Back to Ask the Diabetes Team Questions from June 2003

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  1. My almost eight year daughter is on Glucophage XL to help with her weight. I have been checking some glucose levels, and her fasting, two hour after breakfast, and two hour after dinner are all within normal range, but, each day, her two hour post lunch blood sugars seem high. Do you have any ideas as to what could be causing these raises? Should I be concerned? (30 Jun 2003)

  2. My almost five year old son has been urinating as much as every 10 minutes for about two weeks now, he is asking for drinks and food more, and he is also sleeping in later in the morning. His urine test was okay, and a fingerstick blood sugar was normal. Has diabetes already been ruled out with initial fingerstick test? Are they possibly looking in that area still? (30 Jun 2003)

  3. My nine year old daughter has had type 1 diabetes for six years, and this week I saw that the FDA approved the Sleep Sentry to monitor symptoms of hypoglycemia. Do you have any information about Sleep Sentry? Do you think this device would be good for children? (30 Jun 2003)

  4. I am a teenager who has type 1 diabetes, and I find it so hard to lose weight. What can I do? (30 Jun 2003)

  5. I now have a huge lump across my waist. I have stayed away from this year for over a year now, and the lump doesn't seemed to be getting any smaller. It's a disfigurement, very noticeable, and I want to get rid of it ASAP. The only way my insurance will cover surgery is if it's medically necessary. Is there any way that this procedure could be medically necessary? (30 Jun 2003)

  6. After I had several low blood sugar, my doctor put me on twice daily Lantus with Humalog. I'm a very active person and have had several low blood sugars alternating with very high at work. My diet is very well controlled, and I check my blood sugar regularly so I am if the Humalog is inconsistent. Are others having problems with Humalog? (30 Jun 2003)

  7. My daughter has been going to see an endocrinologist for about a year now, each time her A1c goes up, and now it is 5.6%. Since going to the doctor her skin looks very pale, she is tired all the time, and she is normally like this. Should I call her doctor? (30 Jun 2003)

  8. My daughter asked another child on the bus to hold her "lancet" and "finger pricker" for her while she got her meter ready. The other child took the cap off the lancet, stuck her finger by accident, and then my daughter used that same lancet. The girl's father has hepatitis B. What are the chances are of anything being transmitted? (30 Jun 2003)

  9. How do you determine when your child is "ready" for an insulin pump? (29 Jun 2003)

  10. We have been having some difficulties with our child's "attitude" lately, and every time we test him when he's like this, he is always excessively high. When ever his levels are normal, or even low, this behavior is not present. Is there any correlation between bad behavior, aggression, or emotional outburst that is strictly related to high blood sugars? (29 Jun 2003)

  11. I am 61 years old and have type 2 diabetes. Other than the obvious sexual effects, what physiological effects will Viagra have? Could the Viagra increase the glucose uptake (reduce the blood glucose level)? (29 Jun 2003)

  12. My 10 year old son, who has had type 1 diabetes, has had a terrible odor to his hair lately and his blood sugar has been up and down for about six months. Is the hair odor part of puberty? Do kids with diabetes tend to have "heightened" problems during puberty? (29 Jun 2003)

  13. My nephew has had extremely high readings while in school. He has normal readings at home, but there is always a problem at school.I baby sit for her as often as I can, and I don't feel that anyone has come up with an answer regarding this situation. (29 Jun 2003)

  14. My 20 month old son's endocrinologist has suggested putting him on pump therapy. Being a toddler, he is is very active, and I am not sure if he is going to accept this or not. The doctor is recommending a brand of pump, but I am not sure if that is the best choice for him. Which pump brand is the best for a kid his age? (29 Jun 2003)

  15. My 12 year old stepson has been overweight since age four and prefers sedentary activities. His consumption of simple sugars is very high, he drinks much more fluid than anyone in the family and frequently has to urinate. Should my stepson be tested in any way? Could you please provide some guidelines that we might use to encourage a more healthy lifestyle? (29 Jun 2003)

  16. I don't know what is going on with my daughter's blood sugars, and it' s upsetting all involved. The doctor just keeps changing the insulin and doesn't seem to know what is going on with her either. What are your suggestions? (29 Jun 2003)

  17. I know of a 59 year old woman who was diagnosed with type 1 diabetes at the age of 41, but she believes that she should have been diagnosed with diabetes some seven years earlier. Should this woman have been diagnosed with type 1 diabetes earlier? Would early detection have made any difference to her current condition? (29 Jun 2003)

  18. My 10 year old son, who has had diabetes for six years and is in fair control, has broken his arm five times in the last four years. He is not abnormally active or clumsy, and I have six other children who all play hard, but they do not break their bones. I have talked to another mom with the same experience, but my son's endocrinologist and his orthopedist say there is no link whatsoever. (28 Jun 2003)

  19. For the past two weeks, we have pretty consistently seen our five and a half year old daughter wake up with low fasting blood sugars. She is currently on NovoLog in the morning with Lente, and we we've cut out her nighttime Lente, and have bumped up her pre-bed snack. Any thoughts or insight would be greatly appreciated. (28 Jun 2003)

  20. My cat was tested for diabetes, and she appeared to not have it. However, her blood sugar was 73 mg/dl [4.0 mmol/L], and I would like to know if that is good or bad. (28 Jun 2003)

  21. We have noticed that our almost three year old daughter, who has had diabetes for two years, does not have tears when she cries. Is it normal not to have tears while crying? Could this condition be related to her diabetes? (28 Jun 2003)

  22. Is there diabetes educator training available for nurses? (28 Jun 2003)

  23. When I went in to wake my daughter for gym class, I knew from her response that she was having a low. When I checked, she was low and 25 minutes later (after two juice boxes and some bread), her reading was normal. Should my daughter take it easy for a few hours or can she resume regular activities once her blood glucose is in range? (28 Jun 2003)

  24. My six year old daughter has always been very klutzy and seems to stare off in space a lot, but the pediatrician said not to worry. She falls asleep in the oddest places, has mood swings, does not eat well at all, craves sweets and her attention span at school as per the teacher improves after a light snack. I doubt the doctor will feel my concerns are valid and would like to know what to do next. (28 Jun 2003)

  25. I was told I have borderline diabetes, but the doctor never went into detail what that means. What are some side effects of that? (28 Jun 2003)

  26. My three year old son was diagnosed with type 1 diabetes about four months ago, and his endocrinologist has yet to perform an A1c test. How critical is an A1c test? (27 Jun 2003)

