Diabetes Overview--
Diabetes is a chronic (lifelong) disease marked by high levels of sugar in the blood.
******Definition of Diabetes
Diabetes mellitus is a chronic disease caused by the inability of the pancreas to produce insulin or to use the insulin produced in the proper way. Diabetes is the 7th leading cause of death among Americans; over 15 million Americans suffer from one form or another of this disease.
Description of Diabetes
After a meal, a portion of the food a person eats is broken down into sugar (glucose). The sugar then passes into the bloodstream and to the body's cells via a hormone (called insulin) that is produced by the pancreas.
Normally, the pancreas produces the right amount of insulin to accommodate the quantity of sugar. However, if the person has diabetes, either the pancreas produces little or no insulin or the cells do not respond normally to the insulin. Sugar builds up in the blood, overflows into the urine and then passes from the body unused. Over time, high blood sugar levels can damage:
eyes - leading to diabetic retinopathy and possible blindness
blood vessels - increasing risk of heart attack, stroke and peripheral artery obstruction
nerves - leading to diabetic neuropathy, foot sores and possible amputation, possible paralysis of the stomach, chronic diarrhea
kidneys - leading to kidney failure
Diabetes has also been linked to impotence and digestive problems. It is important to note that controlling blood pressure and blood glucose levels, plus regular screenings and check-ups, can help reduce risks of these complications.
******* Diabetes mellitus (DM) is a set of related diseases in which the body cannot regulate the amount of sugar (specifically, glucose) in the blood.
The blood delivers glucose to provide the body with energy to perform all of a person's daily activities.
The liver converts the food a person eats into glucose. The glucose is then released into the bloodstream.
In a healthy person, the blood glucose level is regulated by several hormones, primarliy insulin. Insulin is produced by the pancreas, a small organ between the stomach and liver. The pancreas also makes other important enzymes released directly into the gut that helps digest food.
Insulin allows glucose to move out of the blood into cells throughout the body where it is used for fuel.
People with diabetes either do not produce enough insulin (type 1 diabetes) or cannot use insulin properly (type 2 diabetes), or both (which occurs with several forms of diabetes).
In diabetes, glucose in the blood cannot move efficiently into cells, so blood glucose levels remain high. This not only starves all the cells that need the glucose for fuel, but also harms certain organs and tissues exposed to the high glucose levels.
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TYPES---
Type 1 diabetes (T1D):--- The body stops producing insulin or produces too little insulin to regulate blood glucose level.
Type 1 diabetes involves about 10% of all people with diabetes in the United States.
Type 1 diabetes is typically diagnosed during childhood or adolescence. It used to be referred to as juvenile-onset diabetes or insulin-dependent diabetes mellitus.
Type 1 diabetes can occur in an older individual due to destruction of the pancreas by alcohol, disease, or removal by surgery. It also results from progressive failure of the pancreatic beta cells, the only cell type that produces significant amounts of insulin.
People with type 1 diabetes require insulin treatment daily to sustain life.
Type 2 diabetes (T2D):--- Although the pancreas still secretes insulin, the body of someone with type 2 diabetes is partially or completely unable to use this insulin. This is sometimes referred to as insulin resistance. The pancreas tries to overcome this resistance by secreting more and more insulin. People with insulin resistance develop type 2 diabetes when they fail to secrete enough insulin to cope with their higher demands.
At least 90% of adult individuals with diabetes have type 2 diabetes.
Type 2 diabetes is typically diagnosed in adulthood, usually after age 45 years. It used to be called adult-onset diabetes mellitus, or non-insulin-dependent diabetes mellitus. These names are no longer used because type 2 diabetes does occur in younger people, and some people with type 2 diabetes require insulin therapy.
Type 2 diabetes is usually controlled with diet, weight loss, exercise, and oral medications. However, more than half of all people with type 2 diabetes require insulin to control their blood sugar levels at some point in the course of their illness.
There are three less common types of diabetes called......
gestational diabetes,
secondary diabetes and
impaired glucose tolerance (IGT):
Gestational diabetes occurs during pregnancy and causes a higher than normal glucose level reading.
Although gestational diabetes typically resolves after delivery of the baby, a woman who develop gestational diabetes is more likely than other women to develop type 2 diabetes later in life.
Women with gestational diabetes are more likely to have large babies
Secondary diabetes is caused by damage to the pancreas from chemicals, certain medications, diseases of the pancreas (such as cancer) or other glands.
Impaired glucose tolerance (IGT) is a condition in which the person's glucose levels are higher than normal.
