Dr. Linda Gaudiani founded and is the Medical Director of the Braden Diabetes Center at Marin General, as well as medically directing the Diabetes InPatient Care services at Marin General Hospital. She is the president of Marin Endocrine Care and Research a specialty practice in Endocrinology, Diabetology and Metabolism and part of the Marin Health Care District.
In addition to her endocrinology practice, Dr. Gaudiani co-directs the Marin Endocrine Bone Density Services. In the research department at Marin Endocrine she has acted as Principal Investigator in state of the art endocrine pharmaceutical research trials over a period of three decades. Dr. Gaudiani is an Associate Clinical Professor of Medicine at UCSF and has enjoyed her teacher/mentor role for medical students there, receiving the Alpha Omega Alpha Honor Medical Society Volunteer Clinical Faculty Award in 2008.

Questions Answered by Dr. Gaudiani

Q: Not sure my Doctor is managing my diabetes care. My A1c levels are up to 7.3 from 7.1. My Doctor tells me to exercise more & watch my carb intake, but I am concerned. Shouldn’t I be on medications? Or have things changed in the treatment for diabetes care?

A: Great question! Your Dr. is right to start with lifestyle modifications including Medical Nutritional Therapy and exercise delivered by a proactive care team that focuses on “patient-centered care”. This means that the goals of therapy and recommendations must take into account patient preferences, needs, and values. These measures can result in reversal of hyperglycemia in many patients and are the initial cornerstone of treatment depending on the A1C at the time of diagnoses. BUT, you are right to be concerned about a rising A1C over 7% because, depending on the individual, life style changes are not always sufficient to treat hyperglycemia and get blood sugars to goal. Current recommendations are to reassess an individual’s progress in one to three months and if glycemic targets are not met to add pharmacologic therapy to lifestyle. Subsequently it is recommended to be monitored every 3 to 6 months until goals are met for further adjustments in medications and lifestyle as well as monitoring of the other associated goals for blood pressure and lipid control. Diabetes Education Centers such as the BDC can help you understand your goals and how to get there and your Dr will probably be glad to know you want to be proactive in treating this condition optimally to avoid complications! - Dr G.

Q: Can I still travel if I have diabetes?

A: Yes -- you can absolutely travel if you are living with diabetes. This disease does not have to limit the activities in your life, but there are a few steps you can take to better prepare for your travels. Always plan ahead by having extra supplies on hand, including test strips, insulin, syringes, pen or pump supplies, oral medications, and batteries. It is important to have fast acting glucose on you at all times to treat hypoglycemia and extra snacks in case you are in a situation where a meal is delayed. Always keep your diabetes supplies in your carry-on bag. You never know when your checked bag can get lost, so it is best to keep these valuables on you at all times. Happy travels! - Dr G.

Q: How can I feel more comfortable giving myself injections in social situations?

A: Giving yourself injections in front of others can feel uncomfortable at times, but having diabetes is not something to be embarrassed about. It often helps if you tell the people around you what you are doing and explain to them why you need to take injections. Many people have a basic understanding of diabetes and often may know someone else who also has diabetes. Use this as an opportunity to educate others; it might even bring you closer to one another. - Dr G.

Q: How do I avoid days when I can’t seem to keep my blood sugar stable?

A: Having diabetes is a 24/7 job. There are going to be good days and bad days. It is important to try your best and not be too hard on yourself if you don’t get the results you were hoping for. Work on correcting it, and know that tomorrow brings a new day to reach your goals. It helps if you have a routine and stick to it as best as possible. Plan ahead for the days you expect to deviate from your routine. Also, don’t forget to take time for yourself. A daily walk or meditation can help relieve stress and keep your mind clear and focused. - Dr G.