FAQs Type 2 Diabetes Finale

Frequently Asked Questions About Type 2 Diabetes
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2
Frequently Asked
Questions About
Type 2 Diabetes
Written by Dr Sonia Copeland and Temi Mosaku
3
Contents
Disclaimer........................................................................................................................................ 2
Frequently Asked Questions About ................................................................................................ 3
Type 2 Diabetes............................................................................................................................... 3
General Questions .......................................................................................................................... 7
1. What exactly is diabetes?........................................................................................................ 7
2. No one else in my family has diabetes. Why did I get it? ....................................................... 7
3. Can I get diabetes from another person? ............................................................................... 7
4. What are the early symptoms? ............................................................................................... 7
5. What is the link between African American and Diabetes? ................................................... 8
6. How can I be tested for diabetes? .......................................................................................... 9
7. Is there a special diet for persons with diabetes? .................................................................. 9
8. Will I have to be on insulin? .................................................................................................... 9
9. My child has diabetes. Where can I get help? ........................................................................ 9
10. I have developed diabetes in pregnancy. Why is this happening? ..................................... 11
The Eyes ........................................................................................................................................ 13
1. A complication of diabetes is deterioration of the vision. How can I prevent this?............. 13
2. How often should I get my eyes checked?............................................................................ 13
3. Why is my vision blurry at times? ......................................................................................... 13
4. What is Diabetic Retinopathy? .............................................................................................. 13
Foot Care ....................................................................................................................................... 14
1. What should I avoid in caring for my feet? ........................................................................... 14
Who should I see to care for my feet? ...................................................................................... 14
Where can I find proper shoes and insoles? ............................................................................. 14
My feet are often cold. What does this mean? ........................................................................ 14
Why should I be very careful when cutting my toe nails? ........................................................ 14
Exercise ......................................................................................................................................... 15
1. Is it safe to exercise? ............................................................................................................. 15
4
2. Which sporting activities are recommended? ...................................................................... 15

3. Should I have a light meal before or after exercising? ......................................................... 15
4. Do I need to adjust my insulin after exercising? ................................................................... 15
Meditation and Diabetes .............................................................................................................. 16
1. Can Meditation Help Diabetes? ............................................................................................ 16
2. What about stress and diabetes? ......................................................................................... 16
Skin Care........................................................................................................................................ 17
1. I frequently get skin fungus. Why does this happen? ........................................................... 17
2. Why are diabetics more prone to infection? ........................................................................ 17
3. What can I do to relieve dry skin? ......................................................................................... 17
4. Is it advisable to soak my feet? ............................................................................................. 17
Which foods can help my skin? ................................................................................................. 18
Sexual & Reproductive Health ...................................................................................................... 19
1. Will I get impotence? Can this be prevented? ...................................................................... 19
2. Is there treatment for impotence? ....................................................................................... 20
3. I am diabetic and pregnant, what should I do? .................................................................... 20
Essential tips to consider:.......................................................................................................... 21
Diet And Nutrition ......................................................................................................................... 22
1. What are the key diet and nutrition messages for diabetics? .............................................. 22
2. Will I have to give up my favorite foods?.............................................................................. 22
3. How often should I eat? ........................................................................................................ 22
4. Is there a favorite breakfast for a diabetic? .......................................................................... 22
5. Which milk is better? ............................................................................................................ 22
Why is fiber good for the diabetic?........................................................................................... 23
Natural Remedies.......................................................................................................................... 24
1. Are there natural remedies? ................................................................................................. 24
2. Are there natural sugar substitutes? .................................................................................... 24
Herbs and Supplements ................................................................................................................ 25
1. Which herbs have been shown to help with blood sugar control? ...................................... 25
2. How helpful are sugar free foods and drink?........................................................................ 25
3. Are herbs safe? ...................................................................................................................... 25
5
4. Can I just buy supplements? ................................................................................................. 26

