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FAQs

Diabetes Consults

What is diabetes?

Diabetes is a chronic condition in which the body does not properly process food into energy. When we eat food (particularly carbs) the body turns it into glucose (sugar), the substance our body uses as energy. Central to this process is insulin, a hormone made by the pancreas to help cells absorb glucose. In people with diabetes, the body either does not produce enough insulin or uses it inefficiently. This causes the blood sugar, or blood glucose levels, to either get too high (hyperglycemia) or too low (hypoglycemia).

How do you treat diabetes?

If you have diabetes, your doctor may recommend a number of at-home remedies to help you manage your symptoms and keep the condition's progression at bay. These include:

Eating healthy foods: This means staying away from salt, sugar, and unhealthy fats. Aim to have a large portion of your food intake come from veggies (especially leafy green ones), fruits, and other natural sources. This will help you reach and stay at a healthy weight, keep your blood sugar in a good range, and help to prevent cardiovascular problems, such as blood vessels and heart disease.

Get plenty of physical activity: Exercising, like proper nutrition, is good advice for everyone. If you're a diabetic, it can help keep you at a healthy weight, keep your heart and lungs healthy, and may even help your body regulate blood sugar.

Be consistent with your medicine: Follow all instructions given by your health care provider.

Test your blood sugar consistently: Glucose monitoring will not only help you keep track of how well the above steps are working, but it can also help you catch any complications such as diabetic ketoacidosis, which can be deadly if not treated.

What is the best treatment for diabetes?

Treatment for diabetes involves keeping a close eye on your blood sugar levels and keeping them in the target range set by your doctor through a combination of diet, exercise, and medication.

Your doctor may recommend you check your blood glucose levels daily. An instrument called a glucometer is used to check the blood sugar by dabbing a sample of your blood on a strip of paper. A newer device, known as a continuous glucose monitor (CGM), can be attached to your body and can measure your blood sugar every few minutes for up to a week at a time.

Monitoring your glucose gives you and your doctor a better idea of your body's changing need for insulin. For some people with type 2 diabetes, diet and exercise may be enough to control your diabetes. Others will need medication, which may be either an oral drug or insulin. There are a variety of oral drugs that a doctor may choose to prescribe, that each works in different ways. Insulin may be administered either as a shot, an insulin pen, or have an insulin pump.

How can I reverse diabetes naturally?

Diabetes is a serious illness that you cannot treat on your own. You will want to see a doctor, and possibly build a team of health professionals, to help with your diabetes management. While there is no cure for diabetes, in some cases type 2 diabetes can be reversed. This means that the disease is in remission and your blood sugar levels can stay in a healthy range without needing medication. The key to this is often weight loss. Consult your health care team to figure out what method is best for you.

What are the risk factors for diabetes?

The exact cause of type 1 is unknown, though risk factors may include: family history, environment, presence of autoantibodies, and geography. Risk factors for type 2 diabetes may include:

  • Being overweight
  • Inactivity
  • Family history
  • Race/ethnicity
  • Age
  • High blood pressure
  • Low HDL ("good cholesterol") or high triglyceride levels

What is a diabetes care plan?

A diabetes care plan is a written document detailing the specific needs of diabetic students for the faculty and staff. It includes information such as what foods and medicines they take, when to take them, how much, and how the medicine is administered. Children and students with diabetes should have a care plan on file at their schools.

What are the possible complications of diabetes?

Possible complications from diabetes include:

  • Cardiovascular disease
  • Kidney disease
  • Eye damage
  • Nerve damage
  • Foot problems
  • Skin conditions

What are the four types of diabetes?

There are four main kinds of diabetes. They are:

Prediabetes: This is when your blood sugar is too high, but not high enough for your doctor to diagnose it as diabetes. It can, however, make you more likely to get type 2 diabetes and heart disease. More than a third of all people in the United States have prediabetes, though most are unaware of it. Exercising more and losing weight can lower the risk of it progressing.

Type 1 diabetes: Also known as insulin-dependent diabetes, type 1 diabetes is an autoimmune condition. It occurs when your body attacks your pancreas with antibodies causing the organ to stop producing insulin.