  27. My best friend' s five year old son was diagnosed with hypothyroidism when he was 10 months old. At age three, he was diagnosed with type 1 diabetes, and his blood sugar is very hard to control. Can the thyroid medication affect his insulin? (27 Jun 2003)

  28. I am a active 17 year old girl on an insulin pump, and I am currently 50 pounds overweight. My doctor keeps nagging me to lose weight and wants me to lose 10 pounds per month. I am currently restricting my diet to 1200 calories (and sometimes to 1000 calories), but I never lose weight even with strenuous exercise daily. I am looking for a second opinion on how to lose weight. (27 Jun 2003)

  29. My boyfriend, diagnosed with type 2 diabetes two months ago. He has said that his asthma has improved since he has changed his diet. Is there a reason for that? (27 Jun 2003)

  30. Even though the doctor prescribed NovoLog, our pharmacy gave us Humalog. Around the time of the switch, it seemed like we had a few days of unexplained differences in blood sugars. Her endocrinologist seemed indifferent, but the diabetes nurse educator told us it might make a difference. Is there a difference in action between Humalog and NovoLog? (27 Jun 2003)

  31. Four weeks ago, my father collapsed was diagnosed with diabetes resulting from steroid treatment for a brain tumor. He was taken into hospital, given insulin by drip and the steroids stopped. He has now been discharged from hospital and instructed to continue taking insulin. How will we know if the blood sugar levels have reverted back to a level at which his body can control without insulin? (27 Jun 2003)

  32. I currently seeing a 35 year old healthy black woman who was recently diagnosed with type 2 diabetes by her primary care physician. The doctor's recommendation is to start oral medications, but I am wondering if she really has type 2 diabetes as he suspects. Are there other tests she should have? Are there certain medications that might work better than others? (27 Jun 2003)

  33. My son's blood sugar levels fluctuate at times even when proper carb-counting, insulin injections, and appropriate activity levels are maintained. Last night at supper blood-sugar check, he was very high, had ketones, and it was not until 2 am that he was in range. What are common reasons children's blood sugar fluctuates? What should you do about it? (27 Jun 2003)

  34. My mother, who has been taking Actos and Actonel, started experiencing various symptoms. Are these reactions due to Actos or Actonel, or the mixing of both? (27 Jun 2003)

  35. My primary care physician aid that I have prediabetes, and I had an A1c test which was 6.4%. I monitor my blood glucose levels at home, and they have been 68-126 mg/dl [3.8-7 mmol/L], depending on what I eat. The dietitian has prescribed 250 mg. of Glucophage, plus diet and exercise. Is the Glucophage necessary? Should I see a diabetes specialist? (26 Jun 2003)

  36. I have been a regular user of marijuana, am also an avid bourbon drinker, and recently, I have been monitoring my blood sugar levels with a machine a friend loaned me. Is there a possibility that the marijuana usage has "controlled" my glucose levels from the bourbon? (26 Jun 2003)

  37. I am six months pregnant with my first child, and even though my husband himself does not have diabetes, there is a strong family history of type 1. I have several questions. (26 Jun 2003)

  38. I am an 18 year old female with type 1 diabetes. I have been unsuccessful in losing weight, and I have begun abusing laxatives in an attempt to control it. Should my use of laxatives decrease my insulin needs? (26 Jun 2003)

  39. I suggest you get on touch with a Medical Social Worker. Given your husband's complications (blindness), he may be eligible for a variety of services including something like Meals on Wheels and/or a housekeeper who can provide appropriate meals. (26 Jun 2003)

  40. My grandmother, who has had diabetes for almost a year, is on oral medications. How much should her blood sugar levels decrease? (26 Jun 2003)

  41. My family and I are going on holiday to South India with our seven year old son who has had type 1 diabetes since he was four. He is taking insulin twice a day morning and evening, and it is the first holiday since being diagnosed with diabetes. Would you please be good enough to give me some do's and don'ts for this holiday? (25 Jun 2003)

  42. My daughter was diagnosed with type 1 diabetes at the age of four, and from the time she was an infant until she was two years old, she would have sopping wet diapers all the time, loved to drink and had horrible yeast infections. Could these symptoms have been warning signs that she could have had diabetes then? (25 Jun 2003)

  43. My six year old son has nephrotic syndrome, and a month after he started on steroids, he went into diabetic ketoacidosis and is on insulin. How are these two connected? Will my son recover from diabetes once his steroids are stopped? (25 Jun 2003)

  44. My son had an anti-GAD test of 0.5, his hemoglobin A1c was 5%, and he was diagnosed with diabetes due to an autoimmune problem. The doctor has not answered all of my questions concerning what labs confirm this diagnosis. What other lab tests should he have done? We are only checking his sugar levels one daily. Is this normal? (25 Jun 2003)

  45. I'm just looking for a way to buy a comprehensive list of food exchange values for common foods and fast food. I just can't justify paying $15 US in shipping for the ADA Exchange lists. How can I get a copy of a meal planning publication without ordering it through their site? (25 Jun 2003)

  46. My male friend takes high doses of insulin daily, manages his diet well, is a farmer who has reasonably high stress levels, and has a problem with maintaining a reasonable blood-sugar level. I believe it should read at a level of 4-5 mmol/L [72-90 mg/dl], but it constantly jumps to a level of 8 mmol/L [144 mg/dl]. (25 Jun 2003)

  47. Since my wife has been put onto three injections per day, she occasionally has seizures at night which are becoming more frequent. Is there anything else besides glucose tablets I can administer to bring her round? We have been trying to adjust the level of insulin to compensate but are struggling to achieve the required results. Is there a better way? (25 Jun 2003)

  48. I've had type 1 diabetes for 18 years, I've been spilling protein in my urine, and I am concerned by its recent increase. What can I do better along the lines of aggressive control to decrease my microalbumin readings? Is there anything else that can be done to prevent kidney and nerve damage? Overall I'm feeling well, but I don't want to damage my organs any more. (25 Jun 2003)

  49. Since starting her injections, my daughter has steadily gained weight, and her tummy and face seem especially bloated. I have begun buying her women's shirts since that is the only size that will cover her tummy. Could this be a side effect of the insulin or the diabetes in general? Should I have her examined for something else? Is this just a part of growing up? (25 Jun 2003)

