Managing Diabetes: A Q&A with CDE Stephanie Graziano

November 30, 2021

On Tuesday, November 2, Certified Diabetes Educator Stephanie Graziano answered questions through Instagram Live about diabetes care and management.

Check out the transcript below:

“Good afternoon everyone. My name is Stephanie Graziano and I am a Certified Diabetes Educator at the Institute for Family Health. November is Diabetes Awareness Month, and we wanted to give you the opportunity to ask any questions you have about diabetes, prediabetes and diabetes care. Thank you all for joining us today here on Instagram Live. So, what questions do you have about diabetes?”

What causes diabetes?

This is a great place to start. Diabetes is caused by a variety of factors, but what happens is the body has a harder time processing blood sugar. There is Type 1 Diabetes and Type 2 Diabetes. With Type 1 Diabetes, the pancreas actually does not produce any insulin at all. With Type 2 Diabetes, the pancreas might still make some insulin, but it may make less and less over time. The body may also stop responding to insulin. Certain factors can increase your likelihood of getting diabetes, including your family history. Older people are also at higher risk for diabetes.

Do I have diabetes because I ate too much sugar?

I am so glad you asked this question—thank you! Because diabetes has to do with how the body processes blood sugar, some people think that if you eat a lot of sugar it causes diabetes. While eating sugar can cause the weight gain that can lead to diabetes, scientists have not found a precise link between diabetes and eating sugar. It’s important to recognize that there may be other things that cause diabetes that may be out of your control, like genetics and family history. Having diabetes should not make you feel ashamed!

What makes someone more at risk for diabetes?

There are a few factors that could increase someone’s risk for getting diabetes. One major factor is family history. If you have a family member, like a parent or a sibling, that has diabetes, then you may have a higher likelihood of having diabetes too. There are also lifestyle issues related to diabetes—such as being overweight or having an inactive lifestyle. But there really isn’t a single factor that causes diabetes, and if you have diabetes, it is not your fault.

What is prediabetes?

Thanks for bringing this up! Prediabetes means that a person has a higher blood sugar level than normal, but not high enough to be diabetic. Sometimes, for some people, even being under stress can cause prediabetes. If your provider tells you that you have prediabetes, then your blood sugar level might be a little high, but you still have time to reverse it. You can do this by making lifestyle changes, like taking steps to manage stress, maintaining a healthy weight or incorporating more movement into your daily routine. And if you would like some help making these changes, my team and I are here to help you! At the Institute, we have nutritionists that specialize in helping people with diabetes, as well as diabetes educators like myself who can answer any questions you may have and offer support.

What is A1C test and when should I take one?

The A1C test is a simple blood test that measures your average blood sugar over the past three months. This test tells us if you are have either prediabetes or diabetes. Your provider can give you the A1C during your physical. If you get a result that is higher, we can help you talk through any concerns you may have and recommend more tests to get a clearer picture of your blood sugar.

I follow a diabetic diet and I was told not to eat white foods like white flour, white sugar and bananas. Is this true?

This is great—let’s get into some healthy eating tips. We often tell people with diabetes to avoid the “white foods,” like white flour and white sugar. White flour and white sugar are heavily processed so that the fiber in the grain has been removed. Because there is very little fiber in foods containing white flour and white sugar, they are absorbed very quickly into the blood stream and can make your blood sugar go up quickly, without giving you the fiber, nutrients and vitamins that you can find in other foods. This is why your provider is probably recommending that you eat whole grains, like bread and cereal with whole grains.

How do I support a loved one with diabetes?

If you have a loved one with diabetes, there are lots of ways you can offer your support. If your loved one is open to it, you can offer to join them for a walk or another type of easy workout. You could also offer to join them for healthy, diabetes-friendly meals.

People with diabetes are often dealing with stress and/or depression. If you have a loved one with diabetes, it can be very helpful to just check-in regularly. Ask them what they need and be kind and patient.

I have trouble remembering when I need to test my blood sugar. What are some ways I can remind myself?

When you have diabetes, it’s important to test your blood sugar regularly so you can make sure you’re not getting too high or too low. Some people have trouble remembering to test themselves according to the schedule. If this is a problem for you, you can set a reminder on your phone or ask a family member to help you remember. You may also want to explore one of the wearable devices that will monitor your blood sugar throughout the day. Talk about this option with your provider.

I hate exercise. What are some physical activities I can do?

I am glad you asked this–thank you! Let’s start by talking about what we mean when we say “physical activity.” Physical activity can include taking a walk, using the stairs, or even just putting some music on and dancing–just everyday life stuff. The key is sitting less and moving more. Find a part of it you like and really focus on how good it feels when you do it. By doing these everyday things, you can change your perspective and start thinking of yourself as an active person. Make little changes to your lifestyle so that it becomes familiar. You don’t have to join a gym (I hate gyms) or buy a weight set. Also, you can find many free workout videos on Youtube.

I love soda but I know it makes my blood sugar go up. What are some alternatives?

When you have diabetes, people always say to avoid sugar at all costs. But do the best you can, of course! If you don’t like water, drink the next best thing. You could try unsweetened seltzer, or if you want something sweet, choose an artificially sweetened one. But do your best to avoid regular soda and juice.

I gained some weight during the pandemic and my blood sugar went up. What diet should I follow?

This is so common—you are not alone. I would recommend by starting with addressing the word “diet,” which sounds so restrictive. You’re not exactly going to follow a strict diet. You’re going to change your eating pattern to a healthier eating pattern.

To help visualize this, I brought a visual aid. These are Healthy Plates, which are designed to show you how to design your plate in a way that supports a diabetes-friendly eating pattern. You can see more on our website.

The Healthy Plates are designed to help you eat lots of fruit and veggies (starchy and non-starchy). Fruit does not have a lot of sugar (if you follow the serving size, you’re good). Protein should be lean (poultry, fish). This is a healthy eating pattern to help you lose weight, which will bring blood sugar down.

Besides the Healthy Plates, you can also look into other healthy eating patterns, like the Mediterranean diet or the vegetarian diet. Both of these eating patterns have been shown to help with chronic diseases.

What support services are available to me as a diabetes patient at the Institute?

At the Institute, we have lots of groups and classes to help you manage your diabetes. We also have certified diabetes educators like myself who can offer you individual appointments. And if you don’t have insurance, let us know what your situation is and we will help. At the Institute, our mission is to provide affordable health care to all who need it, even if you don’t have insurance. We are here to support you.

If you or someone you know has diabetes, please visit our website or call your health center for an appointment.

All right, if there are no more questions, I’m going to wrap it up. Thanks again for joining us! Remember, if you would like to learn more about diabetes care, check out the Institute website. If you are already an Institute patient and you want additional diabetes services, call your health center or send a MyChart message to your provider. New patients can also reach us at 1-(844) IFH-APPT. That’s (844)-484-2778. Thank you!”

And for more information on future Live events, don’t forget to follow us on Instagram and our other social media channels!

Please note: this transcript has been edited for readability.

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