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Diabetes Questions and Answers

Ask Ginny Banner

"I hope this web site will help connect the members of our community who have diabetes so we can support each other and gain a better understanding of our disease." Ginny Burns

Ginny Burns is a local nurse who has worked with people who have diabetes for the last 20 years. She is credited with years of dedication to the American Diabetes Association and Utah Association of Diabetes Educators. She also brings the invaluable experience of having Type 1 diabetes for 39 years which makes her a unique resource to answer your questions.

Please click here to submit your question to Ginny.

Your Questions, Ginny's Answers

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10/27/2008 -- Lips Tingle

Q: Why do your lips tingle when your blood glucose is low?

A: Nerves thoughout the body are often irritated when glucose levels are low. Sensory facial nerves can be affected and some reported symptoms have been with eyes, with twinkling lights in the periphery or colors that become vivid; ears with buzzing in the ears or loss of hearing; with cheeks that tingle or itch; and lips and/or tongues that tingle or become numb.

I asked several endocrinologists if they noticed specific low glucose readings when these symptoms occurred and they didn't. The numbers that have been reported from patients have ranged from 10 to 90mg/dL. It was very individual and seemed to often depend on how fast the glucose levels had fallen. The endocrinologists felt that the faster the readings fell the greater the occurance of symptoms. Numb tongue and lips, rather than just tingling, were associated with the lower readings however. If these are symptoms that you experience, be sure and test your glucose levels right away and treat quickly.

Thanks for the great question! Ginny

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10/16/2008 -- Family History & Diabetes Prevention

Q:My father developed Diabetes in his late 40s.  I'm approaching my 40s and want to avoid this disease if possible.  Is there anything I can do to be proactive in preventing Diabetes?  To what extent is genetics a major contributing factor in developing Type II diabetes?

Thanks,
Dave

A:Dave,

Having parents or siblings with Type 2 does put you at a greater risk of developing Type 2 Diabetes. Being proactive now may help you prevent diabetes from developing. If you can, check with your primary care physician and see if you have had a fasting blood sugar test during a recent visit. If not, see if you can have this very quick test done. The fasting blood sugar should be below 100. If it begins to rise, it is a signal that something is happening.

The American Diabetes Association tells us that if the fasting blood sugars are between 100 and 125, this is considered prediabetes. It means you have not been diagnosed with diabetes -- the fasting glucose would have to be 126 or higher -- but you are certainly headed in that direction. It is often very helpful to learn where your fasting blood sugar is standing.

The best way to prevent diabetes is to make several important lifestyle changes.

  1. Start to exercise and become active (check with your physician first if you have any health problems that would prevent you from becoming active).
  2. Try eating smaller healthier meals (Try using higher fiber foods like whole grains, fruits and vegetables and try to eat less fried or high fat foods).
  3. If you need to, try to lose 5-10% of your current body weight and it will take a tremendous amount of pressure off your system.

Good luck to you!
Ginny

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10/3/2008 -- Dessert & Diabetes

Q: I am a type 2 diabetic. I currently am managing my diabetes with oral medicine. My numbers are currently between 90 – 126. if I increase my exercising would I be able to have a piece of cake or pie? I would also limit my carbs that day.

Kathy

A: Kathy,

It sounds like you have been giving this some thought. Your medication and exercise routine are helping your body handle the carbohydrates you are eating. Since the glucose readings are so very good, it sounds like there is a good balance in what you are doing. How many grams of carbohydrates are you eating per meal? Remember, cake and pie are carbohydrates too and they can be substituted for other carbohydrates in a meal if you choose.

For example--- You might want a piece of pie for dessert after dinner (a slice of pumpkin pie, about 1/8 of a pie has about 30 grams of carbohydrates). If you usually have 45 grams of carbohydrates for dinner, you could have chicken, salad and green beans with a biscuit (a 2 and 1/2 inch biscuit is about 15 grams of carbohydrates) and then use the remaining 30 grams of carbohydrate for your piece of pie. Generally a piece of fruit pie, with 2 crusts, has about 45 grams of carbohydrates. If you choose a piece of fruit pie, you would need to substitute the fruit pie for all the carbohydrates in our sample dinner.

