Don’t Ask Me, Ask the Expert!

I am no medical expert, but I love learning about different aspects of diabetes from people who are. I also love listening to the questions that people ask health care professionals. No, I haven’t hidden microphones in your doctor’s office, but I do find any medical Q&A session to be a great learning opportunity. Why? Because sometimes the questions asked are related to something I’ve been wondering about and other times the questions are something I would never have considered before.

Does this type of curiosity seem strange? Give it a try and check out the American Diabetes Association’s Ask the Expert section on, where people from all over submit their questions. If selected, the questions are answered by an expert and posted here.  I scan the questions from time to time and found a few to share with you today:


When you are pre-filling insulin syringes, is there a time limit for how far in advance they should be pre-filled?


Insulin syringes are only approved by the FDA for immediate use, not for pre-filling.  When mixing 2 types of insulin in a syringe, it is best to inject the mixture immediately. Becton Dickinson (BD), a manufacturer of insulin syringes, does not recommend the use of their syringes for anything other than immediate use. In addition to multidose vials, many manufacturers package their products in pre-filled pens, and pens with pre-filled, replaceable insulin cartridges with disposable needles. This packaging eliminates the need to draw up insulin into a syringe.

I take 1500 mg of metformin a day. When is the best time to take it?

Regular-release tablets of metformin are usually dosed twice a day with meals.  If you have been prescribed the extended-release tablets of metformin, the dose is usually administered once daily with the evening meal.

How does insulin absorption vary if injected into muscle compared to fat?

When insulin is injected into muscle instead of fat, it is absorbed more quickly and the risk of hypoglycemia (low blood glucose) increases. The thicker the layer of fat tissue is, the slower the blood flow resulting in slower insulin absorption.

Do the blood test strips have a grace period after their expiration date?

Would they not provide an accurate reading? There is no grace period for expiration dates.  Expired test strips can cause inaccurate results and should be discarded.

How many carbohydrate grams should I consume at each meal?

This is a very common question among people with diabetes. ADA recommends following a meal plan that works for you and helps you meet your own diabetes goals. You should talk to your healthcare provider about setting goals. Goals might include losing weight, improving your A1C, lowering your blood pressure and/or cholesterol levels.

We suggest about 45-60 grams of carbohydrate per meal as a starting point when you are carbohydrate counting. However, you should talk with your provider to set up a plan that is individualized for you. You may need more or less than 45-60 grams. Ask about how many carbs to have at each meal. You should also discuss whether or not to include snacks in your meal plan, and when/ how many carbs to eat at snack time.

Are there any foods low in carbs that can be eaten “mindlessly”?

It is okay to treat yourself once in a while, but you should still consider portion sizes and try to avoid overeating. I wouldn’t suggest eating anything “mindlessly”. Eating too much of anything, whether you have diabetes or not, can have serious consequences.

There are a few foods that you can eat in large portions without having to worry too much about your blood sugar. This includes certain raw, non-starchy vegetables:

  • Spinach
  • Cucumbers
  • Mushrooms
  • Broccoli florets
  • Salad green
  • Zucchini
  • Yellow squash
  • Radishes

All of these raw veggies have less than 5 grams of carbohydrate per cup. So, you can eat quite a bit without raising your blood glucose too much. They also have other benefits because they are high in vitamins, minerals, and fiber.

Another food that is high in fiber and a good carb option for snacking is popcorn. You can eat 3 cups of (popped) popcorn for just 15 grams of carbohydrate but careful not to add extra butter and salt! Try air popping it yourself or buy light versions of microwave popcorn. There are also 100-calorie bags in stores now.

Should I tell my dentist and hygienist that I have diabetes?

Yes. People with diabetes have special needs. Keep your dentist and dental hygienist informed of any changes in your condition and any medication(s) you might be taking. Postpone any non-emergency dental procedures if your blood sugar is not in good control.

Does diabetes affect the enamel on your teeth?

Diabetes is associated with low saliva production and dry mouth, which are conditions that increase the risk for enamel demineralization and make enamel more prone to decay. Very good daily oral hygiene with a soft brush and a fluoride containing and plaque fighting dentifrice will reduce this risk greatly. Use of fluoride containing mouthwashes also reduces enamel demineralization.

Seriously – how often do you stop to think about the enamel on your teeth – and if diabetes affects it? If you’re like me, you haven’t questioned this before… but once you see that it’s been asked, you feel as though you have to know the answer.

I think it’s better to learn from other people’s questions, and not their mistakes, so keep going – look around our Ask the Expert pages and if you don’t see a question you’ve been curious about, feel free to submit it in the form provided. At least you will have learned something!

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4 Responses to Don’t Ask Me, Ask the Expert!

  1. dixie long says:

    i have type 2 diabetes – my doctor told me that spots on my arm are caused by high blood sugar and give me some long name for it – would you know what it is so i can do some reserach on it
    thanks a bunch

  2. lisa m fox says:

    My husband has been dealing with diabetes since 11/10. I would like him to get an endocrinologist besides his family doctor. He has lost 40 pounds since November. Our family doctor stated that losing that much weight may not be a good thing. Any suggestions

    • Dayle says:


      I recommend you try talking with the family doctor again. Ask him if he recommends speaking with a registered dietitian about your husband’s weight loss and what he should be eating. Everyone is different, so a health care professional that can assess your husband’s unique situation may be the best way to go.

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