M anaging your diabetes
T ype 1 diabetes
You will have diabetes for the rest of your life. For now, there is no cure. So, the more you know about your life with diabetes, the better off you will be. Why? Because, you can control diabetes and still lead a happy, healthy and active life.
Type 1 diabetes used to be called insulin dependent diabetes because everyone with type 1 has to take insulin. It is often called juvenile diabetes because it usually appears in children and adolescents. It can also appear in adults, but this is rare.
You want to know how to control it, feel good and stay healthy. Use this information to help you do that. It’s never too late to start. This booklet will teach you:
T ype 2 diabetes Type 2 is the most common type of diabetes. In most cases, it is linked to being overweight. You may hear it called “adult-onset diabetes.” It often affects adults over age 30 who have a family history of diabetes, are overweight and are not physically active.
• what diabetes is • how it is treated • how you can prevent problems • your part in managing it
W hat diabetes means When you eat, some foods (carbohydrates) are broken down into glucose or sugar. Sugar flows through your blood and into your body’s cells, giving you the energy you need each day. Sugar cannot get into the cells without insulin (a hormone made by your pancreas) helping it. So, it stays in your blood and builds up.
When you have diabetes, there is a problem with insulin. The problem may be either that: • your pancreas does not make insulin – type 1 diabetes • there is some, but not enough insulin or your body cannot use the insulin that it does make – type 2 diabetes
However, about 40% of the children who are newly diagnosed with diabetes have type 2. This may be because children today are more overweight and less active.
S ymptoms of diabetes You may: • not have the energy you need • often feel tired and weak • seem unable to get going • often feel nervous • have headaches
H ealthy meal planning Food is fuel for your body. How much food you need depends on how active you are, how much energy you need and your gender. You don’t have to go on a strange diet because you have diabetes. But you do need to follow a healthy meal plan.
• have blurred vision • have numbness (loss of feeling) in some areas
• not heal as fast as you used to
The goal is to get your blood sugar level as normal as possible (80 - 120 mg/dl) and keep it there. The main parts of treatment are: • healthy meal planning • regularly checking your blood sugar • exercising • taking insulin and/or oral medicines • reducing stress
• measure the foods you eat—know the serving sizes (learn to read food labels)
Food Facts
• be hungry all the time
H
• cut down on fatty foods—bake, broil or grill lean meats and cut away any fat on them
C heck your blood sugar Testing your blood sugar levels is vital in your care plan. It gives information about how your plan is working. Your blood sugar test results can show if you are: • taking the right amount of medicine
L earn to manage stress Reducing stress is important in your management plan. Stress (from emotions or an illness) can cause your blood sugar to go up or down. Most often, it will go up. When stress occurs, your body takes action. Your hormones increase to make a lot of energy for your cells (sugar and fat).
• eating the right amount of food • eating the right kinds of food • eating when you should • exercising as you need to • managing stress
• always feel thirsty
ow it is managed
• keep track of the carbohydrates you eat
• choose foods close to nature often —fruits, vegetables and whole grains
• have to go to the bathroom a lot
• get a lot of infections
Here are some tips to help you make these choices:
A healthy meal plan: • gives you healthy and balanced meals • gives you the same amount of food each day • spreads out what you eat over the course of a day • allows you to enjoy the foods you prefer to eat • is flexible and offers you choices You can create a healthy meal plan by making good choices about: • what you eat • how much you eat • when you eat
Foods are put into groups based upon how much of each nutrient they contain. The 3 major energy food groups are: • carbohydrates (starches like bread, cereal, pasta, rice, potatoes and sweets) • proteins (meats, eggs, fish and poultry) • fats (butter, margarine and oils) Carbohydrates, proteins and fat all affect your blood sugar. But, carbohydrates affect it the most.
It’s important to monitor your blood sugar and take action to keep it in a normal range. Some people monitor their blood sugar once a day. Others need to test more often. Ask your doctor, nurse or diabetes educator how often you need to test. Keep a record of your results. Take it with you to each doctor, nurse or clinic visit.
When you have diabetes, however, insulin may not be able to get this extra sugar into your cells. It piles up in your blood. This makes it harder for you to keep your blood sugar level within your target range. Stress also makes it hard to take good care of yourself. You are less likely to exercise as you should, follow your meal plan and test your blood sugar levels. At this point, you are not managing your diabetes well. This can lead to even bigger problems. So, learning to manage the every day stress you face is a must.