  50. How do you prevent diabetes? (25 Jun 2003)

  51. A 14 year old boy in the middle school where I teach has diabetes. He uses this as an excuse for his behavior, which includes inappropriately touching girls, and making sexually explicit comments. Can diabetes in any way cause this behavior? (24 Jun 2003)

  52. School is difficult for my child who has had type 1 diabetes since age two, and and no one has an answer to that question. What effect does type 1 have on the brain? Do the highs and lows have a neurological impact or not? How does the fluctuation affect the learning process of these children? (24 Jun 2003)

  53. My 10 year old son will wake up in the morning and soon after breakfast (sometimes he has no breakfast), he will get a very bad headache, nausea, vomiting, weakness, and will take a nap or two. The symptoms will last about 24 hours. What do you think? What is a good level for a normal 10 year old boy? (24 Jun 2003)

  54. My four year daughter has been having frequent urination, is constantly thirsty and wants to eat all the time. Her blood sugars are varying, and she had a low fasting insulin level. Is there another explanation for her blood sugars being from one extreme to the other? Could she have diabetes? What are the diagnostic criteria? (24 Jun 2003)

  55. My mother, sister, and I all have type 1 diabetes, and my 12 year old son seems to drink and urinate a lot at times. Would it be reasonable to check my son's antibodies? (24 Jun 2003)

  56. During illness when our two and a half year old daughter can't eat or because of behavioral issues won't eat, we have had to give small doses of glucagon twice in the last month for low blood sugars. Why are there no glucose suppositories? (24 Jun 2003)

  57. Does this sound like prediabetes or something else? Given the strong family history on both sides, we are a little paranoid about diabetes symptoms. What might we expect from the consultation? (24 Jun 2003)

  58. My newly pregnant daughter is currently visiting her in-laws in Morocco for a month, and since becoming pregnant, her blood sugars have been dropping very low during She has reduced her Lantus, but she is still having lows in the middle of the night.What should she do? (24 Jun 2003)

  59. My son's team said that if he wants a meal at a non-meal time give him Humalog, and I need to know how I judge what to give him. Adjusting insulin according to carb intake is not a strong area of knowledge for us. (24 Jun 2003)

  60. My 24 year old son, diagnosed with type 1 diabetes at the age of ten, has recently experienced several cases of muscle strains. Can these muscle strains be attributed to his diabetes in any way? (24 Jun 2003)

  61. My almost 15 year old daughter, who has had diabetes for three years, is not very well regulated, and I find myself actually depressed, angry, and very often obsessed with helping her keep her values down. How do I as a mother of a teenager with diabetes child deal with my own fears and worries? (23 Jun 2003)

  62. My mother, sister, and I all have type 1 diabetes, and my 12 year old son seems to drink and urinate a lot at times. Would it be reasonable to check my son's antibodies? (23 Jun 2003)

  63. My seven year old son was diagnosed with type 1 diabetes three weeks ago, and I have noticed he has bad breath, even just after brushing. I know this is a symptom of diabetes, but will it always be present? (23 Jun 2003)

  64. My daughter takes Humalog and NPH. How does an endocrinologist calculate the proper insulin doses? Is there a formula based on weight, age, etc.? (23 Jun 2003)

  65. My 24 year old brother is quite obsessed about having his glucose levels lower rather than slightly higher which results in hypoglycemia during sleep. Should he switch to Lantus is order to avoid these ups and downs? What is the tail effect of Regular insulin? Could this be related to my brother's hypoglycemic events? (23 Jun 2003)

  66. I use alternate site testing, and I hate using my fingers because it hurts. Is it really necessary to test the fingers when you think you're low? (23 Jun 2003)

  67. If I do not eat a snack containing about 30 grams of carb before going to bed, my blood sugar is always higher when I get up, but I would prefer not to have to eat any snacks at bedtime. Why is this happening? (23 Jun 2003)

  68. I am 23 years old, I am not overweight, my diet and exercise plans are good, and I was just diagnosed with type 1 diabetes. However, my doctor put me on Avandia and Glucotrol which I thought were for type 2 diabetes. Why would he give these to me? (23 Jun 2003)

  69. Recently. I was diagnosed with renal insufficiency, and I have been having debilitating fatigue, headaches, and back-ache in the kidney area. The doctor is looking for diabetes and high blood pressure and says I could have either or both. How does this connect with diabetes? (23 Jun 2003)

  70. I heard that people with diabetes have sugar sticking to the walls of their veins and arteries like cholesterol does. Is this true? (23 Jun 2003)

  71. My three year old son uses a very small amount of Humalog, and due to the expense of his medication when we were using the 10 ml vials, we opted for the cartridges. The major difference is that we still give him his medication using a syringe versus using the Inject-Ease that the cartridges were designed for. Do you thing using cartridges instead of vials is possibly affecting his readings? (21 Jun 2003)

  72. I was diagnosed with type 2 diabetes during a routine physical two months ago. Despite changes in my Glucotrol XL several times, my fasting blood sugar is still high. Please advise. (21 Jun 2003)

  73. Should vitamin C (or any other anti-oxidant) be used to prevent circulation problems (arteries) in a nine year old who has had diabetes for three years? (21 Jun 2003)

  74. Can people who have diabetes wear contact lenses? (20 Jun 2003)

  75. I have thirst, bad shakes, dizziness, vomiting, abdominal pain, and I am having problems staying awake. The doctor suggested it might be diabetes, and did a for a blood test. I then did some home glucose monitoring. Do these figures represent normal blood sugar levels? (20 Jun 2003)

  76. My girlfriend who has hypoglycemia, will pass out and have convulsion at least twice per month, but she absolutely refuses to see a doctor and says they don't believe in hypoglycemia, so she has been living her life based on information from two books she read. What should I do? (20 Jun 2003)

  77. My current BMI is 48 percent, and I've tried all the other options, only to lose a pound or two and gain fifteen or more in the end. I'm considering bypass surgery for multiple reasons. How much, if any, research has been done on gastric bypass in people with type 1 diabetes? (20 Jun 2003)

  78. I have had diabetes since the age of nine months, and my microalbumin was elevated for the first time in my life. Is there anything else this could be? (20 Jun 2003)

  79. I am aware of people with type 1 diabetes going through the honeymoon stage, but do people with type 2 experience it? (20 Jun 2003)

  80. What advice would you give a parent contemplating a temporary switch back to Lantus with Humalog from a pump? What guidelines would you use? Can a child with basal requirements such as this be switched back to Lantus? Is there any way to manage night time highs if they occur other than Humalog correction? (20 Jun 2003)

