Diabetes Q and A

By Janis Roszler, MSFT, RD, CDE, LD/N

Q I really try to follow my diabetes diet, but just can’t do it. Do you have any ideas that might help me?

A Your diabetes meal plan shouldn’t be a burden. If it is, meet with a registered dietitian who can redesign your plan to better fit your preferences and lifestyle. If you find that you still indulge once in a while, try to do the following:

  • Learn to treat abnormal glucose levels that may result from eating foods in portions that aren’t recommended. Don’t punish yourself for veering off your redesigned meal plan! We are all human. If you make a poor food choice, forgive yourself and eat healthier at your next meal.
  • Learn your A1C number. Most experts recommend a starting A1C goal of less than 7 percent with an ultimate goal of less than 6.5 percent. If your A1C level is good, an occasional high blood glucose meter reading should not be a problem. If it is too high, meet with your healthcare team to adjust your treatment plan.

Q If I have to start insulin, will I ever be able to stop?

A If you have type 1 diabetes, the answer is no – you must take insulin from an outside source because your body can’t produce any of its own. If you have type 2, it may be possible to reduce or even eliminate your need for insulin if you do the following:

  • Follow a healthy meal plan. A registered dietitian who specializes in diabetes can help design a meal plan that fits your lifestyle and improves your diabetes control.
  • Stay physically active. The addition of even a small amount of movement can make a significant improvement in your blood sugar control. Discuss exercise choices with your doctor before starting.
  • Lose weight, if needed. You should be able to see an improvement in your diabetes control after a small amount of weight loss.

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Q Is it true that pregnant women with diabetes make more amniotic fluid? I had an awful lot of fluid appear when my water broke and the nurse blamed it on my diabetes. Just curious.

A This is actually true. Women who are pregnant and have diabetes may make more amniotic fluid if their blood glucose level runs high during the pregnancy. Those who control their glucose level well will probably produce the same amount as other women.

Q I used to feel my blood sugar level drop, but can’t anymore. Can I ever get the sensation to return?

A Unfortunately, it is very common to lose the ability to feel a drop in your blood glucose (sugar) level when it runs low. This often happens to people who make a real effort to keep their blood sugar level in a very narrow range. Some experts also believe that frequent low blood sugar episodes can cause this unawareness to develop. It may be possible to get this sensation to return or to better anticipate when it may drop, by trying the following:

  • Maintain blood sugar level within 80-180 mg/dl for 2-3 weeks. Many people have regained their ability to feel blood sugar lows after doing this.
  • Meet with your health care team to review your daily blood sugar test results for patterns. You may be able to learn to predict when a low will occur and change your eating and/or medication schedule to help prevent it.

*This article originally appeared in 2010
** please consult with your healthcare provider before making any changes to your diabetes regimen.

About Janis Roszler, RD, CDE, LD/N (15 Articles)
<p>Janis Roszler, RD, CDE, LD/N is the 2008-2009 Diabetes Educator of the Year (AADE). She is also a Marriage and Family Therapist, Fellow of the Academy of Nutrition and Dietetics, former radio show host, and award-winning medical media producer. Janis is the author and co-author of APPROACHES TO BEHAVIOR: CHANGING THE DYNAMIC BETWEEN PATIENTS AND PROFESSIONALS IN DIABETES EDUCATION (ADA, 2014), DIABETES ON YOUR OWN TERMS (Marlowe & Co, 2007), SEX AND DIABETES (ADA, 2007), and THE SECRETS OF LIVING AND LOVING WITH DIABETES (Surrey Books, 2004).</p>
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Constance Brown-Riggs, MSEd, RD, CDE, CDN—an award-winning RD, certified diabetes educator, and past national spokesperson for the Academy of Nutrition and Dietetics, is the author of The African American Guide to Living Well With Diabetes, which received the Favorably Reviewed designation from the American Association of Diabetes Educators, and Eating Soulfully and Healthfully with Diabetes.

Dr. Lori Shemek, PhD, CNC, CLC, the best-selling author of “Fire-Up Your Fat Burn! and leading health and weight loss expert, is also known as “The Inflammation Terminator.” She has made it her mission to educate the public on the toxic effects of certain foods and lifestyle choices and how they create inflammation in the body. She is a leading authority on inflammation and its role in weight loss, preventing disease and optimizing health.

Rebecca Bitzer – MS, RD/LD, CEDRD is an award-winning Registered Dietitian, writer, speaker, blogger, and REBEL Dietitian business owner. Rebecca and her team of six Registered Dietitians have counseled thousands of clients struggling with diabetes for over twenty-five years. They work closely with each other along with internists, endocrinologists, therapists, and families.

Maureen Sullivan – RN, CDE has worked for many years as a Registered Nurse, most of them in emergency and trauma services. She is a Certified Emergency Nurse, Certified Diabetes Educator, and the former manager of a hospital stroke program. Maureen’s wealth of knowledge, passion for nursing and education, and ability to engage people makes her an excellent teacher and a captivating lecturer. Recently, Maureen has been concentrating on writing, speaking and teaching, as well as working on her award-winning weekly podcast, “The Health and Humor Show.”

Lauren Harris-Pincus, MS, RDN is a nutrition communications specialist, registered dietitian in private practice, social media consultant, speaker, spokesperson and corporate consultant. She is currently the owner of Nutrition Starring YOU, LLC and www.NutritionStarringYOU.com. Lauren strongly believes that we should “Think Healthy, not Skinny”, and “EveryBODY is unique, your diet should be too”. Lauren was co-host of the Family Food Experts Kitchen radio show, available for listening on iHeart Radio and iTunes. Also known as one of the “NutritionBabes”, Lauren co-founded NutritionBabes.com, a popular Health and Wellness website in 2009. NutritionBabes.com was voted one of Healthline’s Top 100 Health Blogs in 2011, 2012 and 2013.

