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Laurie Anderson, MSN, RNP, CDOE

Joined: 02/05/2010

Expert Profile:

Laurie Anderson is a certified family nurse practitioner and is the Director of Wellness for Fitness4Diabetics, LLC, a web based fitness and nutrition coaching program for individuals with all types of diabetes, pre-diabetes, and metabolic syndrome. Fit4D coaches are nurses, registered dietitians, and exercise specialists who utilize motivational interviewing, webinars, and telehealth methods to assist individuals to meet their goals. Laurie works with individuals with diabetes and related conditions in emergency medicine, an endocrinology specialty practice, and in a primary care setting with Native Americans; she has practical experience with exercise prescription in the cardiac and pulmonary rehab setting. Her area of special interest is motivational interviewing for health behavior change and she has presented on this topic for other health professionals.

She has been affiliated with WebMD for many years, previously hosting the heart disease and devices message board and more recently affiliated with the diabetes boards. "It is my pleasure to once again be associated with WebMD and it's evidence-based resources for patient education. I believe in the combination of expert advice and individual to individual support to empower health behavior change, and the WebMD community is powerful example of those resources in action."

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Reply: Pre-Diabetic and confused

PS: an A1c > 6.4% is used to diagnose diabetes: ...

Posted by Laurie Anderson, MSN, RNP, CDOE

21 Replies | Reply | Watch This DiscussionReport This| Share this:Pre-Diabetic and confused PS: an A1c > 6.4% is used to diagnose diabetes: ...

Reply: Pre-Diabetic and confused

Hi, Some thoughts: You are correct about anemia increasing the...

Posted by Laurie Anderson, MSN, RNP, CDOE

21 Replies | Reply | Watch This DiscussionReport This| Share this:Pre-Diabetic and confused Hi, Some thoughts: You are correct about anemia increasing the...

Reply: Dr visits-

Hi Barb, What time do you typically test in the AM to get those...

Posted by Laurie Anderson, MSN, RNP, CDOE

Hi Barb,

What time do you typically test in the AM to get those fasting numbers? As Gomer mentioned, one cause of an increase in the morning glucose is the dawn phenomenon. This is a rise in glucose starting about 2 hours before you typically get up in the AM and it's the body's way of preparing for the day. The hormones work to increase not only your blood glucose, but also your heart rate, blood pressure, and breathing rate just a bit to prepare you to get out of bed and be ready to move about your day. The dawn phenomenon can cause some people to have their highest blood glucose of the day first thing in the morning. One way to stop this response is to eat some food; once the body realizes that it's receiving another source of glucose it will stop producing it (this is not immediate, like flipping a switch, so it can continue to rise for a bit after you eat). This is why your blood glucose will continue to rise when you are fasting for blood work; it's producing the glucose needed to feed your brain and body in the absence of food.

Another cause of high blood glucose in the morning is the somogyi effect. This happens when one has a low blood glucose overnight (typically about 2-3 AM) and the body responds to the low by causing an increase in blood glucose. The cause of an overnight low can be late day exercise, the content and timing of food (and/or alcohol if you imbibe) intake in the evening, or the need for medication adjustment. While many people will awaken with a low glucose overnight, others will sleep through the low and then awaken with an elevated blood glucose that is puzzling to them. If you think this is the cause of an excessively high morning blood glucose (typically over 200) then set your alarm for between 2-3 AM and check your blood glucose; if you are lower than 70 mg/dl overnight then discuss the results with your health care provider. Kind regards, Laurie

Laurie J Anderson, MSN, RNP, CDOE
Check out our upcoming events and videos on facebook at www.facebook.com/fit4dcoaching
Check out diabetes management tips and research at www.fit4d.com/blog

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Posted byLaurie Anderson, MSN, RNP, CDOE

7 Replies | Reply | Watch This DiscussionReport This| Share this:Dr visits- Hi Barb, What time do you typically test in the AM to get those...

