Diabetes, Websites, Apps Oh My!

February 28, 2017

If you missed our February 16th Support Group, don’t worry!  Here is a list of our recommended applications for your mobile devices and websites to help track your diabetes:

BG Monitor Diabetes: Allows you to track everything, calculate how much insulin you need, set reminders, create spreadsheets and graph your data. Organize your entries with tags.  Create a photo log of meals.

My Fitness Pal: Track food intake, exercise and weight. At the end of each day you are given an overall nutritional snapshot of your eating and an estimate of how long it will take to reach your weight loss goal based on current eating habits.  You can also log activity from an extensive list of exercises and the app will calculate calories burned.  You can also input numbers from a heart rate monitor from your treadmill for example of some other fitness tracker.

Calorie Counter PRO: This is a weight loss app that can help track your daily eating and can be useful when managing your diabetes. It allows you to chart your progress and take daily notes without being overwhelming.  It also tracks body measurements.

Glucose Buddy: Tracks food, insulin, blood sugar results and will show a graph of your glucose results. You can set an alert to remind you to check your blood glucose throughout the day.

Lose it: Used for weight management. Create a profile and use the apps recommended amount of calories for weight loss or input your own.  It has a large food database.  Input custom foods, scan bar codes or it will suggest foods based on a photo of your meal or snack.

MySugr: Track everything in one place, meals to mood. Create monthly reports.  This app does offer advanced services for a fee.

Fooducate: Offers good community support, has a scanner that gives groceries a grade. Good choice if feeling overwhelmed at the grocery store.

Diabetes Goal Tracker: This app was developed by the American Association of Diabetes Educators. Set goals to manage diabetes based on the 7 self-care behaviors we use when tracking our program participants.  Set goals for yourself and the app will send you reminders to help keep you on track and give inspiration.  The My Nutrition section allows you to scan bar codes of foods or enter foods and track calories, carbs, fat and sodium.

Diabetes.org: This is the main website for the American Diabetes Association. Under the Food and Fitness tab you will find tips for eating out, planning meals, and carbohydrate information.  Under this tab is also a link to My Food Advisor where you can find nutrition information about various foods and even create a database of your own recipes.  You will need to create an account, but it is free.

Diabetesselfmanagement.com: This site was created by the providers of Diabetes Self -Management magazine. Good resource for recipes and general information about caring for diabetes.

Nutritiondata.com: Create your own food database; use the website to analyze nutrition content of your favorite recipes



Blood Sugar Swings

August 9, 2016

Do you ever experience blood sugar swings? A recent article in Diabetic Living discussed 10 reasons for blood sugar swings.

  1. Improper Control: Routinely checking your blood sugar levels, taking medications correctly, and meeting healthy lifestyle recommendations all play a role in helping to control your blood sugars.
  2. Sugary Drinks: Sugars hidden in specialty drinks, like special coffee drinks or mixed drinks can pack in carbs and cause blood sugar spikes. Know the ingredients and limit added sugars.
  3. Medication Mistakes: Taking the wrong dose of medication can cause a swing in blood sugar. Prevent incorrect dosing by using a pill box and by asking questions at your doctor’s office and at the pharmacy.
  4. Illness: Coming down with a bug can mean spikes in sugar levels. When you are sick – anything from the flu to food poisoning, your liver releases extra sugar. Stay hydrated. Check blood glucose more often.
  5. Inaccurate Counting: Letting those portion sizes get away from you can lead to miscalculating the number of carbohydrates you are actually eating. Use measuring cups and spoons.
  6. Stress! Stress comes in all forms – physical, mental, and emotional. Sudden bouts of stress can cause blood sugar to spike or drop! Practice relaxation exercises.rollecoaster
  7. Irregular Carbohydrate Intake: Consistent carbohydrate intake is the key. Spread your in-take out throughout the day to help ensure sugar levels remain steady.
  8. Your Period: Your blood sugar readings may swing around your period. Changing hormones in your body around that time of the month can raise your blood sugar.
  9. Pushing too Hard too Fast: High intensity workouts that push the body out of its comfort level can cause low and high blood sugars. Increase the length and intensity of your exercise in increments!
  10. Dehydration! If you don’t have enough water in your system, sugar concentrates in your bloodstream. Drink plenty of water throughout the day. Your urine should be close to clear if you are drinking enough.


