Diabetes Question Marks - Part 2
Theresa answers your specific questions about managing your diabetes in Part 2 of this 2-part column.
Here are more of your questions. As stated before, resources in your area, like your physician, pharmacist, and diabetes educators can provide individual advice. (Call 800-832-6874 to locate a certified diabetes educator nearest you.)
Q: I am having a hard time with my diagnosis of type 2 diabetes. My husband has cancer and a bad heart. In the last 2 years we have struggled to survive in our every day life, we have lost everything, and now this. I was told to test my sugar 2 times a day, but there is just not enough money in our budget to buy the test strips. Do you have any suggestions for people that can not afford the testing supplies?
A: My heart goes out to you and your husband. I have a few thoughts. First, do you have a prescription for your testing supplies? Most states require insurance to pay for a portion of the testing supplies, but unfortunately, many people don't know they need a prescription for strips to be covered. Second, are your glucose values in the target range of 70-120 before meals and a 2 hour after meal reading of less than 150? If so, you can test less—just don't stop testing! The guideline is to move the tests around. For example, one day check before breakfast. Next day, check 2 hours after dinner. Beware: test more often if you feel sick, because glucose values can go very high, even when you are not eating, during periods of illness. Third, have you seen a medical social worker? Check with your diabetes program or local hospital as they can look at ways to help you maximize your healthcare dollar (plus, the diabetes educator may have some sample of strips available in the office). Lastly, check with your pharmacy. Most drug companies offer low-cost medications to people with limited incomes. If you are not paying as much for medication, it will help you to afford the test strips.
Here is a sample of drug-assistance programs for people with limited incomes:
- Humalog or Humulin insulin: 800-545-6962
- Lantus insulin: 800-221-4025
- NovoLog insulin: 800-727-6500
- Avandia: 888-672-6436
- Actos: 877-825-3327
- Glucophage: 800-736-0003
Q. I know that I could achieve better control if I tested my glucose more, but I find it hard to stay motivated to test. If I test consistently, and things seem to stabilize, I am encouraged to keep trying. Then, if I get numbers that swing wildly for reasons I can't fathom, I give up. Do you have advice on motivation and maintaining control?
Q. I'm a type 2 diabetic and 58 years old. I have so much on my plate with working and taking care of grandchildren, etc. How do I keep myself motivated to do all the things necessary to manage my diabetes when I hardly even have time to take a breath, much less measure my food?
A. For most people, it is a quite an endeavor to make health a priority, and especially for those with an active lifestyle. Motivation is primarily self-regulated. What will help you renew your sense of motivation? Taking care of yourself so you can enjoy the things in life for which you feel passion? What is on your plate that is taking energy away from you, or that you can eliminate, or reduce? How about attending a local diabetes support group so you can glean some tips from others in a similar situation? Another angle is to see a diabetes educator for tricks on healthy eating (without measuring food!). Also, a diabetes educator can help unlock the mystery as to why glucose values fluctuate wildly. I think staying motivated is one of the biggest challenges with which people grapple. If you are connected to others, whether locally, on the Internet, with dLife TV, or a diabetes magazine, it can make all the difference.
Q. I noticed a little tingling in my feet last week. I saw my doctor about it and all he said was, I should control my diabetes. What can be done to stop this tingling feeling?
A. If your diabetes is out of control, that could cause the tingling sensation you are having. By controlling glucose levels, the ability of nerves to communicate improves, and the tingling sensation can go away. What is your A1C level? Is your diabetes in control? Could the tingling in your feet be caused by another condition, like poor circulation, a pinched nerve in your back, or a medication side effect? The other consideration is to see a neurologist. If you do have diabetic neuropathy, wherein the nerves going to the feet slow down and cause tingling and pain, a treatment called Anodyne is available. Anodyne is an infrared treatment that can reverse the pain of neuropathy. It is a FDA-cleared treatment and has been available for over 10 years. Physical Therapists typically provide this therapy, which usually involves 3 half an hour treatments a week (a little pad of "diodes," much like the little beam of light in most remote control devices, is placed on your foot). The scientific literature behind this treatment is solid. Of course, we can put the practice in practicing medicine and try any one of a number of medications on the market for neuropathy. I think you need further evaluation.
Women's Sexual Health
Q: There's a lot of talk about how diabetes can affect male sexual function. How about long term type 1 diabetes and its affect on women?
A. Thank you so much for bringing this up. I am tired of the male focus of sexual dysfunction and diabetes when women have just as much of a problem, and we need to talk about it. Diabetes is an equal gender opportunist! I just attended a lecture on diabetes in Hawaii, and a group of 170 diabetes educators were asked, "How many of you ask your women patients about their sexual health, as it pertains to diabetes?" Only 3, yes 3, raised their hands (I was one of them!).
If diabetes is out of control, much like it effects men and their sexual abilities, it effects women too. That means a woman can experience lack of interest or desire in sexual relations, vaginal dryness, and sometimes painful intercourse (assuming that is part of her repertoire). If dryness is an issue, lubrications are available at the pharmacy. If diabetes is in control, other causes can be the root of disinterest in sex (side effect of a medications, hormones with peri or post-menopause, stress of life, etc.). Just because a woman has diabetes does not mean she will have problems with sex. You have had type 1 for a long time. That, in and of itself, doesn't mean you'll have problems. It is important to have a dialogue about this with your doctor. Thank you for bringing up a subject that is often overlooked.
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.
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Many people say that depression is a side effect or complication of diabetes. Without discounting the association of the psychological condition with the physical one, I'm not convinced that our high and/or unstable glucose levels are directly responsible for that change in our mental state. My belief is that the unrelenting need for self-care, for following the sort of care schedules that can drive licensed, professional caregivers crazy, is what overwhelms us...