Care New England Medical Group Nutrition Services, Diabetes Education
2191 Post Road
Warwick, RI 02886
P: (401) 732-3066 option 1
111 Brewster Street
Pawtucket, RI 02860
Care New England Medical Group Endocrinology at Kent Hospital
Ambulatory Services Pavilion
455 Toll Gate Road
Warwick, RI 02886
P: (401) 736-1034
Women & Infants Endocrinology and Metabolic Clinic
100 Dudley Street, 2nd Floor
P: (401) 453-7950, option 2
Women & Infants Hospital Center for Obstetric and Consultative Medicine
100 Dudley Street, 3rd Floor
Providence, RI 02903
P: (401) 453-7950, option 1
Diabetes in Pregnancy Program, Division of Maternal-Fetal Medicine
Women & Infants Hospital
2 Dudley Street, 5th Floor
Providence, RI 02905
P: (401) 274-1122, ext. 47452
Gestational diabetes develops in some women during pregnancy, and it is similar to type 2 diabetes. During pregnancy, your body makes hormones that make your body resistant to insulin. Most pregnant women make more insulin to keep their blood sugar levels normal. But seven to 14 percent of pregnant women still cannot make enough insulin to keep their blood sugar levels normal during pregnancy, resulting in gestational diabetes.
Our team at Women & Infants’ Diabetes in Pregnancy Program, part of the Division of Maternal-Fetal Medicine, is here to provide a wide variety of services for women who are pregnant and have diabetes, whether living with the condition prior to pregnancy or developed during it.
At Care New England, we are continuously striving to bring better quality, service, and access to support our community, which is why over the coming year we will be leveraging our collective clinical...
Care New England offers a variety of comprehensive management programs. The staff at Care New England includes nutritionists, an RN, and a pharmacist. All of our experts have specific information about diabetes to share with you to help you better manage your diabetes.
At Care New England, we understand that everyone has different needs. That is why our diabetes program uses a personalized approach to help you meet your individual goals and lifestyle. We offer a variety of patient teaching programs and dietitian consultations for people living with diabetes including gestational diabetes.
Diabetes Outpatient Education classes are now being offered. Pre-screening and a physician referral are required. Please call (401) 732-3066 for more information.
The Care New England Diabetes Self-Management Education Program has been recognized by the American Diabetes Association for Quality Diabetes Self-Management Education* and Support.
The Care New England diabetes program has been awarded recognition by the American Diabetes Association in accordance with the National Standards for Diabetes Self-Management Education Programs and is a state-certified Diabetes Outpatient Education (DOE) site. Classes are taught by a registered dietitian, a registered nurse, and a pharmacist.
The program meets for two hours once a week over a five-week period and includes an individual appointment with a nurse practitioner and registered dietitian. This program is ongoing with evening and morning sessions available. After completing the series, there is a three-month follow-up appointment.
The Program includes:
A 1997 Rhode Island law mandates insurance coverage for diabetes education when ordered by physicians. Patients are encouraged to call their insurance company for information regarding co-pays. Private consultations are available with certified diabetes educators, including nurse practitioners registered dietitians.
The American Diabetes Association has several cookbooks that would be helpful.
Diabetes is controllable. Sometimes individuals can come off diabetes medications if they are adhering to proper dietary guidelines and exercising regularly. These individuals are still, and will always be, diabetics so regular medical appointments are always important.
Poorly controlled diabetes can cause gum disease. Bacteria, especially those that thrive in the mouth, love sweets. When you have high glucose levels, your saliva makes your mouth a home for the bacteria that causes gum infections. It's harder for your body to fight off infections when you have diabetes. Schedule regular visits with your dentist and remember to inform him or her that you are diabetic.