Source: Diabetic Living; Precision Nutrition

Heat and Humidity – What about those Test Strips???

July 5, 2016

By Susan Klick, MSN, RN, CNL

Summer Storage of Test Strips: Heat, humidity, temperature and exposure to air can all affect strips. Store test strips at a temperature less than 86 degrees F.  DO NOT FREEZE and DO NOT expose test strips to direct sunlight.

Other Good Test Strips Tips:

Loose diabetes test strips. If you put individual diabetes test strips into your purse or wallet this can affect the accuracy (unless they are foil-wrapped from the manufacturer). Also, try not to move the few remaining strips of one vial into the new vial you are opening if the code numbers don’t match. And if you have one vial of diabetes test strips at home and one vial at work but just use the one meter – make sure the vials have the same coding. WAIT!!! Ahhh. . . and one more thing. Even if the strips have the same code, they may have different expiration dates! After transferring a few strips a couple of times, you could end up with some pretty outdated strips floating around in a vial!

Age of blood sugar monitor: Old blood sugar monitors may be inaccurate simply because of age. But old diabetic meters also tend to need cleaning or the dirt/dried blood could affect the accuracy of the reading. Be sure to follow cleaning instructions from the manual to ensure accurate results. If you have a diabetic meter older than 5 years please consider calling the meter company (often there is a 1-800 # on the back of the meter) and asking for a free updated model. They should want to keep you as a customer buying their strips.

Expired diabetes test strips? Check the expiration date when the pharmacy gives you the diabetes test strips. If you don’t feel you’ll be using them before that date, ask for another batch with a later date

Underfilled? Most newer meters have under-fill detection of some sort, and some beep after a few seconds even if the chamber isn’t full.   You may get a reading lower than anticipated.   Some meters tend to “err” and waste strips if you don’t hold your finger in place long enough. It’s a good practice to hold your finger to the strip for 1-2 seconds after the beep to avoid wasting diabetes test strips because of under fill.

Date vial opened? For some diabetes test strips, once you open the vial you should use the content of the vial within 3 months no matter what the expiration date (because of repeated exposure to air). Some products have a lid with a preservative in it so they are supposedly good up until the actual expiration date on the bottle. However, other vials of strips are good for a limited time once the lid is opened (regardless of the date). Check the information in your diabetes test strip box to be sure.

Storage of meter: Don’t leave blood sugar monitors in the car on hot or freezing days. They are just tiny little devices and you know how temperamental electronics are.

Have a safe and healthy summer!




Source: American Diabetes Association


Hyperosmolar Hyperglycemic State – Watch Out

May 24, 2016

by Susan Klick, MSN, RN, CNL Diabetes Educator

Hyperosmolar Hyperglycemic State (HHS) is a serious condition caused by extremely high blood sugar levels. The condition most commonly occurs in people with type 2 diabetes, but can occur in those with type 1 as well.   It’s often triggered by illness or infection. As a result, your body tries to rid itself of the excess blood sugar by passing it into your urine. Left untreated, this condition can lead to life-threatening dehydration. Prompt medical care is essential. Take a few minutes to learn about this very serious, life-threatening complication.

What is it?

HHS is the most serious acute hyperglycemic emergency associated with diabetes that involves extremely high blood sugar (glucose) levels and severe dehydration. The buildup of ketones in the body (ketoacidosis) may occur, however it is unusual and often mild.

Why does it happen?

