Dr. Mezitis Replies to Your Questions:
I work untimely hours. They are never consistent, so my sleep cycle is also different. Lately I have been feeling extremely tired and giddy when I don't eat on time. I went to the doctor and was diagnosed with type 2 diabetes. I have no family history of the disease. Could lack of sleep be the reason of my diabetes? I am not sure what to do.
Restful sleep in sync with the daily light-darkness cycle has been identified as a very important factor in preventing diabetes. Night shift work challenges the body's restorative mechanisms that operate in the evening and overnight. Problems are compounded by eating overnight when the digestive system is in rest mode. Preventing diabetes and 'reversing' diabetes depend on synchronizing our lifestyle with the day/night rhythm: generous breakfast, good lunch, light supper and early bedtime.
Dr. Mezitis Replies to Your Questions:
I have a startup company, and I have 3 employees who are diabetic. As an employer, can you tell me the first aid steps I need to incorporate in case someone goes into hypoglycemia?
The company should have simple sugary snacks and drinks (e.g. orange juice) readily available for dealing with hypoglycemia symptoms. A glucagon kit should be stored in the refrigerator to be injected into muscle in emergencies where the employee or customer are poorly responsive and forcing liquids or foods into their mouth would be unsafe. More recently, an inhaled form of glucagon (Baqsimi) has become available. It may prove more convenient for staff who are unfamiliar or uncomfortable giving injections to administer.
Dr. Mezitis Replies to Your Questions:
My mother has been a diabetic for the past 20 years and has been taking the same medications over a long period of time. Will the medicines lose their effectiveness after some time?
Medications prescribed for diabetes target a variety of organs including the pancreas in order to improve blood glucose levels. If lifestyle changes are not made, the medications may either lose their efficacy or higher doses will be required to control blood glucose.
Dr. Mezitis Replies to Your Questions:
"My husband has been on diabetic medication for the past 3 months. Particularly after his morning medicine, Janumet, he feels very hungry, which is making him gain a lot of weight. What should I do?"
Many diabetes medications stimulate the appetite and promote weight gain and this may prove counterproductive in the management of the problem. In this situation a change to a medication such as a GLP-1 analogue (Victoza, Trulicity, Byetta, Ozempic) which curbs appetite while reducing blood glucose, may be considered. I prefer to introduce an appetite suppressant such as phentermine, early in the course of management for obese patients with diabetes, knowing that weight loss will solve many of their problems.