Your blood glucose reacts to any exercise. Exercise can lower your levels right after, or for as long as 24 hours afterward. If you take oral medications or insulin, your blood glucose level can sometimes drop too low. Always check your blood glucose readings before you exercise. If your blood sugars are between 120 and 250, you can exercise. Always carry a snack, 15gms of carbohydrate with you in case your blood glucose goes too low. The best time to exercise is one to three hours after a meal.
You may be able to delay or prevent diabetes with continued physical activity and healthy, balanced eating. Your present BMI (height to weight ratio) is 26.5, a healthy BMI is 25. A 5 to 10 lb weight loss can be helpful. You had an annual physical, did your physician have you do blood work? If so, always ask them to review the results with you.
Sugar-free soda does not have a harmful effect on diabetes. Artificial sweeteners have been subject to intense scrutiny for years but they are FDA regulated and approved. They are a good alternative to sugar for diabetics. Like anything we consume, moderation is the key.
Typically sugar-free hard candies/lollipops should be limited to 3 per day. These products are made with sugar alcohol that gets into the bloodstream slowly and shouldn't affect blood sugar levels. Sometimes sugar alcohol has a laxative effect and can cause some stomach cramping.
Exercise usually makes your blood glucose levels go down, however, if your blood glucose level is high before you start, exercise can make it go even higher. Your blood sugars should be between 120 and 250 before you exercise. Glucose is not usually found in urine. When the level of glucose in the blood is high, the kidneys will move excess glucose into the urine because it cannot properly absorb it all. This urine is characteristically sticky. It is important to inform your physician of this symptom as soon as possible. Diabetes can cause changes in your eyes. Keeping your blood glucose levels in control lowers your risk of developing any eye diseases. You should see an eye specialist (ophthalmologist or optometrist) once a year for a complete exam.
Pre-diabetes is a condition that comes before diabetes. It means that blood sugar levels are higher than normal but aren't high enough to be called diabetes. If you have been diagnosed with pre-diabetes, you are at a higher risk of developing diabetes and should do something about it at this time. Studies show that you can prevent or delay type 2 diabetes by making changes in your lifestyle. Begin by making an appointment with a registered dietitian. What and how you eat is a key part of your care, the dietitian can help you figure out your food needs. The classes are for individuals who have already been diagnosed with diabetes whether or not they are on medication or insulin.
Individuals with diabetes can consume sugar, have desserts, and almost any food that contains caloric sweeteners. After you eat, your blood sugar level is largely determined by the TOTAL amount of carbohydrate you have consumed, not the source. The source of carbs does affect how fast it turns into glucose. However, it is important to remember that while foods with sugar can be incorporated into a diabetic meal plan most sweets and desserts are HIGH in carbohydrates, calories, fat and have little or no nutritional value. While these foods can be consumed, they should be considered TREATS and eaten less often in limited amounts. The American Diabetes Association suggests you limit these treats to special occasions.
First, allow me to congratulate you on being proactive in your diabetes care by watching your diet, exercising, and taking your prescribed medication. I hope your blood sugar levels are still in good control. Loss of sensation in the feet due to nerve damage is a problem for people with diabetes. Neuropathy is more likely to affect people who have had diabetes for a long time or whose glucose control is poor, however, this condition could also occur from other causes not related to diabetes. Continue to be pro-active and follow-up regularly with your physician.
Exercise is truly one very important part of the diabetes care plan. When you exercise, your muscles work harder and use up their glucose stores for fuel. When those sources run low, glucose from the blood is used, lowering your blood glucose levels. Exercise also makes muscles and other tissues more sensitive to insulin, so less insulin is needed to move glucose out of the blood and into the cells. The American Diabetes Association recommends at least 30 minutes 5 days a week. Always remember to check your blood glucose levels before exercise. It should always be between 120 and 250 before you exercise.