HHS can occur for several reasons:

  • Infection (such as a urinary tract infection or pneumonia)
  • Illnesses such as heart attacks, congestive heart failure, strokes, kidney disease or recent surgery
  • Certain medications such as corticosteroids (prednisone), diuretics (hydrochlorothiazide, water pills); anti-seizure medication (Dilantin) and some anti-psychotics; any medication that can raise blood sugar levels
  • Missed or not enough insulin
  • Undiagnosed diabetes, or not monitoring your blood sugar


HHS can take days or weeks to develop. Possible signs and symptoms include:

  • Blood sugar level of 600 or higher
  • Dry mouth
  • Increased urination (particularly at the beginning)
  • Warm, dry skin
  • Fever
  • Weakness
  • Drowsiness, confusion
  • Hallucinations
  • Vision loss
  • Convulsions
  • Coma


This condition is a medical emergency. Go to the emergency room or call 911 if you develop symptoms of HHS. The best treatment plan is prevention by recognizing the early signs of dehydration and infection and monitoring blood sugars regularly.

The goal of treatment is to correct the dehydration, which will improve blood pressure, urine output, and circulation. Fluids and potassium will be given and high glucose levels are treated with intravenous insulin. Without proper treatment HHS can lead to shock, blood clot formation, brain swelling, increased blood acid levels and even death.



Sources: Mayo clinic.org. and the American Diabetes Association

Christmas is a Mixture of Things

December 22, 2015

by Susan Klick, MSN, RN, CNL

Christmas 2015

First, we at the Outpatient Diabetes and Nutrition Services office at St. Anthony’s Medical Center would like to wish each of you and your family a very Merry Christmas and a Healthy 2016!

Christmas is a mixture of many things – presents, excitement, food, drink, travel, guests, worry, stress – especially if this is your first Christmas with diabetes. Celebrating Christmas is not just a time for presents but also about food. We all eat a lot more than we should and we tend to eat more of the sort of food that is not exactly ideal for people with diabetes. You can’t really take a day off from diabetes but it is also important to remember that Christmas is a time to be enjoyed with family and friends.

Thing to Remember!

  • Stress tends to raise blood sugars
  • Eating more than usual can raise blood sugars
  • Exercise lowers blood sugars, so a walk after a big Christmas dinner will help to lower them.
  • Avoid keeping extra food around to nibble on.
  • Stay active – exercise reduces stress, burns excess calories and helps control blood sugars.
  • Pamper yourself! Whether by taking a relaxing bath or curling up with a book, make time for yourself. Get plenty of rest to prevent holiday tiredness.
  • Plan! Make sure that you have enough medication/insulin to cover the Christmas/new Year holidays.

If you take insulin or medications that can cause hypoglycemia (low blood sugar) remember the following tips:

  • Excitement tends to lower blood glucose levels (especially if you take insulin).
  • Try to keep meal times as near as possible to your usual times but if meals are later, then you need to remember to have a snack.
  • Maintain your blood glucose testing schedule as much as possible and test more often if you are eating more frequently or at irregular times.

A word (or two) about Alcohol:

  • Alcohol lowers blood glucose levels, not just while drinking, but for 24 hours afterwards!
  • Drink in moderation (good advice for all).
  • Limit yourself to 1 or 2 drinks
  • Drink alcohol with food, not by itself. Make it part of a meal.
  • Do not drive after drinking alcohol

Be safe and healthy this Christmas!





Insulin Dependent Diabetes Trust




Blood Glucose Monitoring has a Top Ten List

June 22, 2015

by Susan Klick, MSN, RN, CNL

This is Part One of a two part blog on monitoring blood glucose.  This week we will look at the Top Ten Reasons something so easy….becomes such a big deal. In Part Two, we will look at overcoming these common barriers.   So here we go… The Top Ten Reasons to Avoid Testing Your Blood Glucose:

Reason #1: Your meter makes you feel bad about yourself – Do you judge yourself based on your results? Do you think of blood glucose monitoring as a “test”, and the resulting number a grade? You begin to think of high numbers as a failing grade.   Naturally, the meter ends up in a drawer.

