Diabetes Self-Management Blog

If you regularly read my postings, you probably realize that I tend to write about a specific topic on a weekly basis. However, this week, my posting will be something of a "mishmash" of three topics—all diabetes-related, however.

I just got back from the American Association of Diabetes Educators (AADE) 35th Annual Meeting, held in Washington, D.C. this past week. Someone told me that about 3,500 educators (nurses, dietitians, physicians, and more) attended. When you get that many people together, you’re bound to learn something, and I did. I wanted to share some pearls of wisdom, tidbits of interest, and interesting facts that I picked up over the last few days.

If things seem a little jumbled, well, it’s because they are. Since you can’t attend more than one session at a time, I picked and chose those sessions that were of most interest and relevance to me. So, here goes:

Welchol, or colesevelam, is not a new medication. It’s primarily been used as a cholesterol-lowering agent, binding to bile acids in the intestine. Welchol can be used along with a statin. What’s new about Welchol is that it’s also been found to lower HbA1c levels by at least 0.5%. That may not sound like a lot, but a 1% drop in HbA1c lowers your risk of diabetes complications by 37% and your risk of a heart attack by 14%. Welchol lowers LDL (bad) cholesterol by about 15% to 17%, as well.

If used as a diabetes drug, Welchol can be prescribed along with metformin, a sulfonylurea, or with insulin. It’s not meant to be taken by itself. Also, it’s not intended to treat Type 1 diabetes. As with any medication, it comes with a few side effects: It can raise triglyceride (blood fat) levels, so caution should be used if your triglyceride levels are higher than 500 mg/dl. Welchol can also decrease the absorption of fat-soluble vitamins (A, D, E, K), and it shouldn’t be used in people with gastroparesis, other gastrointestinal disorders, or a history of bowel obstruction. Finally, you need to take six tablets every day, so if you’re not a pill-taker, this drug may not be for you.

This session was given by one of my Joslin colleagues, Katie Weinger, Ed.D., R.N., who does a lot of behavioral health research. Some of the takeaway messages that I got from this session were that as the duration of Type 2 diabetes increases, one is more prone to hypoglycemia (low blood glucose); that there’s no evidence that hypoglycemia causes a substantial decline in cognition; and that in people with hypoglycemia unawareness (the inability to feel classic symptoms of hypoglycemia), symptoms of hypoglycemia can be restored.

Also, she mentioned that, in the Diabetes Control and Complications Trial (DCCT), a landmark Type 1 diabetes study, 55% of hypoglycemic episodes occurred during sleep. My conclusion is that this means one should occasionally set an alarm at 2 or 3 AM to do a blood glucose check or think about wearing a continuous glucose sensor, especially if your lows tend to occur overnight.

Hypoglycemia and driving don’t mix, so it’s crucial to check your blood glucose before you get in the car, and if you think you’re on the way down, to eat a snack to be on the safe side. By the way, men are more likely than women to drive when they’re low.

A last tidbit of interest: Pediatric endocrinologists are more likely to talk to their patients—meaning adolescents—about the dangers of driving when low than adult endocrinologists.

Dietary Supplements
This excellent talk was given by a pharmacist, who relayed that people with diabetes are almost twice as likely to use supplements as people without diabetes, and that 20% to 30% of people with diabetes take some kind of supplement. She provided a lot of helpful information; two supplements that she discussed that I wasn’t aware of were chia (yes, as in Chia Pets!) and salacia.

Chia, also called Salvia hispanica, became popular after being mentioned on Oprah (of course!). These are little seeds that are very high in fiber and can lower insulin levels, post-meal blood glucose levels, and blood pressure.

Salacia works to inhibit an enzyme in the gastrointestinal tract to help lower post-meal glucose levels (much like the drug acarbose [Precose], although actually more potent). So, expect to hear and read more about these two supplements in the near future.

All in all, this conference was another success, and in the future I’ll share more “clinical pearls” that I picked up over the last four days.


