Saturday, March 17, 2012

MANAGING DIABETES




Symptoms

High blood levels of glucose can cause several problems, including:

  • Blurry vision
  • Excessive thirst
  • Fatigue
  • Frequent urination
  • Hunger
  • Weight loss

However, because type 2 diabetes develops slowly, some people with high blood sugar experience no symptoms at all.

Symptoms of type 1 diabetes:

  • Fatigue
  • Increased thirst
  • Increased urination
  • Nausea
  • Vomiting
  • Weight loss in spite of increased appetite

Patients with type 1 diabetes usually develop symptoms over a short period of time. The condition is often diagnosed in an emergency setting.

Symptoms of type 2 diabetes:

  • Blurred vision
  • Fatigue
  • Increased appetite
  • Increased thirst
  • Increased urination

Signs and tests

A urine analysis may be used to look for glucose and ketones from the breakdown of fat. However, a urine test alone does not diagnose diabetes.

The following blood tests are used to diagnose diabetes:

  • Fasting blood glucose level -- diabetes is diagnosed if higher than 126 mg/dL on two occasions. Levels between 100 and 126 mg/dL are referred to as impaired fasting glucose or prediabetes. These levels are considered to be risk factors for type 2 diabetes and its complications.
  • Oral glucose tolerance test -- diabetes is diagnosed if glucose level is higher than 200 mg/dL after 2 hours. (This test is used more for type 2 diabetes.)
  • Random (non-fasting) blood glucose level -- diabetes is suspected if higher than 200 mg/dL and accompanied by the classic diabetes symptoms of increased thirst, urination, and fatigue. (This test must be confirmed with a fasting blood glucose test.)

Persons with diabetes need to have their hemoglobin A1c (HbA1c) level checked every 3 - 6 months. The HbA1c is a measure of average blood glucose during the previous 2 - 3 months. It is a very helpful way to determine how well treatment is working.

Treatment

The immediate goals are to treat diabetic ketoacidosis and high blood glucose levels. Because type 1 diabetes can start suddenly and have severe symptoms, people who are newly diagnosed may need to go to the hospital.

The long-term goals of treatment are to:

These goals are accomplished through:

  • Blood pressure and cholesterol control
  • Careful self testing of blood glucose levels
  • Education
  • Exercise
  • Foot care
  • Meal planning and weight control
  • Medication or insulin use

There is no cure for diabetes. Treatment involves medicines, diet, and exercise to control blood sugar and prevent symptoms.

LEARN THESE SKILLS

Basic diabetes management skills will help prevent the need for emergency care. These skills include:

  • How to recognize and treat low blood sugar (hypoglycemia) and high blood sugar (hyperglycemia)
  • What to eat and when
  • How to take insulin or oral medication
  • How to test and record blood glucose
  • How to test urine for ketones (type 1 diabetes only)
  • How to adjust insulin or food intake when changing exercise and eating habits
  • How to handle sick days
  • Where to buy diabetes supplies and how to store them

After you learn the basics of diabetes care, learn how the disease can cause long-term health problems and the best ways to prevent these problems. Review and update your knowledge, because new research and improved ways to treat diabetes are constantly being developed.

SELF-TESTING

If you have diabetes, your doctor may tell you to regularly check your blood sugar levels at home. There are a number of devices available, and they use only a drop of blood. Self-monitoring tells you how well diet, medication, and exercise are working together to control your diabetes. It can help your doctor prevent complications.

The American Diabetes Association recommends keeping blood sugar levels in the range of:

  • 80 - 120 mg/dL before meals
  • 100 - 140 mg/dL at bedtime

Your doctor may adjust this depending on your circumstances.

WHAT TO EAT

You should work closely with your health care provider to learn how much fat, protein, and carbohydrates you need in your diet. A registered dietician can help you plan your dietary needs.

People with type 1 diabetes should eat at about the same times each day and try to be consistent with the types of food they choose. This helps to prevent blood sugar from becoming extremely high or low.

People with type 2 diabetes should follow a well-balanced and low-fat diet.

See: Diabetes diet

HOW TO TAKE MEDICATION

Medications to treat diabetes include insulin and glucose-lowering pills called oral hypoglycemic drugs.

People with type 1 diabetes cannot make their own insulin. They need daily insulin injections. Insulin does not come in pill form. Injections are generally needed one to four times per day. Some people use an insulin pump. It is worn at all times and delivers a steady flow of insulin throughout the day. Other people may use inhaled insulin. See also: Type 1 diabetes

Unlike type 1 diabetes, type 2 diabetes may respond to treatment with exercise, diet, and medicines taken by mouth. There are several types of medicines used to lower blood glucose in type 2 diabetes. See also: Type 2 diabetes

Medications may be switched to insulin during pregnancy and while breastfeeding.

Gestational diabetes may be treated with exercise and changes in diet.

EXERCISE

Regular exercise is especially important for people with diabetes. It helps with blood sugar control, weight loss, and high blood pressure. People with diabetes who exercise are less likely to experience a heart attack or stroke than those who do not exercise regularly.

Here are some exercise considerations:

  • Always check with your doctor before starting a new exercise program.
  • Ask your doctor or nurse if you have the right footwear.
  • Choose an enjoyable physical activity that is appropriate for your current fitness level.
  • Exercise every day, and at the same time of day, if possible.
  • Monitor blood glucose levels before and after exercise.
  • Carry food that contains a fast-acting carbohydrate in case you become hypoglycemic during or after exercise.
  • Carry a diabetes identification card and a cell phone in case of emergency.
  • Drink extra fluids that do not contain sugar before, during, and after exercise.

You may need to change your diet or medication dose if you change your exercise intensity or duration to keep blood sugar levels from going too high or low.

FOOT CARE

People with diabetes are more likely to have foot problems. Diabetes can damage blood vessels and nerves and decrease the body's ability to fight infection. You may not notice a foot injury until an infection develops. Death of skin and other tissue can occur.

If left untreated, the affected foot may need to be amputated. Diabetes is the most common condition leading to amputations.

To prevent injury to the feet, check and care for your feet every day.


-HEALTH ENCYCLOPEDIA

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