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Managing Your Diabetes

If you or someone you love is living with diabetes, you already know it can be challenging. Living a full, healthy life with diabetes is within reach, but it takes commitment and the right team of health care professionals.

Hendricks Regional Health offers a comprehensive team of nurses, dietitians and certified diabetes educators.

Listen as Angie Thompson, NP , Diabetes Educator and Family Nurse Practitioner with Hendricks Regional Health Diabetes Center , explains that the The Hendricks Regional Health Center for Diabetes Excellence helps patients learn how to manage and live well with diabetes – whether they are newly diagnosed or have had diabetes for years.
Managing Your Diabetes
Featured Speaker:
Angela Thompson, NP
Angela Thompson is a Family Nurse Practitioner with a specialized focus in diabetes and conditions related to diabetes. She has earned Board Certification in Advanced Diabetes Management (BC-ADM) to provide skillful management of the complex needs of patients with diabetes as well as Board Certification in Diabetes Education.

Angela enjoys working with her patients to find a diabetes management program that works best for their needs. She has experience and training specific to continuous glucose monitoring and insulin pump devices. For patients interested in using technology supports such as smartphone applications to help track their blood sugar, Angela is knowledgeable about a variety of solutions available.

Angela also has expertise in helping pregnant patients with Type 1, Type 2 or Gestational Diabetes manage their diabetes throughout pregnancy. She also helps support those patients struggling with difficult-to-control blood sugars.

Learn more about Angela Thompson

Melanie Cole (Host): If you or someone you love is living with diabetes, you already know its challenges. Living a full, healthy life with diabetes is within reach but it takes commitment and the right team of healthcare professionals. My guest today is Angie Thompson. She's a diabetes specialist and family nurse practitioner with Hendricks Regional Health Diabetes Center. Welcome to the show, Angie. So, first tell us what is diabetes?

Angie Thompson (Guest): Diabetes is a medical condition that occurs in individuals that prevents them from being to regulate their blood glucose levels and it typically results in a deficiency of insulin production in combination with something called “insulin resistance”.

Melanie: So this is an insulin resistant type, and just to clear up for the listeners, Type I, this is not the one we're talking about. We're talking about Type II. Now, can Type II diabetes affect anyone at any age?

Angie: It can; however, there is an increased risk with the aging process. So, that is a risk factor for Type II diabetes. However, in today's day and age where we have reduced activity, we have an increase in obesity and being overweight; the incidence of diabetes is occurring, Type II diabetes, is occurring earlier and earlier. So, there have been children and teenagers that have been diagnosed with Type II diabetes which wasn't really seen in the past.

Melanie: Sure. It was called “adult-onset” before and now they've changed it to Type II because of the childhood obesity epidemic and we're seeing diabetes in children as young as nine years old. So, what are some of the other risk factors that people can look to let them know that they might be headed towards pre-diabetes?

Angie: That's a great question. One risk factor which, unfortunately, no one can change, is family history. So, that is a huge component of this. There's a huge genetic component to Type II diabetes. So, if you have family members that have diabetes, then you, yourself, are at a higher risk. In addition to that, you've got the inactivity; if you're sedentary, you're not very active, or if you are in the overweight or obese category, then you also have that higher risk for Type II diabetes. And then, you've got age as a risk factor, you've got certain ethnicities, so, unfortunately, you can't change your ethnicity, but you know, there is a higher risk there, and then, in addition to that, high blood pressure, high cholesterol. If you've got those medical conditions that you're being treated for, your chances are you have a higher risk for developing Type II diabetes.

Melanie: And, what are some of the symptoms? Would people know that they have it?

Angie: Not always. It's actually we call it an “insidious condition” in that you can actually have Type II diabetes and really not have any symptoms. So, it's important to actually get checked, to have an annual physical exam, and to have blood tests to help determine whether or not you have an abnormality or just to confirm that your blood glucose levels are in fact in the healthy range and normal range. There are some symptoms that are associated with hyperglycemia and diabetes but, typically, individuals have had it for five to ten years before they would recognize, potentially, these symptoms. I can go over them very briefly with you. They are frequent urination, frequent thirst, increased hunger, increased infections--skin infections more than other types of infections, fatigue, and blurry vision. So, those are the most common symptoms someone will have.

Melanie: And, so, what are normal blood sugar levels? When they do get that annual physical and they see those numbers, what do they mean?