Type 2 diabetes: With type 2 diabetes, the pancreas usually produces some insulin, but it either doesn't produce enough, or the body doesn't use it correctly. About 90% of people who have diabetes have type 2. People who are obese (more than 20% over their target body weight) are at higher risk of type 2 diabetes.

Gestational diabetes: Pregnancy often causes some amount of insulin resistance. When it gets bad enough to become diabetes it is known as gestational. Gestational diabetes occurs in about 2%-10% of pregnancies and it usually goes away after birth. However, about 10% of women who have gestational diabetes get type 2 later on.

How can a podiatrist help with diabetes?

Diabetes can cause complications that affect foot health. Some of these complications are:

Nerve damage (neuropathy)

Untreated diabetes can damage nerves in the legs and feet. When nerves in those parts of the body are damaged, they may be unable to feel heat, cold, or trauma. This leads to infections, muscle weakening, and diabetic ulcers. If left untreated, these foot problems can be severe and threaten the safety of the limb. Podiatrists can help with wound care and preventative medicine to maintain foot health. This may save the foot from amputation.

Peripheral Vascular Disease

Diabetes can reduce blood flow to your feet, which makes it more difficult for infections and cuts to heal and increases the risk of developing gangrene or ulcers. Gangrene is a type of tissue death caused by a lack of circulation. Podiatrists can prescribe antibiotic medication to help the infection, but if left untreated, gangrene can lead to amputation.

Podiatrists can help create a foot care plan that keeps your feet healthy and free from infection. If you have a cut or blister that isn’t healing, or if you have chronic foot pain, talk to a doctor right away.

Podiatrists on Sesame offer affordable new patient consultations to talk you through your foot health and treatment plans that might be right for you. Sesame uses a direct-to-patient model, which means you book directly with the doctor you want to see and pay an upfront price with no insurance needed. Foot care can help prevent serious infection or disease. Talk to a doctor today to get the care you need.

What is a hemoglobin A1c lab test?

Hemoglobin A1c Lab Tests, also called A1c, HbA1c, or glycated hemoglobin is a test that measures the average amount of blood sugar (also called glucose) attached to your hemoglobin over the past three months. Hemoglobin is a protein in your red blood cells that carries oxygen throughout your body. Doctors generally recommend getting an HbA1c every three months if you are managing a chronic condition like diabetes. That's because three months is the average lifespan of a red blood cell.

An HbA1c test is generally used by doctors to check for diabetes or prediabetes in adults. If you have already been diagnosed with diabetes, an HbA1c can help you and your doctor evaluate and manage your condition.

What does an HbA1c test screen for?

Diagnostic HbA1c tests are used to determine blood sugar levels - the critical factor in diabetes diagnosis. The results of an A1c test are given as percentages. These correspond to your blood sugar levels.

- Below 5.7%: A1c levels that are below 5.7% indicate healthy blood sugar levels. This means you are not currently at risk of developing diabetes.

- Between 5.7-6.4%: This range indicates prediabetes, a serious health condition. Prediabetes requires immediate treatment to manage blood sugar levels and prevent the development of Type 2 diabetes.

- 6.5% or higher (after 2 separate tests): Blood sugar levels higher than 6.5% indicate that you have developed diabetes. Doctors will order two separate A1c tests to conclusively test dangerous blood sugar levels. If both tests come back with blood sugar levels at over 6.5%, they will begin treating you for diabetes.

For individuals already managing diabetes, doctors will aim to keep blood sugar levels under 7%. Blood sugar levels over 7% may require an adjustment in your treatment plan.

Where do I go to get an HbA1c test?

A1c tests are usually performed by your primary care provider. To diagnose prediabetes or diabetes, the test is performed by taking a sample of blood via a needle inserted in the arm. If your doctor suspects that you may be at risk for diabetes, they will usually order two separate A1c tests to be performed on different days. Once the blood has been drawn, it will be sent to a lab for analysis. It may take a day or two before you get your results back.

If you have been diagnosed with diabetes and are undergoing an A1c test to manage your condition, your provider can draw blood via a prick of the finger. This drawn blood will be put in a vial and tested in the office that day. This means you will usually get your results on the same day as your appointment.

What causes chronic illnesses?