Complications Of Diabetes............................................................................................................ 27
1. I have heard there are serious complications if the blood sugar level is not controlled. What
are the complications? .............................................................................................................. 27
Why do some diabetics lose limbs? .......................................................................................... 27
Self-Management Of Diabetes ..................................................................................................... 29
1. There is a lot of emphasis on self-management. What is this? ............................................ 29
Treatment ..................................................................................................................................... 30
Can diet alone treat diabetes? .................................................................................................. 30
What is the treatment for type 2 diabetes? ............................................................................. 30
Are other medications needed?................................................................................................ 30
Why is it so important for me to control my weight?............................................................... 30
Quality Of Life ............................................................................................................................... 32
1. Can I live a normal life with diabetes? .................................................................................. 32
2. I am a diabetic with sweet tooth, what can I do about my indulgences? ............................ 32
3. Is It Safe To Consume Alcohol if I Have Diabetes? ................................................................ 33
4. Is it wise to consume alcohol if you have diabetes? No. Is it safe? No................................. 33
5. Is it okay to have a glass or two of wine? ............................................................................. 34
6. What is the effect of smoking in Diabetes? .......................................................................... 34
7. Is there a guide for eating out? ............................................................................................. 35
8. How often do I need to see the doctor? ............................................................................... 36
9. What are the most important Lifestyle choices for diabetics? ............................................. 36
10. What is Metabolic X syndrome? ......................................................................................... 37
11. What are the characteristics of this syndrome? ................................................................. 38
12. What are the risks associated with this syndrome? ........................................................... 38
13. What is the basic difference between type-1 and type-2 diabetes? .................................. 38
14. Can we use all the drugs used for type-2 diabetic patients in type-1 diabetes? Explain your
answer. ...................................................................................................................................... 38
15. Can we use the drug of choice for type-1 diabetes in type-2 diabetes? ............................ 39
Explain your answer. ................................................................................................................. 39
6
General Questions
1. What exactly is diabetes?
Diabetes also called diabetes mellitus is a metabolic disorder which results in an
individual having high blood sugar levels over a period of time.
2. No one else in my family has diabetes. Why did I get it?

Risk factors for diabetes include a family history of diabetes but there are
others:
Overweight and obesity

Poor diet with excessive intake of carbohydrates
Smoking
Abuse of alcohol
Sedentary lifestyle
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in Type 2 Diabetes
3. Can I get diabetes from another person?

Diabetes cannot be transmitted from one person to the next as it is not a
communicable (infectious) disease.
4. What are the early symptoms?

These are the Early Signs of Diabetes
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Thirst which is not quenched easily even after drinking fluids.

Frequent urination.
Dehydration
Weight loss. The weight loss can be a dramatic occurrence.
Tiredness even after resting/sleeping.
Nausea and vomiting are fairly serious symptoms.
Itchy skin with or without fungal Infections.
Bladder and genital infections.
Poor healing wounds.
Blurred vision
5. What is the link between African American and Diabetes?

According to the National Diabetes Education Program, there is a current epidemic
of diabetes among African Americans. African Americans are one of the largest
groups in the population in the United States that are contracting Type II diabetes.
In addition, diabetes is also one of the leading causes of death and disability among
African Americans in the United States. No one is quite sure why African Americans
are more likely to get Type II diabetes than any other ethnic group. One thing is
certain, however.
Poor African Americans are more likely to die from complications of the disease
than those in other ethnic groups. This is most likely due to poor health care in
certain communities, limited access to drugs that can potentially save their lives
and less education.
Affluent African Americans have the same chance as other ethnic groups of dying
from complications of the disease.
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Many people who live in poor communities, in addition to receiving substandard

medical care, little education about disease and limited access to lifesaving drugs,
also are inundated with fast food restaurants that seem to target certain ethnic
groups.
Fast foods are usually very high in carbohydrates, fats and offer very little in the
way of nutrition. They are inexpensive, however, and many people with little
money find this to be the only way they can feed their family on a limited budget.
6. How can I be tested for diabetes?

Blood tests for fasting and 2 hours after eating blood sugars tests. Another blood
test used for monitoring the control of diabetes over weeks and months is called
the Glycosylated hemoglobin test.
7. Is there a special diet for persons with diabetes?

The diet is individualized by the dietitian based on an individuals age, routine
physical activity and food preferences.
8. Will I have to be on insulin?

This is a decision that the doctor will make. What will be taken into consideration
are the patients age and existence of diabetic complications. Diabetic children
are given insulin therapy to reduce medical complications in adulthood.
9. My child has diabetes. Where can I get help?

Support for diabetic kids and their caregivers can be accessed at the clinic, from
the school nurse and social worker as well as the American Diabetes Association
to name a few.
9
Diabetes in children is also known as juvenile diabetes, but more commonly known
as type 1 diabetes. It is the most common form of diabetes in children with ninety
to ninety-five percent of carriers being under 16.
Juvenile diabetes is caused by the inability of the pancreas to produce insulin. It is

an autoimmune disease, which means the bodys own defense system attacks the
body's tissues or organs.
In the last 30 years the number of juvenile diabetes had increased three times over
and in Europe and the US we are now seeing type 2 diabetes in children for the first
time.
Obesity easily explains type 2, but not why there is such a rise in type 1 diabetes in
children. It is believed that a mixture of genetics and environmental factors are
what triggers juvenile diabetes. But the majority of children don't have a family
history of diabetes.
The symptoms for juvenile diabetes are the same as in adults. Thirst, weight loss,
fatigue, frequent urination is typical, but diabetes in children can also increase
stomach pains, headaches and behavior problems.
Doctors should consider the possibility of diabetes in children who have

