How to Live with Your

___Type 2 Diabetes__
Answers to Frequently Asked
Questions

Copyright Notice: 2009 Beverleigh H Piepers RN. All rights reserved. No portion of these
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should always speak with your Health Care Provider before taking any medication or
supplement or adopting any treatment for a health problem.

Beverleigh H Piepers RN 2009

About the Author

http://drugfreetype2diabetes.com

Hi Im Beverleigh Piepers and have been a Registered Nurse for 25 years. I am

registered in both Australia and the United States. I have worked in several
areas of Health including Pediatrics, Geriatrics, Medical, and Chemical Dependency.
From the early days of my training I had the deepest respect for the administration of
the drug Insulin. I have seen many diabetic patients admitted to hospital due to
accidental misuse of this drug. The common cause I believe, is lack of understanding of
information on food choices, exercise and when, or if, insulin is required. I do not think
its the patients fault, often the condition and treatment is not explained, or is
inadequately explained.
And now the most common form of diabetes is Type 2, affecting 85-90% of all people
diagnosed with diabetes.
Imagine my surprise when following a regular blood test which included fasting blood
sugar levels, I was told my blood sugar levels were elevated and I would require a
glucose tolerance test. These results came back within normal levels. So that meant,
due to the original elevated levels, I was told: I would possibly become Type 2 Diabetic
in the future. In other words I was pre-diabetic.
I was not overweight; I had been having yearly fasting blood sugars done along with
cholesterol levels. I had been telling the Health Care Provider for almost eight years that
I didnt feel right, I was ever so tired. It seems my climbing blood sugar levels had been
overlooked.

I was given no satisfactory information on Type 2 Diabetes, just follow a low-GI diet!
That is how my journey began.
My search for information on Type 2 Diabetes took me everywhere and then I really
started to realize why so much people do not understand. The information sounds
complicated and is in a foreign language.
So I would really like to translate for you and help you take back your power, as you are
in charge of your body and your Type 2 Diabetes.
This guide is in response to some of the many questions put to me, I hope they help you
on your journey to living
Beverleigh Piepers RN
Beverleigh H Piepers RN 2009

http//:drugfreetype2diabetes.com

Those of us diagnosed with pre-diabetes or Type 2 Diabetes usually have

several years in which to avoid long term complications. So the good news
is you get the chance to make those changes to your lifestyle that will not
only prevent complications, but help you to live longer with a good quality
of life.
You already know Type 2 Diabetes:
is the more common form of diabetes and affects 85-90% of diagnosed
cases
is brought about by lifestyle choice
until recently it was found to occur mainly in adults and was known as
Adult Onset Diabetes
is also known as non-Insulin Dependant Diabetes Mellitus
( NIDDM )
People with Type 2 usually have ample insulin but their bodies resist its
normal healthy action. This is where the term insulin-resistance comes
from. It is now known this also relates to:

high blood pressure

elevated tri-glyceride levels
high cholesterol levels
heart disease

Beverleigh H Piepers RN 2009

http://drugfreetype2diabetes.com

How would I know I have Type 2 Diabetes?

Want to Cure Diabetes? Click Here

Usually you would have a few of the following symptoms:
extreme fatigue
frequent urination and unusual thirst
blurred vision
cuts that are slow to heal
urinary tract infections
genital itching
heart disease
tingling and/or numbness in hands or feet
abdominal obesity
See your health care provider so he can organize:
fasting blood glucose test
glucose-tolerance test
fasting insulin levels

Why would I need to have fasting insulin levels checked?

Because elevations in insulin precede the increase in blood sugar by as

much as fifteen years. High insulin levels actually do more damage. It leads
to an increase in belly fat, blood pressure and blood fats.

Beverleigh Piepers RN 2009

http://drugfreetype2diabetes.com

Can I undo the damage done by high blood sugars?

If you have had high blood sugars for a while this will have increased the
strength of your insulin resistance. If your liver has become insulinresistant also, this may be dumping glucose into your bloodstream also.
The good new is, yes. By lowering your carbohydrate intake you can reduce
your insulin resistance. By getting your levels as near as possible to normal,
after a few days your insulin resistance will start to decrease. Then,
whatever insulin you are making will work more effectively and you will get
a lower rise in your blood sugars.

What are the signs of hypoglycemia?