  81. I currently am on a pump and, over the last week, my blood sugars have been spiking extremely high, although not every night. I strained several muscles in my back about a week ago, and I have allergies. Could this be from the strained back muscles and/or the allergies? Could it be something else? Why is it affecting me just at night? (20 Jun 2003)

  82. My four year daughter has been having frequent urination, is constantly thirsty and wants to eat all the time. Her blood sugars are varying, and she had a low fasting insulin level. Is there another explanation for her blood sugars being from one extreme to the other? Could she have diabetes? What are the diagnostic criteria? (20 Jun 2003)

  83. I have seen my doctor three times since my diagnosis of diabetes three weeks ago, and he has never checked my feet even though I complain about them burning and feeling hot and cold. Shouldn't a doctor routinely check feet when someone has diabetes? (20 Jun 2003)

  84. Our 12 year old son, diagnosed two and a half years ago, has been on a pump for a year and a half, and last summer (and already this year), we have had trouble with infusion sets falling off. (19 Jun 2003)

  85. I am 41 years old, and four years ago, I had gestational diabetes requiring insulin. Now I seem to be having frequent symptoms of low blood sugar, especially weakness, nausea, and headache. Could hypoglycemia somehow be related to my previous diabetes? Is there a test to find out if my pancreas is producing too much insulin? (19 Jun 2003)

  86. My friends son has type 1 diabetes, and even though his diet has changed, and he takes insulin five times per day, his blood sugar levels are very high. She came to me today extremely upset that the doctors want to hospitalize her son, let him bottom out, and then start him on an insulin synthesizer. I have a few questions. (19 Jun 2003)

  87. Over the last few weeks, my 15 year old son diagnosed about three weeks ago, has been losing a lot of hair. Do all newly diagnosed people lose hair? If so and it is so common, why don't the text books mention? What is the cause? How long will it last? How bad will it get? When will it stop? (19 Jun 2003)

  88. I have been on the lisinopril for approximately two weeks now and have noticed a blood pressure decrease to 130/ 85 along with a blood sugar decrease. How does lisinopril work reducing blood sugars in people with type 2 diabetes? Why was this medication more visibly and rapidly effective in reducing my blood sugar levels than the Glucophage or glyburide combined? (19 Jun 2003)

  89. Do you think it could be muscle or nerve regrowth? What caused him to lose all muscle tone and no telling what else? Can you point me in the right direction to start looking for an answer to help him feel a lot better? (19 Jun 2003)

  90. My boyfriend has type 2 diabetes treated with pills, is always tired. This has only been since he was diagnosed two years ago with the diabetes. Why do you think my boyfriend is so tired all the time? (19 Jun 2003)

  91. My 54 year old husband, who has had type 2 diabetes treated with pills for less than five years, has had no sexual drive for the last two to three years. His physician says there is nothing that can be done, and that it is just part of having diabetes. However, I have been reading about testosterone therapy. Should we insist on a testosterone test? What kind of specialist should we see? (19 Jun 2003)

  92. I have patches of white skin which are all scaly, always sweaty, and they smell. It's now spreading to my toes,and when I walk a lot, it feels like something is squeezing my foot which throbs. (19 Jun 2003)

  93. My son plans to visit the United States for five to six months, and his pump infusion sets are going to be a problem because they don't want to give him enough for the visit. I have tried to find where to purchase the sets (and to find out how much they cost), but have not been successful. (19 Jun 2003)

  94. My daughter is going to camp where she will be doing intense physical exercise, so we have decided that she not use her pump and go on Lantus with Humalog for the week.. Since she has as never been on Lantus, I have several questions. (18 Jun 2003)

  95. I had a hypo seizure about nine months ago, and I'm not getting any warning signs of going low.My general practitioner and diabetes consultant don't know what's causing this and it is starting to get to me as I can no longer drive, work or go out without my wife worrying. What do you think I should do? (18 Jun 2003)

  96. I am concerned because my son thinks he doesn't need much sleep, and I need some information to give him so that he realizes how sleep deprivation can affect his health. How important is it for my 18 year old son to have enough sleep? (18 Jun 2003)

  97. I know that typically an A1c less than 6.0% is considered to be normal, depending on the laboratory, but a range of 4.0-6.0% sees to cover a pretty wide variation in blood sugar averages. If a normal, healthy person who does not have diabetes had his or her A1c tested, what would it likely be? What is a normal average blood sugar in someone who does not have diabetes? (18 Jun 2003)

  98. My son is on a pump, and at times his basal rates are very low, and we have noticed what appears to be great variability delivery. Our son's physician suggested that we dilute the NovoLog so that more volume of fluid was delivered with each dose which would possibly decrease the variability of delivery. I have several questions. (18 Jun 2003)

  99. My 16 month old grandson has been having some problems lately that I'm concerned about, and something clicked in my woman's intuition and said to check out diabetes. How on earth can you diagnose a 16 month old for diabetes? What would the symptoms in a 16 month old who can't communicate what is bothering him be? (18 Jun 2003)

  100. I have been hearing about the glycemic index for foods, but I have not discussed this with my daughter's pediatrician. Where can I find a list of foods and their glycemic index? (18 Jun 2003)

  101. At the time of diagnosis, my. doctor classified me as having type 2 diabetes, but recently, he reclassified me with LADA. Has been any research studies done on the natural progression and transition of someone with LADA? What is your take on this situation? How long does it take for an adult to fully lose beta cell function? (18 Jun 2003)

  102. For about six years, my husband who is on insulin, has had problems with amnesia, and I am looking for some help as to what we need to do. He has been through a lot of medical tests, from heart to brain to physical. Can someone help us with knowing what we need to do? I am getting very frustrated and am afraid of what could happen. (18 Jun 2003)

  103. Why is my husband's blood sugar only normal when he drinks? Why is his sugar so high when he takes his medicine, eats right and is very active? (18 Jun 2003)

  104. My four year old son is always hyper so I took him to the doctor where his blood sugar was 58 mg/dl [mmol/L], and we are going ready to see an endocrinologist.. My friend has a blood glucose meter so I am keeping a log for the doctor, and my son has had readings of 74-156mg/dl [4.1-8.7 mmol/L]. What do you make of all this? Does this mean he has diabetes? (12 Jun 2003)

