Answered by: Dr. Mariela Glandt

Most of the risk that comes from eating too many sweets is associated with fact that eating a lot of sugar leads to weight gain, which in turn can lead to diabetes.  Having said that, there are studies that show, for example, that if you drink more than 2 soft drinks a day you are at increased risk of developing diabetes, regardless of the amount of weight gain.

When we say that type 2 diabetes is caused by genetics and lifestyle factors, it is in a way saying yes, there is a predetermined level of insulin production.  There are those lucky people who eat lots of sweets, but somehow their pancreas can compensate for this by producing more insulin, and hence keeping the sugars in the normal range. While there are others whose pancreas cannot respond to that kind of stress, and thus cannot produce enough insulin, and their blood sugar levels go up.  This is indeed preset mostly by genetic factors, and perhaps also by circumstances set in the mother’s womb.  If you have a history of diabetes in your family, try not to stress your pancreas too much! Keep to a healthy diet and exercise.

Answered by: Dr. Mariela Glandt

One of metformin’s very rare side effects is that it can cause lactic acidosis. Although rare, lactic acidosis is potentially a very severe, even fatal,side effect mostly related to kidney function.
If the liver is not working well, this is also a reason not to take metform since it could also make you more prone to lactic acidosis.Because drinking excessive alcohol at one time, or drinking hard drinks on a regular basis can harm your liver, it is not recommended. A hard drink once a week seems acceptable, but consult your physician for his/her recommendation.

Answered by: Dr. Mariela Glandt

There is definite rationale in what your doctor suggested, it’s just very difficult to do.  We as a society are intoxicated with carbohydrates. If you think about the fact that rice, potatoes, and bread are actually a very recent addition to the human diet, it starts to make sense. For millions of years humans were hunters and gatherers, and ate mostly meats, nuts, and fruits.  Only recently (10,000 years or so ago) with the advent of agriculture, did they start making carbohydrates a large part of the diet.  We are supposed to eat carbs, yes, but at much, much lower quantities than what we encounter in our current diet. Try eating much smaller portions, substituting rice with a salad, and don’t drink any soft drinks–ever! (that is just liquid candy).  Soon you will be amazed at how well you are doing without large quantities of carbohydrates. This will make it a lot easier to lose weight, too, and that in itself might make the insulin resistance much better.
 

Answered by: Dr. Mariela Glandt

It is expensive to check blood sugar levels 7 to 8 times a day. While it is fine to eat some bread or brown rice when you exercise, perhaps you need to check with your doctor to make sure that
your medication doses don’t need to be adjusted.  If you are trying hard to keep the blood sugar level above 100, even on the days you are not exercising, then you might be taking too much medication.

Answered by: Dr. Mariela Glandt

You might be experiencing hypoglycemia unawareness. This can happen after being a diabetic for many years. While it is fantastic that you are now tightly controlled, it probably means you are having more frequent bouts of hypoglycemia. Usually when a diabetic experiences hypoglycemia (low blood sugar), hormones such as epinephrine, cortisol, growth hormone and glucagon kick in to raise your blood sugar levels, and they cause changes in your body such as sweating and heart palpitations that warn you that something is wrong.  But if you are having too many hypoglycemic events these hormones might be somewhat depleted and you may not be able to respond appropriately to the low blood sugar levels.  Also, when you have hypoglycemia unawareness
the sugar preferentially goes to your brain, rather than to the rest of your body, so that your brain is unaware that you are actually not doing well. I suggest you take extra caution to try to avoid low blood sugar levels.  This will probably restore the response somewhat. In general,  I would suggest checking  your blood sugar at least 7 or 8 times a day, especially before driving or other potentially dangerous situations where low blood sugar could impair your performance. As always, consult your physician for further recommendations, as you may require changes in your medications.

Answered by: Dr. Mariela Glandt

There are many conditions that can lead to edema and these should be fully worked up by your physician. These conditions can depend on your age, how much time you spend on your feet, other medical conditions you may have, medications you may take, and a plethora of other factors, including whether this swelling is in one leg or both. However, fluid retention prior to menses can certainly occur, and the reasons for this are very poorly understood. There does not seem to be any direct connection between high blood sugars and edema of the legs.