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Metabolic syndrom (also referred to as syndrome X)-- is a set of abnormalities in which insulin-resistant diabetes (type 2 diabetes) is almost always present along with hypertension (high blood pressure), high fat levels in the blood (increased serum lipids, predominant elevation of LDL cholesterol, decreased HDL cholesterol, and elevated triglycerides), central obesity, and abnormalities in blood clotting and inflammatory responses. A high rate of cardiovascular disease is associated with metabolic syndrome.
Prediabetes is a common condition related to diabetes. In people with prediabetes, the blood sugar level is higher than normal but not yet high enough to be considered diagnostic of diabetes.
Prediabetes increases a person's risk of developing type 2 diabetes, heart disease, or stroke.
Prediabetes can typically be reversed (without insulin or medication) with lifestyle changes such as losing a modest amount of weight and increasing physical activity levels. Weight loss can prevent, or at least delay, the onset of type 2 diabetes.
An international expert committee of the American Diabetes Association redefined the criteria for prediabetes, lowering the blood sugar level cut-off point for prediabetes. Approximately 20% more adults are now believed to have this condition and may develop diabetes within 10 years if they do make lifestyle changes such as exercising more and maintaining a healthy weight.
About 17 million Americans (6.2% of adults in North America) are believed to have diabetes. AIt has been estimated that about one third of adults with diabetes do not know they have diabetes.
About 1 million new cases of diabetes is diagnosed occur each year, and diabetes is the direct or indirect cause of at least 200,000 deaths each year.
The incidence of diabetes is increasing rapidly. This increase is due to many factors, but the most significant are the increasing incidence of obesity associated with the prevalence of a sedentary lifestyle.
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Diabetes + Smoking = Trouble---
I can summarize this little article in one quick sentence: Smoking is bad. In the general population, and particularly in patients with diabetes.... Smoking is bad.
Cigarette smoking is the leading cause if avoidable death in the United States, and accounts for almost 500,000 deaths a year. Smoking plays a role in one out of every five deaths in the United States per year. Smoking is indeed bad.
Where the health of diabetic smokers is concerned, the statistics are even worse. There is an increased risk of premature death and the development of heart disease in patients who have diabetes and continue to smoke. There is also evidence that links cigarette smoking with microvascular disease (kidney and eye damage) in diabetes. Additionally, there is data that shows that smoking may actually play a role in the development of type 2 diabetes. Smoking is bad.
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causes..----
Risk factors for developing type 2 diabetes include the following:
High blood pressure
High blood triglyceride (fat) levels
Gestational diabetes or giving birth to a baby weighing more than 9 pounds
High-fat diet
High alcohol intake
Sedentary lifestyle
Obesity or being overweight
Ethnicity, particularly when a close relative had type 2 diabetes or gestational diabetes: certain groups, such as African Americans, Native Americans, Hispanic Americans, and Japanese Americans, have a greater risk of developing type 2 diabetes than non-Hispanic whites.
Aging: Increasing age is a significant risk factor for type 2 diabetes. Risk begins to rise significantly at about age 45 years, and rises considerably after age 65 years.
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Insulin is a hormone produced by the pancreas to control blood sugar. Diabetes can be caused by too little insulin, resistance to insulin, or both.
To understand diabetes, it is important to first understand the normal process by which food is broken down and used by the body for energy. Several things happen when food is digested:
A sugar called glucose enters the bloodstream. Glucose is a source of fuel for the body.
An organ called the pancreas makes insulin. The role of insulin is to move glucose from the bloodstream into muscle, fat, and liver cells, where it can be used as fuel.
People with diabetes have high blood sugar. This is because:
Their pancreas does not make enough insulin
Their muscle, fat, and liver cells do not respond to insulin normally
Risk factors
Age over 45 years
A parent, brother, or sister with diabetes
Gestational diabetes or delivering a baby weighing more than 9 pounds
Heart disease
High blood cholesterol level
Obesity
Not getting enough exercise
Polycystic ovary disease (in women)
Previous impaired glucose tolerance
Some ethnic groups (particularly African Americans, Native Americans, Asians, Pacific Islanders, and Hispanic Americans)
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Complications of diabetes------
Both type 1 and type 2 diabetes ultimately lead to high blood sugar levels, a condition called hyperglycemia. Over a long period of time, hyperglycemia damages the retina of the eye, the blood vessels of the kidneys, the nerves, and other blood vessels.