Reply: Sugars going up!

Hi Mimi, It's also possible that a medication that has been...

Posted by Laurie Anderson, MSN, RNP, CDOE

Hi Mimi,

It's also possible that a medication that has been effective in the past stops working due to changes in your weight, metabolism, exercise levels or eating habits. Would you tell me a little more about how you are eating. Since you don't like meat, what are you substituting? I am not a huge meat fan either, although I do eat some; I try to make a number of meals vegetarian choices every week. I spent a number of years eating a completely vegetarian diet and since that time there are now a lot of soy, plant, and vegetable protein based foods that I didn't have years ago. For example, there is a brand called Quorn that is made from mushrooms and has been turned into a ground meat substitute (great for tacos, chilli, meat sauces), burgers, "chicken" patties and nuggets. I find that my hunger is more stable if I get enough protein in my diet and there are ways to do that without consuming meat. It is also important to limit carb portions (perhaps 45 grams per meal) and make them complex, such as brown rice and whole grain or low carb/high protein pastas in appropriate portions. Have you met with a dietitian to see what you might do with food choices to improve your blood glucose?

Milk thistle is known to help the liver heal when it is injured; I will have to do some reading but I have never seen it indicated for diabetes. There are supplements and herbals that have shown some evidence in helping to improve blood glucose, but I would recommend seeking the advice of a licensed practitioner such as a naturopath before taking these kinds of medications as they can have side effects and interactions with your metformin. Please don't get me wrong; I am a strong advocate of alternative medications as long as they are prescibed safely, have evidence of effectiveness (sometimes this means studies in Europe, where they are more commonly used), and are monitored to make sure they are notr causing harm.

Kind regards, LaurieView Thread

Posted byLaurie Anderson, MSN, RNP, CDOE

6 Replies | Reply | Watch This DiscussionReport This| Share this:Sugars going up! Hi Mimi, It's also possible that a medication that has been...

Reply: Could this be glucose intolerance, hypoglycemia, p...

Hi, I think this is unlikely to be related to blood glucose;...

Posted by Laurie Anderson, MSN, RNP, CDOE

6 Replies | Reply | Watch This DiscussionReport This| Share this:Could this be glucose intolerance, hypoglycemia, pre-diabetes? Hi, I think this is unlikely to be related to blood glucose;...

Reply: Is this high

Hi Denise, Very good plan to start the metformin slowly; to...

Posted by Laurie Anderson, MSN, RNP, CDOE

72 Replies | Reply | Watch This DiscussionReport This| Share this:Is this high Hi Denise, Very good plan to start the metformin slowly; to...

Reply: Is this high

Hi Denise, Very good plan to start the metformin slowly; to...

Posted by Laurie Anderson, MSN, RNP, CDOE

72 Replies | Reply | Watch This DiscussionReport This| Share this:Is this high Hi Denise, Very good plan to start the metformin slowly; to...

Reply: Is this high

Hi, I think "verbatim" may be stretching it a bit, but for the...

Posted by Laurie Anderson, MSN, RNP, CDOE

72 Replies | Reply | Watch This DiscussionReport This| Share this:Is this high Hi, I think "verbatim" may be stretching it a bit, but for the...

Reply: Is human insulin made from humuan urine?.

Interesting discussion! Despite how awful it sounds, urine is...

Posted by Laurie Anderson, MSN, RNP, CDOE

14 Replies | Reply | Watch This DiscussionReport This| Share this:Is human insulin made from humuan urine?. Interesting discussion! Despite how awful it sounds, urine is...

Reply: Is this high

Hi, An average glucose of 253 mg/dl is equal to a hemoglobin A1c...

Posted by Laurie Anderson, MSN, RNP, CDOE

72 Replies | Reply | Watch This DiscussionReport This| Share this:Is this high Hi, An average glucose of 253 mg/dl is equal to a hemoglobin A1c...

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