  1. I, too, attended the AADE conference. There was alot of knowledge all around. I also learn some new and exciting information that I hope will help improve the lifes of people with diabetes.
    Terry Jennings, RN, CDE

    Posted by Terry Jennings, RN, CDE |
  2. Dear Amy.

    One reason that caused my night time lows but is easy to correct is that in my case Lantus acts much longer than 24 hours. So injecting it at bedtime as is the common wisdom recommended by all Doctors is a really bad idea. The doses will overlap and you wills have a real nightmare. The bedtime injection time is a good idea for those people that their dose lasts less than 24 hours as then it will cover the night time highs. In my case I can wait at least 30 hours between Lantus doses which is a hassle or overlap during the day which makes dealing with a low much easier.

    Posted by Calgarydiabetic |
  3. Hi Calgarydiabetic,
    Thanks for bringing up a good point about Lantus. When Lantus first came out, instructions were to inject this insulin at bedtime. However, instructions now say that Lantus can be taken once at a day, at any time (such as morning or evening) as long as it’s injected at the same time each day. It’s important to work with your healthcare team to determine the best time of day to take your insulin, since everyone is different!

    Posted by acampbell |

Post a Comment

Note: All comments are moderated and there may be a delay in the publication of your comment. Please be on-topic and appropriate. Do not disclose personal information. Be respectful of other posters. Only post information that is correct and true to your knowledge. When referencing information that is not based on personal experience, please provide links to your sources. All commenters are considered to be nonmedical professionals unless explicitly stated otherwise. Promotion of your own or someone else's business or competing site is not allowed: Sharing links to sites that are relevant to the topic at hand is permitted, but advertising is not. Once submitted, comments cannot be modified or deleted by their authors. Comments that don't follow the guidelines above may be deleted without warning. Such actions are at the sole discretion of DiabetesSelfManagement.com. Comments are moderated Monday through Friday by the editors of DiabetesSelfManagement.com. The moderators are employees of Madavor Media, LLC., and do not report any conflicts of interest. A privacy policy setting forth our policies regarding the collection, use, and disclosure of certain information relating to you and your use of this Web site can be found here. For more information, please read our Terms and Conditions.

Alternative Medicine/Complementary Therapies
Love Hormone Treats Diabetes (10/15/14)
Color Me Healthy (09/29/14)
Misinformation (01/22/14)
Acupuncture Improves Diabetic Gastroparesis (05/31/13)

Oral Medicines
Statins May Reduce Risk of Nerve Damage, Other Diabetes Complications (09/18/14)
New Metformin Combo Drug Approved for Type 2 Diabetes (08/13/14)
FDA Approves New Oral Drug for Type 2 Diabetes (08/07/14)
New SGLT Drugs Coming (07/23/14)

Low Blood Glucose
Antibiotics Linked to Lows in People Taking Certain Diabetes Drugs (09/11/14)
Did Somebody Say Diabetes Is Dull? BWAAA-ha-ha-ha-ha (06/10/14)
Limbo Stick or Not: How Low Can You Go? (06/03/14)
Almost 20 Years… (05/15/14)

General Diabetes & Health Issues
Getting to Sleep and Staying There (09/24/14)
How Much Do You Know About Diabetes? Six Facts to Get You Thinking (08/25/14)
Doing Your Own Research (08/06/14)
Ensuring a Successful Hospital Stay (08/15/14)



Disclaimer of Medical Advice: You understand that the blog posts and comments to such blog posts (whether posted by us, our agents or bloggers, or by users) do not constitute medical advice or recommendation of any kind, and you should not rely on any information contained in such posts or comments to replace consultations with your qualified health care professionals to meet your individual needs. The opinions and other information contained in the blog posts and comments do not reflect the opinions or positions of the Site Proprietor.

Blood Glucose Self-Monitoring — Part 3: Smart Monitoring

10 Keys to Long-Term Weight Loss

Take Your Best Shot: Stay Up to Date on Vaccines

Complete table of contents
Subscription questions