There are many possibilities why your blood sugar levels are out of control in the morning. To begin with, blood glucose levels at bedtime should be between 100 and 140. When you ate last and what you ate can play a large part. If and when you are taking oral medications or insulin affects this number. Your body stores sugar inside the liver during the day and sometimes releases sugar into your bloodstream when you are not eating (such as during sleep). Hormones released overnight can also cause blood glucose levels to rise. For people who don't have diabetes, the increase in glucose is offset by increased production of insulin. For people with diabetes, this can be a problem. If this scenario continues you should speak with your physician or diabetes educator.
From my research into this topic, I learned there has been little medical research done on the effectiveness of epsom salts on relieving symptoms of diabetes. epsom salt is magnesium sulfate that is absorbed through the skin. People with high blood pressure, heart problems, or diabetes should consult their personal physician prior to using. Epsom salts can cause severe drying of the skin, making the skin more fragile and this is something diabetics want to avoid. When reading any health articles in magazines or online please make sure the sources are reliable.
Once you are diagnosed with diabetes, you will have it for the rest of your life. Although you can not cure diabetes, be assured that with the help of your health care team, you can treat your diabetes, take charge of it and control it. There are a number of ways to keep your diabetes in control, including following a meal plan, checking your blood glucose levels, staying or becoming active, getting regular check-ups, and taking medications, if necessary.
If you have already been diagnosed with diabetes, a blood sugar level of 111 is within normal range whether the reading was taken fasting or two hours after a meal. If you have not been previously diagnosed, two fasting blood sugar levels greater than 100 and less than 126 classify you as pre-diabetic. Pre-diabetes means that your blood sugar levels are higher than normal but aren't high enough to be called diabetes. Even if you have pre-diabetes, you may be able to delay or prevent diabetes. If you have pre-diabetes you can and should do something about it. Talk with your physician or member of the health care team on the steps you should be taking.
If you haven't recently changed your eating or exercise habits which could alter your numbers, then a call to your physician is suggested to apprise him or her of the situation.
Your kidneys are your body's filter units. They work 24 hours a day to rid your body of toxins that your body makes or takes in. Toxins enter the kidney by crossing the walls of the small blood vessels, called capillaries, along its borders. Diabetes can cause changes in the small blood vessels. They can become blocked or leaky. The most important thing you can do to prevent kidney disease is to keep your blood glucose levels under control. A special type of blood pressure medication, called ACE Inhibitors, lisinopril being one, is usually prescribed, even if your blood pressure is normal, to decrease the rate of progression. Your physician or pharmacist are excellent resources for more specifics.
Congratulations on your weight loss. Have you seen any changes in your blood sugar numbers since starting on the Lantus? Your previous medication, Metformin, doesn't make the body produce more insulin and your body was probably not producing enough on its own to get the sugar out of the bloodstream into the cells. You stated you were following a rigid diet, not knowing what that actually consisted of makes it difficult to assess why your blood sugars are out of control. Consistency and appropriate portion sizes of carbohydrates at meals are important in getting your blood sugar levels in control. If you haven't met with a dietitian yet, I highly recommend you do. He or she can work with you and help you get your diabetes under control.
Your risk for nerve damage is greater because you have diabetes. The small blood vessels that feed your nerves can become blocked and cause poor circulation. The feet and legs are commonly affected. Numbness is a common symptom as is pain and a tingling sensation. You should contact your physician whenever you experience changes in your physical being.
As a newly diagnosed diabetic, it is always a good idea to meet with a registered dietitian. Learning how and what to eat is an essential part of managing your diabetes. The dietitian will provide you with an individualized meal plan, adjusted to fit your lifestyle, so you consume the right kinds and amounts of food. Foods are made up of carbohydrates, proteins, and fats. Carbohydrates affect your blood sugar levels the most. Carbohydrates turn into sugar, but they are the main source of fuel for our bodies as well as provide essential vitamins and minerals and therefore necessary in a healthy diet. The amount of carbohydrates you need depends on your age, weight, activity, and medications you may be taking. Sugar and sweets are OK to include once in a while but keep in mind they often contain lots of carbohydrates, calories, and fat with very little nutritional value.