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Open Q&A and 2014 Tour de Cure - Cassie Wright, C.D.E. and Kelly Mueller, American Diabetes Association, March 25, 2014

Spring is upon us! Share exercise tips and menu ideas to "lighten up" now that the weather is nice.
Cassie@Unity:
Welcome to the Unity Diabetes Online Community! I’m Cassie Wright, a certified diabetes educator at Unity Diabetes & Endocrinology Services, and I’ll be hosting today’s chat. Today is Diabetes Alert Day and our guest tonight is Kelly Mueller from The American Diabetes Association. I’m glad you could join us today. We’re excited to answer all of your questions.
Cassie@Unity:
Before we get started let me just tell you how I’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.
Cassie@Unity:
And you might need to refresh every few minutes to keep up with the latest posts in the chat if you switch to another application on your computer.
Cassie@Unity:
Let’s get started.
KellyM@ADA:
Hi all. Sorry about the delay
Cassie@Unity:
Welcome Kelly! Glad you could join us.
eloughborough:
Good evening, Cassie.
KellyM@ADA:
Thanks for having me. We have had a fun day today spreading the word.
Cassie@Unity:
Hi eloughborough, so glad you could join our chat tonight.
dbhattac12345:
Does blood glucose level drop after exercise?
Cassie@Unity:
The positive publicity around Diabetes Alert Day has been fantastic. Could you take a moment, Kelly to tell us all about Diabetes Alert Day.
KellyM@ADA:
Sure and DBHattac, that will give Cassie time to answer you.
KellyM@ADA:
So Diabetes Alert Day is all about spreading the word about risk factors for diabetes. We want to catch the 79 million Americans who have pre-diabetes.
KellyM@ADA:
There is a big local and national push to have people take the risk test and share it with their families and friends so that people can engage in programs like the Diabetes Prevention Program.
KellyM@ADA:
One of the interesting conversations that we have had a lot today is about the risk of developing Type 2 if you had gestational diabetes or if you delivered a baby weighing more than 9 pounds.
KellyM@ADA:
A lot of people do not realize that those are two of the leading risk factors for developing Type 2.
Cassie@Unity:
Great question dbhattac! Exercise in many cases will lower blood glucose, even for several hours after finishing a workout. Are you referring to moderate exercise or intense?
dbhattac12345:
Moderate exercise
KellyM@ADA:
That is a good question. We are talking about how to plan meals around your workout on Monday morning on Fox Rochester.
Cassie@Unity:
In the case of moderate exercise, one can expect BGs to be lower after exercise. As you exercise, your muscles take up more sugar from the blood for energy. For this reason, we recommend patients exercise most days of the week for a minimum of 60 minutes. If 60 minutes is too much, start with a realistic goal you can tackle each day.
sassy35:
What symptoms should you be aware of if you're at risk?
Cassie@Unity:
Kelly, where can people take the risk test?
KellyM@ADA:
Common symptoms of diabetes: Urinating often; feeling very thirsty; feeling very hungry—even though you are eating; extreme fatigue; blurry vision; cuts/bruises that are slow to heal; weight loss—even though you are eating more (type 1); tingling, pain, or numbness in the hands/feet (type 2). See more at: http://www.diabetes.org/diabetes-basics/symptoms/#sthash.0s2tUAxw.dpuf
KellyM@ADA:
Risk Factors for Type 2: older than 45 years; men are at higher risk than women (slightly); women who were diagnosed with Gestational Diabetes or delivered a baby weighing more than 9 pounds; having a mother, father, sister or brother with Diabetes; if you have high blood pressure; if you are physically inactive; if you are overweight
KellyM@ADA:
People can take the Risk Test at www.diabetes.org/alertny
Cassie@Unity:
Very good information, particularly about pregnancy. If a woman has a 9-pound baby or had gestational diabetes during pregnancy, what should she do following the birth of her baby to screen for diabetes?
KellyM@ADA:
One of the biggest challenges is if people switch doctors. It is important that women tell their primary care physicians if they had gestational diabetes to make sure that they are aware of their increased risk.
eloughborough:
Great information Kelly. I will start using the risk test with my non-diabetic patients.
KellyM@ADA:
Prevention of diabetes and living healthy with diabetes all share the same messages: Eat a balanced diet and get exercise.
KellyM@ADA:
Good targets for preventing diabetes are to get 150 minutes of exercise each week: 30 minutes five times per week
KellyM@ADA:
The risk test is good because it is a paper test. Many people are leery of blood work or pricking their fingers, so this really outlines the risk on paper.
eloughborough:
What kind of exercise do you recommend for diabetics that are in pain due to arthritis?
KellyM@ADA:
Then when you know that you are at risk and that you can actually take steps to prevent diagnosis, you can enroll in some of the great prevention programs, like the one offered at Unity.
Cassie@Unity:
Great point!
Jane@Unity:
If you have diabetes, Type 2, is it possible to be healthier and get off medications?
KellyM@ADA:
Yes. Some people are able to manage diabetes with diet and exercise
KellyM@ADA:
As Cassie was saying earlier, bumping up your exercise to 60 minutes a day can have a huge impact.
Cassie@Unity:
Thanks for joining us Jane. Absolutely! We encourage all of our patients to begin eating a balanced, carbohydrate controlled diet, exercise regularly, and aim for a 10% weight loss.
KellyM@ADA:
Healthy eating is also important. There is a lot of good research about plant-based diets.
KellyM@ADA:
For people who are newly diagnosed, it is so important to really engage with a healthcare TEAM. Make the pharmacist part of the team, work with a dietician, and talk to a diabetes educator.
Cassie@Unity:
If 30-60 minutes of exercise is intimidating, find ways to really enjoy being physically active. Suggestions include snow shoeing in the winter, swimming or hiking as the weather improves, playing sports, or even enjoying water activities like canoeing.
KellyM@ADA:
I was talking to friends earlier today and they also suggested some of the great Meet-Up hiking groups around Rochester.
Jane@Unity:
Thank you Cassie!
KellyM@ADA:
There is a group that does walks in the different villages and the whole point is just to get out and get active.
Cassie@Unity:
All great points again Kelly. A team of specialists can really help someone grasp and take control of their diabetes.
KellyM@ADA:
Stay engaged in the Unity Online Community and connect with the ADA at www.diabetes.org/rochester
eloughborough:
If there is a care manager in your primary doctor’s office, the care manager can also be part of the team that helps get patients started on making healthy lifestyle changes. I encourage everyone to check to see if there is a care manager at your doctor’s office.
Cassie@Unity:
Yes eloughborough! An additional amazing resource all patients should look into!
KellyM@ADA:
Yes, that is a great point. The Rochester community seems so be a leader in placing Care Managers in practices to help patients. They are a very good resource.
Jane@Unity:
What would be a goal weight for a male who is 5'9" and 225 lbs?
Cassie@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 on Tuesday, April 8 at 8 p.m. with Dr. Rajamani, Chief of Endocrinology, Unity Medical Group.
Cassie@Unity:
He will be holding an open Q&A session to answer all of your diabetes questions!
KellyM@ADA:
Thanks for having me!
Cassie@Unity:
Thanks so much Kelly for joining us! We really enjoyed all of the information you shared!
KellyM@ADA:
You're welcome. Have a good night.
Cassie@Unity:
Jane - last point - a good starting place would be to have the patient aim for a 10% weight loss or 25 pounds.
Cassie@Unity:
Research shows a 10% weight loss can significantly improve blood sugars, blood pressure, and cholesterol!
Cassie@Unity:
Thanks again everyone. Have a great night!!
 
 
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