Talk
Do PWDs need to snack?
ANSWERED BY JILL WEISENBERGER, M.S., RDN, CDE
Not necessarily. Years ago, if you were on a diabetes medication,
snacks weren’t really optional. There were few medication options,
and each generally required snacking between meals to prevent low
blood sugar. But today, there are more medications to choose from,
and many of them don’t have hypoglycemia (low blood sugar) as a
side effect. So if you’re eating snacks when you aren’t hungry because
you think it will help keep your blood sugar stable, you may want
to reconsider (especially since there’s no good evidence to say that
snacking helps people lose weight). Some medications can still cause
low blood sugar—namely insulin and insulin secretagogues like sul-
fonylureas—so check with your provider to learn more about your
risk for hypoglycemia. If you do experience low blood sugar and don’t
like to snack, different treatment options like a change in medication
or dosing strategy can help. Talk to a member of your health care
team about your options. And if you do nosh between meals, think of
snacking as a chance to fill in nutritional gaps—opt for nutrient -
dense foods like fruits, veggies, nuts, or low-fat dairy.
It is normal to have side effects
when taking metformin?
ANSWERED BY EVAN SISSON, PHARM.D., CDE
Metformin is widely used and, in general, very well
tolerated. But, like most drugs, it does have side
effects. Because it lowers blood sugar by decreasing
the amount of glucose you absorb from your food,
the most common side effects stem from irritation
of the lining of the gastrointestinal tract, includ-
ing abdominal discomfort, nausea, diarrhea, and,
surprisingly, a metallic taste in the mouth. Rapid
dose increases, such as when you first start taking
metformin, can bring on these symptoms. But
don’t be discouraged! Talk with your doctor about
lowering the dose, taking the medicine with food,
trying an extended-release version, or—if all else
fails—trying alternative treatments such as SGLT-
inhibitors or GLP-1 receptor agonists.
PHOTO NATAŠA MANDIĆ / STOCKSY FALL 2019 / DI ABETIC LI VING 9
