Ask Nurse Lorraine - Common Questions Answered by an On-staff Certified Diabetes Educator

What You Should Eat, Blood Sugar Testing and More!

By Lorraine Farrar, MSN, RN, APN, BC-ADM,CDE
Vice President of Education and Wellness

If you’ve ever wondered if your blood sugar test results are normal or what foods you can eat, you’re not alone! As a Certified Diabetes Educator, I speak to people with diabetes every day providing information and personal support to guide them on their journey to better health.

I’ve collected a few of the most common questions that people with diabetes ask me. I encourage you to use this handy reference guide to learn more about diabetes, managing your blood sugar and avoiding many diabetes-related complications.

Q. Why should I care about meal planning?
A. If you have diabetes, the right meal plan can improve your blood sugar, blood pressure, cholesterol, and help prevent long-term complications such as heart disease. A healthy meal plan may also help you lose weight if you are overweight.

Q. What should I know about carbohydrates?
A. All types of food and beverages that contain carbohydrates raise your blood sugar level, not just those that contain sugar. Carbohydrate is the general name for both starches and sugars. All food choices except protein and fat contain carbohydrates. People with diabetes can still enjoy food that contains carbohydrates, the key is moderation. After all, you need carbohydrates for energy. Your body breaks down the starches and sugars in carbohydrates to create glucose, the fuel for our bodies. All sources of carbohydrates can be included in your personal meal plan, but choose wisely. In general, high-fiber food choices are better for you. High fiber foods include fresh vegetables and fruit, whole grain breads and cereals, and dried beans.

Q. Are there any free foods?
A. Yes, free foods are usually less than 20 calories per serving and/or less than 5 grams of carbohydrate. Eating larger portions can require counting the calories/carbohydrate of some food items. Some examples of free foods:

• Low Carb Vegetables (1 cup raw or 1/2 cup cooked)
• Broth
• Gelatin, sugar free
• Jam/Jelly, sugar free
• Whipped Topping, sugar free
• Gum, sugar free

Q. Why is it important to check my blood sugar?
A. Monitoring your blood sugar is very important for anyone with diabetes. A finger stick test using a blood glucose meter measures the actual amount of sugar in the blood at the time of the test. Self monitoring of blood sugar helps people with diabetes see how the blood sugar level changes throughout the day. Food, physical activity and diabetes medication affects your blood sugar hour by hour and day by day.

Q. Why do I need to get an A1c test AND self monitor my blood sugar at home?
A. Monitoring your blood sugar gives a snapshot of control at the time of the test. The A1c test gives the long term picture of blood sugar control over the past three months. Together these tests provide you and your doctor with information about your level of blood sugar control throughout the day and over the past three months.

Q. What should my blood sugar level be?
A. Your doctor will tell you what blood glucose level is right for you. Your goal is to keep your blood sugar as close to this level as possible. The American Diabetes Association recommends you keep a blood sugar level of 70 -130 mg/dL before meals and less than 180 mg/dL one to two hours after meals.

Q. How does diabetes cause nerve damage in the feet and legs?
A. High blood sugar may damage the nerves (neuropathy) in all parts of your body. About 60 to 70 percent of people with diabetes have some form of neuropathy. The nerves are insulated just like the electric wires in your home. The blood sugar attaches to the insulation on the nerve and destroys its ability to send and receive signals. As a result, some people have feelings of “pins and needles” or numbness and tingling in the feet, legs, hands, or arms. Others may not have any symptoms at all. Ask your doctor to test the nerves in your feet at least once a year. Don't wait until it is too late. Keep an eye on your feet. Your risk for developing neuropathy increases the longer you have diabetes. Being overweight and having high levels of blood fat and blood pressure also increase your risk of nerve damage.

Q. How does diabetes cause blindness?
A. The most common cause of blindness is diabetic retinopathy. This disease damages the eye’s retina which is needed for vision. This condition affects up to 80% of all people who have had diabetes for ten years or more.

Diabetes causes blindness because high blood sugar can damage the tiny blood vessels located in the back of your eye in an area known as the retina. Over time, high blood pressure and high blood sugar can weaken these damaged blood vessels allowing them to leak or bleed. Since you need the retina to see, the bleeding within your eye (called retinopathy) may lead to vision loss or blindness. The blindness or vision loss may be sudden or a gradual change. You can help save your vision by getting a complete dilated eye exam each year. When retinopathy is found early, laser treatment can help keep you from losing your vision.