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

Q I recently went to a restaurant and ordered a diet drink. The waitress accidentally brought me a regular soda and boy did I have problems with my blood sugar level after drinking it! How can I keep this mistake from happening again?

A Here are a few suggestions that may help:

• If possible, watch the serving staff pour your drink.
• Ask the waiter to place a slice of lemon in your diet soft drink. This request makes your order is a bit unusual, so the waiter must give it a bit more attention as he or she pours it into the glass.
• When riding a plane, request the can, so you can be certain that you are getting a diet beverage. If they refuse, tell them that you have diabetes and have a medical need.
• Take a sip or two before enthusiastically drinking your entire beverage; you may be able to taste the difference.
• Carry a bottle of visual glucose test strips that change color when sugar is present. If it changes color when you dip it into your drink, your beverage is not a diet one.

Q I think I’m starting to enter menopause. What kinds of diabetes-related changes can I expect to see?

A You can expect the unexpected. As your hormone levels start to change, your blood sugar control may become a bit unpredictable. Test frequently and you should be fine. Hormonal swings can create symptoms that resemble blood sugar swings. If you think that your BS level is low, test it before you take a high carbohydrate snack. Your feelings may have nothing to do with your blood sugar level. If you treat a blood sugar low that isn’t really there, your level will climb and you will gain weight. Exercise regularly and stay active.

Q This is a sensitive subject. I wear an insulin pump. Lately, after being intimate with my spouse, my blood sugar level shoots way up into the 300’s. Why do you think this is happening?

A This same problem happened to a patient of mine. She discovered that her pump infusion set was —–. When this happened, she stopped receiving insulin and her blood sugar level went high. Not everyone wears a pump during intimacy, but some find that they need the insulin. If you don’t have enough insulin in your system when participating in any physical activity, your blood sugar level may climb. Try moving your infusion set to another area on your body or secure it better with special adhesive tape. Contact your pump company to order some.

Q I think I’m developing diabetes. My doctor says that my fasting blood sugar level is fine, but my blood sugar level is running higher than normal (at least 200) after meals. Is it possible to tell if I have diabetes by checking my after-meal blood sugar level?

A I’m impressed! You are on the right track. A person’s fasting blood sugar level is usually the LAST level to show a change as type 2 diabetes develops. Unfortunately, it is often the only level that is checked by health care professionals. Many people who are diagnosed with type 2 diabetes discover that they probably had it for many years before it was finally identified by their physician. You are catching a growing problem nice and early. Bring this information to the attention of your doctor or see an endocrinologist (diabetes specialist).

*please consult with your healthcare provider before making any changes to your diabetes regimen.