If you are not injecting insulin or taking any sulfonylurea drugs (Amaryl,
Glucotrol, Glucotrol XL, Micronase) you will not have a hypo.
whiteness or skin pallor
sweating
palpitations
anxiety
hunger sensation
The above signs and symptoms show when your blood sugar falls quickly.

 Beverleigh H Piepers RN 2009

http://drugfreetype2diabetes.com

You have the following symptoms when hypoglycemia takes longer to

occur:
headache
loss of concentration
maybe double vision
confusion
fatigue
Hypoglycemia means any reading below 75 mg/dl (4.2 mmol/l)

Why am I putting on weight, I am watching what I eat? I take Glucotrol

before meals.
Glucotrol is in the family of drugs known as sulfonylureas and helps your
pancreas produce more insulin. More insulin more weight gain. The
weight gain may also be from intense hunger that is often experienced
when taking these drugs. Hunger may be due to the intense variations in
blood sugars that they cause.
Many people do not like taking these drugs because of the hunger and
weight gain.

Does Metformin cause Low Blood Sugar

Metformin is not supposed to cause dangerous hypos, though some people
have found themselves feeling uncomfortable due to a fall in their blood
sugar level.

Beverleigh H Piepers RN 2009

http://drugfreetype2diabetes.com

Why do some people get Type 2 diabetes?

To Cure Diabetes Click Here

Insulin-resistance is one cause. But most people have a genetic predisposition
based on family history or ethnicity. Add to that age, weight gain, and a
sedentary lifestyle.

What is a HbA1c test and why do I need it?

This test is abbreviated as HbA1c and looks at how blood sugar has damaged
proteins in your blood. The test provides a picture of your average glucose
levels over the last six weeks and reveals what a single fasting glucose test
does not. Research has found the risk of developing health problems
increases when HbA1c levels are above 5%, and the risk of a heart attack
increases by approximately 20% for each 1% rise in HbA1c levels. In other
words a person with an HbA1c level of 7% had a 40% more chance of having a
heart attack than a person with an HbA1c of 5%.

And how do I interpret the HbA1c result?

Normal HbA1c 4.5 to 5.7%
Pre-diabetic
5.7 to 6.9%
Diabetic
7% or higher
Sometimes eating sugary foods the day before a fasting blood sugar test will
throw your levels out. The HbA1c provides an average over the past six
weeks.

Beverleigh H Piepers RN

http://drugfreetype2diabetes.com

I am 65, I have been diagnosed with Type 2 Diabetes but due to arthritis I have
trouble exercising. Can I still lose weight?

Yes, arthritis does make it difficult to exercise but lack of mobility will not stop
you from losing weight or getting control of your blood sugar levels. Exercise
is beneficial but nowhere near as much as losing weight. So be really careful
about sticking with your diet. Just do what you can, walk when you are able.
Dont forget everyday things such as climbing stairs, going shopping,
gardening and housework all count as activity.
What has caused neuropathy in my legs? I have Type 2 Diabetes?
In addition to continuously high blood sugar levels, neuropathy is made worse
in the following:
the age of the diabetic is higher than 40
drinking even small amounts of alcohol can make the pain worse
Damaged nerves cant send messages, send them at the wrong time or send
them too slowly. Researchers arent sure how high glucose levels damage
nerves, but it is believed that the damage is due to a cut-off in the blood
supply to the nerve in some cases. Often when the blood sugar level is brought
down to normal the signs and symptoms improve.
If you dont improve your control, the neuropathy will continue until you feel
no pain at all and that is not a good sign. If the pain is unbearable, see your
Health Care Provider so he can help you with pain relief.
Beverleigh H Piepers RN 2009

http://drugfreetype2diabetes.com

My blood sugar level is really high in the morning, should I have breakfast?
Yes, you should have breakfast. Many diabetics have high glucose in the
morning. As morning approaches levels of other hormones, such as cortisol
and growth hormone, begin to increase. Some of these make insulin less
effective, so the result is a temporary morning insulin resistance. This is
known as the dawn phenomenon or the dawn effect.
Check your blood sugar level when you wake in the morning, if it is often
above 126 mg/dl (7 mmol/l); try to lower this by doing some form of physical

To Cure Diabetes Naturally Click Here

activity the previous evening. If you are taking insulin, your Health Care
Provider may need to adjust the timing or amount of your evening insulin
dose.

How often should I check my blood sugar levels?

