Will a person with Type 2 diabetes under control end up with the need for insulin?

A: As you may have read, Type 2 diabetes is a progressive disease. Will you require insulin? That all depends on individual factors that includes, among many other factors, weight, exercise, genetics, hormones and beta-cells, those cells that produce insulin in your pancreas. Research shows that managing your diabetes early in the disease process can […]

A: As you may have read, Type 2 diabetes is a progressive disease. Will you require insulin? That all depends on individual factors that includes, among many other factors, weight, exercise, genetics, hormones and beta-cells, those cells that produce insulin in your pancreas. Research shows that managing your diabetes early in the disease process can have big payoffs in later years. Joining a support group for people with diabetes can be helpful in keeping you going in your health quest. Following up with your health care team regularly and keeping abreast of the new developments in diabetes management can also benefit you.

Answered by Andrea Dunn, RD, LD, CDE: Andrea Dunn is a registered dietitian and certified diabetes educator with the Center for Human Nutrition.

What medications are best for the treatment of asthma? What are their side effects?

A: Albuterol is usually the primary “rescue” or short-term medicine that is used to help acute asthma symptoms, such as coughing or wheezing. When a patient needs to use albuterol to relieve daytime symptoms more than twice per week, however, it usually reflects the need to use daily “controller” or anti-inflammatory medications. Many people are concerned about possible side effects of inhaled steroids, which are the largest group of “controller” medications available. When used in low- to medium-doses, however, inhaled steroids are very safe, even used on a daily basis for years. They are much safer than either multiple courses of oral steroids OR uncontrolled/undertreated asthma symptoms.

Answered by John Carl, MD. Dr. Carl is a pediatric pulmonologist at Cleveland Clinic Children’s who diagnoses and treats pneumonia, asthma, bronchitis, emphysema, and other respiratory problems in infants, children, and adolescents.

Can drinking water with lemon prevent kidney stones? Also, I have been told not to drink city water. What is the best water to drink?

A: One-half cup of lemon juice concentrate added to drinking water over the course of the day is a preventive therapy for calcium oxalate stone formation.

As for city water, it is safe to drink but the concern is with water softened using a sodium ion exchange. Softened water should not be used for cooking, drinking, or for ice dispensers.

Answered by Maxine Smith RD, LD. Ms. Smith has more than 20 years of experience as a registered, clinical dietitian and currently works in the department of Nutrition Therapy.

Is Greek yoghurt healthier than regular yoghurt?

A: Greek yoghurt typically has more protein than regular yoghurt (about 16 gm. versus 6 gm.), but it is not necessarily more healthy. No matter what type of yoghurt you choose, look for one that is fat-free or at least low-fat and that is not loaded with sugar. Plain yoghurt will obviously not have added sugar; and, typically, yoghurts that are 100 calories or less for a 6 oz. container will be moderate in added sugar.

Answered by Maxine Smith, RD, LD. Ms. Smith has more than 20 years of experience as a registered, clinical dietitian and currently works in the department of Nutrition Therapy.

I am always tired. Why is this, and what can I do to change it?

A: Getting enough sleep is not to be underestimated. Unfortunately, given our busy lives with work and family and other obligations, many of us do not get enough sleep. Fortunately, there are behaviour modifications that you can make, starting tonight, that will improve your ability to get a good night’s sleep and feel less tired. We call this “sleep hygiene,” and it includes the following behaviours:

Trying to go to bed and wake up at the same time every night, regardless of whether it is a weekday or a weekend day

Avoiding caffeine at least after 6 pm, if not earlier

Limiting alcohol intake

Trying not to exercise at night just before sleep

Lying in bed awake: If you are in bed trying to sleep and are awake for more than 20 minutes, get up and out of bed; beds are for sleeping – not reading, eating, watching television, etc.

Answered by Elizabeth Ricanati, MD. Dr. Ricanati is a staff physician for the Department of Disease Reversal at Cleveland Clinic’s Wellness Institute and is the medical director for its Lifestyle 180 Program.

If you are diagnosed with “pre-diabetes,” can you eat right and exercise enough for it to go away?

A: The diagnosis of pre-diabetes is a risk factor for developing diabetes, not an absolute certainty. So, yes, diet and exercise can normalize blood sugars and reduce your future risk of developing diabetes.

Answered by Kathryn Teng, MD. Dr. Teng is an Associate Staff Physician in Cleveland Clinic’s Department of Internal Medicine. Her specialities are diabetes, high cholesterol, and hypertension.

Is there an increased risk of migraine for women who choose to take estrogen for menopausal symptoms?

A: Yes, possibly. Women with a history of migraine who take estrogen (i.e. birth control pills or hormone therapy) may experience a worsening of their migraine. Headache can be one of the more common side effects of estrogen containing medications.

Answered by Jennifer Poptic, MD. Jennifer Poptic, MD, is a family practitioner, Cleveland Clinic Brunswick Family Health Center.

www.clevelandclinic.org