Diabetes

Diabetes

Diabetes mellitus (MEL-ih-tus), often referred to as diabetes, is characterized by high blood glucose (sugar) levels that result from the body’s inability to produce enough insulin and/or effectively utilize the insulin. Diabetes is a serious, life-long condition and the sixth leading cause of death in the United States. Diabetes is a disorder of metabolism (the body's way of digesting food and converting it into energy). There are three forms of diabetes. Type 1 diabetes is an autoimmune disease that accounts for five- to 10-percent of all diagnosed cases of diabetes. Type 2 diabetes may account for 90- to 95-percent of all diagnosed cases. The third type of diabetes occurs in pregnancy and is referred to as gestational diabetes. Left untreated, gestational diabetes can cause health issues for pregnant women and their babies. People with diabetes can take preventive steps to control this disease and decrease the risk of further complications.

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    Unlike many other diseases and chronic medical conditions, good diabetes care depends on self-management. However, because of your child’s age, maturity level, or level of experience or skill, he or she may not be able to handle various aspects of diabetes care alone. Because of these factors, or in the event of an emergency, trained school personnel will be needed to check blood glucose levels, to administer insulin or medication, or to recognize and treat hypoglycemia (and administer glucagon) or hyperglycemia.

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    People with diabetes must manage their blood glucose levels through the careful balance of food, exercise, and medication. Blood glucose monitoring is an essential component to good health. It is the only way of making sure blood glucose levels are maintained within your child’s target range.

    Your child’s immediate access to diabetes equipment and self-care is important so that symptoms don’t get worse and so that she or he doesn’t miss valuable classroom instruction or other school activities.

    You may want your child to check his or her blood glucose levels and promptly treat wherever he or she is at school or during a school-related activity. However, this depends on your child’s age, level of experience and skill, and personal preference.

    Good diabetes care depends on self-management. However, because of your child’s age, maturity level, or level of experience or skill, he or she may not be able to handle various aspects of diabetes care alone. Trained school personnel will be needed to check blood glucose levels, to administer insulin or medication, or to recognize and treat hypoglycemia (and administer glucagon) or hyperglycemia.

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    Your child’s school may already have a policy in effect to deal with the needs of children with chronic illnesses, including diabetes. However, you and your child’s health care team will need to develop a Diabetes Medical Management Plan (DMMP)—to address your child’s specific health care needs.

    The plan spells out the medical care your child should receive at school, including information about blood glucose monitoring, meals and snacks, insulin, and emergency care, which may include the administration of glucagon.

    Some children are capable of self-care, whereas other children will need a great deal of help. All children with diabetes will need help in the event of an emergency.

    ADA has developed a sample DMMP, which is available on the Internet for printing or downloading at www.diabetes.org or by calling 1-800-DIABETES and asking for a school discrimination packet.

    Details of a DMMP

    • A child should be able to receive assistance with blood glucose monitoring and insulin or glucagon administration if needed.
    • A child can eat whenever and wherever necessary. This includes keeping snacks or glucose tablets close at hand.
    • A child can go to the bathroom or water fountain when necessary.
    • A child can participate fully in all school activities, including extracurricular activities such as sports or field trips, with diabetes care provided by trained school staff members.
    • Option to refrain from exams or physical activity when blood glucose levels are too high or too low.
    • A child should be able to eat lunch on schedule, with enough time allotted to finish eating.
    • A child can be excused for tardiness in case of a blood glucose problem.
    • A child should be allowed to check blood glucose levels in the classroom or wherever he or she happens to be (if the child is capable of this self-management task).
    • A child is allowed to be absent, without penalty, for medical appointments and diabetes-related illnesses.

    The implementation of a DMMP by the school is called a Section 504 plan if it is developed under the federal Rehabilitation Act or an Individualized Education Program (IEP) if it is developed under the Individuals with Disabilities Education Act. For example, a physician and parents develop a DMMP. The school, with input from parents, develops the 504 or IEP plan. You’ll want to ensure that your school has one of these plans in place so that your child’s needs are met.

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    ARobin Miller, MD, Integrative Medicine, answered
    Dr. Robin Miller - vegetarians lower risk of diabetes
    A vegetarian diet can be healthier than a meat-eating diet in many ways. In this video, Dr. Robin Miller discusses metabolic syndrome, which increases a non-vegetarian's risk for diabetes.


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    AStacy Wiegman, PharmD, Pharmacy, answered
    Glucose is a natural sugar that provides cells with energy. The presence of glucose in the blood stimulates the pancreas to secrete insulin. The insulin facilitates the transport of glucose from the blood into the cells where it is used. If not enough insulin is secreted, the glucose blood level remains high. Consistently high blood glucose levels caused by insufficient insulin is diabetes mellitus.

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    AStacy Wiegman, PharmD, Pharmacy, answered

    Glucose is a natural sugar that provides cells with energy. Many glucose supplements and gel (jelly-like) products are available. You should always discuss taking these products with your doctor before using them. In small doses, no side effect problems are expected. If used in large doses, however, hyperglycemia may occur. In any dose, the products could cause nausea and stomach upset because they are concentrated glucose products.

    But if more serious side effects occur, immediately contact your doctor. The most serious side effect possible would be severe allergic reactions. Symptoms of a severe allergic reaction include:

    • Rash
    • Hives
    • Itching
    • Difficulty breathing
    • Tightness in the chest
    • Swelling (of the mouth, face, lips or tongue)
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    AShelley Peterman Schwarz, Neurology, answered
    Use hand tracing to record injection sites. If you are diabetic and have difficulty remembering which fingers have been used for blood sugar monitoring, trace an outline of a pair of hands on a piece of paper and mark the site of the last blood sample. This will help you remember to change sites.

    Use a bracelet to remember to alternate injection locations. If you need to alternate injection sites and have trouble remembering which side you did last, wear a bracelet on the arm where the injection went. When you give the next injection, move the bracelet to the other arm. If you don't like to wear bracelets, change a ring from one hand to the other or use a sticky tab on the medication that indicates right or left. If the medication is refrigerated, you may want to use a refrigerator magnet to help you remember which side, arm or leg to use.
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    You might suggest that your child visit a diabetes educator alone. This gives your child a chance to ask questions and establish a relationship that can be helpful in the future as well. When your child is treated like an adult, he or she may act more like an adult. It is critical that your child understands that it is up to her to take charge of her care.

    It is not uncommon for children and teenagers to feel depressed. Eating disorders, especially among girls, are common. One type of eating disorder among teens with diabetes involves skipping insulin. This allows a person to eat and not gain weight. If you start to suspect that your child is depressed or developing any sort of coping problem, eating disorder, or behavioral problem, seek the help of a professional counselor immediately.

     

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    Caring about someone who has diabetes offers special challenges.

    Here’s how you can help:

    • Get an education in diabetes care.
    • Be supportive, but don’t take on the role of caretaker.
    • Learn to listen without offering advice or criticism.
    • Be flexible and open to new ways of eating and spending free time.
    • Plan for emergencies.

     

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    Depending on your family, you can expect different responses to your diabetes and different levels of enthusiasm for helping you work toward your diet and exercise goals. Some may partake wholeheartedly, looking at this as a team effort. Other families or family members may resent making changes when they aren’t even sick. You need to find the approach that works best for you. In some situations, you may be better off if you go it alone.

     

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