Practical Meal Plans

Q: Hi Ginny,

I am having trouble finding a nutritionist/dietitian to help me with meal plans. The books are some help, but not very personal or adaptable. I went to one that my insurance will pay for when I was first diagnose, but her suggestions were not really practical and we didn't have a good repore. I need practical doable plans for a single person. Eating a half a banana is not practical, just wasteful. Any suggestions?

Thank you.

A: First, let me tell you how sorry I am that your appointment wasn’t what you needed. I don’t know who your insurance is with, but insurance providers usually have lists of dietitians that are contracted with them. You may want to start your search with your insurance provider. Ask your insurance company to help you find another dietician. You can also check with your insurance to see if your primary care physician has a diabetes educator or care manager in his/her clinic who could help you. At your next diabetes visit, be sure and take all the information you were previously given. Take a few minutes at the beginning of the visit to let the new dietician know your exact needs. Your statement “I need a practical doable plan for a single person” would be a great place to start. If you were given a certain number of carbohydrates to eat at each meal, be sure and add that information too. If you need or want sample meal plans, be sure and ask because that would be very easy for a dietician to provide. Please let us know what happens in your search.

Do not give up! You are paying for this service and you should get the exact information you need from the visit. ginny

Insulin Pump & C-peptide

Q: Hello i have had diabetes for 22 yrs my doc wanted 2 put me on a insulin pump but after lab work she stated i couldnt get one because of my labs somethimg about my pancreas...can u explain this 2 me?? thanks

A: I think the test you had was something called a C-peptide.

When our pancreas produces insulin, it starts off as a large molecule. It divides into two pieces, insulin and C-peptide. We don’t know what C-peptide does, but we know when it is present in the blood, the body is making its own insulin. C-peptide is measured in a blood sample to see if the body is still making insulin.

Sometimes this is important if you want an insulin pump. Often an insurance company does not want to cover the cost of a pump for a body that is still able to produce its own insulin.

Normal results for C-peptide is usually .5 to 2.0 ng/mL. Be sure and check the values from the laboratory where your test was run and ask your physician exactly what your number was.

To make sure that the results really reflect how much insulin your body is producing, you may have been asked to fast or not eat for 8 to 12 hours before the test was drawn. Any food you eat may trigger your pancreas to produce any insulin it can----which would make the results higher than they usually are.

Check again with your doctor. Follow the directions very carefully before the blood is drawn.

Are you seeing an endocrinologist? They may be able to write a letter in your behalf. Each pump company also has specialty nurses that may be able to help you as well.

Best of luck to you! ginny

Diabetes Diet and Insurance Issues

Q: Ginny,

My name is Jennifer, and I'm pretty sure I have Type II Diabetes. My HgA1C was last checked two years ago, and it was 5.9. My doctor told me I'd be diagnosed at 6.0, so I haven't had it rechecked because I don't have insurance and if I'm diagnosed, I'll never have insurance. My husband's employer doesn't offer group insurance.

Anyway, I am about 40-50 lbs. overweight, and I have the basic knowledge of what I should be eating, but I don't want to. I have no desire for healthy food whatsoever. I not only have no desire for it, it sometimes makes me feel sick. I know it's backwards, and I really need to get a handle on my cravings, but they've been out of hand for about eight years and I've never been able to beat them.

I cannot do moderation. I try and I end up eating 1 lb. of chocolate or more. Chocolate is the main problem. I know I'm not healthy and I know that I need to be conscious of my eating not only for weight control, but to control my diabetes.

Can you recommend a dietician who has had experience with addictions and might not charge too much for consultations? I need to do something. Thanks.

Jennifer

A: You are right that you need to do something. Can you go to a clinic and get a blood test? There are low cost or free clinics that may be able to test you.

Check with the

• University of Utah Med Center at 801-581-2121;
• Maliheh clinic at 415 East 3900 South at 801-266-3700; or
• Sorenson Clinic at 855 California Avenue at 801-977-0502.

If your physician is in a clinic and you want to continue to see him/her, please apply for financial assistance. You need some information about what is happening to your body so you will know where to begin.

Sometimes when blood sugar levels are high, people become very hungry and describe the same symptoms you have described in your letter. The best place to start, I think, is to see if you have diabetes and what your blood sugar readings are. Anyone who can help you with a diagnosis will be able to direct you to a dietician.

Find out if you have diabetes first, o.k.? Remember, knowledge is power!!!

Good luck to you, Ginny

Shoes & Diabetes

Q: Ginny, I have had Diabetes for over 40 years and have been one of the luckier ones, my older siblings both died from complications of having diabetes. My sister never even knew, my brother passed away after 25 years with it.

My question is where is a good and reasonably priced place to purchase a good pair of shoes that work well for a Diabetic who has some problems with finding a shoe that fits and is comfortable to walk and even stand in?

Thank You,

Don

p.s. I have been a pump for over 15 years. (works great)

A: Have you gotten any guidelines from your podiatrist for what you need? There are some specialty shoe stores that will help with shoes for diabetic feet but I think the best place to start may be a diabetes specialty store that also sells shoes. Check in the phone book and call to make sure you find a store that you feel will help you with your special issues.

Very few of our insurance companies in Utah cover specialty shoes but a few do, so be sure and check with your insurance policy to see if there is any coverage. Medicare does cover but you will need a prescription; Medicare will cover 80% of the cost. Generally a pair of specialty shoes will cost $130 to $150. Be sure and discuss the cost with the store you are checking with to see if they provide any assistance for someone paying cash or can help with a payment plan.

I know shoes may be expensive, but it is so very important to take care of our feet! Three cheers for you wearing a pump for 15 years!!!

Ginny