Damage to the retina from diabetes (diabetic retinopathy) is a leading cause of blindness.
Damage to the kidneys from diabetes (diabetic nephropathy) is a leading cause of kidney failure.
Damage to the nerves from diabetes (diabetic neuropathy) is a leading cause of foot wounds and ulcers, which frequently lead to foot and leg amputations.
Damage to the nerves in the autonomic nervous system can lead to paralysis of the stomach (gastroparesis), chronic diarrhea, and an inability to control heart rate and blood pressure during postural changes.
Diabetes accelerates atherosclerosis, (the formation of fatty plaques inside the arteries), which can lead to blockages or a clot (thrombus). Such changes can then lead to heart attack, stroke, and decreased circulation in the arms and legs (peripheral vascular disease).
Diabetes predisposes people to elevated blood pressure, high levels of cholesterol and triglycerides. These conditions both independently and together with hyperglycemia, increase the risk of heart disease, kidney disease, and other blood vessel complications.
Diabetes can contribute to a number of acute (short-lived) medical problems.
Many infections are associated with diabetes, and infections are frequently more dangerous in someone with diabetes because the body's normal ability to fight infections is impaired. To compound the problem, infections may worsen glucose control, which further delays recovery from infection.
Hypoglycemia or low blood sugar, occurs intermittently in most people with diabetes. It can result from taking too much diabetes medication or insulin (sometimes called an insulin reaction), missing a meal, exercising more than usual, drinking too much alcohol, or taking certain medications for other conditions. It is very important to recognize hypoglycemia and be prepared to treat it at all times. Headache, feeling dizzy, poor concentration, tremor of the hands, and sweating are common symptoms of hypoglycemia. A person can faint or have a seizure if blood sugar level become too low.
Diabetic ketoacidosis (DKA) is a serious condition in which uncontrolled hyperglycemia (usually due to complete lack of insulin or a relative deficiency of insulin) over time creates a buildup of ketones (acidic waste products ) in the blood. High levels of ketones can be very harmful. This typically happens to people with type 1 diabetes who do not have good blood glucose control. Diabetic ketoacidosis can be precipitated by infection, stress, trauma, missing medications like insulin, or medical emergencies such as a stroke and heart attack.
Hyperosmolar hyperglycemic nonketotic syndrome is a serious condition in which the blood sugar level gets very high. The body tries to get rid of the excess blood sugar by eliminating it in the urine. This increases the amount of urine significantly, and often leads to dehydration so severe that it can cause seizures, coma, and even death. This syndrome typically occurs in people with type 2 diabetes who are not controlling their blood sugar levels, who have become dehydrated, or who have stress, injury, stroke, or are taking certain medications, like steroids.
Possible Complications--
Emergency complications include:
Diabetic hyperglycemic hyperosmolar coma
Diabetic ketoacidosis
Long-term complications include:
Atherosclerosis
Coronary artery disease
Diabetic nephropathy
Diabetic neuropathy
Diabetic retinopathy
Erection problems
Hyperlipidemia
Hypertension
Infections of the skin, female urinary tract, and urinary tract
Peripheral vascular disease
Stroke
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When to Seek Medical Care
If a person has diabetes and experiences any of the following, call a health care professional:
Experiencing diabetes symptoms: this may mean that the person's blood sugar level is not being controlled despite treatment
Blood sugar levels, when tested, are consistently high (more than 200 mg/dL): Persistently high blood sugar levels are the root cause of all of the complications of diabetes.
The patient's blood sugar level is often low (less than 70 mg/dL): this may mean that the diabetes management strategy is too aggressive. It also may be a sign of infection or other stress on the body's organs such as kidney failure, liver failure, adrenal gland failure, or the concomitant use of certain medications.
An injury to the foot or leg, no matter how minor: even the tiniest cut or blister can become very serious in a person with diabetes. Early diagnosis and treatment of problems with the feet and lower extremities, along with regular diabetic foot care, are critical in preserving the function of the legs and preventing amputation.
Low-grade fever (less than 101.5 F or 38.6 C): Fever is a sign of infection. In patients with diabetes, many common infections can potentially be more dangerous for them than for other people. Note any symptoms, such as painful urination, redness or swelling of the skin, abdominal pain, chest pain, or cough, that may indicate where the infection is located.
Nausea or vomiting, but can keep liquids down: The health care professional may adjust medications while the patient is sick, and will probably recommend an urgent office visit or a visit to the emergency department. Persistent nausea and vomiting can be a sign of diabetic ketoacidosis, a potentially life-threatening condition, as well as several other serious illnesses.