unexplained stomach pains for a few weeks, along with the typical symptoms.
in Type 2 Diabetes
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10. I have developed diabetes in pregnancy. Why is this

happening?
Some individual are pre-diabetic and conditions which put added demand on the
pancreas and or the immune system could trigger diabetic symptoms. Pregnancy
is one such condition.
When a woman develops insulin resistant during pregnancy it is referred to as

gestational diabetes. The disease acts in the same manner as when a person who
is not pregnant has diabetes. In most cases, after the baby is born the diabetes
goes away and a woman's blood glucose control and insulin production return to
normal.
The placenta that provides nourishment and keeps the baby alive as it grows inside
the uterus also releases a hormone that effectively blocks or inhabits a woman's
insulin production from the pancreas. It can also affect the way a woman's body
uses the insulin that is produced. When there is too much sugar (glucose) in a
woman's system that is not being converted to energy it produces high blood sugar.
This condition is known as hyperglycemia.
Every woman is routinely screened for gestational diabetes at her monthly doctor's
exam during pregnancy. The urine sample that the woman provides is checked for
glucose (among other things). If there is glucose in the urine it is a red flag to the
doctor to have the woman screened for gestational diabetes. The doctor will then
send the patient to a medical lab for blood work and if the results come back
positive a referral will be given to an endocrinologist (a doctor specializing in the
treatment of diabetics). A treatment and management plan will be put into action
for the women to follow for the remainder of the pregnancy.
11. Why is my blood sugar low in the morning?

This can be caused by a number of different factors, from exercising too close to
bedtime to drinking alcohol in the evening. If untreated, low overnight blood sugar
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levels can lead to headaches and loss of sleep and in extreme cases, seizures or
death.
You can prevent low blood sugar while asleep by following these simple tips
Check your blood sugar before bed.
Know the signs of low overnight blood sugar.
Avoid excessive exercise late at night.
Dont skip dinner.
Limit alcohol at night.
It is important to have a snack at bedtime to prevent hypoglycemia (low blood

sugar) episodes. If low blood sugar at night is a common problem for you, talk to
your doctor about changing your diabetes treatment plan to better control your
nighttime glucose levels.
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The Eyes
1. A complication of diabetes is deterioration of the vision.
How can I prevent this?
Well controlled blood sugar levels are important in preventing complications
related to diabetes including poor vision and blindness.
2. How often should I get my eyes checked?

A detailed eye exam must be done at least annually (once for the year).
3. Why is my vision blurry at times?

This could be an early sign of diabetes or poorly controlled diabetes.
4. What is Diabetic Retinopathy?

It is the damage done to the retina (back of the eyes) as a result of poorly
controlled blood sugar levels.
13
Foot Care
1. What should I avoid in caring for my feet?
Tight or poor fitting shoes.
High heels
Ingrown nails
Injury to toe nails
Dry or cracked skin
Who should I see to care for my feet?

A foot care specialist (podiatrist/chiropodist) is trained to take care of a range of
skin, nails and bony problems.
Where can I find proper shoes and insoles?

The podiatrist (chiropodist) will be able to recommend where to take your specific
measurements to for custom made shoes and insoles.
My feet are often cold. What does this mean?

This could be an early sign of poor blood circulation in the lower limbs.
Why should I be very careful when cutting my toe nails?

Over time a diabetic could have a loss of sensation in the feet including the toes.
A nip while cutting the nails could go unnoticed and lead to serious infection.
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Exercise
1. Is it safe to exercise?
Adequate exercise is a part of the treatment regime for diabetics. One should
however avoid extreme contact sporting activities which carry a high risk for
injuries.
2. Which sporting activities are recommended?

All exercises are encouraged including jogging, walking, tennis, dancing, aerobics,
swimming, yoga. It is important to wear well-fitted foot wear and exercise gear.
3. Should I have a light meal before or after exercising?

It is important to be guided by the diet given by the doctor or nutritionist. An
energy bar or glucose drink should always be on hand.
4. Do I need to adjust my insulin after exercising?