  105. If a person with diabetes has nocturnal hypoglycemia (in particular hypos are not severe enough to wake that person or induce a seizure but still well below target), would this cause a lesser quality of sleep leaving the person more tired than would be expected after a night's sleep? (12 Jun 2003)

  106. My five year old son has had type 1 diabetes for seven months, I researched pumps and was very encouraged about them. However, when I approached his pediatrician, he said he felt my son was too young and that my son has great control with multiple injections so why change it. What age is a good age to start pumping? Should I push the issue? (12 Jun 2003)

  107. I would love to try the DASH diet for lowering blood pressure, but my other two concerns (blood sugar levels and continued weight loss) make me very cautious. What are your suggestions? Have you tested the DASH diet on individuals with diabetes? If so, what were the results? If not, do you feel I could make the DASH diet, with possibly some modifications, work for me? (12 Jun 2003)

  108. If I don't eat every two to three hours, I get shaky, nervous, lightheaded, confused and experience mood swings. I also have heart flutters and cold sweats. Within 15 minutes of eating, I feel much better. However, I've also experienced extreme thirst and frequent urination, even in the middle of the night. Is it possible to have hypoglycemia and diabetes concurrently? (12 Jun 2003)

  109. My father, who has had type 2 diabetes for 30 years, has been able to control it with diet alone, but this year, his doctor placed him on Glucophage, and my dad is worried that his treatment plan will be changed to include insulin. Is there a time limit for the to the effectiveness of Glucophage before a someone must move on to insulin? (12 Jun 2003)

  110. You could try to experiment and test twice in a row (on the correct code and on the wrong code) and see how much of a difference there is. At least you figured it out! (12 Jun 2003)

  111. Since I started insulin, I have put on an extra 15 pounds. I am very unhappy with my weight, I don't know what else to do, and I would be thankful for your advice. (12 Jun 2003)

  112. About a month ago, my daughter, who has type 1 diabetes, became hypoglycemic, had a seizure and was advised to take medications since EEG showed some epilepsy, but the doctors can't differentiate whether the seizures where due to low glucose level or epilepsy. Is there any specific test to rule out epilepsy? If the seizures were due to low glucose levels is it correct to give anticonvulsant medications? (12 Jun 2003)

  113. I have had an insulin pump for two years now, and I am on my ninth pump of the same brand right now, so it appears they're continually going bad. The company, and they sent me the newest version, but I don't feel very comfortable with it, and I would like to switch brands. Do you know whether or not my insurance company will let me switch brands if I have a "working" pump? (11 Jun 2003)

  114. My son was hospitalized with an extremely high blood sugar, and this morning he had 20 units of Lente with 30 units of Humalog, and his blood sugar is still high at 1:00 PM. If a person is insulin resistant what else can be done? Is there a safe limit as to how much insulin a 12 year old can receive during a 24 hour period? (11 Jun 2003)

  115. A week ago, the doctor did more tests and now says my dad has type 1 diabetes instead of type 2, and he has to give himself a shot of Lantus every morning. My dad is still eating what he wants including the big portions sweets. What will happen if he does not change his diet and eats all these sugary things? (11 Jun 2003)

  116. About ago week ago my friend's 17 month old grandson become dehydrated and was hospitalized with what the parents thought was the flu, but he was ketoacidosis and was diagnosed with type 1 diabetes. He was very ill, and everyone in the family is worried. Is there any positive, hopeful or helpful information you can give? (11 Jun 2003)

  117. A student I care for is absent a lot, and his mom states it is because of his type 1 diabetes. When is the parent abusing the right to educate a child? What is the law on this? (11 Jun 2003)

  118. My nephew has type 1 diabetes. Is it always necessary to increase the insulin dose when a child with type 1 diabetes starts puberty (growth spurt)? (11 Jun 2003)

  119. I'm thinking about adopting an eight year little girl who diabetes. She takes insulin shots two to three times per day, and they have to check her blood sugar three times per day. Am I taking on a very big responsibility? Does having a child with diabetes totally change your lifestyle? (11 Jun 2003)

  120. I need to start my husband on a diet to help get is sugar level into a more normal range. I need a diet that tells me what he should be eating at each meal and for snacks and what foods he should avoid. (11 Jun 2003)

  121. My almost eight year old daughter has had multiple problems that I think "could" be related to diabetes, but her doctors have ruled it out. I don't want to keep going to my doctors insisting there is something wrong with my daughter when they have done lots of tests. Should I be concerned? Does this sound like diabetes? Is there something else the doctors should look for? (11 Jun 2003)

  122. I recently got my first pump, but I had a very difficult time choosing which pump to go with after narrowing it down to two. Sometimes I wish I had chosen the other one, even though I'm very happy with the one I am using. Are there any plans on ranking pumps like you do meters? (11 Jun 2003)

  123. I take my Lantus at 8:00 pm, and I've noticed that even though my blood sugar is normal at that time, when I test again at 12 midnight it's high. I do take some Humalog to bring it down. Shouldn't my blood sugar be lower four hours after taking my Lantus? I'm very confused by this! Can you shed some light? (10 Jun 2003)

  124. My doctor now has me trying Lantus in an attempt to get the fasting sugar level down. However, he is very willing to let me be in charge of my diabetes, but both of us are concerned with the "dawn phenomenon". Any suggestions of how to deal with it would be greatly appreciated. (10 Jun 2003)

  125. My daughter has been suffering with headaches for the last two years. What is the possibility this is diabetes? (10 Jun 2003)

  126. I just had the diabetes tests, and when I called to see if I had passed, I was told no, but not to worry. What worried me the most was that she said the cutoff is 130 mg/dl [7.2 mmol/L], and my level was 192 mg/dl [10.7 mmol/L]. My grandpa also had diabetes. What are the chances I have diabetes? (10 Jun 2003)

  127. I have type 2 diabetes treated pills and my sugar level fluctuates drastically, and I have been told that my diabetes is"brittle". (10 Jun 2003)

  128. My 11 year old son was diagnosed with type 1 diabetes after being in a severe DKA two months ago, and now he is only on 5 units of NPH in the morning. If his antibodies are negative, does this mean he does not have an autoimmune disease? (10 Jun 2003)

  129. ! am 24 weeks into my fifth pregnancy, and I have gestational diabetes. My fasting numbers are a bit high, but my after meals numbers are normal, and my doctor wants to put me on insulin. Do I still need insulin just because of the high fasting numbers even though my A1c shows that my overall average levels are normal? (10 Jun 2003)