Small sore(s) (ulcer) on the foot or le:. Any non-healing sore or ulcer on the feet or legs of someone with diabetes needs to be seen by a medical professional right away. A sore less than 1 inch across, not draining pus, and not exposing deep tissue or bone, can safely be evaluated by a health care professional, as long as the patient does not have fever and their blood sugar levels are under control.
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importent Diabetes Symptoms----
Diabetes is a chronic disease marked by high levels of sugar in the blood. There are many types of diabetes.
The most common signs of diabetes include:
excessive thirst and frequent urination
headaches
constant hunger
reduced mental focus
High blood levels of glucose can cause several problems, including:
Blurry vision
Excessive thirst
Fatigue
Frequent urination
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
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Symptoms of type 1 diabetes are often dramatic and come on very suddenly.
Type 1 diabetes is usually recognized in childhood or early adolescence, often in association with an illness (such as a virus or urinary tract infection) or injury.
The extra stress can cause diabetic ketoacidosis.
Symptoms of ketoacidosis include nausea and vomiting. Dehydration and often-serious disturbances in blood levels of potassium follow.
Without treatment, ketoacidosis can lead to coma and death.
Symptoms of type 2 diabetes are often subtle and may be attributed to aging or obesity.
A person may have type 2 diabetes for many years without knowing it.
People with type 2 diabetes can develop hyperglycemic hyperosmolar nonketotic syndrome.
Type 2 diabetes can be precipitated by steroids and stress.
If not properly treated, type 2 diabetes can lead to complications such as blindness, kidney failure, heart disease, and nerve damage.
Common symptoms of both type 1 and type 2 diabetes include:
Fatigue, constantly tired: In diabetes, the body is inefficient and sometimes unable to use glucose for fuel. The body switches over to metabolizing fat, partially or completely, as a fuel source. This process requires the body to use more energy. The end result is feeling fatigued or constantly tired.
Unexplained weight loss: People with diabetes are unable to process many of the calories in the foods they eat. Thus, they may lose weight even though they eat an apparently appropriate or even an excessive amount of food. Losing sugar and water in the urine and the accompanying dehydration also contributes to weight loss.
Excessive thirst (polydipsia): A person with diabetes develops high blood sugar levels, which overwhelms the kidney's ability to reabsorb the sugar as the blood is filtered to make urine. Excessive urine is made as the kidney spills the excess sugar. The body tries to counteract this by sending a signal to the brain to dilute the blood, which translates into thirst. The body encourages more water consumption to dilute the high blood sugar back to normal levels and to compensate for the water lost by excessive urination.
Excessive urination (polyuria): Another way the body tries to rid the body of the extra sugar in the blood is to excrete it in the urine. This can also lead to dehydration because a large amount of water is necessary to excrete the sugar.
Excessive eating (polyphagia): If the body is able, it will secrete more insulin in order to try to manage the excessive blood sugar levels. Moreover, the body is resistant to the action of insulin in type 2 diabetes. One of the functions of insulin is to stimulate hunger. Therefore, higher insulin levels lead to increased hunger. Despite increased caloric intake, the person may gain very little weight and may even lose weight.
Poor wound healing: High blood sugar levels prevent white blood cells, which are important in defending the body against bacteria and also in cleaning up dead tissue and cells, from functioning normally. When these cells do not function properly, wounds take much longer to heal and become infected more frequently. Long-standing diabetes also is associated with thickening of blood vessels, which prevents good circulation, including the delivery of enough oxygen and other nutrients to body tissues.
Infections: Certain infections, such as frequent yeast infections of the genitals, skin infections, and frequent urinary tract infections, may result from suppression of the immune system by diabetes and by the presence of glucose in the tissues, which allows bacteria to grow. These infections can also be an indicator of poor blood sugar control in a person known to have diabetes.
Altered mental status: Agitation, unexplained irritability, inattention, extreme lethargy, or confusion can all be signs of very high blood sugar, ketoacidosis, hyperosmolar hyperglycemia nonketotic syndrome, or hypoglycemia (low sugar). Thus, any of these merit the immediate attention of a medical professional. Call your health care professional or 911.
Blurry vision: Blurry vision is not specific for diabetes but is frequently present with high blood sugar levels.
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Diabetes diet---
If you have type 1 diabetes, it is important to know how many carbohydrates you eat at a meal. This information helps you determine how much insulin you should take with your meal to maintain blood sugar (glucose) control.