Many chronic diseases are brought on by factors under our control. These include:

Tobacco use: Tobacco is the leading cause of preventable disease, disability, and death in the US. Each year 480,000 people die from smoking cigarettes with an additional 41,000 dying from secondhand smoke exposure.

Poor nutrition: Diets in the United States tend to be high in added sugars, sodium, and saturated fats, which can lead to high blood pressure, heart disease, heart attacks, and stroke. Fewer than 1 in 10 adults and adolescents living in the US meet their requirements for fruits and vegetables.

Lack of physical activity: Only 1 in 4 adults and 1 in 5 high school students in the US get the recommended levels of physical activity. Lack of activity combined with poor nutrition can lead to obesity. 40% of US adults have obesity, which puts them at increased risk for cardiovascular disease, heart failure, type 2 diabetes, and some cancers (primarily endometrial, colorectal, and breast cancer). Additionally, obesity costs the US health care system $147 billion each year.

Excessive alcohol consumption: Excessive use of alcohol can lead to serious health problems such as alcohol use disorder and problems with learning, memory, and mental health. Chronic health conditions linked to excessive alcohol consumption include high blood pressure, heart disease, stroke, liver disease, and cancer.

What is the best way to treat chronic diseases?

Treatment plans are as diverse and varied as the chronic conditions they fight.

However, for many chronic conditions, there are a few actionable steps that can help a great deal with chronic disease management. Here a just a few:

- Take time to learn about your disease. It will be helpful to know what you can expect, what is happening, and why.

- Build a team. Your doctor is a great resource, but may not be as helpful to you for making key changes to your diet as a dietician might be or to an exercise regimen as a physical therapist.

- Make healthy choices. If you smoke, quit. If you drink, stop. Not getting enough exercise or proper nutrition? Fix that too! Small steps can affect big change.

- Get better at stress management. Meditate, do yoga, find a support group, get a message or book an acupuncture session.

- Recruit your family. Changes to ease a chronic condition such as high cholesterol, hypertension, or heart disease are generally good for everyone. Making healthy changes will not only help to hold you accountable, but it might keep them from getting a chronic illness as well.

What are the best options for weight loss?

Your best option for weight loss is to find sustainable lifestyle changes that you can implement and stick with long-term. Healthy eating, physical activity, and stress management techniques can provide great results. Even in cases that require more extreme methods, these will still be foundational in achieving and maintaining a healthy weight.

There may be some who require a little extra help achieving their weight loss goals. In these cases, it is best to consult with a healthcare professional to discuss options that might be best for you. Some of those options include:

Doctor-supervised very-low-calorie diet: These diets involve drinking a liquid nutritional formula of about 500 to 800 calories each day for the first few months, before slowly reintroducing healthy solid foods while working with a counselor to modify your behaviors so you can keep the weight off. One of the great benefits of this form of dieting is rapid weight loss (5-10+ pounds per week) which can be motivating.

Surgery: When other obesity treatments and weight loss programs have failed, you may consider undergoing bariatric surgery. Bariatric surgeries, such as gastric bypass and other weight-loss surgeries, involve making changes to the digestive system to restrict the number of calories a person can consume and digest.

If you're struggling with your weight and don't know where to start, let Sesame help! We offer in-person and telehealth weight consultations at savings of up to 60%. Meet with a doctor from the convenience of your own home and get started on your wellness journey today!

Is seeing a nutritionist worth it?

Yes! Nutritionists provide services that can help you establish an effective weight loss program and take the guesswork out of meal planning, helping you meet your dietary requirements and live a healthier life. They can help to combat obesity, high cholesterol, high blood pressure and can help you recognize and work around food intolerances or sensitivities.

If you're ready to improve your eating habits, but don't know exactly where to start, Sesame can help! We can connect you directly with top-rated nutritionists in Anchorage, AK at affordable cash pay prices. Sesame works with nutritionists who set their prices directly on the site, getting you quality care for affordable prices. Save up to 60% on your nutrition consult by booking through Sesame.

What does a nutritionist do?

Nutritionists are experts in food and nutrition who promote healthy living and well-being through healthy eating. They provide nutritional counseling to help patients develop nutrition plans based on their patients health concerns. Nutritionists can even help patients evaluate meal plans, promote better nutrition, and develop healthier lifestyles.

