An important part of diabetes treatment is empowering yourself through knowledge. Learn how to better manage your diabetes by reading the FAQs answered by Dr. Edelman, a leader in the fields of endocrinology, diabetes and metabolism.
ASK DR. EDELMAN YOUR QUESTIONS ABOUT DIABETES HERE!
Questions will be reviewed and Dr. Edelman will answer select questions. Please allow several weeks for your question to be reviewed and answered. Due to the volume of questions, not all questions will be answered on
this site.
Sugar alcohol is a type of reduced-calorie, artificial sweetener found in foods labeled as "sugar-free" or "no sugar added" and usually provides about half the calories of sugar and other carbohydrates. Examples of sugar alcohols are erythritol, hydrogenated starch hydrolysates, isomalt, lactitol, maltitol, mannitol, sorbitol and xylitol. The effect that sugar alcohols have on your blood glucose can vary so it is difficult to predict how sugar alcohols will affect your blood glucose levels every time. These sweeteners may be useful for reducing calories and carbohydrates when used instead of sugar in recipes and foods and beverages such as cereal, coffee and tea.
Sugar-free foods may be helpful in maintaining a healthy diet, but because a food is labeled sugar-free, it doesn't mean it is carbohydrate-free. Sometimes sugar-free foods are high in carbohydrates, so be sure to read nutrition labels carefully. Typically sugar-free foods have almost as many calories as the regular non sugar free food!
The nutrients in sugar and honey are similar, but a teaspoon of honey has slightly more calories and carbohydrates than sugar (honey has approximately 21 calories while sugar has approximately 15). Since honey is sweeter than sugar, you may be able to use less to sweeten foods, but you should always factor in the overall calorie and carbohydrate count when deciding whether to use sugar or honey.
Energy is produced by the body through dietary carbohydrates, including sugars and starches. The speed in which carbohydrates are broken down and absorbed depends on the chemical makeup of carbohydrate-containing foods. Simple sugars, such as the ones in orange juice, and regular soda, pass quickly to your bloodstream. In addition, fast carbohydrates, or high glycemic index foods including processed foods like cold cereal and white flour, cause a quick and significant increase in blood sugar levels. Low glycemic index foods, or slow carbohydrates, such as whole grain oatmeal and beans, are broken down and absorbed more slowly than fast carbohydrates. As a result, slow carbohydrates raise blood sugar levels gradually and have less of an effect on blood sugar levels.
Fruits can be high in vitamins, minerals and fiber and are an important part of a healthy diet. However, fruit contains fast absorbing carbohydrates so it's important to factor the fruit you eat into your overall carbohydrate count. It's also important to be mindful of portion size - especially with dried fruit and bananas since a small portion contains a more concentrated amount of carbohydrates. For example, two tablespoons of raisins or dried cherries can contain 15 grams of carbohydrates. As a general rule, people with diabetes should limit the amount of fruit that they eat but they certainly can be built into your daily dietary plan.
Borderline diabetes is an old term used to describe a "minor case" of type 2 diabetes. It is impossible to have a minor case of diabetes; you are either living with the condition or you are not. However, it is possible to have pre-diabetes, in which a person commonly experiences above average blood glucose levels, but the levels are not high enough for the formal diagnosis.
Through blood glucose monitoring, healthy eating, physical activity and possibly a diabetes medication such as insulin or an oral diabetes medication, you can learn to manage your type 2 diabetes. It's important to speak with your doctor so you can determine a treatment plan that works best for you.
Sugar numbers (or glucose levels) can vary based on a variety of factors, including what you eat. Normal glucose levels may vary throughout the day and tend to be at their lowest just before meals and increase slightly after you eat, which causes your pancreas to release insulin so that your blood glucose levels do not get too high. A normal glucose level is currently considered to be less than 100 mg/dL when fasting and less than 140 mg/dL two hours after eating.
A high carbohydrate diet and/or delayed or variable stomach emptying may increase the potential for blood glucose variability. You should be sure to speak to your doctor if your blood sugar levels are fluctuating.
Managing type 2 diabetes is a lifelong commitment to blood glucose monitoring, healthy eating, physical activity and sometimes diabetes medications such as insulin or an oral diabetes medication. Some recent studies have shown that cinnamon may lower blood sugar levels (others have shown no effect) and therefore may be a helpful supplement to your overall diabetes treatment plan. However, more research is needed to confirm the potential benefits of cinnamon. It's best to speak with your doctor to determine a comprehensive treatment program that is best suited for you.
The amount of carbohydrates you should consume depends on your diet, exercise routine and overall diabetes treatment plan. The American Diabetes Association recommends about 45-60 grams of carbohydrates per meal. You can adjust your diet to include more or less carbohydrates depending on what works best for you. The decision is an individual one and remember that some carbohydrates are better than others (i.e., complex carbohydrates are better than simple carbohydrates or brown rice compared to orange juice).
Hair loss could be the result of hormonal imbalance, however there are many different causes. Since diabetes can affect your hormone levels, it is possible that diabetes may be involved but this is not common. If your diabetes is under poor control, you may be losing vitamins and minerals in your urine, which can contribute to hair loss. You should see a dermatologist which is the best specialty to deal with hair loss.
Insulin is required for all people with type 1 diabetes and sometimes necessary for people with type 2 diabetes. The most important thing to remember is that your glucose control is your primary consideration, whether you are on insulin or not. Depending on many variables, you may not need insulin and/or oral medications if you lose 50 pounds. Losing 50 pounds may improve your health, but needs to be medically supervised.
If you are living with type 1 diabetes you should be checking your blood sugar often (at least before each meal and at bedtime). Be sure to talk to your doctor about a continuous glucose monitoring device, which may help prevent and detect high and low glucose values.
You should also discuss with your doctor how you can alter your diabetes treatment plan, including your fast-acting and long-acting insulin or insulin pump settings, to reduce the risk of hypoglycemia (low blood sugar). There are many causes of hypoglycemia other than too much insulin. Exercise, a reduced caloric meal, certain medications and changes in your schedule may all lead to hypoglycemia. Lastly, if you have type 1 diabetes, glucose variations throughout the day are frequently unavoidable, even when doing everything you have been asked to do to control your diabetes.