The main reason for testing is to find out what you need to do to keep your
blood sugars in the recommended range. So it will depend on what
information you need. If you are ill or have changed your medications you
made need to test 5 to 8 times/day. Your Health Care Provider can help you
work out how often you should test.

When is it really important for me to test my blood sugar level?

If you use insulin or insulin-stimulating pills, and you start to feel
hypoglycemic, check your level so you can take action straight away. Test
before you drive so you can take preventative action and not have a hypo
while driving. And test when you feel ill.

Beverleigh H Piepers RN 2009

http://drugfreetype2diabetes.com

My Doctor has suggested I try Byetta because I overeat, how does this work?
When your stomach does not empty you feel full. Byetta works by closing off
the stomach valve through which food passes into your intestines. Sometimes
this lasts for hours and makes it impossible for you to overeat.
So when you stop eating so many calories or kilojoules at your meals, your
weight will drop. If overeating is the reason for your weight gain and high
blood sugar levels, this drug will reduce both.

Over time though the effect does wear off as does Byettas effect on weight
loss.
If you test your blood sugar levels normally two hours after eating, you will
need to check them much later as stomach emptying is delayed.
Another thing Byetta does in some people is stimulate the pancreas to release
more insulin when the food you have just eaten starts to raise your blood
sugar. This is different to what the sulfonylurea drugs do, because Byetta only
stimulates while the blood sugars have risen and stops when they drop. This
means you would not get a hypo.
Byetta does not work for everyone; it may not work for you. Many have
become nauseated; others vomit a lot. This is due to the way it closes off the
lower stomach valve.
If you try Byetta for a month and your blood sugars get worse, ask your Doctor
to help find a medication that will work better for you.

Beverleigh H Piepers RN 2009

http://drugfreetype2diabetes.com

Why should I always have to check my blood sugar level?

Regular testing is extremely important and that will mean you should check
them more than once a day. You should also change the times you test
regularly. The best times to check is a half an hour before breakfast, then
two hours after breakfast, a half hour before lunch and then two hours
after lunch. And also at bed time.
You should write those numbers down, or some glucose meters actually
record them, and take them to your Doctor. This is the only way your
Doctor will know whether you need to change your medications and/or
diet.

To Cure Diabetes in 21 Days Click Here

Without regular testing it could be months before you realize that your
overall blood sugar levels are too high and this is when diabetic
complications accelerate. Complications include strokes, heart attacks or
blindness. And you dont want that to happen.
When you become fairly stable (in the area of 72-126 mg/dl or 4-7 mmol/l)
and by the HbA1c result, (best is less than 5%, though ADA suggests under
6%), maybe your Doctor will suggest testing less each day.

What do you think of Medi Alert necklaces?

I think it is important to wear an identification of some kind to alert people
to your diabetes, especially if you are taking medications. A bracelet is
more likely to be noticed if you happened to become unconscious, eg.
following a motor vehicle accident. Health care professionals would then
know you are diabetic and take the appropriate action. Personally, I think a
bracelet is the best option and should be worn at all times.
Beverleigh H Piepers RN 2009

http://drugfreetype2diabetes.com

How often should I have my eyes tested?

You should have a yearly examination by an Ophthalmologist so you can
preserve your vision. For this examination, the Doctor will instill drops into
your eyes and then use different instruments to check the pressure, the
appearance of your lens and most importantly, the retina.
All kinds of procedures can be done if any abnormalities are found. If you
havent been doing so, you need to get an examination at the time of your
diagnosis and every year after that.

You mention low-GI foods a lot, what is a low-GI value?

A high-GI value is ... ... 70 or more

A medium-GI value is 56-69 inclusive

A low-GI value is 55 or less

Most rice types have a high-GI value, which one would you recommend?
Basmati, Moolgiri or Doongara have lower GI values. Rice vermicelli ( a rice
noodle) is also low-GI.

Beverleigh H Piepers RN 2009

http://drugfreetype2doabetes.com

Potatoes have a high-GI, do I have to stop eating them?

You dont have to stop eating everything that has a high-GI, just enjoy them
in moderation. And mix them with low-GI foods, then that will put the
overall count in the medium-GI range. The GI is also affected by how
theyre cooked. Pre-cooking and reheating potatoes, or eating cold
potatoes, eg. in potato salad, reduces the glycemic response. Freshly
cooked and mashed potatoes have a high GI. And were not even dealing
with fried potatoes!

