FAQ - Diabetes and Nutrition Center

Non-diabetes Medical Nutrition Therapy or Nutrition Education:
I don't have diabetes, I have another medical condition. My healthcare provider referred me to the Center to meet with a Registered Dietitian/Licensed Dietitian Nutritionist to learn about nutrition for my medical condition. Does my insurance company cover my visit?
-For NON-diabetes nutrition-related conditions, such as high cholesterol, renal disease, celiac disease, etc.: Call your insurance company and ask if your plan covers outpatient nutrition education, also called Medical Nutrition Therapy (MNT), provided by a Registered Dietitian, Licensed Dietitian Nutritionist.

Medicare patients: Under Plan B, Medicare provides coverage for 3 hours of nutrition education (Medical Nutrition Therapy) for stage IV renal disease or diabetes during the first calendar year with NO co-pays and additional hours as needed and prescribed. Call Medicare or visit their website for questions about your Medicare benefits for medical nutrition therapy for renal disease or diabetes.

Is there anything I should do differently before I meet with the dietitian?
-No. The Registered Dietitian (RD) will be happy to explain any changes you might need to make to manage your condition when you meet at the time of your appointment. Before your appointment, if possible, please keep a 2 to 3-day record of everything you eat and drink, including the meal and snack times, a description, and the amounts (portions) of every item, and bring this information with you when you come in for your appointment. This will help the RD understand your current eating habits and design a meal plan that's best for you.

Diabetes Self-Management Education/Training:
How do I know if my insurance covers diabetes self-management education/training (DSME/T)?
-Maryland law mandates that outpatient diabetes education/training is a covered benefit, but your plan deductibles and co-pays apply. Call your insurance company to ask about your specific plan coverage, deductible, and co-pay amounts.

Medicare patients: Under Plan B, Medicare covers 10 prescribed outpatient DSME/T visits per lifetime during a 12-month period with additional annual visits as needed and prescribed. Co- pays apply. Additionally, Medicare provides coverage for 3 hours of diabetes nutrition (Medical Nutrition Therapy) visits in a 12-month period with NO co-pays and additional annual visits as needed and prescribed. Call Medicare for specific questions about your Medicare benefits for diabetes self-management training and medical nutrition therapy. Learn more here. You can also call the Geckle Diabetes and Nutrition Center for additional insurance information and help.

What is diabetes?
-Diabetes is a disease in which the levels of glucose (sugar) in the blood are too high. Glucose is the body's main source of fuel for energy. Insulin, a hormone made by the pancreas, allows the body to use glucose properly. A person with diabetes
  • does not make insulin, or
  • makes only a small amount of insulin, or
  • makes insulin, but the insulin doesn't work properly.
People with diabetes must manage their disease and blood glucose levels to stay healthy. About 29.1 million people or 9.3 percent of the U.S. population have diabetes. Of that number, 21.0 million people have been diagnosed, and 8.1 million (27.8 percent) are undiagnosed.

(Source: National Diabetes Statistics Report 2014)

What are the common types of diabetes?
-Type 1 diabetes, formerly called "juvenile diabetes," is an autoimmune disease. It occurs most often in people under the age of 40 but can develop at any age. People with type 1 diabetes make very little or no insulin and must take insulin daily to survive. About one out of 10 people who have diabetes has type 1 diabetes.

Type 2 diabetes, formerly called "adult onset diabetes," occurs when insulin is made but it doesn't work as it should. This type occurs most often in people who are over 40 years old but can occur in younger people as well. People diagnosed with type 2 diabetes are often overweight and have a family history of type 2 diabetes. Nine out of 10 people who have diabetes have type 2 diabetes.

Gestational diabetes is a type of diabetes that develops only during pregnancy. The hormones that are produced during pregnancy increase the amount of insulin needed to control blood glucose levels. If the body can't meet this increased need for insulin, women can develop gestational diabetes during the last few weeks of pregnancy. The diagnosis of gestational diabetes in one pregnancy increases the risk of developing it with other pregnancies. Gestational diabetes usually goes away after childbirth. About 5 to 10 percent of women with gestational diabetes continue to have high blood glucose levels after the pregnancy and are diagnosed with diabetes, usually type 2 diabetes. Women who have had gestational diabetes are also at a greater risk for developing diabetes later in life. On average, about 9 percent (nine out of 100) of pregnant women develop gestational diabetes. The risk factors are similar to those for type 2 diabetes.

(Source: National Diabetes Statistics Report 2014)

What is prediabetes?
-Prediabetes occurs when blood glucose (sugar) levels are higher than normal but not high enough for a diagnosis of diabetes. Prediabetes means a person is at increased risk for developing type 2 diabetes, as well as heart disease and stroke. An estimated 86 million Americans aged 20 years or older have prediabetes. Without lifestyle changes to improve their health, 15 to 30 percent of people with prediabetes will develop type 2 diabetes within 5 years. Modest weight loss and physical activity can help people with prediabetes delay or prevent the onset of type 2 diabetes.

