Refinements in the care of this serious, lifelong disease have improved--from the development of new forms of medication to insulin pumps that continuously measure your blood sugar. Managing this complex condition is easier now than ever before.
A healthy pancreas contains cells that produce insulin, a hormone that transports a form of sugar called glucose from the bloodstream into all your cells. It's an important job: sugar is the body's fuel. when you develop type 1 diabetes, however, your immune system gets confused and destroys the insulin-producing cells in the pancreas. Because the insulin supply then dwindles, your cells are deprived of sugar, which builds up instead in your bloodstream. Your body then tries to get rid of this excess glucose through its normal filtration system, namely your kidneys. As a result of this process, you can feel weak and hungry, need to urinate frequently and be intensely thirsty. And if you don't drink a lot of water, you may even get dehyrated.
Such high blood sugar, known as hyperglycaemia, can lead to serious health problems. Blood vessels and nerves can become damaged, leading to kidney failure, blindness, heart disease and other complications. There are three variations: type 1, once known as 'juvenile-onset' diabetes, usually appears abruptly before age 30 and accounts for about 10 percent of all cases. Most people have type 2, or 'adult-onset' diabetes (see on shortly). The third form, gestational diabetes, develops only during pregnancy.
LIKELY FIRST STEPS
Daily insulin injections to replace the harmone no longer produced naturally.
Careful glucose testing to monitor blood sugar levels.
A special diabetes diet tailored for you, as well as regular exercise for general health and improved blood sugar control.
Would any of the new insulin forms be good for me?
Given my medical history, are there steps I need to take to avoid diabetic complications?
What kind of exercise is best?
Should I try an insulin pump?
To deal with this chronic, potentially damaging disease, you'll need to be under the long-term care of a specialise medical team. They'll help you learn day-to-day management techniques to keep your blood sugar levels in normal ranges, including how to give yourself daily insulin injections. To determine how much insulin you need, you'll have to test your blood sugar levels several times a day. If levels are too high, you inject insulin; if they're too low (a condition called hypoglycaemia), you eat a sugar-containing food, such as orange juice or lollies. Ultimately, a balanced diet and regular exercise will go along way towards regulating your blood sugar levels.
There's no cure for diabetes, but by montoring your blood sugar levels and by maintaining meticulous control, you can dramatically reduce your risk for complications. An oral diabetes drug such as metformin (Diabex, Glucophage) may also be added to increase your sensitivity to the insulin you inject. The good news is that once you start treating diabetes, you'll feel better almost instantly, and will find there's practically no limit to your daily activities.
EMERGENCY! DIABETIC KETOACIDOSIS
When you lack the insulin needed to process glucose, your whole metabolism shifts as your body turns to fat stores for energy. This transition creates waste products called ketones, which, when excessive, can lead to coma or even death. Get help immediately if you feel mentally clouded, or have a dry mouth, extreme thirst, or nausea and vomiting.
What is happening
A healthy pancreas contains cells that produce insulin, a hormone that transports a form of sugar called glucose from the bloodstream into all your cells. It's an important job: sugar is the body's fuel. when you develop type 1 diabetes, however, your immune system gets confused and destroys the insulin-producing cells in the pancreas. Because the insulin supply then dwindles, your cells are deprived of sugar, which builds up instead in your bloodstream. Your body then tries to get rid of this excess glucose through its normal filtration system, namely your kidneys. As a result of this process, you can feel weak and hungry, need to urinate frequently and be intensely thirsty. And if you don't drink a lot of water, you may even get dehyrated.
Such high blood sugar, known as hyperglycaemia, can lead to serious health problems. Blood vessels and nerves can become damaged, leading to kidney failure, blindness, heart disease and other complications. There are three variations: type 1, once known as 'juvenile-onset' diabetes, usually appears abruptly before age 30 and accounts for about 10 percent of all cases. Most people have type 2, or 'adult-onset' diabetes (see on shortly). The third form, gestational diabetes, develops only during pregnancy.
Daily insulin injections to replace the harmone no longer produced naturally.
Careful glucose testing to monitor blood sugar levels.
A special diabetes diet tailored for you, as well as regular exercise for general health and improved blood sugar control.
QUESTIONS TO ASK
Would any of the new insulin forms be good for me?
Given my medical history, are there steps I need to take to avoid diabetic complications?
What kind of exercise is best?
Should I try an insulin pump?
