Category Archives: low blood sugar

Seven Tips People Living With Diabetes Mellitus Type 2 Can Use to Make the Most of an Office Appointment with Their Healthcare Provider

Diabetes MellitusFor some people living with diabetes mellitus type 2, an appointment with their healthcare provider, particularly a doctor, can be overwhelming.

When I was in a primary care practice, I often told my patients that for the most part they had an average of four to six office appointments a year. The typical primary care visit is limited to only 15 minutes. So you need to prepare ahead of time to make the most of the appointment.
Here are seven tips you can use to make the most of your office appointment. If you use all these tips, you will get the most out of every visit to the doctor.

Tip Number 1: Take a Long Record of Your Blood Sugars

Make a habit of keeping a record of your blood sugars. Keep it simple. You do not need fancy computer software. All you need is a small notebook. You can get this at any office supply or drug store. Divide each page of the notebook into at least two columns.

The first column is for the date and time that you check your blood sugars. The second column is to a record of your blood sugar levels.

Some people do not like to prick their fingers to check their blood sugars. I’ve shared in an article some tips on how to check your sugars once a day. Over the period of a week you be able to trend of how your blood sugars are running.

By keeping a log of your blood sugars, it helps provide important feedback for you as well as your healthcare provider. For instance if your blood sugars suddenly begin to run high or low, you can pinpoint the exact time this happened. Perhaps you were sick, had started an exercise program or went on vacation and over-indulged in food. All this information can help you and your healthcare provider to make important decisions regarding your diabetes management.

Tip Number 2: Take Along Your Glucometer

When I was in an office based practice, I liked to look over the blood sugar readings on my patients’ glucometers. A number of the new generation glucometers provide a lot of valuable information. For instance some machines average the sugars over say a 14-30 day period. Others may average the blood sugars before and after meals. This is a great teaching tool for diabetic patients. It allows them to see how their blood sugars affects their overall health and wellbeing.

Tip Number 3: If Your appointment is First Thing in the Morning Do Not Eat Breakfast

Take advantage of an early morning appointment with your healthcare provider and arrive ‘fasting’. Nowadays, a lot of healthcare providers perform blood tests in their offices to check blood sugar, A1C and lipid profile. For more information on the importance of knowing your numbers, click here.

Tip Number 4: Always Carry a Snack

Has this ever happened to you? You are at the doctor’s office and the wait time is longer than you planned. But you had taken your medications earlier on in the day. Next you begin to experience the ‘bottoming out’ sensation as your sugars take a nose-dive.

Next thing you know it you’re being carted into a waiting ambulance to the emergency room!

I advise people living with diabetes to always carry around a piece of ‘hard candy’. I also recommend meal replacement bars such as glucerna. So always be sure to take a snack along with you wherever you go.

Tip Number 5: Keep a Journal and Take This Along to Your Visit

Living powerfully with diabetes requires that you do things a little differently than the crowd. Keeping a journal or a diary is one of those things. A lot of times, a journal is for your personal use. However at times it may help your healthcare provider to detect why your sugars may be running high or low.

There are several ways you can choose to journal. For instance, you can keep a food journal. If you keep a record of what you eat, you may notice there are certain foods that make your blood sugars go up.

This gives you a good idea of knowing what foods to reduce or what to take out of your diet completely.
You may find out that stress affects your blood sugars. Some people may prefer to journal and record their blood sugars in the same book. Decide what works for you and just do it.

Tip Number 6: Be Prepared to Take Off Your Shoes and Socks

Foot care is a very important aspect of diabetes care. Inspecting the feet helps to prevent or detect early foot infections, which could lead to other complications. I always insisted on looking at the feet of all my diabetic patients at least every 2-3 months.

It is also important to make sure that you have sensation on the bottom of your feet.

Your physician can perform a very simple test called a fine filament test on your feet. This is a simple instrument and as there name suggests a thin filament. If you do not feel the filament being pressed on the bottom of your feet, you may be developing a complication called diabetic neuropathy. This is when the nerves are damaged and you can no longer feel your feet. The danger is that you could step on a nail for instance and not know because you could not feel it.

Diabetic neuropathy is one of the leading causes of amputations in people living with diabetes mellitus. So make sure that your doctor performs this test on your feet every three months.

Tip Number 7: Be Prepared for Change

In diabetes type 2 is a disease that has the potential to change over time. Regimens that worked earlier on may not work so well as the disease advances. As time goes on it may get harder to control your blood sugars. So be prepared for change.

For example you may have been on a medication for a long time and your blood sugars had been well controlled. All of a sudden your blood sugars start running high. Your doctor may decide to add another medication or even insulin. Always believe that your healthcare provider has your best interest at heart.