The other two major nutrients, protein and fat ,also have an effect on blood glucose levels, though it is not as rapid or great as carbohydrates.
A delicate balance of carbohydrate intake, insulin, and physical activity is necessary for the best blood sugar (glucose) levels. Eating carbohydrates increases your blood sugar (glucose) level. Exercise tends to decrease it (although not always). If the three factors are not in balance, you can have wide swings in blood sugar (glucose) levels.
If you have type 1 diabetes and take a fixed dose of insulin, the carbohydrate content of your meals and snacks should be consistent from day to day.
CHILDREN AND DIABETES
Weight and growth patterns can help determine if a child with type 1 diabetes is getting enough nutrition.
Changes in eating habits and more physical activity help improve blood sugar (glucose) control. For children with diabetes, special occasions (like birthdays or Halloween) require additional planning because of the extra sweets. You may allow your child to eat sugary foods, but then have fewer carbohydrates during other parts of that day. For example, if child eats birthday cake, Halloween candy, or other sweets, they should NOT have the usual daily amount of potatoes, pasta, or rice. This substitution helps keep calories and carbohydrates in better balance.
MEAL PLANNING
One of the most challenging aspects of managing diabetes is meal planning. Work closely with your doctor and dietitian to design a meal plan that maintains near-normal blood sugar (glucose) levels. The meal plan should give you or your child the proper amount of calories to maintain a healthy body weight.
The food you eat increases the amount of glucose in your blood. Insulin decreases blood sugar (glucose). By balancing food and insulin together, you can keep your blood sugar (glucose) within a normal range. Keep these points in mind:
Your doctor or dietitian should review the types of food you or your child usually eats and build a meal plan from there. Insulin use should be a part of the meal plan. Understand how to time meals for when insulin will start to work in your the body.
Be consistent. Meals and snacks should be eaten at the same times each day. Do not skip meals and snacks. Keep the amount and types of food (carbohydrates, fats, and proteins) consistent from day to day.
Learn how to read food labels to help plan you or your child’s carbohydrate intake.
Monitor blood sugar (glucose) levels. The doctor will tell you if you need to adjust insulin doses based on blood sugar (glucose) levels and the amount of food eaten.
Having diabetes does not mean you or your child must completely give up any specific food, but it does change the kinds of foods one should eat routinely. Choose foods that keep blood sugar (glucose) levels in good control. Foods should also provide enough calories to maintain a healthy weight.
Back to TopRecommendations
A registered dietitian can help you best decide how to balance your diet with carbohydrates, protein, and fat. Here are some general guidelines:
The amount of each type of food you should eat depends on your diet, your weight, how often you exercise, and other existing health risks. Everyone has individual needs, which is why you should work with your doctor and, possibly, a dietitian to develop a meal plan that works for you.
But there are some reliable general recommendations to guide you. The Diabetes Food Pyramid, which resembles the old USDA food guide pyramid, splits foods into six groups in a range of serving sizes. In the Diabetes Food Pyramid, food groups are based on carbohydrate and protein content instead of their food classification type. A person with diabetes should eat more of the foods in the bottom of the pyramid (grains, beans, vegetables) than those on the top (fats and sweets). This diet will help keep your heart and body systems healthy.
GRAINS, BEANS, AND STARCHY VEGETABLES
(6 or more servings a day)
Foods like bread, grains, beans, rice, pasta, and starchy vegetables are at the bottom of the pyramid because they should serve as the foundation of your diet. As a group, these foods are loaded with vitamins, minerals, fiber, and healthy carbohydrates.
It is important, however, to eat foods with plenty of fiber. Choose whole-grain foods such as whole-grain bread or crackers, tortillas, bran cereal, brown rice, or beans. Use whole-wheat or other whole-grain flours in cooking and baking. Choose low-fat breads, such as bagels, tortillas, English muffins, and pita bread.
VEGETABLES
(3 - 5 servings a day)
Choose fresh or frozen vegetables without added sauces, fats, or salt. You should opt for more dark green and deep yellow vegetables, such as spinach, broccoli, romaine, carrots, and peppers.
FRUITS
(2 - 4 servings a day)
Choose whole fruits more often than juices. Fruits have more fiber. Citrus fruits, such as oranges, grapefruits, and tangerines, are best. Drink fruit juices that do NOT have added sweeteners or syrups.
MILK
(2 - 3 servings a day)
Choose low-fat or nonfat milk or yogurt. Yogurt has natural sugar in it, but it can also contain added sugar or artificial sweeteners. Yogurt with artificial sweeteners has fewer calories than yogurt with added sugar.