  130. Somehow, whatever I do, the mornings are high, or I have low sugar at night. In order to identify the exact problem I have at night, I would like to perform an "experiment" in which, every night, all the factors, besides the tested factor will be the same. The problem is, that every night the "factors" vary. How do I simulate the same exact factors every night? (10 Jun 2003)

  131. My six month old nephew, who has had numerous medical problems from birth, was taken to the hospital due to a mental status, and they found he had a very high blood sugar. What could cause this? Could this be a temporary condition that could go away on its own? If it can, will it come back? What are the short term and long term complications? (10 Jun 2003)

  132. I have type 2 diabetes and have been experiencing episodes of violent shaking for several years. There is no pattern that I can identify. Mostly my head shakes, but sometimes my whole body. Is this a symptom associated with diabetes? (10 Jun 2003)

  133. A month ago, I was informed that I have diabetes, and I also have had psoriasis for 10 years. Will a wound still not heal fast? (10 Jun 2003)

  134. My physician says I must continue taking the Actos throughout my pregnancy, but I am very concerned about the effects on the developing fetus, and I understand that the chance for a miscarriage is decreased by remaining on it. Do the benefits of preventing miscarriage outweigh the possible effects on the baby? Is this safe? (10 Jun 2003)

  135. My 11 year old son was diagnosed with type 1 diabetes two months ago, now he is only on 5 units of NPH in the morning, and we think he is in the honeymoon period. Should I change to Ultralente or Regular, or only change the hour the insulin is given? (9 Jun 2003)

  136. I think my friend is making her blood sugars go high to lose weight. She told me previously that she used to do it, but was stopping and she didn't do it anymore. She's always been really self conscious of her weight, even though she is not fat at all. Is this going to damage her in the future? Should I even be worried? (9 Jun 2003)

  137. Scenario: my son is doing homework, he tests, is high, and we correct with insulin. Should I give him a break from homework until the correction takes effect or insist that he gets back to homework (which is not his favorite past-time even when blood glucose s are normal)? (9 Jun 2003)

  138. I have a patient who no longer wishes to take the diuretic bendrofluazide and and wishes to take L-taurine. She is an advocate of the Atkins diet, and her glucose levels are very good. However, I have no experience using this substance and have no idea of what dosage would be a match for the bendrofluazide. Your advice would be greatly welcomed. (9 Jun 2003)

  139. My seven year old son, diagnosed with type 1 diabetes two years ago, weighed 62 pounds at the time of diagnosis, now weighs 60 pounds, and his height for his weight is normal per the growth charts. Is this normal? (9 Jun 2003)

  140. I am 28 years of age, struggling with type 2 diabetes, and I really need someone my age I can relate with. Are there support groups for people my age? (9 Jun 2003)

  141. My son's doctor changed him to a lower dose of NPH, but then his sugars were high all the time, so he changed him back to one unit less than what he was on before, and now he is back to the high to low thing. It seems to me that his sugars are dropping about the time the NPH peaks out, and I think perhaps he needs to change the type of insulin he takes. What is your opinion? (9 Jun 2003)

  142. Do groups of parents with children with diabetes together help each other? Is it better for the children to be alone? (9 Jun 2003)

  143. I have type 2 diabetes and have been experiencing episodes of violent shaking for several years. There is no pattern that I can identify. Mostly my head shakes, but sometimes my whole body. Is this a symptom associated with diabetes? (9 Jun 2003)

  144. My son, diagnosed with type 1 diabetes one and a half years ago, is in acceptable control (A1c: 7%) using an insulin pump, and he is very good about taking care of himself. However, but like many teens, he's not always so quick to share information. I am assuming his honeymoon period is over. How how do I know for sure? (9 Jun 2003)

  145. I am now 240 pounds, and I keep trying to lose weight. My doctor tells me just leave it alone because it would be too difficult to regulate me to lose weight. My blood sugars are good, and my A1cs are 5.5-6.4%, but I am worried if I don't do something. I could be in serious jeopardy. Do you any suggestions? (9 Jun 2003)

  146. I have type 1 diabetes, and I want to take a weight gaining, muscle building supplement, but I am not sure if this is safe. What would happen if I did take the supplement? (9 Jun 2003)

  147. I am 54 years old and have had type 2 diabetes for a little over two years. I take Lantus along with Glucotrol XL. How will my doctor know if I have reached the stage when I need to take Humalog or NovoLog? (9 Jun 2003)

  148. My daughter's pediatrician was not concerned, but the main thing is I don't want to feel crazy for being concerned about this.Could she have diabetes? Is there anything else that can make my daughter's insulin level low? Is there is their another explanation for her blood sugars being from one extreme to the other. What are the diagnosis criteria? (8 Jun 2003)

  149. I have type 1 diabetes, and I know that excess sugar is excreted from the body in urine. Does it also comes out in sweat or through other body organs? (8 Jun 2003)

  150. Are isometric exercises recommended for children with diabetes? (8 Jun 2003)

  151. I've let my daughter go back to Lantus and Novolog for two weeks because she feels uncomfortable with being connected all the time. have checked with her doctor who prefers that she stay with the pump. Is there any harm in changing back and forth? (8 Jun 2003)

  152. Initially, we were told that my grandson had glucose intolerance. Then we were informed that he had type 1 diabetes, and the paediatrician wished to commence insulin, but he was seen by a different paediatrician who wishes to carry out glucose tolerance testing and says he does not require insulin. What would be our best course of action? (8 Jun 2003)

  153. I'm 75 years old, have had type 2 diabetes for about 13 years, and I am now experiencing tingling in my hands and forearms and my legs, which I have never had before, and my doctor says he doesn't have the answer to improve it. Is there a way to reduce the tingling sensations? Is my condition worsening? (8 Jun 2003)

  154. I am very athletic, am trying to slim down a little bit. and I need help with food choices. What would the best food to eat? Chicken? Cheese? Fruit? Veggies? Are pretzels better then chips? Pasta or rice? Pizza or a sub? Fish or steak? (8 Jun 2003)

  155. How many times per day can we use Humalog? Is there a maximum? Can we use at the same time with Regular? (8 Jun 2003)

  156. We are travelling to California in the fall to visit several amusement parks, and my brother uses an insulin pump. Is it safe to wear his insulin pump on extreme roller coasters? Does he need to disconnect it because of the rapid drops, inversions and great g-forces? Can he wear the pump on the airplane? (6 Jun 2003)