Angie: Normal glucose levels, fasting, are defined as less than 100. So, it kind of depends on what lab test is done, but, again, if it's a fasting blood glucose test, less than 100 is defined as normal. If it's a random, so if you're appointment's in the afternoon, for whatever reason you couldn't attend fasting, then less than 140 is considered normal. And then, there's another blood test called an “A1C” which really doesn't, it doesn't matter if you're fasting or not with that particular blood test. There's a normal or abnormal value and it's not dependent on whether you ate or not. And so, it's a different scale which throws people off, I think. But, normal for an A1C is less than 5.7. Anything above any of those ranges I mentioned indicates that there is some kind of an abnormality with regulating glucose and the degree of that, really, it could be pre-diabetes; it could be diabetes. It depends on where you're at in the spectrum.

Melanie: So, then, what are some of the treatments that are offered up for someone who's been told that they either have pre-diabetes or that they have full-on diabetes? What do you tell them as the most important things they need to do?

Angie: Well, absolutely lifestyle is a huge component. So, trying to eat a well-balanced, healthy diet, monitoring the portion sizes, because that's a big component of it; trying to choose healthier food options. And, in addition to that, exercising regularly and managing your weight. So, either maintaining weight or potentially even weight loss is a huge component of the treatment and oftentimes missed. And so, exercising 30-45 minutes up to five times a week is the recommendation and, actually, that's where you see the most robust benefit to patients in regulating their blood glucose and maintaining weight. And then, in addition to that, there are medications that can be prescribed. Some people require more than just the lifestyle component in order to be able to really regulate their blood glucose levels in a healthy range.

Melanie: So, diet, exercise, reducing that sedentary behavior. When does it come to medicational intervention?

Angie: If the lifestyle intervention is not sufficient enough to regulate glucose levels in the normal range, that's when it's deemed a medication would need to be added. Because the bottom line is you really need to maintain healthy glucose levels and whatever it takes to get there is you know, what should be employed.

Melanie: So, what would some of those medications be intended to do? People hear about giving yourself insulin shots if you're a Type I diabetic, someone who's had it since you were a child, but if this is an insulin-resistance, and your body is still making insulin, then what are the medications doing?

Angie: There are actually several different medications that are now available. What we've found over the years is that there are about eight core defects that we've seen in Type II diabetes--the two main ones again being an insulin deficiency in the setting of insulin resistance. However, it's more complicated than that. So, there are actually medication to try and address the production issue. So, we've got medications that stimulate the insulin production from the remaining cells in the pancreas that produce insulin. Then, we've got medications that increase the sensitivity. So, they try to combat that resistance. And then, we've got some other medications that help regulate through the liver glucose or sugar production. So, it tries to suppress that a little bit; it tries to increase the sensitivity of the insulin's effect on the liver. You've got medications that kind of address the gut issue, the digestive issue and how glucose or sugar is coming into the bloodstream through digestion and trying to slow that down and help improve the satisfaction with the meal so people don't feel as hungry. So, there are really a lot of different ways to address these core defects with the medications we have available.

Melanie: And, do you like people to self-monitor their glucose levels on a regular basis?

Angie: Oh, absolutely. It's kind of an integral part of determining if the medications are effective and it's really the only way in between appointments to really get an idea of medicine working, medicine not working, and so it's a huge component.

Melanie: So, wrap it up for us, if you would, Angie, and let us know, tell the listeners what you tell your patients every single day about living with and managing the symptoms for diabetes.

Angie: Well, it's actually something that can be much easier to manage now than it ever has been. We have so many options available to help. There's not a one-size-fits-all, you know, absolutely the treatment regimen can be customized to that patient. I also really stress just a healthy lifestyle in general. The exercise component. If you're having difficulty losing weight or maybe you don't even need to, maybe you're at your ideal body weight, maintaining that weight is huge because the more you weigh, the more insulin you need and if you're already operating off of a deficit, that's going to make it more difficult. And, just knowing that they can live a long, healthy life with diabetes, we just need to focus on what it takes to regulate those blood glucose levels and keep them in the healthy range.

Melanie: Tell us about your team at the Hendricks Regional Health Diabetes Center.

Angie: We actually have a very great, comprehensive team. We have registered nurses who are certified as diabetes educators; we have registered dietitians who are also certified as diabetes educators; and we have, in addition to that, access to other members of the Hendricks Regional Health team that can help with things like activity. We have exercise physiologists that can help us kind of hone in on maybe a regimen that would best fit our patients, and then, of course, myself in helping with managing the diabetes. And then, we all work together to help with the psychological and social aspect of trying to deal day-to-day with diabetes.

Melanie: Thank you so much for being with us today. It's great information. You're listening to Health Talks with HRH, Hendricks Regional Health and for more information, you can go to That's This is Melanie Cole. Thanks so much for listening.