A patient of mine who had diabetes and peripheral neuropathy came home from the hospital after a below-the-knee amputation of her right leg. She lived alone and was housebound. Having lost one leg, I knew she was at increased risk for losing her other leg. While in rehab, she had a professionally custom molded shoe made for her left foot which she started to wear.
Read More »Carbohydrate Loading: Effective If Done Right for Even a Day
By Sheri Colberg, PhD
What is a better topic to discuss after the gluttony most of us experience over the Thanksgiving and other fall/winter holidays than carbohydrate loading? (Actually, it probably should be excess calorie consumption in general, but you get the idea.) The following is excerpted from The Athlete’s Guide to Diabetes (2019) and gives you a better understanding of the topic from an exercise physiology (and diabetes) point of view.
Insulin Before Exercise May Be Needed to Lower Morning Highs
A man with type 1 diabetes started an exercise program to help him manage his early morning highs. He exercised every evening, at which time his glucose levels would drop during and after exercise. Thinking that exercise would lower his early morning highs, he did not take his insulin before exercise. He was surprised to see his glucose would go up after exercise rather than go down.
Read More »Improving Diabetes Outcomes: Collaborative Patient Care in a New Multispecialty MSO Model
by Guest Writer Richard Purcell
More than 100 million U.S. adults are now living with diabetes or prediabetes, according to the Centers for Disease Control and Prevention.1 This epidemic requires new healthcare models to deliver optimal, patient-focused, guideline-directed care to improve outcomes and reduce costs. The establishment of a new multispecialty Managed Services Organization (MSO) in Arizona spotlights the numerous benefits, to patients and providers alike, of providing end-to-end healthcare services and disease management solutions for complex diabetes.
Is It Sugar-Free or Isn’t It?
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.
Read More »Influenza Virus Causes Potential Hospitalizations in Patients with Type 2 Diabetes
Flu season is upon us; what does that mean for patients with type 2 diabetes?
Read More »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.
A Review of Insulin Errors
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.
Read More »First Major Breakthrough In 20 Years For The Treatment of Diabetic Kidney Disease and Heart Failure
FDA has approved a new treatment for diabetic kidney disease, which affects one in three patients with type 2 diabetes.
Read More »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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