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DIABETES MELLITUS TYPE 1 IN ADULTS |
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GENERAL INFORMATION |
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What is it?
Diabetes is also called diabetes mellitus. Type 1 diabetes happens when your pancreas (an organ that lies behind the stomach) does not make insulin. It may also be called insulin dependent, early onset, or juvenile onset diabetes. Type 1 diabetes is more common in children or young adults but anyone can have it. There is no cure for diabetes, but you can have a long and active life if your diabetes is controlled. |
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How did I get type 1 diabetes?
• Insulin is a hormone (a special body chemical) made by the pancreas. The pancreas is an organ that lies behind the stomach. Much of the food we eat is turned into sugar in the stomach. This sugar goes into the blood and travels to the cells of your body to be used for energy.
• Insulin acts as a "key" to help sugar enter the cells. When your body does not make insulin, sugar builds up in your blood. With type I diabetes, you must take insulin every day.
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What are the signs and symptoms of type I diabetes?
The symptoms of diabetes usually come on suddenly. These are symptoms of hyperglycemia or high blood sugar. With any one or more of the following signs and symptoms, you should see your caregiver:
• Blurry vision.
• Fatigue (feeling very tired).
• Hungry all of the time.
• Losing feeling in your feet or having tingling in your feet.
• Losing weight without trying.
• Sores that take a long time to heal.
• Urinating often.
• Very dry skin.
• Very thirsty and drinking a lot of liquids.
• Vaginal infections in women.
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What is diabetic hypoglycemia?
• People that have diabetes can sometimes have hypoglycemia. This is a condition that happens when your blood sugar level has fallen too low. It may be caused by having too much insulin in your blood, or you may not have eaten enough. Ask your caregiver for more information about hypoglycemia.
• It is very important to treat symptoms of low blood sugar right away. If you have low blood sugar, eat or drink a source of carbohydrate. Some examples of carbohydrates are eight ounces (one cup) of skim milk, four ounces (one-half cup) of juice, or five to six hard candies. Following are the signs and symptoms of hypoglycemia:
o Being confused.
o Fatigue (feeling very tired).
o Feeling weak and dizzy.
o Feeling very hungry.
o Having a headache and feeling irritable.
o Having a very fast heartbeat.
o Looking pale.
o Trembling and sweating with a cold clammy feeling.
o Unconscious and going into a coma. |
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What is ketoacidosis?
Diabetes may also cause ketoacidosis (ke-toe-ah-sih-DOE-sis). This is a condition that happens when your blood sugar stays too high for too long without being treated. This can cause your body to start breaking down body fats for energy rather than using blood sugar. Wastes called ketones are left behind. Ketoacidosis can be very serious and needs to be treated right away. Ask your caregiver for more information about ketoacidosis. Following are the signs and symptoms of ketoacidosis:
• More thirsty than usual.
• Passing more urine than usual.
• Confused or having trouble thinking clearly.
• Fatigue (feeling tired).
• Fast deep breathing.
• Nausea and vomiting (throwing up).
• Fruity-smelling breath.
• Finally, becoming unconscious (coma). |
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Can diabetes cause other health problems?
High blood sugar levels may damage other body tissue and organs over time. Having uncontrolled diabetes can damage your nerves, veins, and arteries. This can cause damage to your feet and legs. With time you may need to have your feet or legs amputated. The buildup of sugar can also damage organs in your body. Uncontrolled diabetes can cause blindness, stop your kidneys from working, or lead to a heart attack. Diabetes can even cause death if it is left untreated. |
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What are the tests that may be done for type I diabetes?
• Tests: Caregivers will ask you questions about your medical history and symptoms of diabetes. Following are some of the blood tests you may have done to find out if you have type 1 diabetes. Caregivers will want to test you twice to be positive that you have diabetes.
o Oral Glucose Tolerance Test (OGTT): Your blood will be drawn two or more times for this test. You must fast (not eat or drink anything) before this test. Your caregiver will tell you how long to fast. After fasting, the first sample of blood will be taken. Your caregiver will ask you to drink a special glucose liquid. Two hours after drinking the liquid, the second sample of blood will be taken. The samples are taken to the lab for tests. A blood sugar result of 200 mg/dl (milligrams per deciliter) or more may mean you have diabetes.
o Fasting Glucose: You must also fast for this test. But, your blood can be drawn as soon as you arrive at the caregiver's office or lab. You may have diabetes if your blood sugar is 126 mg/dl (milligrams per deciliter) or greater.
o If you have the symptoms of diabetes, caregivers may do a blood test anytime of the day (whether or not you have fasted). If your blood sugar is greater than 200mg/dl you may have diabetes. But, you will need another test on another day, as in any diabetes testing, to be positive that you have diabetes.
