Diabetes can require careful maintenance and attention. Finding answers and gaining knowledge may help you feel more in control of your condition. So we turned to an expert for answers to the questions you posted on our Living with Diabetes Facebook page.
Susan Weiner is Healthline.com’s diabetes medical advisor, a certified diabetes educator, and a registered dietitian. She was also named the AADE 2015 Diabetes Educator of the Year! If Weiner doesn’t address everything you want to know here, check out her new book “The Complete Diabetes Organizer: Your Guide to a Less Stressful and More Manageable Diabetes Life.”
Q: How long do you think it will be before we can test for glucose levels without drawing blood? Is there another method to find out blood glucose levels rather than sticking your finger?
A: There have been a number of attempts to check blood glucose levels using non-invasive methods. These methods are evolving as an alternative to using finger sticks. Some of the alternative methods used to test blood glucose include a wristwatch or eyeball scans! Testing through tears and tattoos have also been attempted, but with very limited success.
The latest testing method involves using an earlobe clip. This method is currently undergoing clinical trials. The accuracy and ability of the device is still quite questionable, but it’s a very interesting concept, so stay tuned!
Q: I have dinner at 5 p.m. At bedtime, my blood sugar is 140. Should I have a snack before I go to bed or not?
A: At bedtime, your blood glucose should be between 100 and 140 mg/dl. If your bedtime blood glucose level is 140 mg/dl, you probably don’t need an additional snack. However, if you exercise late in the day, your blood glucose level may fluctuate several hours after your workout (even into the late night hours).
Target blood glucose ranges may vary from person to person. Please continue to test your blood glucose regularly and discuss your target range with your healthcare provider.
Q: Is any insulin available without a prescription?
A: There is currently a great deal of discussion around this topic! Many years ago, certain insulins were available without a prescription. In the future, the FDA may be considering “expanding the availability” of various medications, including insulin. However, many endocrinologists disagree with the idea of insulin becoming available without a prescription. They’re concerned that patients may not seek proper treatment and evaluation from a doctor.
Although this approval is still under consideration, the FDA claims that only limited quantities of certain medications would be available without a prescription, and the patient may be required to make an appointment with a qualified physician after the initial medication is dispensed. In other words, a one-time dose of medication or insulin may be available for purchase without a prescription at some point.
Q: Does breast milk contain glucose?
A: Breast milk contains lactose, which is a disaccharide (sugar) composed of glucose and galacatose. So yes, breast milk does contain glucose.
Q: I've been labeled a "brittle" diabetic, and have been advised by my endocrinologist to steer clear of bearing children. Would you recommend going against my doctor's orders? Of course I'll be making sure all my numbers are in range before even trying!
A: Having children is a very difficult decision for people with type 1 diabetes. I would strongly suggest that you see an endocrinologist who specializes in pregnancy and type 1 diabetes. Contact your OBGYN for suggestions or the American Association of Clinical Endocrinologists to find a specialist. Best of luck!
Q: I’m 52 years old, and I’m still in denial about my diabetes after four years. My A1c is 6.4, and I am on Janumet and Zorclor. My numbers range from mid-150 to over 300. All the tests I’ve taken say I am not a diabetic, and I have no complications. Can you explain?
A: Your hemoglobin A1c level might be even higher if you were not taking medication to help control your blood glucose level. Please consider scheduling an appointment with an endocrinologist. They can discuss your diagnosis and target blood glucose levels with you in detail. I strongly suggest you also make an appointment with a CDE, who can help you understand how food, nutrition, physical activity, stress, and medications may affect your blood glucose levels.
Q: Has there been any research done on the effectiveness of the paleo diet for people with type 2 diabetes?
A: I’m not aware of any evidence (scientific double-blind studies) based on the paleo (or caveman) diet and diabetes. Please consider scheduling an appointment with a registered dietitian who is also a certified diabetes educator. Together you can formulate a meal plan that will help control your blood glucose levels and accommodate your food preferences.
Q: I have type 2 diabetes, and I have dawn phenomenon. I have a difficult time finding information on how to treat this condition with something other than a pump. What are my options? And is this a reversible condition?
A: The dawn phenomenon may be very challenging to manage. How often are you testing your blood glucose levels? Other than the rise in blood glucose in the morning, are you experiencing unusual fluctuations in blood glucose during the day or evening?
I would suggest discussing this issue with your doctor and a certified diabetes educator. Please record your blood glucose levels several times each day, along with your food intake and any exercise you do. Your doctor may be able to use this information to help you better manage this condition.
Thank you everyone for your questions!