If you're ready to make your health a priority, we're here to help. Sesame offers simple online booking with real, quality nutritionists in Anchorage, AK at affordable upfront prices. You can usually book a visit as early as the next day, all at prices up to 60% less than what you'll find through insurance networks. Browse availability and book an appointment online with Sesame. It's that simple!

What is the best way to find a nutritionist?

Sesame!

On Sesame, you can browse availability, compare prices and book an appointments with real, quality nutritionists for affordable prices. Save 60% when you book your next nutrition consult through Sesame.

What is the difference between a nutritionist and a dietician?

Registered dietitian nutritionists (RDNs) provide medical nutrition therapy (MNT) to people with certain health conditions. They may work in a hospital setting or in private practice. Sometimes, RDNs will provide nutritional education and expertise to schools, nursing homes, food-related businesses, or public health offices. RDNs often work with other healthcare professionals and are certified to treat medical conditions such as IBS, eating disorders, cardiovascular disease, and diabetes. A person must receive certification from the Academy of Nutrition and Dietetics to become an RDN.

A certified clinical nutritionist (CCN) assesses people’s nutritional needs based on their lifestyle and health goals. They offer nutrition counseling and are concerned with holistic health and wellness, providing personalized recommendations for diet, exercise, nutritional supplements, and stress relief. This certification is obtained through the Clinical Nutrition Certification Board.

What is the difference between a registered dietitian (RD) and a registered dietitian nutritionist (RDN)?

They're the same thing! When dietitians complete their training, they are able to choose which term - RD or RDN - they would like to use. Both designations are reserved for licensed dietitians and the terms are used interchangeably.

What is metformin?

Metformin is a prescription drug used with diet and exercise to treat type 2 diabetes. Metformin decreases your body’s blood glucose level and increases its response to the hormone insulin to get your type 2 diabetes under control.

Nearly 1 in 10 Americans has diabetes, a condition characterized by high levels of glucose - or sugar - in the blood. If left untreated, elevated glucose levels can wreak havoc on your body, causing kidney damage, eye problems, sexual dysfunction, and more. Doctors prescribe drugs like metformin to help keep patients’ blood glucose - and their diabetes symptoms - in check.

What is metformin used to treat?

Metformin is used to treat type 2 diabetes - the form of diabetes in which the body either does not produce enough insulin or builds a resistance to it.

Insulin is a hormone that plays a role in the way your body takes up and uses sugar for energy. When your body does not produce enough insulin, sugar builds up in the blood, leading to serious problems like kidney problems, eye problems, heart disease, nerve damage, loss of limbs, and even death.

Metformin cannot be used to treat type 1 diabetes, a condition in which the body produces little to no insulin at all.

It is important to note that metformin is meant to work alongside diet, exercise, and lifestyle changes to lower your blood glucose levels and bring your diabetes under control. Metformin alone is not sufficient to treat your blood glucose imbalance.

How does metformin work?

Metformin belongs to a series of medications known as biguanides. This family of drugs decreases the amount of glucose your body absorbs from food and limits the amount of glucose your body naturally produces. Metformin also enhances your body’s response to insulin, a hormone responsible for regulating your blood glucose levels. The combined effect of these actions helps keep your blood glucose level under control.

How long does it take for metformin to work?

It may take 4 or 5 days before metformin will take full effect, but you may notice a difference within 48 hours after starting the medication. It is important to continue taking this medication even if you feel well. Most people with diabetes need to continue taking medications for the rest of their lives.

What are the most common side effects of metformin?

While there are some common side effects associated with metformin, it is important to remember that your doctor prescribed it because they believe its ability to manage symptoms outweighs any adverse effects it may cause. The most common side effect of metformin ER include:

  • Diarrhea
  • Nausea/vomiting
  • Flatulence
  • Asthenia
  • Indigestion
  • Abdominal discomfort
  • Headache
  • Rare but potentially serious side effects may include:

  • Lactic acidosis
  • Hypothermia
  • Hypotension (low blood pressure)

Tell your doctor if you are pregnant, breast feeding, have other medical conditions, or are taking any other medications.

