Diabetes Question Marks - Part 1

Theresa answers your specific questions about managing your diabetes in part 1 of this 2-part column.

Theresa Garnero By Theresa Garnero, APRN, BC-ADM, MSN, CDE

Monitoring Glucose 

Q: Why is it important to check your blood sugar levels daily?

A: It is the only way you know about your diabetes control without waiting for a 3-month A1C value. Without blood sugar testing, it is all guess work. That would be like driving your car without a fuel gauge to tell you how much gas is left in the tank. If your A1C is in an excellent range, and you are not at risk for hypoglycemia, some people do take a day off from testing. The danger is slipping into a comfort zone, and stopping testing completely. The key is testing regularly.


Q: I have type 2 diabetes. My doctor says that I shouldn't let my sugar get below 90. Sometimes I feel like it's real low—I get shaky, light-headed when it's still well above 90, and sometimes it can get down below 90 and I feel fine. Why is this? Also before going to bed, what is the lowest it should be? And what and how much should I eat if it's on the low side?

A. It sounds like you have had problems with low blood glucose levels (hypoglycemia), and your doctor might be playing it safe by setting your target glucose values a little higher to prevent going low. Technically, hypoglycemia is when glucose values are less than 70. Some people are not able to feel when they are low. Others feel low when they do not technically fit the definition of hypoglycemia, and this can be confusing. If you are taking insulin, or medications that make your pancreas release insulin, you can start to feel low as the glucose values plummet. Internally, you feel it, but there hasn't been enough time to have those falling glucose levels reflected in your glucose meter readings.

The other possibility is your meter. Have you done a quality control test recently to be sure your results are accurate? Are your strips in their airtight container? Have your strips expired? All of those things can give you false readings.

I suggest you ask your doctor about target, pre-bedtime glucose values. To answer your question, I'd need to know what meds or insulin you are taking, etc. If you are low, or feeling low, correct it with 15 grams of simple sugar (4 ounce glass of juice, 8 ounce glass of milk, or 3 glucose tablets), then eat something that will last a while (like a half of a sandwich). You might also benefit from the continuous glucose monitoring system to see what exactly is happening with your glucose patterns.

Maximum Insulin Injection

Q: Is it true that the body will only absorb seven units of insulin at one site, so multiple injections are necessary to absorb the full bolus?

A: No, that is not true. The largest capacity in an insulin syringe is 100 units. If you are in need of taking more than that, higher concentrations of insulin are available so you wouldn't have to take multiple injections.

Adjusting Insulin

Q: I am on Humalog insulin. Can I give myself more insulin when I eat more on weekends or if my blood sugar is too high?

A. Yes, with doctor's advice. It is not uncommon to have an insulin-to-carbohydrate ratio, a formula that can help you determine how much Humalog you would need, given the amount of food you are about to eat. A correction factor can also be determined so you will know how to handled periods of high glucose (hyperglycemia). Talk with your doctor, or diabetes educator about determining an individualized insulin scale for you.

Next Month – Part 2 of your Diabetes Question Marks.

Read Theresa's bio here.

Read more of Theresa Garnero's columns.

NOTE: The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.

Last Modified Date: May 24, 2013

All content on dLife.com is created and reviewed in compliance with our editorial policy.

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by Brenda Bell
As I mentioned in an earlier post, one of the benefits that made it cost-effective for me to go with the real healthcare (HSA) plan rather than the phony (HRA) plan is that my company is now covering "preventative" medicines at $0 copay. The formulary for these, as stated by CVS/Caremark (my pharmacy benefits provider), covers all test strips, lancets, and control solutions. I dutifully get my doctor to write up prescriptions for all of my testing needs, submit...
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