood glucose levels on both an insulin pump or daily injections. The key is to work with your endocrinologist to determine a basal/bolus regimen that works well for your daughter. It is true that Lantus should not have a peak, and a 25 point blood glucose drop may not necessarily indicate a peak. However, sometimes doctors will have you split your Lantus dosage if they feel as though it is needed. If your daughter is having consistently low blood sugars she may just need a reduction in her insulin dosages, but it is critical that you discuss all of daughters blood glucose levels and the trends of these levels with your endocrinologist.

Jay (Iowa) - 1:31 PM:
What causes an elevated c-peptide and elevated free insulin level?

Katrina Herrejon (NorthShore):
C-peptide is linked to the amount of insulin present in the body. Increased levels could mean a number of things, so it is best to discuss this with your doctor.

Maria (Hanover Park, IL) - 1:32 PM:
Since I was diagnosed with diabetes I can't loose weight like before i was diagnosed - need help in that problem, but I do drink soda alot !!! Can that be the cause of my weight problem? I do not eat late at night either because I suffer from acid reflects . Please help me to manage my weight, my doctor tells me I need to exercise, but I don't have the energy anymore.

Dana Artinyan & Katrina Herrejon (NorthShore):
Yes. Regular soda is very high in calories and simple carbohydrates (sugar) which can absolutely cause weight gain or make it very difficult to lose weight. For example, if you drink 2 cans of regular soda daily, this contributes almost 400 calories and 80 grams of carbohydrates (which is equivalent to 5 slices of bread). We recommend water (calorie-free!) or other no-calorie beverages if you do not like water.

Fred (Elburn, IL) - 1:38 PM:
There was a research doctor who was experimented with implants of cells in the islet of whatever it is called in the pancreas. They were protected from antibodies but large enough to allow the cells to get blood and go back into the blood stream. What's the status on that research?

Katrina Herrejon (NorthShore):
I believe that there are some clinical trials currently in progress, however you would need to speak to your endocrinologist regarding whether or not you are a candidate.

Percy (Chicago, IL) - 1:40 PM:
Since I've been diabetic my oral hygiene has become worse. Typical methods to control it don't seem to work as well. How can I control my oral hygiene? Is there any other methods I can use?

Dana Artinyan & Katrina Herrejon (NorthShore):
Follow your dentist's recommendations regarding oral hygiene. However, if your blood sugars are not adequately controlled, you are still at risk for oral health problems. Speak to your endocrinologist and a dietitian to learn how to better control your blood sugars.

Rogel (Chicago, IL) - 1:43 PM:
My doctor just informed me of the result of my blood test and everything is normal except my blood sugar, which is about 124 when normal for me is 112, he said. Is that true and what could I do to lower that? I play tennis every weekend and I thought regular exercise is a big factor in keeping check your blood sugar. What other steps should I do?

Dana Artinyan & Katrina Herrejon (NorthShore):
In order to have a diagnosis of diabetes, your fasting blood sugar needs to be greater than or equal to 126 mg/dl on 2 separate occasions. Pre-diabetes is diagnosed by a fasting blood sugar of 100-125 mg/dl. You are correct; exercise can definitely improve your blood sugars but you may also need to change your diet and lose weight to prevent the progression from pre-diabetes to diabetes. Talk to your dietitian or certified diabetes educator about how to implement these changes.

Lori (Chicago, IL) - 1:48 PM:
I am unable to control my diabetes and it depresses and discourages me. My doctor has helped me get it from the 300s and 400s to the 200s, but I know that is not low enough. It seems like I am always injecting 30 and 40 units of humilin-r even though I also do 35 units of humilin-n per day. I am afraid to get an insulin pump because: 1) it is so expensive; does insurance pay for it, 2) will I always feel it sticking me? 3) can an insulin pump handle such high quantities of insulin? Thank you.

Katrina Herrejon (NorthShore):
That is great news that your blood glucose levels have improved! It is important to recognize the success that you have had and to not become discouraged. There is no maximum to the amount of insulin that you can or should be injecting. However, insulin pens, syringes, and insulin pumps all have different capacities. It is important to work with your doctor to determine the insulin dosages that you will need to control your blood glucose levels and then discuss the best delivery method. If you do decide to use an insulin pump, the type of insulin that you will be using in this pump will actually only be rapid acting insulin rather than an intermediate and regular acting insulin so your dosages will be different. Your insurance may cover an insulin pump and no, you should not always feel it sticking you. Most people do not even realize that it is there.

Catherine (Moderator) - 1:52 PM:
Thank you everyone for your great participation, the chat will be ending in approximately 10 minutes. Please submit any final questions you have.

Ron (Oaklawn, IL) - 1:56 PM:
I am insulin dependent, lower limb amputee. I have gained 45 pounds since the amputation, suffer from complications with the residual limb that keep me from being very active. My blood sugars are difficult to control swinging from high to low often. Any advice as to how loose weight while on insulin and some what sedentary?

Dana Artinyan & Katrina Herrejon (NorthShore):
Exercise can help you lose weight and control your blood sugars. If you are unable to do lower body exercises, you can focus on upper body exercises. It is improtant to try different exercises to find ones that match your abilities. It is also important to meet with a dietitian or certified diabetes educator to develop a personalized meal plan to help you lose weight and control your blood sugars.

Sharon (Chicago, IL) - 2:01 PM:
I'm am struggling to lose weight. I did lose in the beginning and now can't seem to diet without my sugar levels either spiraling upward or so low I can hardly move. What should I do?

Dana Artinyan & Katrina Herrejon (NorthShore):
It is important to discuss your medication regimen with your doctor to avoid low blood sugars when you are eating healthy and exercising regularly. By preventing these low blood sugars, you will not have to treat them with calories/carbs and it will be easier to lose weight. In order to lose weight, you need to burn more calories than you take in. So, watching your diet is very important.

Denise (Chicago, IL) - 2:05 PM:
Whats is the best remedy to keep ur blood sugar levels low?

Dana Artinyan & Katrina Herrejon (NorthShore):
Maintain a healthy body weight, exercise regularly, and follow a well-balanced diet, carbohydrate-consistent diet.

George (Chicago, IL) - 2:09 PM:
I am a diabetic with high blood pressure. Is it good for me to exercise playing basketball at age 51, and do I need meal plans for myself?

Dana Artinyan & Katrina Herrejon (NorthShore):
As long as your doctor has given you the 'okay' to play basketball, you should be able to do so. A meal plan would be beneficial to help keep your blood sugar stable while maintaining an active lifestyle. A registered dietitian can help you come up with a plan.

Mary (Gary, IN) - 2:11 PM:
What is the procedure when your blood sugar goes really high...356 etc.?

Katrina Herrejon (NorthShore):
It depends on what, if any, medications you are taking and the plan that you and your doctor have agreed upon. If you do not have a plan in place, speak with your doctor as soon as possible to help avoid/address these highs. A blood sugar of this level can have severe consequences, so it is improtant to address it immediately.

Catherine (Moderator) - 2:16 PM:
Thank you again for participating in our chat today. For more information please visit our Diabetes pages.

Also, a transcript of this chat will be available shortly.
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