Sugar Matters
November 13, 2012

Congratulations – what to do when things go right

After months and months of beating the same drum about taking care of your diabetes, I am taking a break for all of you who HAVE been taking good care of yourselves and succeeded in getting your sugars under control. This means having a hemoglobin A1C now at or less than seven per cent (or at least close if you were very high before), keeping your doctor’s appointments, taking all prescribed medications as directed, staying as active as you can and keeping an eye on your diet.{{more}}

First off: congratulations! As you know, this can be a challenging road. If you have come this far, you deserve a pat on the back.

Second: as great as this is, you need to keep up the good work. Yes, reaching the goal is one thing, but staying there is the other part of the plan.

I have seen some common mistakes made after patients bring their blood sugars under control. No one wants to be imprisoned by his or her medical care, but you need to be cautious not to let your health slip too much. Here are the most common mistakes I see:

Number 1 – they stop taking their medication because blood sugars are now normal. Please stop and think: your blood sugars are normal BECAUSE you are taking medications. If you stop, the blood sugar level will rise again. For those of you taking insulin, if you feel nervous taking full doses of insulin when your blood sugars are within good range, please speak to your doctor about small dose adjustments, if needed. If your blood sugars are staying normal and NOT LOW, then your doses are just right. If you are dropping low (by numbers, not just “feeling low”) then your doses need to be changed.

Number 2 – they relax their diets and “enjoy food more.” Very common. It goes from having one slice of cake at your niece’s birthday party to having a slice every day, to having cake AND ice cream every night. Clearly not a good trend. Again, I do not want anyone imprisoned by this disease and unable to enjoy life, but there is a way to do this without endangering your health even more.

Number 3 – they believe they are “cured” and do not have diabetes anymore. This leads to number 1 and 2 above, as well as a host of other issues including not showing up to appointments and stopping other medications. There are situations where diabetes can truly go away, such as after pregnancy, after significant weight loss, or after stopping medications that were causing high blood sugars. HOWEVER, in almost all cases, those people who had diabetes but then returned to normal are still at high risk for becoming diabetic again in future. So it may not so much be a cure as it is a sort of remission, where diabetes is not present at the moment but can spring back under the right conditions-increasing age, weight gain etc. Everyone who had diabetes at one time, no mater the conditions should remain vigilant and careful about what he/she eats, try to maintain your weight within normal, and stay active. These factors have been shown to help reduce your chances of becoming diabetic in future, and there are also a few medications that can be used.

Again, do not let your guard down, please. You worked so hard to get this far-keep it up!

Until next week, stay safe and healthy Vincies!

Anita Ramsetty, MD
Medical Director Endocrine Care Group
Tel: 843-798-4227