A quick check of your glucose two hours after eating will let you know how your body handled the carbohydrates. You should be able to choose the carbohydrates you would like to eat at each and every meal. If you need to learn more about carbohydrate counting and making substitutions check with a diabetes dietician.

Everyone feels like a little dessert at times---even people who have diabetes! With a few adjustments you should be able to have dessert and keep the glucose readings in your range.

Good luck to you, Ginny

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10/2/2008 -- Ideal A1C Level

Q: I've heard that the ideal A1C number is lowering (below 6.9%) and that the formula for calculating the percentage of sugar in the blood is now different. Is this true? What should my goal be?

L

A: L, the way the test is changing will be how it is checked in the lab. Our results will be showing us an average blood sugar that is associated with the HgbA1c % (Glycosylated hemoglobin). This should make more sense to us as the number will relate more to what we usually see on our meters. The labs that run my tests have a normal range of 4-6%.

Some labs have different normal ranges so check your number with what the normal range that your lab uses. Generally the closer our %s are to the normal range, the better off we are. 6%-7% is generally seen as the safest range for patients with diabetes. The closer you are to normal, 6%, generally the better your diabetes control.

The closer to normal is better but WITHOUT HYPOGLYCEMIA.

Ginny

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10/2/2008 -- Continuous Glucose Monitor vs. Insulin Pump

Q:Ginny,

I have had type 1 diabetes for 18 years, using an insulin pump for 13 years, and now am investigating a continuous glucose monitor. What are the advantages and disadvantages of shifting to this system? Is it a closed loop system?

thanks very much

Laura

A: Laura, There are 3 continuous glucose sensors out on the market and all have advantages and disadvantages: DexCom 7, Navigator and Minimed. There may be others that will have appeared on the market since I have written this letter, but these are the big 3 in the market place today. The advantages is that they all show you results of your blood sugars every minute or every 5 minutes.

I have worn each one and love knowing how my glucose levels are rising and falling during the day and night. The amount of information you can see is amazing. The disadvantages is having another item on your body besides your pump. They vary in size and calibration needs so be sure and check out what you think of each system. 2 sensors, DexCom and Navigator, do not connect with pumps directly but will have ways to overlay the results with different insulin pump information that you can download from your pump. The sensor made by MiniMed sends glucose information to their MiniMed pumps, but it is not a closed system. You still need to look at the results and tell the pump what to do. Check out the web site of each sensor so you can see them for yourself.

The results are amazing and I love wearing this type of device. If you see an endocrinologist, ask if you can wear one on a trial basis or meet with one of the representatives at his office. Check with your insurance company as the coverage is getting better and better. Good luck!!

Ginny

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9/15/2008 -- Shoes & Diabetes

Q: Ginny, I have had Diabetes for over 40 years and have been one of the luckier ones, my older siblings both died from complications of having diabetes. My sister never even knew, my brother passed away after 25 years with it.

My question is where is a good and reasonably priced place to purchase a good pair of shoes that work well for a Diabetic who has some problems with finding a shoe that fits and is comfortable to walk and even stand in?

Thank You,
Don

p.s. I have been a pump for over 15 years. (works great)

A: Have you gotten any guidelines from your podiatrist for what you need? There are some specialty shoe stores that will help with shoes for diabetic feet but I think the best place to start may be a diabetes specialty store that also sells shoes. Check in the phone book and call to make sure you find a store that you feel will help you with your special issues.

Very few of our insurance companies in Utah cover specialty shoes but a few do, so be sure and check with your insurance policy to see if there is any coverage. Medicare does cover but you will need a prescription; Medicare will cover 80% of the cost. Generally a pair of specialty shoes will cost $130 to $150. Be sure and discuss the cost with the store you are checking with to see if they provide any assistance for someone paying cash or can help with a payment plan.

I know shoes may be expensive, but it is so very important to take care of our feet! Three cheers for you wearing a pump for 15 years!!!

Ginny

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For more information, please contact:

Grant Sunada, Media Liaison
Utah Diabetes Prevention and Control Program
PO Box 142107
Salt Lake City, UT 84114-2107
Phone: (801) 538-6896
Fax: (801) 538-9495
E-mail: gsunada@utah.gov

 

This Utah Department of Health web site is designed for informational and educational purposes only. It is not intended for diagnosing or treating a health problem or disease. It is not a substitute for professional care. If you suspect you have a health problem, contact your health care provider.