I know that there are a lot of skeptics out there about the pharmaceutical industry. Research is being conducted to develop new drugs, which may help preserve the function of the pancreas.
To reduce the potential complications of type 2 diabetes follow your doctor’s advice. In the first three chapters of my upcoming book, “Dr Eno’s A-Z Guide to Living Powerfully with Type 2 Diabetes” I address three strategies that are important in order to embrace change. To download a free copy of my e-book that covers this, click here.

As always I welcome your comments and suggestions about more topics you would like to learn about.
To your health & wellbeing,

Seven Tips On How to Maintain Healthy Blood Sugars During The Holiday Season


I recall a number of years ago, when a patient left my office based practice and sent me a very nasty note three months later. She expressed how disappointed she was that I was not a person of my word. I had assured her that due to the fact that her blood sugars were well controlled and her A1C was less than 7% that I would attempt to wean her off some, if not all her medications.

The catch was that at the time that this discussion was going on, the holiday season was also upon us. I had made a mental note to address this in the New Year, as I hate to see anyone fail due to no fault of his or her own.
I should have educated my patient on what it was that I intended to accomplish and my reasoning.

For people living with type 2 diabetes, this is one of the more challenging times of the year. Blood sugar levels may gradually begin to rise with each holiday party. And with that, the A1C rises.

By following these seven simple steps, you can survive the holiday season and come out a winner ready to embrace 2017 as you live powerfully!

Tip number 1- Plan your meals

In order to keep blood sugars within a normal range, planning your meals is very important at this time of the year.

Here’s a simple tip-If you know that you are going to be out at a holiday party later on in the day, consider having a light snack just before leaving home. That way you are less hungry and less likely to go for the sweets that will cause your sugars to rise.

Also consider cutting down on the portion sizes of your earlier meals. Be careful if you are on insulin or an oral hypoglycemic agent not to cut down too low so that you do not experience hypoglycemia.

Tip number 2- Increase your amount of fiber intake

Fiber is a complex carbohydrate. The average American diet contains a low level of fiber. Most nutritionists recommend a daily fiber intake of up to 35G.

Studies have shown that by increasing the amount of fiber in the diet can help control blood glucose levels. This is especially if it is soluble fiber. An example of soluble fiber is oatmeal.

Fruits and vegetables are all good sources of fiber. By making a conscious choice to increase the amount of fiber rich foods in your diet will get you to your goal of maintaining a normal blood sugar range throughout the holiday season and beyond.

Tip number three- Plan to incorporate physical activity

The Winter & Holiday season is traditionally the time when the average American gains between 7-10 lbs. Studies have shown that people living with type 2 diabetes can achieve normal blood sugar range by increasing physical activity. During the winter months make an effort to maintain some form of physical activity. Choose an exercise regimen that is easy to follow.  As always be sure to see your physician before starting out on an exercise program. So if you have not already scheduled your annual physical, now is a great time to go ahead and do so.

Tip number four- Drink enough water

There are a myriad of benefits to drinking water. The important thing in a type 2 diabetic is to maintain good kidney function. Drinking water may also keeps you feeling full and so help with weight loss. The traditional recommendation has always been 8 glasses of water a day. However something else to consider is drinking half of your body weight in ounces. So if you weigh 170 lbs. that equals 85 ounces of water a day.

Tip number five- be consistent with monitoring your blood sugars

This is not the time of the year to slack off testing your blood sugar levels.  It is not the time to stick your head in the sand and rationalize that your blood sugar levels are going to be high and there’s nothing you can  do about it anyway. Your mindset is very important. If you have not been checking your blood sugar levels regularly, this is the time to start. By regularly checking your blood sugar levels,  you get instant feedback. Living powerfully with diabetes, requires that you have an awareness attached to action. High blood sugar levels just do not happen to you. You can make the necessary adjustments in your lifestyle in order to control your blood sugars.

Tip number six- Keep all scheduled appointments with your healthcare providers

This is the time to make your healthcare provider aware of any challenges that you may be encountering during the holiday season. That way you both can explore ways to better control your blood sugar levels.

Depending on your A1C, your healthcare provider may decide to adjust your medications. This is a much better option than starting out the New Year with high A1c levels and blood sugar levels out of control. Sometimes it can take more than 6 months to normalize the blood sugars.

Tip number seven- Enlist the support of family and friends

I have written in a previous article about the importance of a support network. Now more than ever is the time of the year to enlist the support of family and friends. Want to get started in an exercise program? Call up a workout buddy. Not sure how to handle ‘Aunt Martha’s’ three layer chocolate cake? Have a family member share a portion with you. It takes teamwork to make the dream work. Do not be afraid to ask for support. Sometimes just knowing there is someone else looking out for you is what makes the world of difference.