This should not be done without the advice of the doctor or nurse who would be
guided by the record of blood sugar tests for the day.
15
Meditation and Diabetes

1. Can Meditation Help Diabetes?
The body is intricately connected with the brain so that, through practices like
transcendental meditation, the brain can influence the way the body responds to
sugar.
The term holistic medicine refers to treating the person as a whole instead of simply
focusing on a disease they may have or its symptoms, as is typical in western
medicine.
You go to the doctor and he or she prescribes some medication or possibly surgery,
but a holistic practitioner will investigate all angles of your life to determine which
areas need improvement in order to bring you to a state of total wellness and not
just as it pertains to your current condition. Holistic medicine offers alternative
therapies, like meditation to address the many issues that can contribute to and
help manage type 2 diabetes.
2. What about stress and diabetes?

When were under stress, we also tend to eat more at night. Insulin resistance
tends to be worse at night around 3 oclock in the morning. The blood sugar levels
spike and are less affected by the medications taken for diabetes.
This means that controlling stress and anxiety is particularly important in the
management of diabetes. Meditation can help keep us stress-free and can control
the diabetes at the same time. Meditation creates a steady state in the body so
that our hormones and metabolism are better controlled and we feel better, too.
16
Skin Care
1. I frequently get skin fungus. Why does this happen?
Poorly controlled blood sugar levels can promotes the growth of skin fungus and
bacteria.
2. Why are diabetics more prone to infection?

Diabetics live in a high sugar environment much of the time unless they are in
excellent diabetic control. This environment impairs the immune function by
damaging the ability of the neutrophils to act against infection, by damaging the
effects of antioxidants on the body and by damaging the humoral immunity, which
involves the antibody system.
Check your skin daily for injury, treat and keep dry any cuts, irritation and scrapes
immediately.
3. What can I do to relieve dry skin?

It is important to drink at least 6-8 glasses of water to keep the body well hydrated.
The skin (especially the feet) should also be kept moisturized.
4. Is it advisable to soak my feet?

No, its not. Fungi thrive in a damp environment. The chance of infection is
increased between the toes and nails due to dampness. Be sure to dry your feet
properly whenever they come in contact with water. Do not moisturize between
the toes. The daily use of pumice stone is advised.
Make a point to do regular checkups with a podiatrist.
17
Which foods can help my skin?

Foods like avocado, walnuts, salmon and oils like flaxseed and soy bean help in
maintaining the suppleness of the skin. The presence of omega 3 fatty acids in them
is a contributory factor in keeping the skin moisturized.
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Sexual & Reproductive

Health
1. Will I get impotence? Can this be prevented?
There are all-round benefits to health when the blood sugar level is well-controlled.
This is the key to preventing impotence.
Sexual challenges in diabetes affect both men and women but in different ways.
Because your body responds to sexual stimuli through your nerves and high blood
glucose levels affect your nervous system, it is understandable that even sexual
response is affected by this potentially life threatening condition.
In men, diabetes and sexual problems often focus on erectile dysfunction. It is

estimated by the American Diabetes Institute that as many as 85 percent of men
with diabetes experience erectile dysfunction.
Retrograde ejaculation is a more potentially dangerous situation that can happen

to men with diabetes. In this condition, the semen can go into the bladder instead
of being dispelled out of the penis during ejaculation. A man who is experiencing
this side effect of diabetes should seek consultation with a urologist who can help
with medication or surgery to correct the problem.
Women with Diabetes can also be affected. The damage to the nerve cells within
the vagina by high levels of blood glucose can lead to dryness which inevitably
resulting in intercourse being very painful.
Many women also report that the nerve damage caused by the hyperglycemia also
causes them to lose interest in sex and have no sensations in their genital area.
Needless to say, the lack of sexual desire can cause psychological problems for both
men and women and may lead to marital difficulties as well.
19
There are varieties of treatment for those experiencing diabetes and sexual
problems.
One way to prevent such problems from occurring is to maintain your blood glucose
levels by eating a healthy diet, exercising and taking your prescribed medication or
insulin.
Monitor your blood sugars as instructed by your physician. If you experience any
side effects related to your condition, discuss them with your physician. By keeping
informed of the disease and the side effects as well as complications, you can
empower yourself in managing your illness and lead a happier as well as longer life.
2. Is there treatment for impotence?

There are new and improved treatments for impotence. Speak to your doctor to
discuss the possible choices best for you.
3. I am diabetic and pregnant, what should I do?

