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Is It Sugar-Free or Isn’t It?

Sugar

One of my long term patients called my office because she could not figure out what was happening with her post breakfast glucose readings. She counted carbs and would typically have a 2 hour ppg of no more than 145 mg/dl but even though her pre-breakfast readings were around 110 mg/dl she was experiencing glucose levels near 200 mg/dl. I had her do a morning food diary for 7 days and we identified 3 days when she was eating French toast when her readings were going over 200 mg/dl. This meal had never been a problem in the past.

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What Is the Best Time of Day to Exercise? The Answer Is…

By Sheri Colberg, PhD
I often get asked, “What is the best time of day to exercise?” Like most things related to physical activity—especially with diabetes as an added variable—the answer often is, “It depends.” What is your goal for being active? Are you trying to better balance your blood glucose, or is weight loss your goal? Do you take insulin? What is your normal diet? How much time do you have? Which activities? There are so many questions that likely need answering before you may be able to ascertain the best time for you personally to be active.

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A Review of Insulin Errors

The U.S. Pharmacopeia Medication Errors Reporting Program states that approximately 50 percent of all medication errors involve insulin. As the incidence of diabetes increases, insulin use can reasonably be expected to increase, and the mistakes will no doubt increase as well. Insulin is a very powerful medication, and some of these mistakes will require the ambulance, the hospital, or worse.

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Friend’s Advice Causes Patient Problems

Last week I saw a patient who seemed to be losing control of her blood glucose levels. She had been doing well and her A1c had been around 6.0 - 6.3 for the past couple of years. She was doing this while only on metformin 1000 twice a day. She was referred to me by her physician because of high after-meal readings ranging up to 350 mg/dl. I went over her medical history and medications looking for a possible problem and found nothing.

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What Causes Blood Glucose to Go Down or Up During Exercise

By Sheri Colberg, PhD

For all the time that I spend praising the “miracle” of being physically active to help better manage diabetes and health, there are times when exercising does lead to better managed blood glucose and times when it does not. It is not always possible to predict the glycemic outcomes in all cases either, although individual patterns and responses can be determined over time. It is helpful to know the main factors that are predictive of outcomes.

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Syringe Type Mystery

My colleague and I were working with a client new to insulin. We each saw him separately. He was taking Lantus and Humalog by syringe at meals. He had been taught how to use the syringe by his physician's office staff. He was claiming much different numbers than expected for his mealtime doses.

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