Questions About Diabetes
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Frequently Asked Questions About Diabetes

Q: Are sugar-free foods always a smart choice?

A: Look beyond sugar—check the label for total carbohydrates and fats. If a food is labeled sugar-free but is high in carbs, it can still affect blood sugar.

The carb count may drop dramatically in a sugar-free version of a beverage or ice pop, because sugar was the main source of carbs to start with. But the carb count may be high in sugar-free cookies, because they still contain carbs in the form of flour. All kinds of carbs are broken down in the body as sugar. Also, keep in mind that removing the sugar in a product doesn’t always make it low in calories.

In addition, sugar-free products often have the same amount of fat as the original version. To make smart choices, consider all the information on the nutrition label.

Q: Can cold and allergy medicines affect blood sugar?

A: Over-the-counter liquid antihistamines and decongestants can affect blood sugar levels because of a key ingredient: sugar. Check labels on liquids to make sure sugar isn't one of the top 3 ingredients. Solid formulas—tablets and capsules—generally don't contain enough sugar to have an effect. You could also ask your pharmacist to recommend a sugar-free product. Be sure to monitor your blood sugar, and consult your doctor if you see a change in levels.

Q: Can secondhand smoke harm my health?

A:  Smoking is one of the most important modifiable risk factors for heart disease. In people who already have a high risk of heart disease—such as people with type 2 diabetes—smoking is particularly dangerous. The good news: People who quit smoking have only half the risk of those who continue to smoke, regardless of how long they smoked before quitting. The benefits of quitting smoking begin immediately and increase with time.

Even if you don't smoke, secondhand smoke still appears to increase the risk of heart disease. Because you have diabetes, you already have a higher risk of a heart attack, so it's wise to take every precaution to reduce that risk. If you can convince your spouse to quit, you'll probably improve his or her health and yours. As a compromise, you might convince him or her to smoke outside the home.

Q: Are there special warm-weather concerns for people with diabetes?

A: Dehydration is a big concern, so be sure to drink plenty of water. It's also a good idea to avoid strenuous outdoor activity in hot conditions. If you need to be outdoors, stay in the shade as much as possible and check your blood sugar levels more often than usual. Don't forget to carry identification with you, in case of emergency. If you carry insulin, use a cooler to keep it at the recommended 59° to 89°F. Ask your diabetes educator for more hot-weather solutions specific for you.

Q: If I have diabetes, can I donate blood?

A: As long as you're feeling healthy, you can donate blood. Healthy means that you feel well and can perform normal activities. It also means that you are being treated and have your diabetes under control—with lifestyle modifications, oral medicines, or insulin. There's only one automatic decline for a person with diabetes: having received an injection after 1980 of bovine (beef) insulin made from cattle from the United Kingdom, because of concerns about mad cow disease.

Q: Do blood sugar levels change with the menstrual cycle?

A: Every woman's body is different, so menstruation may or may not affect blood sugar. But for many women, levels increase around the third week of their cycle and may remain elevated for up to 5 days. The natural release of hormones that occurs around the time of menses can cause a woman's body to be resistant to insulin, resulting in higher blood sugar levels. Some women may note lower levels the first couple days after their period. If you suspect that changes in your levels could be related to your menstrual cycle, share your blood sugar readings and menstruation dates with your doctor. Only your doctor can determine whether treatment adjustments are needed.

Q: Does diabetes increase the risk of gum disease, which can raise blood sugar levels?

A: Many studies show that people with diabetes are more likely to develop gum (periodontal) disease than people without diabetes. This higher risk may stem from the increased risk of infections common in people with poorly controlled diabetes. Preliminary research indicates that the connection also works in reverse, with gum disease raising blood sugar levels. It’s not known why, but it is suspected that gum disease triggers inflammation in the body, which raises blood sugar levels. For these reasons, you should visit your dentist regularly, floss daily, and brush after meals.

Q: Can a doctor tell if I have diabetes-related complications simply by looking in my eyes?

A: Although an eye exam is not a conclusive test of your heart or kidney health, damage to the small blood vessels in your eyes indicates that problems may be developing in the small blood vessels throughout your body. That's one reason why it's so important to have a comprehensive eye exam with an eye doctor at least once a year. If you are diagnosed with retinopathy (damage to the blood vessels in the retina), it is very important to consult with your primary care doctor to make sure your blood sugar, blood pressure, and cholesterol are under control.

Q: If my levels are normal, why does my doctor advise taking a cholesterol-lowering drug?

A: Even with normal cholesterol levels, someone with diabetes has as great a risk of dying of a heart attack as someone without diabetes who has already had a heart attack. High blood sugar levels over time can lead to increased deposits of fat and other materials along the artery walls. These deposits may affect blood flow, increasing the risk that the artery will become clogged. Increased risk of inflammation in people with diabetes may also contribute. For these reasons, doctors often prescribe medicines to reduce levels of LDL (bad) cholesterol. More recently, we have learned that some drugs also reduce levels of inflammation, protecting you from a heart attack even if your LDL cholesterol is normal.

Q: I constantly need to reprick myself. What gives?

A: First, make sure you're using a new lancet every time. You may also need to use a lancing device that is larger than the one that came with your meter. Read the instructions to learn how to use the device and set it at the proper tension. You may need to change the setting so that the lancet goes deeper into the skin if you're not successful at a particular setting.

The books and inserts that come with a meter are very detailed, but nothing can replace talking with someone one-on-one about the process. Schedule some time with your doctor, pharmacist or a certified diabetes educator. By walking through a self-check with you, a health care professional can help you identify your particular challenges and help you find solutions.

Q: I want to keep up with my checks, but—ouch! What can ease the pain?

A: Use the side of the finger, not the fingertip—which has far more nerve endings. You may also need to decrease the setting on your lancet so that it does not go so deeply into your skin, or try a thinner lancet.

Many of the newer meters are approved for alternate-site testing. One benefit to testing on the arms, legs, or elsewhere is that there are fewer nerve endings in those locations than in your fingers, so the prick won't hurt as much. But there are also fewer small capillaries in sites other than the fingertip, so blood may be harder to obtain there.

Q: I can never get a large-enough sample. How can I increase blood flow?

A: Before sticking your finger, put it under warm water for 15 to 30 seconds. This will help bring blood to the surface. (Just be sure you dry your finger well.) You can also shake your hands down by your sides. Once you prick, realize that the spring action of most lancing devices is very quick and blood won't appear right away. Wait for 5 to 10 seconds, then try pushing the blood forward from the knuckle toward the pricked area.