Diabetes Diabetes is a problem with your body that causes blood glucose (sugar) levels to rise higher than normal. This is also called hyperglycemia. Type 2 diabetes is the most common form of diabetes. If you have type 2 diabetes your body does not use insulin properly. This is called insulin resistance. At first, your pancreas makes extra insulin to make up for it. But, over time it isn't able to keep up and can't make enough insulin to keep your blood glucose at normal levels. What can I do to take care of my diabetes? • Lose weight, if needed. Check your A1C (average blood glucose) Check your Blood pressure Check your Cholesterol • Work with your health care team. Make a plan that helps you reach your goals. • Keep track of your numbers. • If you’re not reaching your goals, change your plan to stay on track. Ask your health care provider for tools that can help you log your numbers. Diabetes Symptoms The following symptoms of diabetes are typical. However, some people with type 2 diabetes have symptoms so mild that they go unnoticed. Common symptoms of diabetes: Urinating often Feeling very thirsty Feeling very hungry -­‐ even though you are eating Feeling very tired Blurry vision Cuts/bruises that are slow to heal Weight loss -­‐ even though you are eating more (type 1) Tingling, pain, or numbness of hands or feet Early detection and treatment of diabetes can decrease the risk of developing the complications of diabetes. Know Your Blood Sugar Numbers You must know your blood sugar numbers to control your diabetes. Testing is the only way to know whether your blood sugar is too high, too low, or just right. There are two types of tests to measure your blood sugar. 1. A blood sugar (glucose) test measures your blood sugar at the time you test. You can do this test at home using a simple meter and test strips. This test is also done in your doctor’s office. 2. The A1C test measures your blood sugar control over the past 3 months. It is the best way to know if your blood sugar is under good control. Have an A1C test at least twice a year. The A1C test is a simple lab test.Your doctor takes a small sample of your blood and sends it to the lab. This test tells you and your doctor the amount of sugar in your blood over the past 2 to 3 months. Your A1C number is the best test to see if your blood sugar is close to normal or too high. •The A1C goal for most people with diabetes is less than 7%. (Look at the meter on the right to see what your A1C number tells you about your blood sugar number over time.) • If your number is over 8%, your doctor will most likely change your treatment plan. We know that the higher your A1C is over time, the more likely you are to have problems related to diabetes. The blood sugar (glucose) test. This is a quick and simple test you can do at home. Blood sugar testing at home is a key part of good diabetes care. Ask your pharmacist or diabetes teacher to show you the proper way t Blood Glucose Goals The American Diabetes Association suggests the following targets for most nonpregnant adults with diabetes. More or less stringent glycemic goals may be appropriate for each individual. Talk with your health care team about the best goals for you. A1C: 7% A1C may also be reported as eAG: 154 mg/dl Before a meal (preprandial plasma glucose): 80–130 mg/dl 1-­‐2 hours after beginning of the meal (Postprandial plasma glucose)*: Less than 180 mg/dl Hypoglycemia (Low Blood Glucose) Hypoglycemia is a condition characterized by abnormally low blood glucose (blood sugar) levels, usually less than 70 mg/dl. However, it is important to talk to your health care provider about your individual blood glucose targets, and what level is too low for you. Hypoglycemia may also be referred to as an insulin reaction, or insulin shock. Hypoglycemic symptoms are important clues that you have low blood glucose. Each person's reaction to hypoglycemia is different, so it's important that you learn your own signs and symptoms when your blood glucose is low. The only sure way to know whether you are experiencing hypoglycemia is to check your blood glucose, if possible. If you are experiencing symptoms and you are unable to check your blood glucose for any reason, treat the hypoglycemia. Severe hypoglycemia has the potential to cause accidents, injuries, coma, and death. Signs and Symptoms of Hypoglycemia (happen quickly) Shakiness Nervousness or Anxiety Sweating, chills and clamminess Irritability or impatience Confusion, including delirium Rapid/fast heartbeat Lightheadedness or dizziness Hunger and nausea Sleepiness Blurred/impaired vision Headaches Weakness or fatigue Anger, stubbornness, or sadness Lack of coordination Treatment for Hypoglycemia Consume 15-­‐20 grams of glucose or simple carbohydrates Recheck your blood glucose after 15 minutes If hypoglycemia continues, repeat. Once blood glucose returns to normal, eat a small snack if your next planned meal or snack is more than an hour or two away. 15 grams of simple carbohydrates commonly used: glucose tablets (follow package instructions) gel tube (follow package instructions) 2 tablespoons of raisins 4 ounces (1/2 cup) of juice or regular soda (not diet) 1 tablespoon sugar, honey, or corn syrup 8 ounces of nonfat or 1% milk hard candies, jellybeans, or gumdrops (see package to determine how many to consume) Healthy eating Many people think that having diabetes means you can’t eat your favorite foods. You can still eat the foods you like but it’s the amount that counts. Ask for a referral to a dietitian who specializes in diabetes. Together, you’ll design a personal meal plan that can help you reach your goals. These steps can help you manage your diabetes: • Count carbohydrates (also called carbs). Carbs—bread, tortillas, rice, crackers, cereal, fruit, juice, milk, yogurt, potatoes, corn, peas, sweets—raise your blood glucose levels the most. Keep the amount of carbs in your meals and snacks about the same from day to day to help you reach your blood glucose targets. • Choose foods low in saturated fat. Cut down on foods with saturated fat to help you lower your cholesterol and prevent heart disease. Foods high in saturated fat include meats, butter, whole milk, cream, cheese, lard, shortening, many baked goods, and tropical oils such as palm and coconut oil. • Lower portion sizes. Cutting back on food portions at meals and snacks can help with weight loss. • Eat more fiber. Eat more high-­‐fiber foods such as fruits, vegetables, dried beans and peas, oatmeal, and whole grain breads and cereals. Physical Activity Regular physical activity helps lower your blood glucose, blood pressure, and cholesterol. It also keeps your joints flexible, strengthens your heart and bones, and tones your muscles. Physical activity can also help lower stress. Your health care team can help you plan what activities are best for you. Work with your Doctor •Write down your questions. Take them with you to each visit •Ask your doctor for your blood sugar goals. •Ask for an A1C test at least twice a year. Know your test result and what it means. •Ask for your blood pressure to be checked at each visit. Ask your doctor about tests for cholesterol and other blood tests. •Remove your shoes and socks at each visit. Ask your doctor to check your feet. •Get your eyes and kidneys checked at least once a year. •See your dentist at least twice a year. Tell your dentist you have diabetes. Medical IDs Many people with diabetes, particularly those who use insulin, should have a medical ID with them at all times. In the event of a severe hypoglycemic episode, a car accident, or other emergency, the medical ID can provide critical information about the person's health status, such as the fact that they have diabetes, whether or not they use insulin, whether they have any allergies, etc. Emergency medical personnel are trained to look for a medical ID when they are caring for someone who can't speak for themselves. Medical IDs are usually worn as a bracelet or a necklace. Traditional IDs are etched with basic, key health information about the person, and some IDs now include compact USB drives that can carry a person's full medical record for use in an emergency.