Questions about diabetes

What is hemoglobin A1c?
This is a type of blood test. A hemoglobin A1c percentage is important because it is the only way to know how well patients are controlling their diabetes over time. Based on blood tests taken over a period of two or three months, doctors can estimate patients' average blood sugar levels. The goal for most diabetics is an A1c of less than 7%. This is roughly equivalent to an average blood sugar level of about 150 mg/dl. An A1c of 9% indicates an average blood sugar level of about 210 mg/dl.
Here's how blood sugar works in the body. Glucose (blood sugar) circulates in the blood after food is absorbed in the intestine. A small amount normally combines with the hemoglobin molecule (A1c). Hemoglobin is the red-colored protein in red blood cells that carries oxygen to the rest of the body. It operates in direct proportion to the amount of glucose in the blood. The glucose remains with the hemoglobin molecule until the individual's red blood cells die - usually between two and three months. When the patient's blood is analyzed for hemoglobin A1c, the resulting value number provides an estimate of the level of glucose over that time period.
How do I properly treat a low blood sugar reaction? Should I eat a chocolate bar to bring my sugar back up?
Chocolate is not usually the best choice because the fat in it slows down the absorption of the sugar. Treat a low blood sugar reaction with some type of fast-acting sugar, such as glucose tabs, four ounces of juice, four ounces of nonfat milk or a half can of regular soda.
Why do I have to check my feet every day?
Diabetes often causes poor circulation in the legs and feet. This is one reason people with diabetes must take special care of their feet. Diabetics are likely to have foot problems, such as fungus, ingrown toenails, infections, bunions and ulcers. Most foot amputations can be prevented with good foot care. Note any changes in your feet, such as cuts, scratches, red areas, corns, cracks, itching or other abnormalities. Any changes should be reported to the podiatrist. To smooth down calluses, use a pumice stone when bathing, and never cut calluses off. Trim or file toenails straight across to cut down on the chance of ingrown nails. Make sure shoes fit properly. Pressure from ill-fitting shoes can cause sore areas and lead to ulcers and infections. Patients who have foot pain should see a podiatrist regularly. Most insurance companies will cover podiatry care caused by diabetes.
What foods should I avoid to help control my diabetes?
Foods with higher amounts of simple sugars should be avoided, such as fruit juice, regular soda, sport drinks, candies, sugar, brown sugar, honey, syrup, jelly and jams.
What should I check on food labels sugar or total carbohydrates?
Total carbohydrates include sugar, starches and dietary fiber. The total amount of carbohydrates is what affects blood glucose levels - not just sugar.
How much salt or sodium can I have if I am also taking blood pressure medication?
Patients who take blood pressure medication should limit sodium intake to 2,000 mg a day. One teaspoon of salt contains about 2,300 mg of sodium. Most sodium in the American diet comes from processed or prepared foods, not from the kitchen table salt shaker. Foods that have 400 mg per serving are considered high sodium foods.
What is the recommended daily amount of fiber I should eat?
The recommended amount of fiber is 25 to 30 grams per day. Check for fiber on food labels to help reach this number. Some examples of high fiber foods are fruits, vegetables, legumes and whole grains. Fiber is not completely digested and absorbed in the intestinal system, and it is unavailable as blood sugar. Therefore, a high-fiber meal does not provide as much available carbohydrates as a similar-content low fiber meal. To avoid constipation, increase water intake as more fiber is added to the diet.
Can I reuse the lancets and syringes I use for insulin injections?
We recommend using new lancets and syringes for each injection. However, many people reuse their personal lancets for one week. This is acceptable as long as the lancet device is not shared with anyone else. In reusing the syringe, patients run the risk of insulin contamination. Therefore, every syringe should be discarded after use.
What should my blood sugar level be?
Blood sugar levels change all the time and vary with each individual. The American Diabetes Association recommends the following: after fasting, your blood sugar should be between 80 and 120 mg/dl; before meals, it should be less than 140 mg/dl; and two hours after a meal, it should be less than 180 mg/dl.
How often should I check blood sugar level?
Blood sugar levels should be checked at least twice each day.
How do I care for my eyes?
Visit the ophthalmologist once a year. For patients with retinopathy, an ophthalmologist should be seen on a routine basis.
If I have gestational diabetes, what should my blood sugar level be?
Your blood sugar level should be between 60 and 90 mg/dl when you have been fasting and less than 120 mg/dl two hours after a meal.
What are the symptoms of high blood sugar?
Signs include extreme thirst, frequent urination, dry skin, hunger, blurred vision, drowsiness and nausea.
What are the symptoms of low blood sugar?
Signs include shaking, fast heartbeat, sweating, anxiety, dizziness, hunger, impaired vision, weakness/fatigue, headache and irritability.