• Other blood tests: Once caregivers know that you have diabetes you will need other blood tests to see how well controlled your diabetes is. The hemoglobin A1c test or " H-b-A-1-c" shows a "snapshot" of your average blood sugar over the last three months. All people with diabetes should have an H-b-A-1-c test twice a year. You may need the test every three months if your blood sugar stays too high. The H-b-A-1-c goal for people with diabetes is less than 7 percent. Work with caregivers to change your diabetes treatment plan if your test result is 8 percent or higher.
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How is type 1 diabetes treated?
The most important thing you must do is control your blood sugar. This can be done by taking your insulin or blood sugar medicine correctly. Eating the right foods and exercising are also very important in controlling diabetes. You must check your blood sugar level one or more times every day to make sure you get the right amount of insulin. |
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How do I check my blood sugar levels?
Your caregiver will teach you how to use a glucose monitor. This is a small device that tells how much sugar is in your blood. There are many different kinds of monitors. All monitors use a small drop of blood. Usually the blood is from a prick on your finger. Caregivers will help you choose the monitor that is best for you. Ask your caregiver for more information about checking your blood sugar.
Do I need to change my diet? Food puts sugar in your body. You can help control your blood sugar by eating the right foods. A diabetes nurse or dietitian will help you learn what to eat, and how food affects your diabetes. There is no one diet that is right for everyone who has diabetes. Following are some of the important changes your caregivers may suggest:
• Certain foods such as carbohydrates can quickly raise your blood sugar. Your caregiver may want you to limit the amount of carbohydrates you eat. Examples of carbohydrates are bread, grains, cereal, pasta, starchy vegetables like corn and potatoes, and milk and yogurt. Ask your caregiver about the amount of carbohydrate that is right for you.
• Choose foods that are good sources of fiber. Examples of high fiber foods are vegetables, legumes (dried beans and peas), and whole grain breads and cereals.
• Choose foods low in fat, saturated fat, and cholesterol. Examples of low fat foods are lean cuts of meat, fish, poultry (chicken and turkey) without skin, and low-fat milk.
• Limit the amount of sugar you eat. Examples of high sugar foods are candy, regular soda and desserts such as cake or pie.
• Eat your meals and snacks at about the same times and in the same amounts each day.
• Never skip a meal. |
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Can I drink alcohol?
Drinking alcohol without having food in your stomach may cause a drop in your blood sugar. People who have certain health problems should not drink alcohol. Talk to your caregiver before you drink alcohol. If you use alcohol, drink it with meals. You should drink only one serving of alcohol per day if you are a woman or two servings of alcohol per day if you are a man. A serving is the same as five ounces of wine, 12 ounces of beer or one and one-half ounces of hard liquor (like gin or whiskey). |
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Why is exercise important if I have diabetes?
Exercise helps keep your blood sugar level under control by helping your body better use insulin. It also makes the heart stronger, lowers blood pressure, and keeps you healthy. Exercising and controlling your weight can change the amount of insulin your body needs. It is very important to work with your caregiver to help plan the best exercise program for you.
• Check your blood sugar before and after exercise to learn how your blood sugar responds to exercise. Caregivers may tell you to change the amount of insulin you take or food you eat.
• Wait to exercise if your blood sugar is over 250mg/dl or less than 100mg/dl.
• If your blood sugar is less than 100mg/dl, eat or drink a carbohydrate snack before exercising. This will help to avoid low blood sugar. Examples of carbohydrate snacks are four to six crackers, one-half banana, eight ounces (one cup) of milk or four ounces (one-half cup) of juice.
• Always have a carbohydrate snack available during and after exercise.