Your doctor will need to see you regularly to ensure your blood sugar is well-
controlled, and also to monitor the growth and size of your unborn baby.
It can be said that among the three types of diabetes, "gestational diabetes" is the
easiest to deal with because it usually ends once the woman gives birth. However,
this is not always the case because there are also those that continue to suffer from
the disease that can lead to type 2 diabetes" if not monitored and given proper
medical attention immediately.
To know if the woman's body is ready for pregnancy despite diabetes, she should
undergo a thorough physical examination administered by a licensed physician.
20
This is very important because the physician can tell if the body is ready for the
demands of pregnancy and labor and the possible complications that might occur
along the way.
Essential tips to consider:

With proper daily management, many women were able to have successful
deliveries. The following are just some of the things that helped them along the
way:
Frequent self-monitoring of blood glucose (SMBG);
Administering insulin injections and identifying how to adjust the doses

depending on results of their SMBG;
Controlling and treatment of hypoglycemia;
Maintaining an appropriate level of regular exercise or physical activities;

and an
Appropriate meal plan specially designed for women who have diabetes.
21
Diet and Nutrition

1. What are the key diet and nutrition messages for diabetics?
It is important to have foods from the various food groups
Portion control helps to manage the caloric intake
Low glycemic foods are essential for blood glucose control
Increase fruits, vegetables and fiber for better blood glucose control
2. Will I have to give up my favorite foods?

No, the dietitian will help you with meal planning and portion control.
3. How often should I eat?

It is recommended to eat three meals a day and have three snacks in between
meals a(midmorning, mid-afternoon and at bedtime).
4. Is there a favorite breakfast for a diabetic?

A typical breakfast is a cup of cereal with low fat milk, a small fruit, a hot or cold
beverage.
5. Which milk is better?

1-2% low fat milk.
22
Why is fiber good for the diabetic?

Fiber is found in fruits and legumes. Fiber helps to keep you full longer, and helps
to regulate the blood sugar level. Fiber helps with regular bowel action.
The role of fiber in healthy diets is very important it aids in digestion and keep
your colon and other organs healthy and functioning properly. It is also a wonder
element that should be a large part of any diabetic's diet. You will reap many benefits
from including fiber in your diet. If you are pre-diabetic it can assist in delaying the
diagnosis of diabetes or if you are already diabetic it can help keep your blood
glucose under control.
Fiber will keep you feeling fuller longer it slows the conversion of carbohydrates
in your body which in turn can keep your blood sugars stable. The type of fiber
diabetics need to eat to gain these benefits is soluble fiber (dissolves in water). Some
good sources of soluble fiber include:
* Choosing whole grain or whole wheat products instead of white (flour, breads and
cereals) * Eating fresh fruit and vegetables instead of processed or drinking them in
liquid form * Beans, use dried beans in your favorite recipes like chili for a
wholesome, high- fiber meal
To ensure that you are getting the most benefit from eating increased amount of
fiber, make sure that you are drinking at least eight glasses of water a day.
Remember, this fiber dissolves in water and you need to stay hydrated for it to work
properly.
23
Natural Remedies
1. Are there natural remedies?
It is not advisable for any diabetic to abandon the prescribed treatment given by a
doctor. Any adjunct treatment should be discussed with the doctor to avoid the risk
of the blood sugar falling dangerously low. The doctor who is an expert in
integrative medicine can advise on the safe use of:
1. Homeopathy preparations
2. Ayuvedic treatments
3. Chinese medicine
4. Herbal medicine
2. Are there natural sugar substitutes?

There are very good plant-based sugar substitutes such as stevia available in
pharmacies. The four different kinds of artificial sweeteners are: saccharin,
aspartame, sucralose, acesulfame potassium.
Each of these types can be found under various product names and brands. Not all
are made the same way and they have different uses. Some you can buy in liquid
or powdered form for baking needs and others like aspartame is only found in foods
that you purchase pre-made.
The use of these artificial sweeteners will not raise blood sugar and are safe for a
diabetic to use. Care, and particular attention is still needed because the food
items you put sugar in or on most likely have an effect on your blood sugar.
Aspartame has been linked in some medical studies with Alzheimer's disease.
Speak to your doctor about the benefits and risks of using any of the artificial
sweeteners if you have any concerns about the potential health risks.
24
Herbs and Supplements

1. Which herbs have been shown to help with blood sugar
control?
Bitter melon
Cinnamon
Gingko, ginseng
Aloe vera
Fenugreek
Ginger
Milk thistle
2. How helpful are sugar free foods and drink?

It is important to read food labels as some sugar free foods could have high fat or
carbs.
3. Are herbs safe?

Not all herbs are safe. Seek advice from a doctor, medical herbalist or CAM
practitioner.
25
4. Can I just buy supplements?

The pharmacist can help you to select the supplement which is appropriate for
you. Always tell your doctor what other non- prescription drugs/supplement you
are taking.
26
Complications of Diabetes
1. I have heard there are serious complications if the blood
sugar level is not controlled. What are the complications?
Poorly controlled diabetes can, over a period of time cause damage to blood vessels
and tissues. This can affect major target organs including:
Kidneys failure
Heart failure
Poor circulation in the lower limbs
Poor vision
Diabetic Neuropathic Pain
Why do some diabetics lose limbs?