  157. My husband is is self employed, and we were out of the country for a while because of business. Having just returned, we tried to buy health insurance for our family, but my son has been denied because of his diabetes! Is this a common problem? What can we do about it? (6 Jun 2003)

  158. I recently read about a study that finds wheat may be one of the environmental triggers causing type 1 diabetes in some people. Is it known whether celiac disease can cause type 1 diabetes in some people? (6 Jun 2003)

  159. My daughter cannot seem to gain weight, and she has every major symptom of type 1 diabetes. She has had some abnormal fingerstick blood sugars and had an OGTT done. What is your opinion? (6 Jun 2003)

  160. My uncle says he wants me to start my daughter (who has had type 1 diabetes for three years) on this stuff called coral calcium that is supposed to cure chronic illnesses.He says if she were to start taking it, she would be cured. What exactly is coral calcium? Is this true? (6 Jun 2003)

  161. My 16 year old daughter is withdrawn, non-participatory and always feels sick, and she has become frail and is underdeveloped for her age. She has also developed a curvature to her back. Her blood sugar is controlled to a normal low. Her endocrinologist wants her to gain weight. I want her to live! Help or suggestions would be great! (6 Jun 2003)

  162. Is there a general guide as to how much one gram of carbohydrate raises a person's blood glucose level? (6 Jun 2003)

  163. My daughter and I would like to raise money to begin a diabetes summer camp for children with type 1 diabetes in our area and also have Holiday Eating Awareness Days (HEAD). I need help in finding federal and/ or state funding to do these things. (6 Jun 2003)

  164. My 15 year old son who is on an insulin pump is completely noncompliant with his diabetes management. Any help you can provide will be greatly appreciated. (6 Jun 2003)

  165. I have a patient who also has type 1 diabetes, and the parents asked me about insulin metabolism and excretion. I learned that insulin is metabolized by the liver and kidney and in normal subjects there is no excretion. Is that information correct? (6 Jun 2003)

  166. My son who has autism had behavior issues that we struggled with but since his diagnosis with type 1 diabetes about eight months ago, his behaviors have escalated and become more violent in nature. How does diabetes affect a person with autism? We know it's different but do not know how to better understand it in order to help him. (6 Jun 2003)

  167. How do I get my son's school to take both academic and emotional needs of a child with diabetes child seriously? Isn't a public school required by law to meet my son's diabetes needs? (5 Jun 2003)

  168. My son is in the honeymoon, and we have been decreasing his insulin over the last week to the point that now he takes no Lantus and uses Humalog only for correction. However, he has not been high, and hence has not had a shot for two days now. How many days do we go without a shot before the risk of insulin allergy becomes a concern? (5 Jun 2003)

  169. A friend who has just been suspected of having type 2 diabetes has been experiencing tremendous "brain fog" as she calls it. Can this be an effect of the diabetes? Should she be looking at something else as wrong? (5 Jun 2003)

  170. I have had diabetes for more than 10 years and recently I was hospitalized with a mild stroke. I experienced right hand weakness, had difficulty picking up things, can't use typewriter, and almost everything that I need to do using my right hand is not possible. My blood pressure is normal, and I had normal scans. Was this caused by my diabetes? (5 Jun 2003)

  171. During a recent physical examination, my urine dipstick was positive for glucose, and a blood glucose reading taken to confirm the urine test was elevated. My doctor drew blood for an A1c, and is concerned but not in a hurry. I am very anxious about the results because I have a family history of diabetes on both sides. How concerned should I be? (5 Jun 2003)

  172. I was once told that as a general rule children require one unit of insulin per kilogram of body weight per day. I know this is only a general rule, but my daughter seems to require double this amount and much more than most other children I know. Why does she seem to need so much insulin? Do you think would an insulin pump would help? (5 Jun 2003)

  173. My blood sugar is okay every morning, and a little higher most evenings after dinner. What is the best level to keep your blood sugar? (5 Jun 2003)

  174. My seven year old son and my oldest brother both have type 1 diabetes, and I am concerned about my four year old son. Is there any way to check to see if he is developing diabetes before it actually full manifests? Is there any therapy that may delay the full onset of diabetes if he is at risk for developing diabetes? (5 Jun 2003)

  175. My 15 year old son, who has had type 1 diabetes, has always had to take a great deal of medication for his petit mal epilepsy. We are told either his body is processing it too quickly or he is not absorbing it totally, and he is on 17 pills per day. Could diabetes play any part in my son's inability to absorb the medication? (5 Jun 2003)

  176. I would like to find someone who can help me with meal planning or where I can obtain meal plans that are already made up. I am willing to pay someone for this information, if needed, but I would prefer something that is free since I am on a limited budget. (5 Jun 2003)

  177. I'm aware of the fact that there is some correlation between medication for schizophrenia and the onset of diabetes. I'm worried about my niece's chances of developing schizophrenia and then diabetes and also about her mother's chances of developing diabetes. Can you verify this correlation? What percentage of people who have diabetes also have schizophrenia? (4 Jun 2003)

  178. Recently, my 11 year old son had a seizure, and I have several questions. (4 Jun 2003)

  179. My 14 year old daughter was diagnosed with reactive hypoglycemia and has been on a special diet, but she still has lows. She was recently referred to a diabetes specialist who put her on pills for type 2 diabetes three times per day. I read about a glucagon emergency kit. Should I have one for her? (4 Jun 2003)

  180. I was recently comparing notes with a friend, and her doses are quite different than mine. She is taking twice as much as I take for food count, one-quarter more as a correction factor, and her Lantus dose is significantly lower. Why is there such a difference, particularly with regard to the Humalog? (4 Jun 2003)

  181. For some time, my wife's blood pressure and blood sugar are not coming under control, despite treatment. She is having watering from eyes, is easily exhausted, and she has occipital headaches. (4 Jun 2003)

  182. I have some high blood sugars, and ever since I went to that endocrinologist I have felt like I was making a big deal out of nothing. Does all of this sound silly to you? What should my blood sugar goal be? Could I possibly have LADA? I was going to talk to my doctor about all this, but I wondered if I was being an alarmist. (4 Jun 2003)

  183. My son daydreams a lot in class and has a very hard time staying focused. Does his diabetes have anything to do with this? (3 Jun 2003)

  184. My 14 year old daughter has severe problems with lows dropping while running in track meets or playing basketball, and she has little to no warning when they are coming on. What can she use to prevent the lows? (3 Jun 2003)

