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This feature is provided for informational purposes only. The answers you receive from BID-Plymouth experts are not intended to be a substitute for individual medical advice in diagnosing or treating a health problem. Please note that experts do not provide diagnosis, prescriptions or referrals via email. Please consult with your physician about your specific health care concerns.

Diabetes Management

What are the new drugs for diabetes and how do they work? What is “quality” diabetes care? When it comes to effectively managing your diabetes, turn to Beth Israel Deaconess Hospital-Plymouth. Ask your questions here! Our endocrinologist, Dr. Nathaniel Clark, is an expert in diabetes management and can provide you with the answers you are looking for.

Clark Nathaniel.jpg Expert:Nathaniel Clark, MD, MS, RD, endocrinologist at Beth Israel Deaconess Hospital-Plymouth. Dr. Clark received his medical degree from the University of Massachusetts Medical School and completed both his residency and fellowship at Bay State Medical Center. He is board certified in Endocrinology, Diabetes and Metabolism. His clinical interests include diabetes, thyroid disorders and metabolic bone disease.

Questions and Answers

If I forget to take my diabetes medication from time to time, can I take double the dose the next time?
Why does my blood sugar level go up in the morning when I haven't eaten all night?
If I'm exercising regularly, is that something that can help a lot with managing my diabetes?
What should I know about my family history of diabetes in order to prevent getting it myself?
How important is foot, eye and kidney care?
I hear conflicting information as to what to look for in your food.

If I forget to take my diabetes medication from time to time while eating foods high in sugar, can I take double the dose the next time?

No. Some medications act quickly and are taken before you eat to limit the increase in your blood glucose (sugar) from eating. Taking these medications after you have eaten will not be effective. Other medications act over the entire day and doubling the dose would not help and could cause a low blood glucose. In general, if you forget to take a dose, take your next dose as scheduled.


Why does my blood sugar level go up in the morning when I haven't eaten all night?

The amount of glucose (sugar) in our blood comes from both the carbohydrates in the foods we eat and also from the glucose made by our bodies, mainly in the liver. The body needs to make glucose mainly overnight because we have not eaten for many hours. Patients with type 2 diabetes (the more common type) often make more glucose overnight than is needed, leading to a higher blood glucose level when you wake up than when you went to bed.


I have type 2 diabetes, a sweet tooth and am struggling to change my diet. If I'm exercising regularly, is that something that can help a lot with managing my diabetes?

Yes, regular exercise is very important for our overall health and also for managing your diabetes. Many patients with type 2 diabetes are overweight and losing even a moderate amount of weight (10-15 pounds) can be very helpful in managing their diabetes. Eating less calories than you expend through activity leads to weight loss. To lose weight, both diet and exercise are very important.


What should I know about my family history of diabetes in order to prevent getting it myself?

Family history is important for both types of diabetes, type 1 and type 2, but much more important in type 2 (the more common type). There are many risk factors for type 2 diabetes including, body weight, family history, race/ethnicity and a history of gestational diabetes (diabetes during pregnancy or having given birth to a large baby).


How important is foot, eye and kidney care?

The complications of diabetes most closely tied to how well your blood glucose (sugar) is controlled are blindness, kidney failure and amputations. A very important part of good diabetes care is making sure that you are getting the required tests on your eyes, kidneys and feet. When these complications are detected early they can be treated preventing further problems. A dilated eye exam by an eye care professional and kidney tests should be done at least once per year. Feet should be examined at each doctor visit.

As a diabetic, I hear conflicting information as to what not to look for in your food and what to look for. I hear carbs are bad because they turn into sugar. I hear protein is very good for you but those types of foods are usually high in fat, which I am told to avoid. And is there any benefit to eating sugarless cookies or candies? I was told there is still some sugar substance in these products. By the way-I love fish/seafood which I hear I can eat all I want.

There is no such thing as a “diabetic diet” any more. Nutrition experts advise that everyone should eat a healthy diet which contains carbohydrates, protein and fat. In regard to carbohydrates, we advise “complex” (bread, pasta, potato) rather than “simple” (candy, soda, cookies, cakes, ice cream, etc). Whole grains have many advantages including nutritional and fiber content. Protein is very important and should be low fat, if possible. How the protein is cooked (baked vs fried) can be very important in regard to calories. Fat should be limited and we recommend vegetable (unsaturated fat) oils over saturated fat (butter). The effect a given food has on blood glucose (sugar) is important but how many calories a food contains can also be very important if one is trying to lose weight.

Looking for more information?

Join Dr. Clark as he discusses diabetes management at a free community health lecture at Stafford Hill Assisted Living in Plymouth on Thursday, May 8 from 6:00 to 7:00 pm. Light refreshments will be served.

Admission is free. Registration is required.

To register call (855) 4BIDPLY (855-424-3759).

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BID-Plymouth
275 Sandwich Street
Plymouth, MA 02360
(508) 746-2000

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