MEAT AND FISH
(2 - 3 servings a day)
Eat fish and poultry more often. Remove the skin from chicken and turkey. Select lean cuts of beef, veal, pork, or wild game. Trim all visible fat from meat. Bake, roast, broil, grill, or boil instead of frying.
FATS, ALCOHOL, AND SWEETS
In general, you should limit your intake of fatty foods, especially those high in saturated fat, such as hamburger, cheese, bacon, and butter.
If you choose to drink alcohol, limit the amount and have it with a meal. Check with your health care provider about a safe amount for you.
Sweets are high in fat and sugar, so keep portion sizes small. Other tips to avoid eating too many sweets:
Ask for extra spoons and forks and split your dessert with others.
Eat sweets that are sugar-free.
Always ask for the small serving size.
You should also know how to read food labels, and consult them when making food decisions.
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Diabetes Treatment-----
Diabetes Self-Care at Home (Lifestyle Changes and Glucose Monitoring)--
If a person has diabetes, healthful lifestyle choices in diet, exercise, and other health habits will help to improve glycemic (blood sugar) control and prevent or minimize complications of diabetes.
Diabetes Diet:-- A healthy diet is key to controlling blood sugar levels and preventing diabetes complications.
If the patient is obese and has had difficulty losing weight on their own, talk to a health care professional. He or she can recommend a dietitian or a weight modification program to help the patient reach a goal.
Eat a consistent, well-balanced diet that is high in fiber, low in saturated fat, and low in concentrated sweets.
A consistent diet that includes roughly the same number of calories at about the same times of day helps the health care professional prescribe the correct dose of medication or insulin.
A healthy diet also helps to keep blood sugar at a relatively even level and avoids excessively low or high blood sugar levels, which can be dangerous and even life-threatening.
Exercise:--- Regular exercise, in any form, can help reduce the risk of developing diabetes. Activity can also reduce the risk of developing complications of diabetes such as heart disease, stroke, kidney failure, blindness, and leg ulcers.
As little as 20 minutes of walking three times a week has a proven beneficial effect. Any exercise is beneficial; no matter how easy or how long, some exercise is better than no exercise.
If the patient has complications of diabetes (such as eye, kidney, or nerve problems), they may be limited both in type of exercise, and amount of exercise they can safely do without worsening their condition. Consult with your health care professional before starting any exercise program.
Alcohol use:-- Moderate or eliminate consumption of alcohol. Try to have no more than seven alcoholic drinks in a week, and never more than one or two drinks in an evening. One drink is considered 1.5 ounces of liquor, 6 ounces of wine, or 12 ounces of beer. Excessive alcohol use is a known risk factor for type 2 diabetes. Alcohol consumption can cause low or high blood sugar levels, nerve pain (neuritis), and an increase in triglycerides.
Smoking:-- If the patient has diabetes, and smokes cigarettes or use any other form of tobacco, they are raising the risks markedly for nearly all of the complications of diabetes. Smoking damages blood vessels and contributes to heart disease, stroke, and poor circulation in the limbs. If a person needs help to quit tobacco use, talk to a health care professional.
Self-monitored blood glucose:-- Check blood sugar levels frequently, at least before meals and at bedtime, then record the results in a logbook.
This log should also include insulin or oral medication doses and times, when and what the patient ate, when and for how long they exercised, and any significant events of the day such as high or low blood sugar levels and how they treated the problem.
Better equipment now available makes testing blood sugar levels less painful and less complicated than ever. A daily blood sugar diary is invaluable to the health care professional in evaluating how the patient is responding to medications, diet, and exercise in the treatment of diabetes.
Medicare now pays for diabetic testing supplies, as do many private insurers and Medicaid.
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The American Diabetes Association recommends keeping blood sugar levels in a range based on your age. Discuss these goals with your doctor and diabetes educator.
Before meals:
70 - 130 mg/dL for adults
100 - 180 mg/dL for children under age 6
90 - 180 mg/dL for children 6 - 12 years old
90 - 130 mg/dL for children 13 - 19 years old
At bedtime:
Less than 180 mg/dL for adults
110 - 200 mg/dL for children under age 6
100 - 180 mg/dL for children 6 - 12 years old
90 - 150 mg/dL for children 13 - 19 years old
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• Bleeding from the anus: This can occur before, during or after stools. This will be bright red blood, not usually mixed with the stools, but often seen on the toilet paper