If I change to low-GI foods do I need to lower my insulin dose?

In theory yes, in practice no. Most studies have shown no need for this, as
the insulin dose is dictated not just by the carbohydrates in the diet but by
the protein and fat also.

I have recently been diagnosed with diabetes. I enjoy a drink with my meal,
is that a problem?

To Cure Diabetes Permanently Click Here

A small amount of alcohol with food will have little effect on your blood
glucose levels. Recent research has shown that a glass or two of wine with,
or before a meal, may reduce glucose levels by 25%. For others, the
opposite can happen blood sugars seem to rise later that night. Sweeter
wines seem to bring on higher blood sugars, so many diabetics drink red
wines and drier wines. If you do have a glass of wine, check your blood
sugar level before bed and if you are awake at 2 or 3am, check it then also.
Beverleigh H Piepers RN 2009

http://drugfreetype2diabetes.com

How does alcohol affect my blood sugar levels?

Sometimes alcohol reduces your levels a lot. If you are using insulin,
alcohol can make your levels go too low. Alcohol can paralyze the
mechanism that brings your blood sugars back up. This can be avoided by
not drinking on an empty stomach and having snacks alongside your drink.
A maximum of one standard drink per day for females and two standard
drinks for males are acceptable recommendations for people with diabetes.
A standard drink is:
1 beer 9.5oz/280mls
1 beer reduced alcohol ... 12.5oz/375mls
1 glass dry wine 4oz/120mls
1 glass port or sherry 2 oz/60mls
1 nip spirits 1 oz/30ml

I am a Vietnam-era veteran with post-traumatic stress disorder. I also take

blood-pressure medication. I have type 2 diabetes and I am tired or hearing
it is a lifestyle disease, especially when its an established fact that taking
antidepressants and blood-pressure medications predisposes one to type 2
diabetes.

Although lifestyle issues such as obesity, are a common cause of type 2,

there are many other aspects to consider. Family history, ethnic
background and, as you quite rightly point out, life experiences, that affect
our long-term health and well being. I am sorry and understand you feel
criticized by this unfair association.
Beverleigh H Piepers RN 2009

http://drugfreetype2diabetes.com

I was diagnosed with diabetes when I returned from duty in Vietnam. I

think I drink too much but what is really bothering me is I have loose teeth.
Is this connected with my diabetes?
If your blood sugar levels are not really well controlled this can lead to
periodontal (gum) disease. Periodontal diseases are infections of the gums
and bone that hold your teeth in place.
So high blood sugars in your saliva encourage the growth of bacteria and
this helps cause gum disease.
Do you smoke? This can be another factor. Smoking is harmful to oral
health even for people without diabetes.
Why not make an appointment to see your local Dentist. He may suggest:
removal of plaque
removal of infected tissue if in the early stages of gum disease
medication
Thrush is another mouth infection common in people with diabetes, again
due to high sugar levels in the saliva.
How much is too much drinking? Suggested alcohol for a male with
diabetes is two standard drinks/day. Do you have a friend you can talk to?
Why not give your local Alcoholic Anonymous group a call?

 Beverleigh H Piepers RN

http:// drugfreetype2diabetes.com

When I wake up in the morning my feet tingle, and feel cold. Do I have
neuropathy?
Virtually all diabetics who have had higher than normal blood sugars for
more than five years can suffer some loss of sensitivity in their feet to pain,
pressure and temperature. Long-term elevated blood sugar may also cause
impairment of circulation in the major arteries of the legs, as well as veins
and capillaries.
Talk to your Doctor and have your fasting blood sugar levels and HbA1c
checked as well.

I am 54 years old and have Type 2 Diabetes. Is this why I can no longer
have an erection?
I would say 50% of males with diabetes have this difficulty. But before
blaming diabetes, are you taking medications for high blood pressure or
depression? Eliminate all other possibilities first.
How long have you had diabetes and how well controlled are your blood
sugar levels? Check with your Doctor and take along your blood sugar
readings to help him with your diagnosis. Fortunately, nowadays there are
many approaches to treatment of erectile dysfunction and the success rate
is high.