(Source: National Diabetes Statistics Report 2014)

Are there other types of diabetes?
-Yes. Other types of diabetes such as maturity-onset diabetes of youth (MODY) or latent autoimmune diabetes in adults (LADA), among others, are caused by specific genetic conditions or from surgery, medications, infections, pancreatic disease, or other illnesses. Such types of diabetes account for 1 to 5 percent of all diagnosed cases.

(Source: National Diabetes Statistics Report 2014)

What causes diabetes?
-Researchers and healthcare providers don't know what causes diabetes. But there are risk factors than can increase the chance of developing type 2 diabetes. These include:
  • Family history of diabetes
  • African-American, Hispanic, Native American or Asian-American race or ethnic background
  • Being overweight or obese
  • Age (risk increases with age)
  • Taking certain medications
  • Pregnancy (increases stress on a woman's body that causes some women to develop gestational diabetes)
Being active, eating healthy foods, and losing weight may help reduce the risk of developing type 2 diabetes.

How is diabetes managed?
-Diabetes is managed through education, meal planning, exercise/physical activity, and, if needed, medication. People with diabetes must use home and lab tests to monitor the levels of glucose (sugar) in their blood.

Type 1 diabetes is managed with:
  • Insulin (injections using an insulin pen or syringe or an insulin pump)
  • Meal planning
  • Exercise/physical activity
Type 2 diabetes is managed with:
  • Meal planning
  • Exercise/physical activity
  • Oral (taken by the mouth) medicine
  • Injectable medication taken with oral medication (in some cases)
  • Insulin taken with oral medication (in some cases)
Gestational diabetes is managed with:
  • Meal planning
  • Exercise/physical activity
  • Insulin (sometimes)
  • Oral medication (less common)


What are the symptoms of diabetes?
-Type 1 diabetes

The onset of type 1 diabetes happens quickly. The symptoms are often severe and include:
  • Increased thirst
  • Dry mouth
  • Frequent urination
  • Weight loss
  • Weakness and fatigue
  • Blurred vision
Type 2 diabetes

The symptoms of type 2 diabetes can go unnoticed or undetected for many months or even years and may include:
  • Blurred vision
  • Slow healing cuts or sores
  • Increased thirst
  • Dry mouth
  • Frequent urination
  • Itchy skin (usually in the vaginal or groin area)
  • Yeast infections


How do I know if I have diabetes?
-Your healthcare provider can perform blood tests to diagnose diabetes. Normal glucose (blood sugar) is between 70 mg/dl and 100 mg/dl. The standard diagnosis of diabetes is made when two blood tests show that the fasting glucose level (blood sugar before eating or drinking anything) is 126 mg/dl or greater.

Can diabetes be cured?
-No. A cure for diabetes has not yet been found. However, diabetes can be treated and controlled with education, healthy eating, physical activity, and medications. Most people with diabetes manage their disease and lead healthy, active lives. But without proper care, uncontrolled diabetes can lead to:
  • Heart disease
  • Kidney disease
  • Eye damage and blindness
  • Nerve damage resulting in pain or loss of sensation
  • Gum disease
  • Serious foot infections, sometimes requiring amputation


What should my glucose (blood sugar) level be?
-Glucose levels change throughout the day, and target levels may be different for each person. Your healthcare provider will advise you about the levels that are best for you.

Is it common to take both pills and an injectable medicine or insulin to control my type 2 diabetes?
-Yes. The combination of prescription oral medication(s) and an injectable medication or insulin is safe and effective in managing type 2 diabetes. There are many different types of oral medications for type 2 diabetes, and it is very common to use more than one kind of pill or tablet to manage type 2 diabetes. Your healthcare provider may also add an injectable medication or insulin to your oral medication(s) to help manage your type 2 diabetes.

I have type 2 diabetes and my healthcare provider prescribed insulin for me. Does that mean that I now have type 1 diabetes?
-No. Type 2 diabetes never develops into type 1 diabetes. Type 1 diabetes is an auto-immune disease and requires daily insulin injections (pen, syringe, or use of an insulin pump). Type 2 diabetes is not an auto-immune disease. Adding insulin to oral medication(s) to help manage type 2 diabetes does not mean that the person now has type 1 diabetes.

For additional information, contact the Geckle Diabetes and Nutrition Center at GBMC, or the American Diabetes Association or 1-800-DIABETES (800-342- 2383). Monday-Friday, 8:30 am to 8:00 pm ET.

Greater Baltimore Medical Center | 6701 North Charles Street | Baltimore, MD 21204 | (443) 849-2000 | TTY (800) 735-2258
© 2014  GBMC. This website is for informational purposes only and not intended as medical advice or a substitute for a consultation with a professional healthcare provider.