• Drink plenty of fluids before, during, and after exercise.
• Wear good socks and footwear to prevent sores and blisters on your feet. |
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Where can I go for support?
You may feel scared, confused, and anxious because you have diabetes. You may blame yourself and think you have done something wrong. These feelings are common. Talk about them with your caregiver or someone close to you. Ask about support groups for people with diabetes.
Some recommendations
• Keep a written list of what medicines you take and when and why you take them. Bring the list of your medicines or the pill bottles when you see your caregivers. Learn why you take each medicine. Ask your caregiver for information about your medicines. Do not take any other medicines, vitamins, or herbal supplements without first talking to caregivers. Some of these may not work well with medicines you are taking for diabetes or other conditions.
• Always take your medicine as directed by caregivers. Call your caregiver if you think your medicines are not helping or if you feel you are having side effects. Do not quit taking it until you discuss it with your caregiver.
• You may need one or more shots of insulin every day to decrease the amount of sugar in your blood. You, a family member, or a friend will be taught how to give the insulin shots.
Keep all medical appointments: Call your caregiver in days for a follow-up visit. Write down questions you have about your diabetes and how it is being treated. This way you will remember to ask these questions during your next visit. Bring your diabetes record book with you every time you visit caregivers. Wear a medical alert bracelet that says you have diabetes. You may get one from the MedicAlert Foundation.
• Call or write them at:
MedicAlert Foundation
2323 Colorado Avenue
Turlock, CA 95382
Phone: 1-888-633-4298
Web Address: http://www.medicalert.org
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Do I need to change my diet?
Food puts sugar in your body. You can help control your blood sugar by making sure you eat the right kinds and amounts of food. A dietitian or diabetes nurse will help you learn what to eat and how food affects your diabetes. There is no one diet that is right for everyone who has diabetes. Following are some of the important changes your caregivers may suggest:
• Certain foods such as carbohydrate can quickly raise your blood sugar. Your caregiver may want you to limit the amount of carbohydrates you eat. Examples of carbohydrate are bread, grains, cereal, pasta, starchy vegetables like corn and potatoes, and milk and yogurt. Ask your caregiver about the amount of carbohydrate that is right for you.
• Choose foods that are good sources of fiber. Examples of high fiber foods are fruits, vegetables, legumes (dried beans and peas), and whole grain breads and cereals
• Choose foods low in fat, saturated fat, and cholesterol. Examples of low fat foods are lean cuts of meat, fish, poultry (chicken and turkey) and low-fat milk.
• Limit the amount of sugar you eat. Examples of high sugar foods are candy, regular soda and desserts such as cake or pie.
• Eat your meals and snacks at about the same times and in the same amounts each day. Never skip a meal. |
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Call your Physician if:
• You have a temperature over 100.4 °F .
• Your blood sugar is greater than 300 or less than 60.
• You have any of the following signs or symptoms of high blood sugar:
o Blurry vision.
o Fatigue (feeling very tired).
o Hungry all of the time but losing weight without trying.
o Losing feeling, have pain or tingling in your hands or feet.
o Sores that take a long time to heal, or very dry skin.
o Urinating often.
o Very thirsty and drinking a lot of liquids.
o Vaginal infections in women.
• You have any of the following signs or symptoms of low blood sugar:
o Being confused and tired.
o Feeling weak and dizzy.
o Feeling very hungry.
o Having a headache and feeling irritable.
o Having a very fast heartbeat.
o Looking pale, trembling and sweating with a cold clammy feeling.
• You have burning or stinging when you urinate. Or, you are urinating often and passing small amounts of urine. These may be signs that you have a urine infection.
• You are vomiting (throwing up).
• You have any questions about your medicine, exercise, or diet.
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Seek care immediately if:
• You have trouble thinking clearly.
• You are feeling worse even though you are following your caregiver's directions.
• You have the signs of advanced ketoacidosis:
o Fruity-smelling breath.
o Fast deep breathing at rest.
o Trouble thinking clearly, confusion, and losing consciousness.
• You have signs of a heart attack:
o Chest pain that spreads to your arms, jaw, or back.
o Nausea (sick to your stomach).
o Trouble breathing.
o Sweating.
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