Reason #2: Monitoring seems pointless – Do you ever think to yourself, “why bother testing, how is testing going to change the fact that I have diabetes?” It is frustrating to work hard to manage your blood glucose, and continue to get results that don’t make any sense. And so the meter ends up in a drawer.

Reason #3: Monitoring reminds you that you have diabetes – Who needs to be reminded that they have diabetes?   Testing can be seen as an irritating, annoying reminder that you have a disease that isn’t going away, that you will have to deal with the rest of your life. Back in the drawer with the meter.

Reason #4: Your meter seems to control your life – If you constantly feel you are being pushed around by your meter, and view your meter as a bully; naturally you are going to stop monitoring.   High readings might be telling you not to eat so much, low readings might be telling you to wait before you drive or exercise. The monitor starts to control your life and limit your freedom. Who needs a puny machine telling you what to do – so you put it in a drawer upside down.

Reason #5: Monitoring gives friends and family an opportunity to bother you – “What was your sugar?” “You wouldn’t be that high if you hadn’t eaten that pasta for lunch” “My friend at work who has diabetes never eats….”   Suddenly everyone is an authority on diabetes, and this time the meter goes in the drawer and the drawer is slammed shut.

Reason #6: Your healthcare team is indifferent to the results – You spend hours making a beautiful spreadsheet, with circles and arrows, and a paragraph describing what you ate and how you felt, and what your blood glucose test results were. It’s in color. You make multiple copies. And your doctor gives it a superficial glance and says “let’s just keep observing your sugars over the next few months and see what happens”. You feel like your time was wasted. “Why bother” you say to yourself? Now the glucometer is in the back of the drawer and the pretty spreadsheet is deleted.

Reason #7: It hurts for goodness sakes! Sticking yourself should be relatively painless, but let’s be honest – you are sticking yourself and sometimes you may hit a tender spot. Your fingers get irritated, sore, and sometimes bruised. So you decide to “take a break” from monitoring, and the meter is covered with papers and other stuff in the back of the drawer.

Reason #8: Monitoring can be inconvenient – You are going out to dinner….don’t forget your meter. You are going on a trip….don’t forget your meter. You are going hiking, biking, swimming, fishing…..don’t forget your meter. It takes time, and it interrupts what you are doing. So the meter gets left behind (in a drawer covered with stuff) while you go out and about.

Reason #9 Monitoring can be expensive – If you don’t have good insurance, or if you are uninsured, you know that test strips can be costly, especially if you are testing several times a day. Once again, the meter is tossed aside.

Reason #10 Life is too busy and demanding to take the time for regular monitoring – At first, we start out with good intentions. Testing regularly isn’t a big deal. Until you are running late for work, or having to get dinner on the table before running the kids to practices and getting the grocery shopping done, and don’t forget to get your 30 minutes of exercise in. Testing gets pushed to the bottom of the list and doesn’t get done as frequently as it should, or doesn’t get done at all because life gets in the way.   Before you know it, the meter is completely forgotten in the back of the drawer, covered with stuff. You don’t even remember what drawer it is in!


Stay Calm

Tune in next time for Part Two….Overcoming Avoiding Testing Your Blood Sugar!



Diabetes Self Management

Managing Low Blood Sugar

February 3, 2015

by:  Susan Klick, MSN, RN, CNL

Do You Know How to Manage a Low Blood Sugar?

A recent online survey of both Type I and Type 2 diabetes revealed that many are uncertain of how to prevent and manage hypoglycemia (low blood sugar). Avoiding alcohol as a way to prevent hypoglycemia was reported by 30% of the participants and 49% were unaware that glucose tablets could be used to treat an episode. Forty-two percent of participants who had never experienced hypoglycemia were unable to correctly define what it is. Let’s take a look at the What – When – Why – and How of low blood sugar.

