Diabetes Education

The path toward a deeper understanding of diabetes begins here. Southside Diabetes recognizes that the more knowledge you have, the more successful we will be at managing your diabetes. Our contemporary approach to management includes education and awareness.

Dana Stallings

Frequently Asked Questions

How is diabetes diagnosed?
This can happen a few different ways: (1) an A1c level 6.5% or higher, (2) two fasting (nothing to eat or drink) blood glucose readings above 126 mg/dL, or (3) a random blood glucose level over 200 mg/dL. Additional testing will occur if you are pregnant (gestational diabetes) or have certain medical conditions that increase your risk for diabetes.
What are the signs and symptoms of diabetes?
The most common symptoms are excessive thirst, excessive hunger, and excessive urination. No matter how much you drink, you cannot quench your thirst. You are constantly eating, yet losing weight. You have to keep running to the bathroom, and sometimes can’t hold your water (urine), despite not drinking many liquids. You may also feel very tired. If any or all of these symptoms apply to you, talk to your primary care provider about testing for diabetes.
What is hemoglobin A1c (HgA1c)?

A1c is a 90 day average of your glucose levels. Most diabetics should have an A1c between 6-7%, although this varies for each person. A1c does not tell us specifics about your glucose control, such as when your levels are high or low. This is why we ask you to bring your blood sugar meter or logs to each visit. This is also why continuous glucose monitor (CGM) or sensor data is valuable, so we can identify glucose patterns that may result in changes to your treatment plan. Reference the following chart to see how your A1c aligns with your average glucose level.

Hemoglobin A1C Conversion Chart

A1C Average BG
6.0% 126
6.5% 140
7.0% 154
7.5% 169
8.0% 183
8.5% 197
9.0% 212
9.5% 226
10.0% 240
10.5% 255
11.0% 269
11.5% 283
12.0% 298

 

What are my blood glucose and A1c targets?
Your targets are individualized; goals are not “one size fits all”. Most people should have a fasting (nothing to eat or drink) blood glucose level between 80-130 mg/dL. If you have eaten in the last 2 hours, your blood glucose level should be less than 180 mg/dL. Most people should have an A1c level between 6.0-7.0%. Talk to the nurse practitioner about what your specific blood glucose and A1c goals should be.
What is hypoglycemia?
Hypoglycemia is low blood sugar. This is usually a blood glucose level less than 70 mg/dL, although this will be different for each person. Most people feel shaky, sweaty, and have vision changes when their blood sugar levels are low. These symptoms will vary for each person and can also mimic high blood sugar (hyperglycemia), so you should always verify your blood sugar level with your meter or sensor.
What is hyperglycemia?
Hyperglycemia is high blood sugar. This is usually a blood glucose level greater than 240 mg/dL, although this will be different for each person. Most people experience vision changes or get a headache when their blood sugar levels are high. These symptoms will vary for each person and can also mimic low blood sugar (hypoglycemia), so you should always verify your blood sugar level with your meter or sensor.
What causes high blood glucose?

This can be related to any number of things. As a type 1 diabetic, high blood sugar can be caused by diet or a lack of exogenous (or external) insulin. As a type 2 diabetic, it can be diet or lack of insulin like a type 1, but also because of insulin resistance. Other things like steroids, infection, or stress can cause high blood sugars. It’s important to call your healthcare provider to discuss high blood sugars so we can best diagnose and treat the issue.

What is the difference between T1 and T2 diabetes?

Type 1 diabetes is an autoimmune condition you’re born with. However, you can be diagnosed with type 1 diabetes at any stage in life. Blood tests ordered by the nurse practitioner will confirm this. Type 2 diabetes can be diagnosed in children, teens, or adults. The causes of Type 2 diabetes are a combination of environmental and genetic factors. Some things you can’t outgrow, such as gender, age, and ethnicity (genetics). Environmental factors include diet, weight, and exercise. Talk to your nurse practitioner to see how best our team can support you.

Will I need medication or insulin to control my diabetes?
For some, lifestyle changes (diet, exercise, weight management) are enough to control their blood sugar. For others, oral or injectable medications are needed to achieve blood glucose or A1c targets. People with type 1 diabetes require insulin because their pancreas is no longer making enough insulin to manage their blood glucose levels. This may also be true for people with type 2 diabetes. Diabetes is a progressive disease: the longer you have diabetes, the less insulin your body will make on its own. You can slow the progression of diabetes by keeping your blood sugar and A1c levels in range, as well as maintaining a healthy lifestyle. If you have type 2 diabetes, oral medications may help to manage your blood glucose and A1c levels, as well as slow the progression of your diabetes.
Why are there different kinds of insulin?