This is not a complete list of side effects associated with metformin. For a complete list of metformin side effects, visit the National Institutes of Health’s DailyMed for more information.

Can I get metformin medication online?

Yes! With SesameRx, you can get metformin medication delivered right to your door starting at just $5- without insurance. Our fully-integrated prescription service lets your doctor write you a prescription (or refill an existing one) during your virtual or in-person visit. That way, you can focus on getting better and not worry about how and when you’ll get your prescription.

Please note that all prescriptions are at the discretion of your provider.

What is metformin ER?

Metformin ER is the extended-release version of metformin, a prescription drug used to treat type 2 diabetes. Metformin decreases your body’s blood glucose level and increases its response to the hormone insulin to get your type 2 diabetes under control.

Nearly 1 in 10 Americans has diabetes, a condition characterized by elevated levels of glucose - or sugar - in the blood. If left untreated, elevated glucose levels can wreak havoc on your body, causing kidney damage, eye problems, sexual dysfunction, and more. Doctors prescribe drugs like metformin to help keep patients’ blood glucose - and their diabetes symptoms - in check.

What is metformin ER used to treat?

Metformin ER is used to treat type 2 diabetes - the form of diabetes in which the body either does not produce enough insulin or builds a resistance to it.

Insulin is a hormone that plays a role in the way your body takes up and uses sugar for energy. When your body does not produce enough insulin, sugar builds up in the blood, leading to serious problems like kidney problems, eye problems, heart disease, nerve damage, loss of limbs, and even death.

Metformin ER cannot be used to treat type 1 diabetes, a condition in which the body produces little to no insulin at all.

It is important to note that metformin is meant to work alongside diet, exercise, and lifestyle changes to lower your blood glucose levels and bring your diabetes under control. Metformin alone is not sufficient to treat your blood glucose imbalance.

How does metformin ER work?

Metformin belongs to a series of medications known as biguanides. This family of drugs decreases the amount of glucose your body absorbs from food and limits the amount of glucose your body naturally produces. Metformin also enhances your body’s response to insulin, a hormone responsible for regulating your blood glucose levels. The combined effect of these actions helps keep your blood glucose level under control.

How long does it take for metformin ER to work?

It may take up to 4 or 5 days before metformin will take full effect, but you may notice a difference within 48 hours after starting the medication. It is important to continue taking this medication even if you feel well. Most people with diabetes need to continue taking medications for the rest of their lives.

What are the most common side effects of metformin ER?

While there are some common side effects associated with metformin, it is important to remember that your doctor prescribed it because they believe its ability to manage symptoms outweighs any adverse effects it may cause. The most common side effect of metformin ER include:

  • Diarrhea
  • Nausea/vomiting
  • Flatulence
  • Asthenia
  • Indigestion
  • Abdominal discomfort
  • Headache

Rare but potentially serious side effects may include:

  • Lactic acidosis
  • Hypothermia
  • Hypotension

This is not an exhaustive list of side effects associated with metformin. For a complete list of metformin side effects, visit the National Institutes of Health’s DailyMed website for more information.

Can I get metformin ER online?

Yes! Sesame offers a fully integrated prescription service, which means you can get the medication you need delivered right to your door, starting at just $5 a month.

Talk to a provider on Sesame and get your online doctor prescription or refill ordered right away for fast and convenient pickup from a pharmacy of your choice.

Note that all prescriptions are at the discretion of your clinician.

What is glyburide-metformin?

Glyburide-metformin (generic Glucovance) is a prescription medication used to treat type 2 diabetes.

Nearly 1 in 10 Americans has diabetes, a condition characterized by elevated levels of glucose - or sugar - in the blood. If left untreated, elevated glucose levels can wreak havoc on your body, causing kidney damage, eye problems, sexual dysfunction, and more. Doctors prescribe drugs like glyburide-metformin to help keep patients’ blood glucose - and their diabetes symptoms - in check. Glyburide-metformin is only used to treat type 2 diabetes and is not approved for other forms of the condition.

As with many diabetes medications, glyburide-metformin works best when taken alongside lifestyle changes that naturally stabilize your insulin levels, including diet, exercise, and weight loss.

Looking for a safe, effective way to manage your type 2 diabetes? Talk to your doctor about whether glyburide-metformin is right for you.

