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.

Recently Answered

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    One piece of information that came out of the Diabetes Control and Complications Trial (DCCT) is that even if you set goals that seem reasonable, they can be hard to reach. The DCCT goals for people in the intensive management group were to have near-normal blood glucose levels before and after meals and at bedtime. Most people just couldn’t consistently reach these goals. No matter how hard you and your health care team work, it is difficult to keep blood glucose levels close to those found in people without diabetes.
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    The idea behind intensive diabetes management is to keep your blood glucose levels as close to normal as possible. If you decide that intensive management is for you, you will want to choose blood glucose goals as close to those of people without diabetes as is reasonable and safe for you. It’s a group decision that you, your family, and your health care team need to make together.
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    There are some people for whom intensive diabetes management is not safe. For instance, because tighter blood glucose levels bring a higher risk of severe hypoglycemia, intensive insulin therapy in children is risky. Severe hypoglycemia can interfere with normal brain development, particularly in young children. Intensive diabetes management in children requires close supervision, usually from a diabetes specialist.
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    The Diabetes Control and Complications Trial, a recent major research study, showed that by tightly managing blood glucose levels, people with type 1 diabetes could delay or even prevent many of the complications of diabetes. 
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    If you take an intermediate-acting insulin, you will need to eat when
    your insulin is peaking, whether it is convenient or not. If you take one shot of long- or intermediate-acting insulin, there are several ways to get the bolus of insulin you need for meals. Some people with type 2 diabetes may be able to make enough insulin to cover the post-meal increase in blood glucose. For these people, providing the basal insulin helps their pancreas to do its job better. Another option is to take oral diabetes medications. These medications can provide the coverage needed for meals. Still another possibility is to take a combination of insulins. You can take a rapid- or short-acting insulin along with your morning shot of long acting insulin. This gives you a bolus of insulin to cover your breakfast meal. You can either use premixed insulins or mix two types of insulin in one injection.
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    People with diabetes now have more choices than ever about where to buy their diabetes supplies and devices. You can shop online, in a local or chain pharmacy, and through the mail. It’s up to you to decide which is the most convenient and cost-effective place to shop. Be wary of online marketplaces where people sell and auction personal items. It is not possible to know if testing supplies have been stored properly or have been altered in any way. Only buy from a reputable source.

    Pharmacies

    Some pharmacies offer a smaller selection of equipment, so check the aisles to see how your pharmacy stacks up. If you have a good relationship with your pharmacist, you may be able to ask him or her to order the machine that you want. Although small pharmacies can be more expensive, establishing a good working relationship with your pharmacist can save you a lot of running around. Pharmacists can often give you information about the ins and outs of different products and models. Local pharmacists will know the products they sell and will be able to spend time training you to use the purchase. This is often a real, convenient advantage.

    Most grocery store and chain pharmacies carry diabetes supplies, which might be convenient if you are shopping for other items.

    Diabetes Supply Stores

    Another shopping option is to visit a diabetes specialty store. To find one near you, call your local American Diabetes Association office or check in the phonebook under “Diabetes” or “Medical Supplies.” If you are lucky enough to have one nearby, you may be able to get many nonprescription items and diabetes information and support in one easy stop. You may also find a selection of healthy foods, books, and information on local diabetes events and organizations. Many diabetes shops have knowledgeable staff who can help you compare models, answer questions, and provide training on new tools.

    Buying Supplies Online

    When purchasing supplies online, make sure to look for an Internet site that is secure and reputable. The Food and Drug Administration recommends purchasing from websites that are located in the United States and provide clear ways to contact the company with questions or concerns.

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    Your personal identification should identify you and your medical condition(s) in case you become unconscious or injured. 
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    There may be times when your blood glucose level plummets and it is difficult to make it to the refrigerator for orange juice. Glucose tablets are easy to handle and they work within minutes. And you are less likely to overcompensate and eat too many glucose tablets because they don’t seem like candy. Try a few different kinds of fruit-flavored tablets to find the one that tastes best to you. The tablets come with varying amounts of glucose. Check the label to see how much to take.
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    If you have tried to stuff your meter, pen or syringes and insulin, and other supplies into a purse or briefcase, you’ll know how handy a special bag can be. Carrying cases can help organize all your supplies and keep them in one convenient place. They can also insulate your insulin from hot or cold temperatures.
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    You may want a lot of room to write in your blood glucose logbook. Consider buying a spiral-bound notebook or using a loose-leaf notebook, where you can add pages as needed, to jot down extra notes. You may find it useful to have extra space to record different symptoms and situations that could be relevant to your health. Your logbook is an important tool for looking for patterns in your blood glucose control, so be sure that it is easy to use. Notebooks also offer lots of room to write for people whose fingers might be a little stiff.

    Logbooks should include:

    -   Spaces to record the date, time, and blood glucose measurement

    -   If you take insulin or other medications, you’ll want spaces to include doses

    -   Spaces to write down comments, such as what you ate, whether you worked out, etc.

    Some meters come with an electronic logbook that records your readings and allows you to enter comments about your meals or other situations. Some people may prefer the convenience of using an electronic logbook rather than paper. However, you should always keep some type of logbook rather than just storing readings in your meter’s memory.