There are four types of insulin: long-acting, intermediate-acting, short-acting, and rapid-acting. Each type of insulin works differently than another. It is not uncommon to pair two different kinds of insulin together to manage your diabetes. See below for a description of each insulin.

Type of Insulin Description Medications
Long-acting

Taken once daily (sometimes two)

Peaks (or max effect) 4-6 hours after injection

Lasts 24-32 hours

Levemir®, Lantus®, Basaglar®, Semglee®, Tresiba®, Toujeo®
Intermediate-acting

Usually taken twice daily

Peaks 2-3 hours after injection

Lasts 8-12 hours

Novolin® NPH, Humulin® NPH
Short-acting

Taken before meals and as needed for high glucose

Peaks 2-3 hours after injection

Lasts 4-5 hours

Humulin® Regular, Novolin® Regular, Humulin® Regular U-500
Rapid-acting

Taken before meals and as needed for high glucose

Peaks 1.5-2 hours after injection

Lasts 3-4 hours

Humalog® (lispro), Novolog® (aspart), Fiasp®, Lyumjev®, Apidra®
Mix
(Combination of short and intermediate, or rapid and intermediate)

Taken twice daily: before breakfast and before dinner

Two peaks: 1.5-3 hours then 4-8 hours after injection

Lasts 8-12 hours

Humulin® 75/25, Novolin® 70/30, Humalog® 75/25, Novolog® 70/30
Does taking insulin mean I’m a “bad” diabetic?
No! Healthcare providers used to threaten patients with insulin if they did not control their diabetes. We have now changed our recommendations. The nurse practitioner may recommend insulin earlier in your treatment plan to prevent the progression of your diabetes and preserve as much of your own natural insulin as possible.
Does weight loss surgery reverse diabetes?
Weight loss, or bariatric, surgery may be a great option to improve your diabetes. It may also improve other chronic health conditions such as high blood pressure and high cholesterol. This procedure is not a “cure” for diabetes, but it may put your diabetes into remission. This means you may no longer require medications to keep your blood glucose levels normal. However, if you do not maintain a healthy lifestyle (diet, exercise, weight management) your blood glucose levels will begin rising again and your diabetes will no longer be in remission. Talk to the nurse practitioner to see if bariatric surgery is an option for you.
Do I need glucagon and ketone strips?

If you use insulin (including injections and pumps), you should have glucagon and ketone strips on hand at all times. If your blood sugar drops too low that you cannot eat or drink anything, or if you pass out, glucagon is an emergency medication that can be injected into the fatty tissue in your body to make your blood sugar level rise quickly. Some patients can inject themselves but most people require someone else to inject the glucagon for them. You should have a snack or a meal within 15 minutes of injecting the glucagon to prevent your blood sugar from dropping again.

Ketone strips should be used to test your urine for ketones if your sugar is much higher than usual and not coming down, such as when you’re sick or using medications such as corticosteroids. Urinate into a clean cup, dip the ketone stick into your urine, and wait about 1 minute for the blocks on the strip to turn colors. Compare the colors on the strip to the colors on the bottle label. If you have mild, moderate, or high ketone levels (1-4+), you should go to the emergency room. Elevated ketone levels may indicate the onset of diabetic ketoacidosis (DKA) which is a medical emergency.

What complications are associated with diabetes?

Many people are surprised to learn that diabetes isn’t just “high sugar”. It increases your risk for heart disease, kidney disease (nephropathy), nerve damage (neuropathy), hearing loss, vision problems and even blindness (retinopathy). Diabetes can also affect your skin, feet, and nails. These complications can be prevented or reversed with improved blood glucose control.

What is diabetic ketoacidosis (DKA)?

DKA used to only be associated with type 1 diabetes, but it’s also a possibility for type 2 diabetics – even though it’s rare. The acid in your blood builds up and throws off the rest of your electrolytes like sodium and potassium, which can cause important organs like your heart not to work correctly. This is a medical emergency; you should go to the hospital and plan to stay for a few days. Only intravenous (IV) fluids and correction of your blood sugars with insulin will correct this. You must control your blood sugars to prevent this from happening again. Too many episodes of DKA can cause organ failure and death. 

What is prediabetes?

Prediabetes should be called stage I diabetes. Your blood sugars are too high to be normal, but without lifestyle modifications you will surely be a diagnosed type 2 diabetic. Lifestyle includes committed, lifelong modifications you can stick to: healthy diet, regular exercise, and a healthy weight. Prediabetes can be managed with lifestyle alone, but can quickly and easily morph into type 2 diabetes if left unchecked.

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