Q&A with Sherry Davidson RN, CDE

I interviewed Diabetes Educator, Sherry Davidson who was actually the first nurse I met after my diagnosis. Sherry has a passion for education and is full of information. She knew at a young age that she wanted to be a nurse and after occasional fill-ins at the hospital, Sherry earned her career as an educator full time. Sherry answers questions from the correlation between stress and diabetes to the do’s and don’ts of drinking alcohol. Read how my favorite nurse educates people on how to live diabetter!
I’m Sherry Davidson, I’m a Registered Nurse and a Diabetes Educator, I’m the Diabetes Coordinator here. So 70% of my job is diabetes education, mostly outpatient education, I do see patients in the hospital as well. The other 30% is checking in on in patients, I look at lab values and blood sugars and try to make sure we’re managing patients well.

1. Is there a correlation between anxiety/stress and diabetes?
   That’s a form of stress… anxiety, stress and being scared so any type of stress can make your blood sugar go up or down, most people they go up but a lot of people they go down. One of my patients was learning to drive and he was going for his test and he took his blood sugar before the test and he failed. He took his blood sugar after and it was way sky high, so the next time he went, he did better and didn’t fail. It showed immediately how that one little event really made his blood sugar skew.
2. Can I reuse a syringe?
   That’s always a hard one, everything you read will say no. There’s a lot of literature that has looked at that just for cost and disposal and all those issues. They do say that technically you can, there’s no risk necessarily of infection to the person, which is what you would be concerned about. The needles are so fine that they do tend to get dull faster and when you look at some of the research that shows the actual needle, after one use it gets a little jagged. It certainly can if you’re using it too much can definitely irritate the skin, but as far as infection risk and everything there’s not really. So I don’t recommend it but I do tell people if you’re out somewhere and you forgot to bring an extra one or you’re over night somewhere and didn’t bring one, reuse it!
3. Tips on drinking alcohol
   Always have food with alcohol because a lot of people think depending on the alcohol they’re drinking, it’s going to make my blood sugar go up so I better not eat as much. It’s actually the opposite because when you’re drinking alcohol your liver is metabolizing the alcohol and it can’t do anything else. So people actually run the risk of a low blood sugar because one of the functions of the liver is to also release sugar that’s stored and it can’t do that when you drink. The rule I have with that is, women 1 alcoholic beverage, men can have 2 and just always make sure you have food if you’re going to drink.
4. What is diabetes burnout?
   One of the things I hear patients say is, “I just want a diabetes vacation” because it’s so much work and you’re thinking about it 24/7. I think there are ways to take breaks from certain parts occasionally depending on what your regimen is and maybe having another person be responsible for parts of it for two days so you can kind of have a little break.
5. Is a CGM (Continuous Glucose Monitor) necessary?
   A continuos glucose monitor is such a great tool, I don’t think it’s a “must” but I think they’re times when it’s helpful. I do think if people are having hard times managing their blood sugar or their a1c isn’t matching because you can’t test 24/7, then it might be necessary. I think the CGM for me is more meaningful to do spot checks. Some people do it all the time, but like you said it’s expensive. Maybe do it 3 days a couple of times a month, just to see where your baseline is and if there is an issue you’re not aware of.
6. Tips on sick day management?
   One of the big things with sick day management is balancing the carbohydrate beverages with the non-carbohydrate beverages. There’s a difference between staying hydrated, you want to stay hydrated with the sugar-free gatorade, broth, sugar-free jello and water, just things that don’t have carbs in them. Drinking lots of sugar-free beverages to stay hydrated but balancing that with apple juice and ginger ale. So usually what I tell people to think about how many carbohydrates you normally have in a meal and have that same amount even though it might look very different. It might look like apple juice or sprite and alternating with the non-caloric and non-carb.
7. Does insulin aid in weight gain?
   Insulin is a fat storage hormone and so it stores fat if you have extra you’re not using. I tend to see this with people who have type 2 diabetes more but it definitely can be with type 1 as well. You have insulin that’s not being used, it’s not causing low blood sugar, it’s sitting there so it does cause you to gain weight. So making sure you are using all that insulin and exercise is the best way to do that. Women tend to run their blood sugar higher to avoid weight gain because they know that if it’s high, they’re burning off the calories which is not good. Sometimes when people are first diagnosed, they’ve lost weight and they put it back on and they are like “uh oh, am I going to keep gaining weight?” No, it’s just initially it’s stabilizing, you shouldn’t continue to gain from that if so, we need to look at the ratio you’re using because you’re not using it all.
8. How can someone manage diabetes without insurance coverage?
   Diabetes is definitely a tough disease if you don’t have insurance coverage. I would say that typically they would be on a different insulin regimen. Some of the newer insulins cost more but we have older insulins that still work fine. You can buy a bottle of insulin for $20 at Walmart if you’re on a generic brand. It can be reasonable but it can be the $200 bottle too. With glucose testing, you can buy name brand which the strips are $1 a piece or you can buy the others that are $15 for 50 strips, so they’re ways to help.
9. Is it safe to use expired supplies?
   Technically yes we do say that you’re not supposed to use them, I don’t really know what happens. One of the things they say with insulin is that a bottle of insulin is good for a month, 28 days. If you go past that it’s not like it isn’t working, it’s probably now 98% effective. So it does lose its potency, I don’t think something bad is going to happen.
10.  What is hypoglycemia unawareness?
    A lot of times after you’ve had diabetes for a long time you just aren’t as sensitive. Those nerves that usually warn you that you’re having a hypoglycemic event aren’t there. So people get really low, 20 before they would have any symptoms but then your brain can’t remember what to do and it can be very dangerous. People tend to run themselves higher so they avoid that. What they do say is that if you run yourself a little higher for a while, your body can reset itself. That’s not always true if you’ve had diabetes for a long time.
11. Any advice for those battling diabetes?
    Staying focused on what the end result is. A quality life is so important and I think enjoying life too. So many people have diabetes controlling them instead of them controlling their diabetes and initially I totally understand because it is self-absorbing and trying to learn everything, but eventually we want to get people where it’s part of what they’re doing. Some people deal with that better than others, I think support systems make a big piece of that.
12. Will there ever be a cure?
    I do think that sometime in the future. They say every 5 years they say, “Oh, in 5 years…” and they’ve been saying that for the last 30 years but we’ve learned so much. Treatments have definitely improved, so I don’t know that will be exciting one day if they can. I think we know why, we just have to figure out how to fix it.

Ms. Sherry is one of many who has encouraged me to turn my diagnosis into a positive by choosing to live diabetter every single day.

Who has helped you on your diabetic journey?

Do you have more questions you want  me to ask on my next doctor’s visit?

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