Digits (toes, fingers) or limbs are amputated (removed surgically) as a life-saving
measure when there is a serious infection which poisons the digits or limbs.
27
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28
Self-Management of
Diabetes
1. There is a lot of emphasis on self-management. What is
this?
Self-management by diabetic older children and adults empower individuals to do
the blood glucose testing daily and in some instances several times a day. It is
important for the diabetic and the care-giver to be vigilant with the tell-tale signs
when the diabetes is out of control: frequency of urination, weight loss, nausea,
vomiting, skin Infections, slow healing wounds, drowsiness or fatigue.
29
Treatment
Can diet alone treat diabetes?
A few diabetics can be controlled with a carefully planned diet, weight
management and other life-style practices.
What is the treatment for type 2 diabetes?

Oral medication or a combination of both oral medication and insulin is prescribed
for Type 2 Diabetes.
Are other medications needed?

For the patient who has circulatory issues or high cholesterol it is very helpful to
have other medical conditions treated.
Why is it so important for me to control my weight?

Weight management (diet and exercise) must be a part of the treatment for obese
diabetics. Being overweight impedes proper blood sugar levels as it contributes to
insulin resistance.
One of the only risk factors that you have control over is your weight. If you are
obese, the single best thing you can do for your health and the prevention of
diabetes is to lose weight. Even in small increments, when you shed pounds you
are increasing your health benefits.
There are new studies now showing that there is a genetic factor or mutation for
people who are obese and have diabetes. This genetic malfunction affects how
30
the bodies use energy and insulin two key elements in the functioning of your
body and the cause of diabetes and obesity.
The studies also state that this is not a cause and effect case. If you carry this
defective gene you are not guaranteed to be obese or have diabetes. But the link
is there, and it can be prevented. You may have to work harder at it than others to
maintain a healthy body weight and put off diabetes, but it can be done. Discuss
with your doctor options and ways to prevent or put-off the onset of diabetes.
The sad fact is that children in their preschool years are being diagnosed with
obesity and type 2 diabetes due to genetics.
Parents can help reduce or prevent these things from happening by being
proactive and giving their children healthy lifestyle choices. Remember, children
learn by examples of what they see.
31
Quality of Life
1. Can I live a normal life with diabetes?
With improvement in drug therapy and better dietary guideline, diabetics can enjoy
optimal wellness.
2. I am a diabetic with sweet tooth, what can I do about my

indulgences?
There are ways that you can satisfy your sweet tooth and stick to your diabetic diet.
There are many sugar substitutes and artificial sweeteners that are available to
purchase on their own or in sweets such as chocolate and hard candies.
Another way to add sweets into your diet is to substitute them for other
carbohydrates in a meal. If you were planning on having a tuna salad sandwich for
lunch you can try eating it without the bread, and save the carbohydrates on a
cookie (depending on size and serving information). This can be done with
variation but should be done in moderation.
Be sure to speak with your dietician too. A dietician is full of ideas and suggestion
on ways to improving diabetic diet. He or she may have suggestions on snacks or
meals that you would not have considered sweet but can certainly satisfy your
sweet tooth. Such is eating a banana to satisfy a chocolate craving.
As time goes on you will begin to appreciate the natural sweet things in life too
such as a juicy apple or a fresh orange.
32
3. Is It Safe To Consume Alcohol if I Have Diabetes?

Most people who ask this question already know the answer. Yet, they are looking
for a reason to convince themselves that alcohol is not too bad if its consumed
occasionally. One glass of wine cant hurt, right?
Alcohol may raise you triglyceride levels. Thats not good. It can cause food craving
and its usually for unhealthy food that is often oily, fatty and rich in carbohydrates.
The carbs and oily food will cause a spike in your blood sugar. It can also raise your
heart rate, slur your speech and increase your blood pressure. Many diabetes
patients have reported feeling hot flushes and nausea too.
Alcohols such as beer and sweet wine also contain carbohydrates which will cause
a spike in your blood sugar.
In worst case scenarios, alcohol may interfere with your diabetes medication and
insulin injections. Its really difficult to predict how your body will react to alcohol.
Some effects may be mild in the short term. However, you will not know the long
term effects.
4. Is it wise to consume alcohol if you have diabetes? No. Is it