What is glyburide-metformin used to treat?

Glyburide-metformin is used to treat type 2 diabetes. It is not prescribed to treat type 1 diabetes.

How does glyburide-metformin work?

Glyburide-metformin is a combination drug comprised of both glyburide and metformin.

Glyburide belongs to a class of medications known as sulfonylureas. These drugs help lower your blood sugar by causing the pancreas to produce insulin and helping your body use and manage insulin more efficiently. Insulin is the chemical that breaks down and regulates sugar in your body.

Metformin, on the other hand, belongs to a family of medications known as biguanides. Biguanides control the amount of glucose in your blood. They help you use insulin more efficiently by limiting the amount of glucose you absorb from food and the amount your liver naturally produces.

How long does it take for glyburide-metformin to work?

Many patients begin to notice improvement within 1-2 weeks of starting glyburide-metformin. It is important to continue taking glyburide-metformin for as long as your doctor prescribes, even if you begin to feel better. Do not stop taking glyburide-metformin without consulting your doctor.

What are common side effects of glyburide-metformin?

While adverse reactions to glyburide-metformin are uncommon, some patients who take the drug may experience mild side effects, including stomach pain, nausea, vomiting, diarrhea, and dizziness.

Rare, more serious adverse events have also been known to occur, including chest pain, rash, yellowing of the skin or eyes, light-colored stools, dark urine, stomach pain, unusual bleeding or bruising, fever, sore throat, and swelling of the eyes, face, lips, tongue, or throat.

If you are concerned that glyburide-metformin may be causing you to experience any number of adverse side effects, please contact your doctor immediately or seek emergency care.

This is not a complete list of glyburide-metformin side effects. For more information on adverse side effects you may experience while taking glyburide-metformin, please visit the National Institutes of Health’s DailyMed webpage.

Can I get glyburide-metformin online?

Yes! Sesame offers a fully integrated prescription service, which means you can get the medication you need delivered right to your door, starting at just $5 a month.

Talk to a provider on Sesame and get your online doctor prescription or refill ordered right away for fast and convenient pickup from a pharmacy of your choice.

Note that all prescriptions are at the discretion of your clinician.

What is glipizide?

Glipizide is a prescription drug used to treat type 2 diabetes. Glipizide decreases your body’s blood glucose level and increases its response to the hormone insulin to get your type 2 diabetes under control.

Nearly 1 in 10 Americans has diabetes, a condition characterized by elevated levels of glucose - or sugar - in the blood. If left untreated, elevated glucose levels can wreak havoc on your body, causing kidney damage, eye problems, sexual dysfunction, and more. Doctors prescribe drugs like metformin to help keep patients’ blood glucose - and their diabetes symptoms - in check.

What is glipizide ER?

Glipizide ER (generic Glucotrol XL) is the extended release version of Glipizide - a prescription drug used to treat type 2 diabetes. Glipizide decreases your body’s blood glucose level and increases its response to the hormone insulin to get your type 2 diabetes under control. Glipizide ER releases the drug more gradually than the instant release formulation. This provides a steadier supply of the medication to your bloodstream and allows you to take it less frequently.

Nearly 1 in 10 Americans has diabetes, a condition characterized by elevated levels of glucose - or sugar - in the blood. If left untreated, elevated glucose levels can wreak havoc on your body, causing kidney damage, eye problems, sexual dysfunction, and more. Doctors prescribe drugs like metformin to help keep patients’ blood glucose - and their diabetes symptoms - in check.

What is glipizide used to treat?

Glipizide is used to treat type 2 diabetes - the form of diabetes in which the body either does not produce enough insulin or builds a resistance to it.

Insulin is a hormone that plays a role in the way your body takes up and uses sugar for energy. When your body does not produce enough insulin, sugar builds up in the blood, leading to serious problems like kidney problems, eye problems, heart disease, nerve damage, loss of limbs, and even death.

Glipizide cannot be used to treat type 1 diabetes, a condition in which the body produces little to no insulin at all.

It is important to note that metformin is meant to work alongside diet, exercise, and lifestyle changes to lower your blood glucose levels and bring your diabetes under control. Glipizide alone is not sufficient to treat your blood glucose imbalance.

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