Are people with diabetes allowed to eat sugar?
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

How can carbohydrate counting help to manage diabetes?
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?
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?
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?
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?
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

What’s the best thing to use to treat low blood sugar?
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

I have type 2 diabetes and my doctor keeps telling me to lose weight Will weight loss really help?
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?
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?
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.

How is insulin stored?

  • 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

Has my insulin gone bad?

  • 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

What if my insulin needs to be changed?

  •  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

How do I dispose of syringes?

  • 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 2/3 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.

Can I reuse my syringes?
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. 

  • 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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