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 Name: Camille Izlar
Date/Age of Diagnosis: April, 1968, Age 8 Type of Diabetes: Type 1 Occupation: Registered Dietitian, Certified Diabetes Educator, Pump Trainer State: North Carolina Country: United States Email:
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Interesting Fact(s): I don’t know that I’d say interesting, but things about me include that I love horses and riding and am competing in horse trials with my horse that I trained from a baby. I enjoy running and have run 2 marathons and 2 half marathons with Team Diabetes in Rome, Dublin, Hawaii, and Bermuda.
Name: Jennifer Stallings Date/Age of Diagnosis: 1985, Age 10 Type of Diabetes: Type 1 Occupation: Registered Dietitian, Certified Diabetes Educator, Pump Trainer State: North Carolina Country: United States Email:
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Interesting Fact(s): Jennifer used to coordinate and conduct grocery store tours for people with diabetes. These tours would help people develop healthy meal planning. **Previous CDE Contributors include: Rachel Gifford, CDE;
DO YOU HAVE A HEALTHCARE QUESTION FOR OUR CERTIFIED DIABETES EDUCATOR? Email her at
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. Your question may be showcased in her weekly CDE Blog.
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Diabetic Neuropathy (Jennifer) |
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Diabetic Neuropathy is a type of nerve damage that can occur if you have diabetes. High blood glucose can injure the nerve fibers. On average, symptoms begin 10 to 20 years after diagnosis. Approximately 50% of people with diabetes will eventually develop nerve damage. here are two main types of neuropathy, peripheral neuropathy and autonomic neuropathy. Peripheral neuropathies affect the skull (cranial nerves) or nerves from the spinal column and their branches. This type of neuropathy tends to develop in stages. Autonomic neuropathies affect the nerves that regulate the heart muscle and smooth muscles. Symptoms of neuropathy can vary depending on the area affected. If the stomach or digestive tract are affected, symptoms can be constipation, diarrhea, nausea, vomiting, and difficulty swallowing. In the hands and feet symptoms can be deep pain in the extremities, loss of sense of warm and cold, muscle cramps, numbness, tingling, burning, and weakness. Other symptoms of neuropathies could be dizziness, drooping face, impotence, orthostatic hypotension, loss of bladder control, rapid heart rate, speech impairment, and vision changes. Exams and tests may be done to determine if neuropathy is present. Physical examination including neurological and sensory tests can help diagnose neuropathies. Absence of ankle reflexes is a common early finding. Healthcare providers often test for loss of sensation in the feet with a monofilament. Electrodiagnostic testing may also be done. Treatment of neuropathy is to improve overall blood glucose control to prevent any further damage. Medications may be used to help relieve symptoms. hese include antidepressant drugs (Elavil, Sinequan, Cymbalta) and antiseizure medications (Neurotin, Lyrica, Tegretol, Depakote)to help with feet, legs, and arms; drugs that block bladder contractions may be used to help with loss of bladder control; Erythromycin, Motilium, or raglan may be used to help with nausea and vomiting; Viagra, Levitra, and Cialis are safe and effective for treating impotence; and Capsaicin can be used topically to reduce pain. Daily foot exams are important to help identify injury in a timely manner. Many times with neuropathies foot injuries can go unnoticed until it is a serious issue. Remember blood glucose control is the key to preventing or delaying or reversing any diabetes complications.
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What is Celiac disease and am I more likely to have it if I have diabetes? (Jennifer) |
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Celiac disease, also called celiac sprue, nontropical sprue, or gluten-sensitive enteropathy, is an autoimmune disorder that damages the small intestine and interferes with absorption of nutrients from food. People with celiac disease cannot tolerate gluten, a protein in wheat, rye, and barley. It can also be found in medicines, vitamins, and lip balm. When people with celiac disease eat these foods or use these other items, their immune system responds by damaging or destroying the villi lining the small intestine. Villi are normally responsible for allowing nutrients from food to be absorbed through the walls of the small intestine into the bloodstream. If villi are not working correctly, one can become malnourished.
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What should I expect during menopause as a woman with diabetes? (Camille) |
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Dear CDE, I have been going through menopause for about a year now and my blood sugar control has suffered. I want to know: Can menopause cause fluctuations in my blood sugars? and can you tell me what should I expect during menopause as a woman with diabetes? Thank you!
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How do I manage a good diet during the holidays? (Jennifer) |
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Dear CDE, With the holiday season soon approaching, do you have any tips or suggestions on how to mantain my good diet? I know that pretty soon work parties, family gatherings and other social events full of sweets and high fat goodies will be around. It's tempting to forget about my diabetes and splurge at these types of events. What would you advise I do so that I can enjoy these functions without being overly concerned about what I'm eating? Thank you!
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I'm sick, what do I do? (Camille) |
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Dear CDE, I've been sick for the past couple of days and my blood sugars are wrecking havoc! I'm trying the best that I can but I don't feel well due to the illness and feel even worse because my blood sugars are out of control. Do you have any suggestions for what I need to do to manage my diabetes while being sick? Thanks! Dear Reader, It’s that time of year again…the cold and flu season. We have discussed this one time before but it deserves reiteration. The basic sick days guidelines for people with diabetes include
1) Always take your diabetes medication. Illness can make blood sugars
go up
2) Monitor blood glucose more frequently (every 2-4 hours) especially if your blood sugars are higher than usual
3) Take your temperature every 4 hours
4) Eat or drink carbohydrates
5) If you have type1 diabetes check for ketones if the blood sugar is >240 mg/dl. You can buy “ketostix” at the drugstore which are dipsticks you test your urine with for ketones
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Why do I need a yearly eye exam? (Jennifer) |
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Dear CDE, My endocrinologist keeps telling me that I need to get eye exams on a yearly basis. Every time I see my endo my A1c is fine and all of my labs come back normal. I don't feel like seeing another doctor when it doesn't seem necessary. Why is it important to get an annual eye exam and what will happen during the exam? The American Diabetes Association and the American Optometric Association recommends dilated eye exams for diabetes patients at least once a year but only 47% in 1998 got exams. The goal is to increase to 75% in 2010. The best cure for diabetes related complications is prevention.
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