Mark Heyman, PhD, CDE is a clinical health psychologist and the director of the Center for Diabetes and Mental Health (CDMH). In addition to treating patients with type 1 and type 2 diabetes, Dr. Heyman provides training for health care providers on how to identify and address the emotional and behavioral aspects of diabetes in their patients. He also works with pharmaceutical and medical device companies to help them understand these issues and incorporate this information into their sales, marketing, and patient education materials. He is particularly interested in empirically supported behavioral interventions that promote behavior change and improve physical and mental health in people with diabetes.

Katie Ferraro, MPH, RD, CDE is a nationally-recognized registered dietitian, certified diabetes educator and author with an expertise in nutrition communications and curriculum development. She is the co-author of “Diet Therapy in Advanced Practice Nursing” (McGraw Hill, 2014) and an Assistant Clinical Professor of Nutrition at the University of California San Francisco and University of San Diego’s graduate schools of nursing.

Dr. Beverly S. Adler, PhD, CDE (aka “Dr. Bev”) is a clinical psychologist and certified diabetes educator, author and speaker. She specializes treating the emotional issues of people with diabetes. In her private practice, she provides individual, family and/or group therapy utilizing a cognitive behavior therapy orientation, combined with a spiritual approach. Her goal is to empower her patients to manage their diabetes.

Dr. Bev is the author of two self-help diabetes books. She has written numerous articles which are published in print and online – always focused on diabetes from the emotional perspective. She also speaks to audiences of people living with diabetes, as well as, to audiences of healthcare professionals and diabetes educators. Dr. Bev, herself, has been living successfully with type 1 diabetes for 40+ years.

In August 2016, Dr. Bev was honored to receive the “CDE Entrepreneur of the Year” Award from her Metropolitan NY Association of Diabetes Educators.

Jill Weisenberger, MS, RDN, CDE, FAND is an internationally recognized nutrition and diabetes expert with more than two decades experience. Through writing, speaking and one-on-one coaching, Jill empowers people to grab control of their health. She has worked as both a nutrition counselor and a diabetes educator in the hospital and research settings, and now in private practice in Newport News, VA. Jill is known for her practical approach and caring attitude. Her no-nonsense strategies to eating well include foods that both taste good and are good for you.

Marlene Koch (pronounced ‘cook’) is a nationally recognized nutritionist, popular TV personality and New York Times bestselling author. She graduated Magna Cum Laude from UCLA with a Bachelor’s degree in Nutritional Science. She is a registered dietitian and one of a select group of dietitians to hold an advanced certificate in Child and Adolescent Weight Management from the Academy of Nutrition & Dietetics.

Marlene has taught professional chefs from the American Culinary Federation the principles of healthy cooking and eating. She has been adjunct Nutrition professor and cooking instructor for Columbus State College and the Columbus State Culinary Academy, and she is a nationally recognized expert in weight loss, diabetes, child and adolescent nutrition, and sugar substitutes.

Marlene has sold over one million cookbooks, and is a regular guest on QVC.

Barbara Ruhs – MS, RDN is a Registered Dietitian Nutritionist and owner of Neighborhood Nutrition LLC, a consulting firm focused on providing solutions to help food companies and supermarkets improve consumer health & wellness. She’s a former supermarket dietitian and has run a successful business for 17 years. A leader in the field of nutrition, her mission is to help people by impacting the way food is produced, marketed and sold. She’s a strong advocate for supermarket dietitians and believes the retail food industry has the greatest potential to impact public health.

Cheryl Orlansky has over 25 years of experience in health promotion and chronic disease prevention and management. Her first career as a registered dental hygienist led her towards a path of wellness and nutrition! Her expertise is in diabetes, weight management and cardiovascular disease for individuals and groups. She works in a large private practice including endocrinology, internal medicine, rheumatology, neurology and sleep medicine. She is an award winning dietitian with current leadership positions in state and local dietetics organizations.

She has been interviewed and quoted in media outlets for WebMD, Atlanta Sports and Fitness, Georgia Public Broadcasting, and the Atlanta Journal and Constitution. She has partnered with V-103 Radio to lead supermarket tours as part of a community outreach during National Nutrition Month.

Cheryl helps her clients reach balance through lifestyle choices: cooking and eating, activity and purpose in life.

Jackie Newgent, RDN, CDN, is a registered dietitian nutritionist and classically-trained chef. With a passion for helping people (including her father) with diabetes, she’s author of The With or Without Meat Cookbook: The Flexible Approach to Flavorful Diabetes Cooking and the award-winning The All‐Natural Diabetes Cookbook, both published by the American Diabetes Association. Jackie is also author of 1,000 Low-Calorie Recipes and Big Green Cookbook. Her next book, The All-Natural Diabetes Cookbook—2nd Edition, was published in 2015.

Nutritionist Rania Batayneh, MPH is the author of the best-selling book, The One One One Diet. She holds a master’s degree in public health nutrition from the University of Michigan School of Public Health and is also a Wellcoaches Certified Health and Wellness Coach endorsed by the American College of Sports Medicine (ACSM).

OmnichannelHealth Media, publisher of DiabetesDigest.com, does not provide medical advice, diagnosis or treatment. See additional information.