Emily Shafer, PharmD has been a pharmacist for 9 years, most of which were in the community setting. She’s worked with many patients to help them manage their diabetes through the City of Chicago “Taking Control of Your Health” program and Medication Therapy Management services.

Facts on Diabetes:

Diabetes is a common condition. 9.3% of Americans have diabetes.

2% of African-Americans 20 years and older are diagnosed diabetes.

The problems that diabetes may cause if left uncontrolled are great and can include heart attacks, stroke, loss of sensation in the feet, amputations, kidney damage and blindness.

African-Americans are significantly more likely to experience blindness, kidney disease and amputations.

The complications of diabetes are not inevitable. You can prevent these complications.

First step:

Understand what diabetes is and how to control it and other conditions you may have, like high blood pressure.

Secondly:

Learning about how your diet and physical activity affects your diabetes is important.

Diet:

Some think they have to completely avoid sugary foods, when the reality is simply reducing the amount of sugary foods and eating more fruits and vegetables can help. Understanding portion sizes and what is in your food, like the amount of salt, carbohydrates, fats, and proteins will help you choose amounts and foods that are best for you.

A good way to identify portion sizes and content is to read food labels and understand how much of each ingredient per serving you can have.

For example, a general guideline for people with diabetes (although check with your diabetes care team first) is to eat 45 to 60 grams of carbohydrate at each meal. Carbohydrate content is important for those with diabetes because it increases your blood glucose levels.

Physical Activity

Others think they have to work out in a gym or run, but walking 30 minutes most days of the week can lower blood sugar levels as well. It is important to note, that you do not need to fit in all of your activity in at once during the day. For example, you can walk 5 to 10 minutes at a time a few times a day to add up to 30 minutes in a day.

Lastly:

Taking medications as directed and testing blood sugar are important for getting and keeping diabetes controlled.

Medications are not going to be as effective if they are not taken as recommended. If you have questions or concerns about your medications, talk with your Walgreens Pharmacist. The pharmacist can work with you and your doctor to ensure you have the most ideal medications for your conditions and situation.

When it comes to testing your blood sugar, ask your doctor how often you should test and when. Every person is different regarding their need for testing. The goal of testing blood sugar is to get information about how your body is responding to medications and any lifestyle changes you make. Your blood sugar numbers should never be viewed as “bad”, rather they are information you and your doctor can use to fine tune your treatment regimen.

It is recommended that if you want to make changes that you talk with your doctor and start with small goals. People cannot sustain change when they make too many changes at once. The goal is to make progressive, sustainable changes over time to improve your overall health and diabetes.

Emily Shafer answers your questions below:

Good morning, I am 58-year-old male. I am a type 1 diabetic on a half tablet of Metforim daily. Just found out last June. What is too many carbs?

This number can be different for different people, depending on the medications you take, how much you exercise, and how long you have had diabetes. The general rule is to eat about 30-60 grams of carbohydrates per meal and about 15-30 grams of carbohydrates for snacks. Check with your doctor or a dietician to see what the right about is for you.

Should I be on Metformin if I’m pre-diabetic? If so, how much should I be taking?

Many people who are diagnosed with pre-diabetes are prescribed metformin by their doctor. The dose can be different for different people so I recommend following up with your doctor to find out if this medication (and what dose) is right for you.

What should your normal range be for Type 2 diabetes?

People with diabetes will have an A1C level of 6.5% or above. The normal range for blood sugar levels change based on when you last ate, may vary throughout the day, and may be a little different for different people.

In general, a fasting glucose level for someone with untreated diabetes would be 126 mg/dL or above and a random glucose test may be 200 mg/dL or above. Once you are undergoing treatment for diabetes, your fasting blood glucose will usually be between 80-130 mg/dL and your post-prandial glucose (1-2 hours after a meal) will be less than 180 mg/dL.

My daughter has a dark ring around her neck. I’ve been told this is a sign of diabetes. Is this true?
Can diabetes be reversed?

Yes, the condition is known as acanthosis nigricans and may be associated with obesity and/or diabetes. I recommend following up with your daughter’s doctor to see if additional test for diabetes need to be done.
Although there is no cure, diabetes can be managed and controlled to the point of reversal in some people. This can depend on what you eat but also your body and how progressive your diabetes is. Check with your doctor to see what the best plan is for you and your diabetes.

Is there any way you can get rid of diabetes?

There is not currently a cure for diabetes, but there are a number of ways to manage diabetes to prevent long-term complications. Make sure you are taking your medication as prescribed, eating the right foods and right about of carbohydrates for you, and maintaining a healthy lifestyle that includes regular physical activity.

Where can I get free diabetes test?

Many community health fairs and hospitals offer free diabetes testing, involving blood sugar readings. These tests can let you know what your blood sugar is at that moment, but your doctor will need to do additional tests to determine if you have diabetes or not. You may also check with your local health department to see what additional free services are available.

I have family history of diabetes. I am a very healthy eater and exercise daily. A few years ago, I was diagnosed as pre-diabetic and now I take metformin daily. My doctor says my numbers are always great, yet she won’t take me off meds. Why?

Metformin is a medication that helps your body respond to insulin, which is the key hormone needed to move sugar (glucose) out of your bloodstream and into your cells for energy. If your body is responding well to the medication and your numbers are at a good level while you are taking the medication, your doctor may want you to continue taking the medication so that your chance of developing actual diabetes decreases.

How can you lower your AC1? My doctor just keep telling me that it’s high, like around 13 to 14.

That’s a great question. Your A1C is a blood test that provides information about a person’s average levels of blood sugar (or blood glucose) over the past 3 months. You can work to lower your A1C level by decreasing your overall blood sugar levels and maintaining the levels so that there are fewer really high (peaks) or really low (dips) readings.

You can do this by taking your diabetes medication as prescribed by your doctor, focusing on a healthy diet with the right amount of carbohydrates at each meal, and maintaining a good exercise regimen. Check with your doctor about other or more specifics recommendations that may work best for you.

Is metabolic surgery an option?

Metabolic surgery (including partial gastrectomies or bariatric procedures) may be an option for some people with Type 2 diabetes. Check with your doctor to see if such surgeries or procedures are appropriate for your treatment. Remember, we are here to help you be Happy and Healthy. Use your Walgreens Pharmacist as a resource.

 

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