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  Chat Transcript
Open Q&A – K.K., Rajamani, M.D., September 26, 2012
 Dr. Rajamani @ Unity:
 Welcome to the Unity Diabetes Online Community! I’m Dr. Rajamani, an endocrinologist at the Unity Diabetes Center, and I’ll be hosting today’s chat. We’re glad you could join us today. I’m excited to answer all of your diabetes-related questions.
 Dr. Rajamani @ Unity:
Before we get started let me just tell you how we’ll address your questions and comments today. I answer questions one at a time, in the order that they are posted to the site, and there might be a slight delay as I respond to each question. It may take a few minutes for me to type answers to your questions, so please stay logged-in to the chat to see my response, even if it takes a few minutes. And you might need to refresh every few minutes to keep up with the latest posts in the chat. Let’s get started.
 LilacBaby:
 Could you recommend a brand of pasta that's safe for Type II diabetic?
 sassy35:
 Is it normal for your A1C to slightly increase year to year?
 Dr. Rajamani @ Unity:

 Hi LilacBaby. Generally for pasta you would like to use a whole grain pasta. Some pastas have a higher glycemic index which is a measure of how much a measured amount of carbohydrate will raise the blood sugar. You can check the carb content on the side of the box. As a reference to the type of pasta, there is a recent (within the past year) article in Diabetes Self Management on pastas and brand names available. I like the Barilla whole grain pastas which have some more fiber.

  Dr. Rajamani @ Unity:
 Hi Sassy35, I cannot think of a reason why A1C will increase year to year. A1C is tied to the level of your sugar over a period of a few months and also to your red blood cell life span . If something affects either one of them this can affect the A1C.
 sassy35:
 What is the normal range for A1C?
 Dr. Rajamani @ Unity:
 LilacBaby, Is there a particular type of pasta that you like?
 RyanRoc:
 My mom is in her 70's. She was told she is close to diabetic. But she is not overweight. Why would she become diabetic?
 Dr. Rajamani @ Unity:
The normal range for the A1C is 4-6%. In diabetes, generally the aim is to get this (if possible) close to or below 7 without causing side effects from the treatment.
 LilacBaby:
 Yes, I think it's called Field Streams. They advertise it as low glycemic.
 LilacBaby:
 Let me go check.
 Dr. Rajamani @ Unity:
 Hi RyanRoc, pre-diabetes is common.. Some older people may actually have a condition called "latent auto immune diabetes of adults" which is a type of diabetes which can occur in older people who are generally not overweight.
 LilacBaby:
 Sorry ... it's called Dream Fields. They only have a few varieties. 5 g of digestible carb per serving.
 sassy35:
 LilacBaby - I'm curious - where do you buy that Dream Fields pasta?
 LilacBaby:
 I ordered it from Amazon because of the reviews.
 Dr. Rajamani @ Unity:
 I haven’t tried Dream Fields but you may need to check the fiber content and also the source of grain.
 LilacBaby:
 Here is a link: http://www.amazon.com/Dreamfields-Healthy-Living-Spaghetti-13-25-Ounce/dp/B004YN7X3G/ref=sr_1_2?ie=UTF8&qid=1348704780&sr=8-2&keywords=dreamfields+pasta
 sassy35:
 Lilac Baby - how does it taste??
 LilacBaby:
 It tastes great. Better than the type I used to buy. It's a little bit more chewy.
 sassy35:
 Dr. Rajamani - I keep hearing flu shots being advertised? Are people with diabetes at any special risk for flu? Should I consider getting a shot?
 Dr. Rajamani @ Unity:
 I like pasta and it is hard to avoid eating too much of it.
 LilacBaby:
 I know :-)
 sassy35:
 Thanks for the tip LilacBaby - I'll have to look for that kind online.
 LilacBaby:
 You're welcome!
 Dr. Rajamani @ Unity:
 Flu shots are recommended for most people and you should really think of getting one.
 Dr. Rajamani @ Unity:
 There are also other vaccines that are recommended for patients with diabetes including a recent recommendation to get hepatitis B vaccination.
 RyanRoc:
 I don't want my mom to become diabetic. Is there anything she can do?
 RyanRoc:
 She has arthritis and can not exercise much.
 Dr. Rajamani @ Unity:
 Even if your Mom does not have diabetes, exercise and being careful with foods can help to control blood sugars. If she is not overweight she could be tested for an antibody called GAD ( glutamic acid decarboxylase) to see if she has the LADA type of diabetes. Could your Mom use water exercises in a pool?
 RyanRoc:
 Yeah, she could if she has access to a heated pool.
 RyanRoc:
 Thanks, Dr. Rajamani. I'll ask her to get tested for GAD.
 Dr. Rajamani @ Unity:
 If she has significant arthritis a physical therapist may help. Unity actually has a pool for patients with arthritis which is supervised by therapists.
 sassy35:
 Dr. Rajamani - How do I get that hepatitis B vaccine - just ask my doctor for it?
 Dr. Rajamani @ Unity:
 You could check with your doctor. I do not know about the coverage but assuming that with the recommendation to vaccinate patients with diabetes most insurance companies may provide coverage.
sassy35:
 Thanks, Dr. Rajamani - I'll ask my doctor about it. And probably get a flu shot! There aren't side effects, right?
 Ama1981:
 What type of insurance does Unity accept?
 Dr. Rajamani @ Unity:
 Some people may get some body aches and flu like symptoms. Most patients are fine with no problem.
 Dr. Rajamani @ Unity:
 Hi Ama 1981, I think Unity accepts most type of insurances. For patients who meet certain criteria Unity also provides care with no insurance.
 Ama1981:
 Do you have a social worker I can contact?
 Dr. Rajamani @ Unity:
 LilacBaby, I am going to check out the pasta that you had recommended.
 LilacBaby:
 Good. I hope you like it. I really like it when it's cooked el dente.
 Dr. Rajamani @ Unity:
 I would contact Unity OnCall at 368-3000. They could help you with information about all of Unity's services.
 Ama1981:
 Okay. Thanks.
 Dr. Rajamani @ Unity:
 That’s all the time we have for today. I’ve really enjoyed our conversation and hope that I was able to provide some insight for you. If we didn’t get to your question today or if you think of another question later on – feel free to jump into the conversation in the forum, or submit a question using our “Ask an expert” feature. Be sure to join us for our next chat Wednesday, October 10 at 8 p.m. – an open Q&A session with Joy Valvano. She will also be sharing information about a plant-based diet.
 
 
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