Beverleigh H Piepers RN 2009

http://drugfreetype2diabetes.com

No-Nos in a Nutshell List by Richard K Bernstein, MD

Here is a concise list of foods to avoid:

To Cure Diabetes Naturally Click Here

Sweets and Sweeteners
powdered sweeteners (other than stevia)
candies especially so-called sugar-free types
honey and fructose
most diet and sugar free foods (except sugar-free Jell-O gelatin when
the label doesnt mention maltodextrin and diet sodas that do not
contain fruit juices or list other carbohydrates on the label)
desserts (except Jell-O gelatin without maltodextrin no more than !
cup per serving) and pastries: cakes, cookies, pies, tarts, etc.
foods containing as a significant ingredient, products who end in ol or
ose (dextrose, glucose, lactose, mannitol, mannose, sorbitol,
sucrose, xylitol, xylose, etc), except cellulose; also corn syrup,
molasses, maltodextrin, etc.
Sweet or Starchy Vegetables
beans: chili beans, chickpeas, lima beans, lentils, sweet peas, etc.
(string beans, snow peas and bell and chili peppers, which are mostly
cellulose, are okay, as are very limited amounts of many soybean
products)
beets
carrots
corn
onions, except in small amounts
packaged cream spinach containing flour

Beverleigh H Piepers RN 2009

http://drugfreetype2diabetes.com

parsnips
potatoes
cooked tomatoes, tomato paste, tomato sauce and raw tomatoes
except in small amounts
winter squash

Fruit and Juices

all fruits (except avocados)
all juices (including tomato and vegetable juices except for some
people, in a small Bloody Mary)
Certain Dairy Products
milk
sweetened, flavored and low-fat yogurts
cottage cheese (except in very small amounts)
powered milk substitutes and coffee lighteners
canned milk concentrate
Grains and Grain Products
wheat, rye, barley, corn, and lesser known alternative grains such as
kasha, quinoa and sorghum
white, brown, wild rice or rice cakes
pasta
breakfast cereal
pancakes and waffles
bread, crackers, and other flour products including whole grain
breads

Beverleigh H Piepers RN 2009

http://drugfreetype2diabetes.com

Prepared Foods
most commercially prepared soups
most packaged health foods
snack foods (virtually anything that comes wrapped in cellophane
including nuts)
balsamic vinegar (compared to wine vinegar, white vinegar, or cider
vinegar, balsamic contains considerable sugar)

Vegetables
Most vegetables, other than those listed in the No-No section are
acceptable. Dr Bernstein mentions cooked vegetables tend to raise blood
sugar more rapidly than raw vegetables because the heat makes them
more digestible and converts some of the cellulose to sugar.
Beets. Like most other sweet-tasting vegetables, beets are loaded
with sugar. Sugar beets are a source of table sugar.
Carrots. After cooking, carrots taste sweeter and appear to raise blood
sugar much more rapidly than when raw. Even raw carrot should be
avoided.
Corn. Not a vegetable at all but a grain. Nearly all of the corn grown in
the US is used for two main purposes. One is the production of
sweeteners. Most of the sugar in Pepsi-Cola comes from corn. The
other main purpose is animal feed, eg. fattening up hogs, cattle and
chickens. Diabetics should avoid eating corn, whether popped,
cooked, or in chips.
Potatoes. For most diabetics, cooked potatoes raise blood sugar
almost as fast as pure glucose, even though they do not taste as
sweet.

Beverleigh H Piepers RN 2009

http://drugfreetype2diabetes.com

Tomatoes, tomato paste and tomato sauce. As you know tomatoes

are actually a fruit not a vegetable, and as with citrus fruits, their tang
can conceal just how sweet they are. The prolonged cooking
necessary for the preparation of tomato sauces releases a lot of
glucose.
Commercially prepared soups. Many commercial soups can be loaded
with added sugar, as much as in a soft drink. Even if there wasnt, the
prolonged cooking of vegetables can break the special glucose bonds
in the cellulose of the slow-acting carbohydrates, turning them into
glucose. Add to that the common inclusion of potatoes, barley, corn,
rice and other unacceptable foods and you have a product you
should avoid.

Health foods. Dr Bernstein says that of the hundreds of packaged food

products that you see on the shelves of the average health food
store, perhaps 1% is low in carbohydrate. Many are sweetened with
honey or other so-called natural sugars.

I included this last section as maybe an alternative to your present eating

plan. If you are having difficulty with your blood sugar levels, eliminating
some of the foods on this No-No List may be worth considering.
Thats it for now.

The End

Beverleigh H Piepers RN 2009