safe? No.
But, ultimately the choice is yours. It may seem like a huge sacrifice to cut out
alcohol completely. You may even know people who have diabetes and still drink
alcohol yet, theyre just fine.
This may be true but it is better to err on the side of caution. Maybe an occasional
glass of alcohol is ok but drinking often like youre aspiring to be a sommelier is not.
A few tips if you insist on drinking alcohol.
Drink slowly. Do not gulp your drinks fast and ask for refills quickly.
If youre a male adult, do not exceed 2 glasses. If youre female, do not
exceed 1 glass.
33
Try not to use mixers that are sweet. Avoid the sweet sodas or energy drinks
that are so often used to make cocktails.
Never drink alcohol on an empty stomach and have some form of
identification on you that states you have diabetes.
Do not drink more than once a week
Moderation is the key. Consuming alcohol is not safe for people with diabetes.
However, if you wish to have a glass or two, do try and be safe and have someone
with you. Dont drink alone at home. Always exercise good sense and caution.
5. Is it okay to have a glass or two of wine?

A glass of red wine with the evening meal but portion control must be practiced.
6. What is the effect of smoking in Diabetes?

Smoking on its own is associated with many different diseases and can be a risk
factor for multiple types of cancer. But in a person with diabetes or a pre-diabetic
there are specific risks that arise. There are some differences between type 1 and
type 2 diabetes and smoking hazards.
Smoking can exacerbate the complications associated with poorly controlled

diabetes. An increased risk of heart disease and cardiovascular problems is found
in diabetic smokers. In type 1 diabetic smokers the risk for kidney disease or kidney
failure is increased.
In pre-diabetics or people who may be at higher risk to develop type 2 diabetes

smoking is a contributing factor to a diagnosis. Smoking increases the likelihood
that their body will develop an insulin resistance and need insulin injections or
medication in the future.
34
If you are having trouble quitting on your own or want more information on the
benefits of stopping, make an appointment with your doctor. There are many
smoking cessation aids that are available as well as support you can utilize to help
you in the process. There are nicotine patches and gum, or you can try medication
or hypnosis.
I personally have also heard a LOT of testimonies of smokers who have been
weaned completely off by simply confessing (whilst still smoking) they are the
Righteousness of GOD in Christ and believing they are already healed by HIS
GRACE. Ill say that is a whole lot cheaper and more permanent, wont you?
7. Is there a guide for eating out?

Many popular fast food chains now give the caloric value of food items and also
offer healthier options. For a La Carte dining, request lean meat
Festive period can be a stressful time for a diabetic. The key is to be proactive. The
hardest part about preparing for a special occasion is if you do not know what is
going to be served. If this is the case, a quick call to your host or hostess can be
made.
Most people will not mind you asking especially if you have dietary needs that need
to be taken into consideration. Once you do know what is being served, plan your
meals for that day accordingly. You may want to have fewer carbohydrates with
your breakfast and snack to make up for the extra ones you will have at a birthday
party where pizza is being served.
Better still, you can take your own dishes and share it.
35
8. How often do I need to see the doctor?

Self-management allows the diabetic to have more control over his blood sugar
levels. It is very useful to learn how to test the blood sugar using a home kit
glucometer. Your doctor should discuss your scheduled routine checkups. If ever
you are in doubt or feel any different, never hesitate to give your doctor a call or
talk to your pharmacist,
9. What are the most important Lifestyle choices for

diabetics?
Some things you should know about the lifestyle choices that are critical to manage
type 2 diabetes
Take a hard look at your weight.
Not everyone with diabetes is overweight but many of them are, especially those
with type 2 diabetes. This means seeing a nutritionist or a doctor and determining
the appropriate weight for you and setting that as your goal.
See a nutritionist.
This can become something you do regularly or just in the beginning of your
diagnosis. You can get some great written materials and can take notes on how to
begin implementing appropriate changes in your lifestyle.
Begin to eat foods with a low glycemic index.
The glycemic index is a measure of how fast a type of food raises blood sugar. Some
foods have a lot of sucrose or plain sugar in them and raise the blood sugar very
fast. This causes a great spike in the blood sugar and is not healthy for diabetics
especially.
36
Keep track of what you eat.
This helps you know if your efforts at the end of the day have been successful. Look
at the number of calories you took in and pay attention to the number of fat grams
you eat as well as the fiber in the food you are consuming. Fiber is good for a
diabetic diet because it diminishes the rush of glucose into your bloodstream when
you eat your meals.
Be prepared to inspect your feet every night before you go to bed.
Diabetics, like anyone, can be cut on something, step on a sharp object or have a
part of their foot rub abnormally on a part of the shoe. In diabetics, these things
dont heal fast enough and infections can easily happen. Keep your feet clean and
dry and make sure any open areas are checked every night to make sure they are
healing properly.
Exercise.
As a diabetic, you should consider exercise to be a big part of your life. Exercise not
only keeps your weight down, it burns sugars and keeps your heart healthy.
Diabetics are at a greater risk of developing heart disease and exercise can
ameliorate some of this risk.
10. What is Metabolic X syndrome?