  185. I have a student with diabetes who eats multiple food items throughout the class period which can be a distraction. I have confronted him about the amount of food and asked him lower it to maybe a drink or a solid. Is this too much to ask? Should he be allowed to eat as much as he would like? (3 Jun 2003)

  186. I have read about the new sweetener called Tagatose. The information I read discusses type 2 diabetes so it is unclear how this new sweetener will affect blood glucose levels in a someone with type 1 diabetes, like myself. Do you have any information on this? (3 Jun 2003)

  187. My three year old son is suddenly (starting a bout a week ago) urinating often (four to six times in a three hour time frame), he is drinking a large amount of fluids, and his appetite is unreal. Should I be concerned? He has a doctors appointment In about three weeks. Should I mention my concerns? Should I make an earlier appointment? (3 Jun 2003)

  188. I am 48 years old, was diagnosed with diabetes 14 weeks ago, and I weight. My doctor did not do any tests to assess what type of diabetes I have, and I am going crazy trying to manage this. Wouldn't a C-peptide or GAD test help in confirming a diagnosis of type 1? Isn't it important to understand the disease process in order to best treat it? (3 Jun 2003)

  189. My daughter, who has had diabetes for approximately 10 years, has pitting edema in her legs, and stiffening of her joints (wrists, elbows and ankles). The dermatologist did a skin biopsy and is leaning toward scleroderma. I have several questions. (3 Jun 2003)

  190. I am very concerned about how my teenage son will adapt to having diabetes. How can I support him in making these adjustments without scaring him by stating the facts too pointedly? (3 Jun 2003)

  191. I took my daughter to her doctor with symptoms that I thought were related to hypoglycemia, but he did not want to order any tests. she has now developed severe allergies and her tolerance for refined sugars is getting even less. I realize she is a challenge, but I feel there has got to be more than allergies at work here, and she is very tired of being sick all of the time. (2 Jun 2003)

  192. I currently am using Lantus in the morning with Humalog for my meals, and even though I have increased my insulin n the past two weeks and have not changed my eating style, my pre-meal blood sugars have consistently very high. I have noticed is that the Humalog shot is having very little effect on my blood sugar level. Is it possible to build up a tolerance to injected insulin? (2 Jun 2003)

  193. On several occasions, I have noticed that my 21 months old daughter's blood sugar is higher than normal, but the pediatric endocrinologist said not to worry unless she was over 200 mg/dl [11.1mmol/L], which to me sounds very risky. What do you think that I should do to make sure that she is safe and any problems are prevented? (2 Jun 2003)

  194. I am 28 years old and have type 2 diabetes. I seem to be freezing cold all the time. I keep the house at 74 degrees, but I am still piling on clothes to try to keep warm with no success. Any ideas as to why this has been such a sudden change? What can I do to alleviate my refrigerator syndrome? (2 Jun 2003)

  195. Another person and I were diagnosed with type 1 diabetes, but the doctors have no idea how we got it. Neither of us have a family history, and we are both in prime health. However both of us were subject to misuse of dieting while we were growing up. How many cases are out there where no one can explain how someone got type 1 diabetes? (2 Jun 2003)

  196. I have been on Lantus with NovoLog for several years, and I've gone through extended spells of feeling 'out of it', like I was drugged. Every time I have experienced this, I have found the culprit to be too much Lantus. (2 Jun 2003)

  197. The doctor believed my son's fainting spells were because his sugar level dropped. He gave me a diet which also included several snacks between meals, and we have been monitoring this for about two years. Today, he had blood drawn to see if he has mono, and immediately afterward, he had a seizure. I have several questions. (2 Jun 2003)

  198. About two weeks ago, my grandson developed a rash on face and upper arms. I'm wondering if it could be hormonal or a reaction to insulin rather than something he is eating.. (2 Jun 2003)

  199. Frequently an air bubble gets trapped in the "quick disconnect" portion of the infusion set. There is no alarm, yet the insulin is not moving past the disconnect portion. She tests high and checks the infusion set, sees the air bubble, and we bolus and flick that area of the infusion set until the air bubble passes through. How can we prevent this from occurring? (2 Jun 2003)

The Diabetes Team

Bill Jones, MD (Specialist in the management of diabetes during pregnancy, member since April 1997)
Marco Songini, MD (Italy) (Pediatric, adolescent, and adult endocrinologist and diabetologist, member since April 1997)
Larry Deeb, MD (Pediatric Endocrinologist, member since July 1998)
John Schulga, MBChB MRCGP MRCP FRCPCH (UK) (Consultant Paediatrician in childhood and adolescent diabetes and endocrinology, member since July 1999)
Stuart Brink, MD (Pediatric Endocrinologist, member since October 1999)
Matthew Brown, MD (Pediatrician and a Pediatric Diabetologist, member since January 2000)
Jim Lane, MD (Adult Endocrinologist, member since November 2000)
David Schwartz, MD (Pediatric Endocrinologist, member since May 2001)
Andrea Scaramuzza, MD (Italy) (Pediatric Endocrinologist, member since October 2003)
Linda DiMeglio, MD (Pediatric Endocrinologist)

Barb Schreiner, RN, MPH, CDE (Diabetes Nurse Specialist, member since July 2002)
Jane Seley, RN, GNP, MPH, MSN, CDE, CHES (Diabetes Nurse Practitioner, member since August 2002)
Joe Solowiejczyk, RN, MSW (Family Therapist, member since April 2010)
Linda Mackowiak, RN, MS, FNP, CDE (Diabetes Nurse Specialist)

Jill Weissberg-Benchell, PhD (Medical Psychology and Psychiatry, member since January 2000)

James Michael Schurig, MS, RD, LD, CDE (Dietitian, member since December 2000)

Exercise Physiologists
Rick Philbin, M.Ed., A.T.C., C.S.C.S (Sports Medicine, member since July 2004)

Lois Schmidt Finney, RD, MPH, CDE (DPT-1 Research Coordinator, member since July 1998)
Heather Speer, MPH, CCRC, CDE (Clinical Diabetes Research and Education Coordinator, member since July 1998)

Social Workers
Debbie Butler, CDE, MSW, LICSW (Licensed Clinical Social Worker, member since October 2004)

And Our Occasional Experts

  Back to Ask the Diabetes Team Return to the Top of This Page

Last Updated: Tuesday April 06, 2010 15:09:46
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