By Janis Roszler, MSFT, RD, CDE, LD/N

Q What would you tell someone who tries to stay on a diet, but cheats every now and again?

A Diabetes meal planning has changed a great deal in recent years. Foods that used to be forbidden, such as sugar, can now be enjoyed in modest amounts. As long as your A1C level (average glucose level for the past 2-3 months) is in a healthy range and you feel well, you are probably doing fine.If your blood sugar level is not in a healthy range, try the following:

• Meet with a registered dietitian to learn how to incorporate your favorite foods into your meal plan.
• Learn to treat abnormal glucose levels that may result from eating foods in portions that aren’t recommended.
• Don’t punish yourself for veering off your meal plan! We are all human. If you make a poor food choice, forgive yourself and eat healthier at your next meal.
• Learn your A1C number. Most experts recommend a starting A1C goal of less than 7 percent with an ultimate goal of less than 6.5 percent. If your A1C level is good, an occasional high blood glucose meter reading should not be a problem. If it is too high, meet with your healthcare team to adjust your treatment plan.

Q My doctor wants me to take insulin. Once I start it, can I ever stop?

AIf you have type 1 diabetes, the answer is no; your body requires insulin from an outside source because it can’t produce any of its own. If you have type 2, it may be possible to reduce or even eliminate your need for insulin if you do the following:

• Follow a healthy meal plan. A registered dietitian who specializes in diabetes can help design a meal plan that fits your lifestyle and improves your diabetes control.
• Stay physically active. The addition of even a small amount of movement can make a significant improvement in your blood sugar control. Discuss exercise choices with your doctor before starting.
• Lose weight, if needed. Only a small amount needs to be lost in order to see an improvement in your diabetes control.

Q People tell me that they can feel their blood sugar level drop. I can’t. Is there something wrong with me?

A Many people with diabetes lose the ability to feel when their blood sugar level runs low. This often occurs in individuals who work hard to keep their blood sugar level within a very narrow range. Some experts also believe that frequent low blood sugar episodes can cause this unawareness to develop. If you have “hypoglycemia unawareness” try the following:

• Check your blood sugar level more often throughout the day.
• Maintain blood sugar level within 80-180 mg/dl for 2-3 weeks. Many people have regained their ability to feel blood sugar lows after doing this.
• Meet with your health care team to review your daily blood sugar test results for patterns. You may be able to predict when a low will occur and change your eating and/or medication schedule to help prevent it.
• Always check your blood sugar before you drive a car; you don’t want to be behind the wheel when your blood sugar level is low.
• Carry carbohydrate snacks to treat surprise lows – glucose tablets, sugar packets, jellybeans, etc.
• Teach your friends, family and co-workers how to help you if your blood sugar level goes low.

*This article originally appeared in 2008
**please consult with your healthcare provider before making any changes to your diabetes regimen.