Metabolic X syndrome is a pro-inflammatory and pro-thrombotic state of the body
resulting from various metabolic abnormalities.
37
11. What are the characteristics of this syndrome?

Low HDL, high triglycerides, raised blood sugar levels and insulin resistance,
hypertension, central obesity, high uric acid etc.
12. What are the risks associated with this syndrome?

Type 2 diabetes and cardiovascular diseases.
13. What is the basic difference between type-1 and type-2

diabetes?
The basic difference between type-1 and type-2 diabetes is the insulin resistance
which is present in type-2 diabetes and absent in type-1 diabetes. Type-1 diabetes
is caused by absence of insulin in our body and not by insulin resistance.
14. Can we use all the drugs used for type-2 diabetic patients
in type-1 diabetes? Explain your answer.
No, we cant use all the drugs used in type-2 diabetes for type-1 diabetes except
for insulin which is used in both. Oral hypoglycemic and euglycemic drugs used in
type-2 diabetes have no role in type-1 disease. This is because pancreatic beta cells
dont produce insulin in type-1 disease and there is no insulin resistance. Insulin is
the only drug we can use in type-1 disease.
38
15. Can we use the drug of choice for type-1 diabetes in type-
2 diabetes?
Explain your answer.

Yes, the drug of choice for type-1 disease is the insulin. Insulin is also used in type-
2 disease in later stages when pancreas cant produce enough insulin to overcome
insulin resistance. Insulin is added when oral drugs are found insufficient for
adequate control of blood sugar level.
Written by Dr. Sonia Copeland, a practicing family doctor and Jubileez,

a practicing pharmacist
Compilation by Dr. Sonia Copeland and Jubileez
in Type 2 Diabetes
39

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Frequently Asked Questions About Type 2 Diabetes

Any perceived slight of specific people or organizations, and any resemblance to

2. Which sporting activities are recommended? ...................................................................... 15

4. Can I just buy supplements? ................................................................................................. 26

2. No one else in my family has diabetes. Why did I get it?

Overweight and obesity

3. Can I get diabetes from another person?

4. What are the early symptoms?

Thirst which is not quenched easily even after drinking fluids.

5. What is the link between African American and Diabetes?

Many people who live in poor communities, in addition to receiving substandard

6. How can I be tested for diabetes?

7. Is there a special diet for persons with diabetes?

8. Will I have to be on insulin?

9. My child has diabetes. Where can I get help?

Juvenile diabetes is caused by the inability of the pancreas to produce insulin. It is

Doctors should consider the possibility of diabetes in children who have

10. I have developed diabetes in pregnancy. Why is this

When a woman develops insulin resistant during pregnancy it is referred to as

11. Why is my blood sugar low in the morning?

Check your blood sugar before bed.

Know the signs of low overnight blood sugar.

Avoid excessive exercise late at night.

Dont skip dinner.

Limit alcohol at night.

It is important to have a snack at bedtime to prevent hypoglycemia (low blood

2. How often should I get my eyes checked?

3. Why is my vision blurry at times?

4. What is Diabetic Retinopathy?

Who should I see to care for my feet?

Where can I find proper shoes and insoles?

My feet are often cold. What does this mean?

Why should I be very careful when cutting my toe nails?

2. Which sporting activities are recommended?

3. Should I have a light meal before or after exercising?

4. Do I need to adjust my insulin after exercising?

Meditation and Diabetes

2. What about stress and diabetes?

2. Why are diabetics more prone to infection?

3. What can I do to relieve dry skin?

4. Is it advisable to soak my feet?

Make a point to do regular checkups with a podiatrist.

Which foods can help my skin?

Sexual & Reproductive

In men, diabetes and sexual problems often focus on erectile dysfunction. It is

Retrograde ejaculation is a more potentially dangerous situation that can happen

2. Is there treatment for impotence?

3. I am diabetic and pregnant, what should I do?

Essential tips to consider:

Frequent self-monitoring of blood glucose (SMBG);

Administering insulin injections and identifying how to adjust the doses

Controlling and treatment of hypoglycemia;

Maintaining an appropriate level of regular exercise or physical activities;

Diet and Nutrition

2. Will I have to give up my favorite foods?

3. How often should I eat?

4. Is there a favorite breakfast for a diabetic?

5. Which milk is better?

Why is fiber good for the diabetic?

2. Are there natural sugar substitutes?

Herbs and Supplements

2. How helpful are sugar free foods and drink?

3. Are herbs safe?

4. Can I just buy supplements?