1.      My doctor is having me tested for sleep apnea.  What is sleep apnea?

Sleep apnea is a condition where people stop breathing for periods of up to 10 seconds or more while they are asleep, sometimes hundreds of times each night.  These periods, called apnea, disrupt sleep and lower the level of oxygen in the blood.  People with sleep apnea are more than twice as likely to have diabetes as those who don't.

2.    How will I know if I have sleep apnea?

To be diagnosed with sleep apnea, you need to have special tests done by a doctor who is knowledgeable in this area. If you can answer yes to any of the following questions, you should talk to your doctor about screening for sleep apnea:

• Do you snore?
• Do you wake up felling tired after a full night's sleep?
• Do you have high blood pressure?

3.   Why is my doctor so concerned about my blood pressure?  My last reading was 138/88 but that is normal for me.

High blood pressure is one of the most important risk factors for stroke, heart attack and kidney failure in people who have diabetes. High blood pressure is two times more common in people with diabetes than in the general population. In people with diabetes, high blood pressure speeds up blood vessel damage from high blood sugar.  It is recommended that ALL persons with diabetes maintain a blood pressure of 130/80 or lower, consistently.

4.  Do I need to take my diabetes medicine even when I am sick and not eating as much as usual?

The answer is yes.  Everyone releases high levels of stress hormones when they are fighting off an illness. These hormones usually raise blood sugar levels. In people with diabetes, this can cause high blood sugars, even when you are not eating as much as usual. You need your diabetes medication during illness for that reason. Check your blood sugar at least 4 times a day, take your medication as usual and if you have any question about your sick day management, contact your health care provider.

5.    Is thyroid disease more common in people with diabetes?

Yes.  People with diabetes have an increased risk of developing thyroid problems. In the general population approximately 6% of people have some form of thyroid disease.  The prevalence increases to over 10% in people with diabetes.  In general, people with Type 1 diabetes should be screened every year.  Those with Type 2 diabetes should be screened at diagnosis and then at least every 5 years thereafter.

6.  I heard that fish is a heart healthy food and many kinds are a good source of Omega-3 fatty acids which have been shown to improve heart health.  I don't care for fish so what other things could I eat that might be a good alternate source?

Walnuts, kale, fish oil supplements or canola oil.

7.  Does having diabetes increase my risk of gum disease and dental problems?

Yes, particularly if your blood sugar is high.  Over time, high blood sugar promotes growth of bacteria.  Keep your blood sugar in good control, brush and floss twice a day and see your dentist at least twice a year.

8.  I have had Type 2 diabetes for over 15 years.  Over the past year, I have been having increased nausea, bloating and the feeling of fullness shortly after I start eating. What could this be?

You may be suffering from a variety of conditions, so of course you should talk with your doctor.  You may be experiencing a condition called gastroparesis or delayed gastric emptying.  It is a disorder that affects people with diabetes when nerves to the stomach are damaged or stop working, so the stomach takes too long to empty its contents.  High blood sugars over a long period of time can increase your risk of developing this condition.

9.  If I do have gastroparesis, what is the treatment?

The most important treatment is getting your blood sugar in good control.  That in itself can improve symptoms.  There are also many medications that can help or you may need to speak with a dietitian who can help you with a meal plan to meet your individual needs.

10.  What is the Diabetes Cost Reduction Act?

This question has appeared in Ask Sue before, but I feel that the information is so vitally important, we decided to print it again!  Most of the states in the U.S. have state legislature in place to ensure all insured people with diabetes have the medication, supplies and education required to properly manage their disease and prevent its serious complications.  Ohio does NOT!   I urge all of you to contact your local government officials and voice your support on this bill.  For more information call

1-800-DIABETES or visit www.diabetes.org.