Treatments
To deal with this chronic, potentially damaging disease, you'll need to be under the long-term care of a specialise medical team. They'll help you learn day-to-day management techniques to keep your blood sugar levels in normal ranges, including how to give yourself daily insulin injections. To determine how much insulin you need, you'll have to test your blood sugar levels several times a day. If levels are too high, you inject insulin; if they're too low (a condition called hypoglycaemia), you eat a sugar-containing food, such as orange juice or lollies. Ultimately, a balanced diet and regular exercise will go along way towards regulating your blood sugar levels.
There's no cure for diabetes, but by montoring your blood sugar levels and by maintaining meticulous control, you can dramatically reduce your risk for complications. An oral diabetes drug such as metformin (Diabex, Glucophage) may also be added to increase your sensitivity to the insulin you inject. The good news is that once you start treating diabetes, you'll feel better almost instantly, and will find there's practically no limit to your daily activities.
EMERGENCY! DIABETIC KETOACIDOSIS
When you lack the insulin needed to process glucose, your whole metabolism shifts as your body turns to fat stores for energy. This transition creates waste products called ketones, which, when excessive, can lead to coma or even death. Get help immediately if you feel mentally clouded, or have a dry mouth, extreme thirst, or nausea and vomiting.
Treatment Options
PROCEDURES
-----------------------------------------------------------------------------------------------------------------------------
Glucose testing Do this often to determine insulin needs.
------------------------------------------------------------------------------------------------------------------------------Insulin pump Provides continuous monitoring and insulin delivery; particularly good
for children.
------------------------------------------------------------------------------------------------------------------------------
Insulin pen Like a large fountain pen with a cartridge of insulin.
MEDICATIONS
-----------------------------------------------------------------------------------------------------------------------------
Fast-acting insulin Work in 15 minutes; good before meals.
Intermediate-acting insulin Peaks in 2 to 4 hours
------------------------------------------------------------------------------------------------------------------------------
Longer-acting insulin Can last 10 to 20 hours
------------------------------------------------------------------------------------------------------------------------------
Premixed insulin Fixed proportions of fast and intermediate-acting insulin for convenience.
LIFESTYLE CHANGES
--------------------------------------------------------------------------------------------------------------------------------
Diet Aim to keep weight in check.
-------------------------------------------------------------------------------------------------------------------------------
Exercise Regular activity aids glucose regulation.
PROCEDURES
-----------------------------------------------------------------------------------------------------------------------------
Glucose testing Do this often to determine insulin needs.
------------------------------------------------------------------------------------------------------------------------------Insulin pump Provides continuous monitoring and insulin delivery; particularly good
for children.
------------------------------------------------------------------------------------------------------------------------------
Insulin pen Like a large fountain pen with a cartridge of insulin.
MEDICATIONS
-----------------------------------------------------------------------------------------------------------------------------
Fast-acting insulin Work in 15 minutes; good before meals.
Intermediate-acting insulin Peaks in 2 to 4 hours
------------------------------------------------------------------------------------------------------------------------------
Longer-acting insulin Can last 10 to 20 hours
------------------------------------------------------------------------------------------------------------------------------
Premixed insulin Fixed proportions of fast and intermediate-acting insulin for convenience.
LIFESTYLE CHANGES
--------------------------------------------------------------------------------------------------------------------------------
Diet Aim to keep weight in check.
-------------------------------------------------------------------------------------------------------------------------------
Exercise Regular activity aids glucose regulation.
TAKING CONTROL
- Wear medical identification ( a bracelet or medallion) saying you have diabetes. If you're unconscious in an emergency, a medical team will need this information.
- Get a good health-care team. Count on seeing your doctors, nurses and dietitians every one to three months. Ask your local hospital if they have a diabetes clinic.
- Make a smart plan. Educate yourself about the disease---and let others help your devise a strategy for dealing with glucose testing, insulin injections, exercise and diet.
- Overwhelmed? Start by visiting an outpatient diabetes clinic everyday until you and your family feel confident and comfortable with the process. What now seems so new (and maybe frightening) will soon become second nature and little more than a minor convenience.
- Improve the accuracy of your home glucose monitor by taking these simple measures. Keep the monitor clean. Test it once a month. Recalibrate it whenever starting a new packet of strips. Use fresh strips. Periodically, compare results with those from a laboratory.
- Take care if you get sick. You're especially susceptible to diabetic ketoacidosis (See table above) if you develop the flu or a urinary tract infection. Never stop your insulin during an illness. Check your urine for ketones every six hours, and let your doctor know immediately if your condition is worsening.
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