I’d love to read your comments and any other strategies that you may have in place to ensure that you keep your diabetes type 2 sugar levels normal this holiday season and beyond.

Until next week,

Here’s to your Health & Wellbeing,


Reducing Low Blood Sugar Complications in Type 2 Diabetes

low blood sugarHello and welcome back to another addition to Women Living with Diabetes

Today I am going to write about a potential complication when treating diabetes especially when using drugs. This complication is low blood sugar known by the medical term hypoglycemia.

Some drugs used to treat type 2 diabetes can cause low blood sugar levels.

Low blood sugar (hypoglycemia) is when the blood sugars drop below 70 mg/dl.

From what a lot of people living with diabetes tell me, this is one complication that they do not like to experience. And from my experience as a physician in clinical practice, once a person experiences this, they will do all they can to avoid it in the future.

Some of the things they may do in order to avoid feeling that way may include cutting down the dosage of their drugs, skipping their drugs, or eating more carbohydrates.

Symptoms of low blood sugar levels

  • Feeling very hungry
  • Nervousness
  • Feeling Irritated
  • Confusion
  • Slurring of speech
  • Sleepiness
  • Sweats
  • Light headedness or dizziness
  • Weakness
  • Anxiety
  • Sudden change in personality

The dangers of low blood sugar levels

Low blood sugar is especially dangerous if it occurs during sleep. Because the brain uses sugar (glucose) exclusively for energy, without enough sugar, a diabetic may slip into a coma.  If this is discovered and treated early, by giving glucose, then no permanent brain damage occurs. However if the low blood sugar persists for many hours then the nerve cells in the brain could begin to suffer permanent damage. At that point it cannot be reversed.

This is why it is very important that a person living with diabetes wears a bracelet letting people know that they have diabetes.

Some causes of low blood sugar levels in a type 2 diabetes

  • Medications- Medications called oral hypoglycemic agents and also injectable medications like insulin are common causes of low blood sugar. Also medications called ACE-Inhibitors and ARBs  can also cause this. These are commonly used to treat heart disease, hypertension and early kidney disease in type 2 diabetes.
  • Increased physical activity- Exercise helps to control type 2 diabetes. It does this by improving how sensitive the cells in the body are to the effects of insulin. The more sensitive the cells, the better they use insulin and so the lower the blood sugars. This is the goal of treating type 2 diabetes. However when a person with type 2 diabetes starts to exercise, it may become necessary to adjust the medications that they are taking. If this does not happen then the result may be low blood sugar levels.
  • Alcohol intake. Alcohol can reduce the blood sugars by affecting the way that the liver stores sugars. For this reason, it is important for someone living with diabetes type 2 to drink alcohol in moderation.

How to treat low blood sugar

If you notice a friend or relative who has type 2 diabetes start acting in a strange manner, especially if they have any of the symptoms that I have listed ACT FAST. GIVE SUGAR.

Here are some suggested ways to do this

  • 4 ounces of regular soda not diet soda
  • 4 ounces of fruit juice or milk
  • 6 pieces of hard candy not no sugar candy
  • A tablespoon of honey
  • 3-4 glucose tablets

Once you give them some sugar, stay with them until they become more alert. Check their blood sugars in about 15 minutes. If it is still lower than 70 mg/dl repeat with any of the things listed above. If they are able to have a conversation with you and not drowsy or unconscious, have them eat a light meal and then repeat the blood sugars again. If the blood sugars are still less than 70 mg/dl then call 911!! If at any point you notice that they are lapsing into unconsciousness, call 911.

Low blood sugar can be a very scary experience not only for a person with type 2 diabetes experiencing it but also the people witnessing it.

If you have several episodes of hypoglycemia that you don’t seem able to explain, then make an urgent appointment to discuss this with your primary care physician.

Ways to prevent hypoglycemia

  • Make sure that if you are taking oral hypoglycemic medications or insulin that you eat shortly after taking your medications.
  • Plan out regular meals throughout the day. Be sure to include snacks. Try not to stay more than 2 -3 hours without a snack or a meal. Binge eating can cause the sugar levels to fluctuate widely.
  • Before you exercise, check your blood sugar. It is a good idea to have a snack especially if your blood sugar is less than 100 mg/dl. Also eat a snack if you plan to exercise for longer than an hour.
  • Limit the amount of alcohol that you drink. If you must have an alcoholic beverage, check your blood sugars to make sure that they are not running low. If you drink alcohol try to limit it to one drink.

I hope this information is useful. As always I welcome your questions, comments, suggestions for upcoming articles.

Until next week,

Here’s to your health & wellbeing’,