E xercise regularly
M edicine
Another important part of managing your diabetes is regular exercise. Regular exercise means that you do it 3 or more days a week. And, for at least 30 minutes each day. But any amount of exercise is helpful. The best kinds of exercises are called aerobic. Brisk walking, bike riding, swimming or singles tennis are examples. But, no matter what type of exercise you choose, anything that gets you moving is good for you.
C ontrol your weight If you are overweight, the extra fat makes it harder for your body’s insulin to work. It also puts you at greater risk for some of the complications of diabetes, like heart disease or stroke. Control your weight by following your meal plan and exercising. As you start to balance what you eat with how active you are, your weight will change.
Whether you have to use insulin and/ or pills, depends on the type of diabetes you have and on your body’s needs. If you have type 2 diabetes, the amount of insulin your pancreas makes may be enough, as long as you stick to your meal plan and exercise. Some people with type 2 diabetes don’t need diabetes medicine. Others need to take pills, inject insulin or do both. Checking your blood glucose levels on a regular basis will help your doctor know how to control your diabetes. You most likely will have to take some kind of diabetes medicine now or in the future. So, learn about them— what they are and what they do for you.
S
hort term problems
Even when you are managing your diabetes, sometimes problems occur. Short term signals may tell you to tighten your blood sugar control before it causes an issue. The 2 most common problems are: • low blood sugar (hypoglycemia) When your blood sugar drops below 70 mg/dl you won’t have much energy. Take 15 grams of quick-acting carbohydrates then rest and recheck your blood sugar again. • high blood sugar (hyperglycemia) When your blood sugar rises to over 200 mg/dl you can get dehydrated. Drink plenty of sugarfree fluids (8 oz /hour). Check your blood sugar every 4 hours. If it stays high, call your primary caregiver.
CAUTION: Pritchett & Hull Associates, Inc. ®
Atlanta, GA 800-241-4925 Providing Quality Health Education Materials Since 1973 Copyright © 2005 Pritchett & Hull Associates, Inc. DO NOT DUPLICATE.
Product # 620
If short-term problems keep occurring, you may need a change in your treatment plan.
D iabetes complications … tend to happen over a period of years. The better you manage your diabetes, the less risk you have. The complications include: • eye disease (retinopathy) • kidney disease (nephropathy) • nerve damage (neuropathy) • heart disease (cardiovascular disease)
Nerve damage
Foot problems
Neuropathy may occur after years of poor blood sugar control. The small blood vessels that feed your nerves become blocked and cause poor circulation. Smoking affects the blood vessels. So, if you smoke, you are at a higher risk for developing neuropathy as well as heart disease.
You may have problems with your feet. Small problems can quickly become big problems if not treated the right way. You need to take special care of your feet. Good foot care means that you: • check your feet each day
F ollow-up care At first, you will most likely have follow-up visits often. While you are adjusting to your meal plan and medicine, follow-up visits may be every 3 months. After that, you may have checkups every 6 months.
• avoid injury to your feet
Heart disease
• wear shoes (and socks) that fit well
You are 2 to 4 times more likely to develop cardiovascular disease (like heart attack or stroke) than someone who does not have diabetes.
• have your feet examined at each doctor visit
• frequent infections • foot problems • skin problems
Eye disease You need to have a dilated retinal exam once a year. Tell your eye doctor about any changes in your vision at each visit. Many other eye problems can be caught early and prevented with regular visits.
Skin problems
Kidney disease You may have kidney disease and not know. This is because your kidneys work fine until it is almost too late. Have a urine test at least once a year to check for micro albumin.
Your follow-up care is based on your needs. Your doctor or nurse will talk with you about how often you need to have a checkup. It is very important to keep your follow-up visits.
Frequent infections White blood cells fight infection. When you have uncontrolled diabetes your white blood cells don’t work as well.
Dry skin may occur more often when you have diabetes. This may be caused by high blood sugar that leads to dehydration or poor blood flow in your feet and legs. It may also be caused by a condition in which your feet and lower legs do not perspire. This can lead to drying and cracking of the skin.
T he part you play Diabetes is complex! There must be a balance in your treatment. You are the key player on your diabetes team. Your doctor, nurse, diabetes educator or dietitian can help set up your plan, but you control it day to day. It really is up to you!
anaging your diabetes