WHAT IT IS: Hypoglycemia or low blood sugar occurs when the blood glucose drops below the normal level. For most people, a blood glucose reading below 70 mg/dl is considered below normal.

WHEN IT OCCURS: Hypoglycemia happens when there is not enough glucose in your blood to provide the energy your body needs. You may experience symptoms when the level of blood sugar in your body falls below its normal range. This may happen if you do not eat enough food at a meal or a snack, or if you skip a meal. It may happen if you take more insulin or diabetes medicine than needed for the food that you eat. It may also occur if you exercise or are more active than usual. Drink alcohol without eating food can also cause hypoglycemia.

WHY IT IS DANGEROUS: This condition is dangerous because your brain is not getting enough glucose (sugar) to work properly. If there is not enough glucose for your brain to function, you may pass out or even have convulsions.

HOW TO RECOGNIZE HYPOGLYCEMIA: A low blood glucose reaction brings on uncomfortable feelings.  Mild symptoms occur in the early stage and include sudden hunger, headache, shaking, fast heartbeat, sweating, feeling tired or drowsy, feeling dizzy, having blurry vision, nervousness, and/or numbness or tingling around the mouth and lips. If not treated, you may experience symptoms of moderate hypoglycemia which can include personality change, irritability, confusion, poor coordination, difficulty concentration, and slurred or slow speech. If the reaction is still not treated, and your blood glucose continues to fall, you may pass out or develop convulsions. This is severe hypoglycemia and will require emergency treatment.

Some people have what is called “Hypoglycemia Unawareness,” a condition in which you lose the ability to feel the symptoms of low blood glucose until the blood glucose is very low. The first symptom may be confusion or passing out. This can occurs in diabetics who keep their blood glucose very close to normal or who have had diabetes for many years. It may be the result of having many episodes of low blood glucose.

HOW TO TREAT HYPOGLYCEMIA:   Check your blood sugar if you think it may be low or if you are experiencing symptoms. If your symptoms make you very uncomfortable and you feel that you do not have the time to check your blood glucose, eat first and then immediately check your blood sugar. If your blood glucose is less than 70 mg/dl:

  1. Treat with 15 grams of carbohydrates (4 oz. juice, 3 glucose tablets, ½ can soda, 8 Lifesavers)
  2. Wait 15 minutes and retest. It takes about 15 minutes for the sugar to raise your blood glucose level.
  3. If your blood glucose is less than 60 mg/dl, treat with another 15 grams of carbohydrates.
  4. If your next meal is more than an hour away, eat a snack of 15 more grams of carbohydrate and one ounce of protein (i.e. five crackers and one ounce of low fat cheese, half of a ham or turkey sandwich)

There may be times when your blood sugar is not low, but has dropped rapidly from a very high level to a lower level. Your body is reacting to the quick drop, not the actual level. You do not want to treat a normal blood glucose and cause it to rise above normal. However, continue to pay attention to your symptoms and your blood sugar. If the symptoms become worse or your blood sugar continues to drop, eat a snack with carbohydrates and protein such as crackers and peanut butter, crackers with cheese, half of a ham or turkey sandwich, or a cup of milk with cereal.

Note: Candy bars, ice cream and chocolate are not good choices for treating hypoglycemia.   Foods with fat or protein will not raise your blood glucose fast enough.

HOW TO PREVENT HYPOGLYCEMIA: The best ways to prevent hypoglycemia are to:

  1. Eat on time
  2. Make sure you eat enough food for the medication you are taking
  3. Do not drink alcohol without eating food
  4. Take your medication on time
  5. Be prepared. Always carry some form of carbohydrate (glucose tablets, juice, hard candy) in the event that a meal is delayed or you are more active than usual.


Healio Endocrine Today:   Survey: People with diabetes uncertain about management of hypoglycemia January 20, 2015.

BD Getting Started: Hypoglycemia and Diabetes

%d bloggers like this: