Complications
Type 1 diabetes can affect many major organs in the body, including the heart, blood vessels, nerves, eyes and kidneys. Keep your blood sugar close to normal most of the time can reduce the risk of complications lot.
The long-term complications of type 1 diabetes develop gradually, over many years. Developed diabetes early - and less control blood sugar levels - the higher the risk of complications. Finally, the complications of diabetes can be disabling or even life-threatening.
Heart and blood vessel disease. Diabetes significantly increases the risk of heart disease, including coronary artery disease with chest pain (angina), heart attack, stroke, narrowing the arteries (atherosclerosis) and high blood pressure. In fact, about 65 percent of those who had died of diabetes due to some type of heart or vascular disease, according to the American Heart Association.
Nerve damage (neuropathy). Excess sugar can cause damage to the small blood vessels (capillaries) nourishing the nerves, especially in the legs. This can cause itching, numbness, or pain usually hot start toes or fingers and gradually spread upward. Hard to control blood sugar levels can cause loss of sensation in the affected limb. Damage to the nerves that control digestion can cause problems with nausea, diarrhea, vomiting or constipation. For men, erectile dysfunction can be a problem.
Damage to the kidneys. The kidneys contain millions of tiny blood vessels, cluster filtering wastes from the blood. Diabetes can damage the filter system. Serious damage can lead to kidney failure or end-stage renal disease can not be reversed, dialysis or a kidney transplant is required.
Damage to the eyes. Diabetes can damage the blood vessels of the retina (diabetic retinopathy), potentially leading to blindness. Diabetes also increases the risk of serious vision conditions, such as cataracts and glaucoma.
Damage legs. Nerve damage in the feet or poor blood flow increases the risk of foot complications. Without treatment, the wound can become serious infections. Serious damage toes, feet may require amputation.
Skin and mouth. Diabetes can be prone skin problems, including infections caused by bacteria and fungi. Oral infection may also be a concern, especially if there is a history of poor oral hygiene.
Osteoporosis. Diabetes can lead to lower bone density than normal, increasing the risk of osteoporosis.
Complications during pregnancy. High blood sugar can be dangerous for both mother and baby. The risk of stillbirth, miscarriage and birth defects is increased when diabetes is not well controlled. For the mother, diabetes increases the risk of diabetic ketoacidosis, diabetic retinopathy, pregnancy induced hypertension and preeclampsia.
Ear problems. Deaf occur more often in people with diabetes.
Tests and diagnosis
In June 2009, an international panel of experts from the American Diabetes Association, European Association for the study of diabetes and diabetes International. Recommend checking Type 1 diabetes include:
Glycated hemoglobin (HbA1c). This shows that the average level of blood sugar in the past two to three months. By measuring the rate of blood sugar attached to hemoglobin, the protein that carries oxygen in red blood cells. High blood sugar, sugar attached to the hemoglobin more. HbA1c level of 6.5 percent or higher on two separate tests indicates diabetes. results between 6 and 6.5 percent is considered prediabetes, indicating the risk of developing diabetes.
If HbA1c test is not available, or if certain conditions can cause the incorrect HbA1c tests - such as if you are pregnant or have abnormal form of hemoglobin (hemoglobin variant called) - doctor she can use the test to diagnose diabetes:
Random blood glucose testing. A blood sample will be taken at a random time. Glycemic values is shown mg / dL or millimoles / liter (mmol / L). Regardless of when to eat, blood sugar level of 200 randomly mg / dL (11.1 mmol / L) or higher indicates diabetes, especially when combined with any of the signs and symptoms of diabetes sugar, such as frequent urination and extreme thirst.
Test your blood sugar while fasting. A blood sample will be taken after fasting overnight. Fasting blood glucose levels below 100 mg / dL (5.6 mmol / L) is normal. The level of fasting blood glucose 100-125 mg / dL (5.6 to 6.9 mmol / L) is considered prediabetes. If the 126 mg / dL (7 mmol / L) or higher on two separate tests, have diabetes.
If you are diagnosed with diabetes, your doctor will also run blood tests to check for common autoantibodies in diabetes type 1. These tests help doctors distinguish between type 1 diabetes and type 2 . The presence of ketones - a byproduct of the breakdown of fat - in urine also showed type 1 diabetes, type 2 is more.
After diagnosis
Once you have been diagnosed with Type 1 diabetes, visit your doctor regularly to ensure good diabetes management. During the visit, the doctor will also check A1c levels. A1c goals may vary depending on the age and different factors, but in general the American Diabetes Association recommended HbA1c levels were below 7 percent, translated into an estimated average sugar is 154 mg / dL ( 8.5 mmol / L).
Compared with blood tests repeated daily, A1c test showed better treatment plan is good diabetes. High A1c may signal the need for a change in insulin regimen or diet plan.
In addition to the HbA1c test, the doctor will also take blood and urine samples periodically to check cholesterol levels, thyroid function, liver function and kidney function and to test for celiac disease. The doctor will also check to assess blood pressure, and check your blood sugar and insulin supply.
Treatments and drugs
Treatment of Type 1 diabetes is a lifelong commitment:
Using insulin.
Exercise regularly and maintain a healthy weight.
Eat healthy foods.
Monitoring blood sugar
The goal is to keep blood sugar levels as close to normal one, can delay or prevent complications. Although there are exceptions, in general, the goal is to keep blood levels between 80 during the day and 120 mg / dL (4.4 to 6.7 mmol / L) and the number of hours of sleep between 100 and 140 mg / dL (5.6 to 7.8 mmol / L).
If managing diabetes seems overwhelming, check out one day at a time. And remember that not alone. Working closely with the group treated diabetes - doctors, educators and diabetes dietitian registered - to keep blood sugar levels as close to normal as possible.
Insulin and other drugs
Anyone who has Type 1 diabetes, insulin therapy to survive.
The types of insulin are many and include the effect of fasting insulin, insulin-mediated effects and options. For example, regular insulin (Humulin R, Novolin R, others), isophane insulin (Humulin N, Novolin N), insulin lispro (Humalog), insulin aspart (Novolog), insulin glargine (Lantus) and insulin detemir (Levemir ). Depending on your needs, your doctor may prescribe a mixture of insulin types to use throughout the day and night.
Inhaled insulin (Exubera) previously available, but the manufacturer has stopped selling because too few people were using it. Since it was launched, this drug is related to the increase of lung cancer in people with a history of cigarette smoking. However, due to the number of additional cases of lung cancer is very small, not clear if there is a link to the drug. If using Exubera and a history of smoking, discuss these issues with your doctor.
Currently, the only option to get insulin into the body by injection or transfer. Insulin can not be taken orally to lower blood sugar because stomach enzymes interfere with insulin action.
Insulin injections can be done using a fine needle and syringe or pen - a device that looks like a pen.
Insulin pumps can also be an option. Pump is a device the size of a mobile phone worn on the outside of the body. A tube connects insulin by a catheter inserted under the abdominal skin. There is also wireless pumps available. Filled into subcutaneous insulin. The insulin can be worn on the abdomen, lower back, or legs or arms. This program is implemented with a wireless communication device with this result. Whether to use the pump, programmed to specific division automatic rapid-acting insulin. Stable dose of insulin is called the basic rate, and it supersedes any acting insulin is used.
Other drugs are sometimes prescribed, such as:
Pramlintide (Symlin). Injection before eating may slow down the movement of food through the stomach to limit the sharp rise in blood sugar after a meal occurs.
Low-dose aspirin. The doctor may prescribe a low dose aspirin therapy to prevent heart disease and blood vessels.
Blood pressure. Even if you do not have high blood pressure, your doctor may prescribe medications called angiotensin converting enzyme inhibitors (ACE) inhibitors or angiotensin II receptor blockers (ARBs), because these drugs may help keep a healthy kidney in reducing blood pressure. It is recommended to people with diabetes have lower blood pressure of 130/80 millimeters of mercury (mm Hg).
Cholesterol-lowering drugs. As with high blood pressure medicines, doctors have cholesterol-lowering drugs called statins. This guide is harder for people with diabetes because of the high risk of heart disease. The American Diabetes Association recommends that the density of low-density lipoprotein (LDL, or "bad") cholesterol below 100 mg / dL and high density lipoprotein (HDL, or "good") cholesterol above 50 mg / dL. Triglycerides, a type of fat in the blood, is ideal when less than 150 mg / dL.
Healthy Eating
Contrary to popular perception, it is not a diet diabetes. Not restricted. Instead, it will need a lot:
Fruits.
Rau.
The grains.
These foods are high in nutrients and low in fat and calories. This means that animal products and sweets less. This really is the best diet plan, even for people without diabetes.
Will need to learn to eat foods can give yourself enough insulin to metabolize carbohydrates properly. A dietitian can help create a meal plan in line with the objectives of health, food preferences and lifestyle.
Physical Activity
Everyone needs regular aerobic exercise, and people with type 1 diabetes are no exception. Then select the proper operation, such as swimming, walking or cycling. The most important is to make physical activity a part of daily routine. The goal of at least 30 minutes of aerobic exercise a day and most of the week. Episode lasting and strength are important. If no activity for a while, start slowly and build up gradually.
Remember that physical activity reduces blood sugar levels, often for long periods after implementation. If starting a new activity, check your blood sugar more often than usual until the said activities that affect blood sugar. You may need to adjust the meal plan or insulin to compensate for the increased activity. If you use an insulin pump, may establish a temporary bottom to keep blood sugar levels. Ask your doctor to see how.
Monitoring blood sugar
Depending on the type of insulin therapy or select required - single dose, multiple injection or insulin pump - may need to check and record blood glucose at least four times a day, and maybe more . Careful monitoring is the only way to ensure blood sugar levels remain within the target range. Be sure to wash your hands before you check your blood sugar to get the most accurate.
Even when insulin and eat in a rigid schedule, blood sugar levels can fluctuate. With help from the group treated diabetes, learn how to alter blood sugar levels in response to:
Food. What type and how much will affect your blood sugar. Blood sugar levels are often highest in 1-2 hours after a meal.
Physical activity. Physical activity moves sugar from the blood into the cells. Lower blood sugar levels. To compensate, you may need to reduce the dose of insulin before physical activity.
Medicines. For insulin to reduce blood sugar levels. However, other medicines may affect blood sugar levels, sometimes requiring changes in the treatment plan diabetes.
Illness. A cold or illness, the body produces hormones that increase blood sugar levels. This may require a change in treatment plan diabetes.
Alcohol. Alcohol can cause either high or low blood sugar, depending on how much drinking and eating at the same time. If you choose to drink, do so in moderation, which means no more than one drink per day for women and two drinks daily or less for men.
Stress. The hormones your body may produce in response to prolonged stress may prevent insulin function properly.
Women, hormone fluctuations. For hormone levels fluctuate during the menstrual cycle, possibly blood sugar level changes - especially in the week before menstruation. Menopause can cause fluctuations in blood sugar levels.
Continuous Glucose Monitoring (CGM). A new way to monitor blood sugar levels, and may be useful for those who have no awareness of hypoglycaemia. Continuous glucose monitoring using a small needle under the skin to test blood glucose levels every few minutes. CGM has not been considered in blood glucose monitoring accuracy standards, so do not be regarded as an alternative method for monitoring blood sugar levels, but more a measure.
Related situations
Certain life circumstances considered different.
Driving. Hypoglycemia can occur at any time, even while driving. Check your blood sugar anytime're behind the wheel. If it is less than 70 mg / dL (3.9 mmol / L), have a snack and then check again in 15 minutes to make sure it rises to a level of safety. Low blood sugar may make it difficult to concentrate or to react as fast as possible to reach while driving.
Work. In the past, people with type 1 diabetes often refuse certain jobs because they have diabetes. Fortunately, advances in the management of diabetes and anti-discrimination law has implemented a ban. However, type 1 diabetes can cause a number of challenges in the workplace. For example, if you work in jobs related to driving or operating heavy machinery, hypoglycemia can cause serious danger.
Pregnancy. Because of the risk of complications during pregnancy for women with diabetes type 1, the experts recommend that women have rated prejudices and A1c less than 7 percent before trying to get pregnant. Some medications such as high blood pressure and cholesterol lowering drugs, may need to stop before pregnancy. The risk of birth defects increased for women with type 1 diabetes, especially when poorly controlled diabetes in the first week from six to eight of pregnancy, therefore, planned pregnancy is important . Careful management of diabetes in pregnancy may reduce the risk of complications.
Elderly. When still active and have normal cognitive abilities, goals of diabetes management can be like when young. However, for those weak, ill or impaired cognition, strict control of blood sugar may not be practical. If you are caring for a person with type 1 diabetes, ask your doctor what is the goal of diabetes need.
Treatments reference
Pancreas transplantation. With successful pancreas transplant, ó may not need insulin. But pancreas transplants are not always successful - and the procedure poses serious risks. Need lifetime powerful immunosuppressive drugs to prevent organ removal. These drugs can have serious side effects, including increased risk of infection and organ injury. Because these side effects can be more dangerous than diabetes, pancreas transplant is often very difficult for people to control diabetes.
Cell transplantation. Researchers also are experimenting with islet cell transplantation, providing new insulin-producing cells from a donor pancreas. Although this experimental procedure had problems in the past with the technology, and better drugs to prevent islet cell removal may improve the chances for success in the future. However, islet cell transplantation still requires the use of immunosuppressant drugs, and just as it did with its natural cells, the body often destroys transplanted islet cells. In addition, a sufficient supply of islet cells are not available for this treatment became popular.
Stem cell transplantation. In a study of Brazil in 2007, a handful of people newly diagnosed with type 1 diabetes can stop using insulin after being treated with stem cells from his blood. Although stem cell transplantation - is related to the closure of the immune system and then build it up again - can be dangerous, may be one of those providing additional treatment options for patients Type 1 diabetes.
Signs of trouble
Despite our best efforts, sometimes problems will arise. Some short-term complications of type 1 diabetes need to take care of immediately. If untreated, these conditions can cause seizures and loss of consciousness (coma).
Low blood sugar (hypoglycemia). This occurs when blood glucose levels fell much below the target. Ask your doctor what is considered low blood sugar levels. Blood sugar levels can be reduced for many reasons, including skipping a meal, the more physical activity than normal or injecting too much insulin.
Learn the symptoms of low blood sugar, and blood sugar checks if thought reduce blood sugar levels. When in doubt, always check your blood sugar. Signs and symptoms of low blood sugar include:
Sweating.
Run.
Hungry.
Weakness.
Worried.
Dizziness.
Pale.
Fast or irregular heartbeat.
Tired.
Headache.
Blurred vision.
Discomfort.
Then, signs and symptoms of low blood sugar, which can sometimes be mistaken for alcohol intoxication in teens and adults include:
The lethargy.
Confusion.
Behavior change, sometimes dramatically.
Poor coordination.
Seizures.
If you develop hypoglycemia at night, may wake up with headaches or sweat. Thanks to the effects of natural recovery, nighttime hypoglycemia can cause high blood sugar abnormalities in the morning.
If you have low blood sugar, some juice, sugar, hard candy, soda, or other sources of sugar. Then check blood sugar in about 15 minutes to make sure it has increased to normal levels. If it is not in the normal range, with more sugar (juice, candy, glucose member or another source of sugar) and then check back in 15 minutes. Keep doing this until you get normal results. A good idea to eat a meal or snack when received normal results. A feed mixture, such as peanut butter and crackers, can help stabilize blood sugar.
If the blood glucose meter is not available, the treatment of low blood sugar if you have symptoms of hypoglycemia, and then test as soon as possible.
Always carry a quick source of sugar effect. If untreated, low blood sugar will cause loss of consciousness. If this happens, you may need an emergency injection of glucagon - a hormone that stimulates the output of sugar in the blood. Be sure to always have a glucagon emergency kit - at home, at work, when out - and make sure it does not expire.
Hypoglycemia without awareness. Some people may lose the ability to sense blood sugar levels are going down, because they have developed a condition called awareness of hypoglycaemia. With no awareness of hypoglycemia, the body no longer respond to low blood sugar with symptoms such as dizziness or headache. The more experience low blood sugar, many do not have the ability to develop awareness of hypoglycaemia. The good news is that if you can avoid hypoglycemia in a few weeks, may start to become more aware of the impending low.
High blood sugar (hyperglycemia). Sugar can increase for many reasons, including eating too much, eating the wrong foods, not enough insulin, or illness.
Frequent urination.
Thirst.
Blurred vision.
Tired.
Nausea.
Discomfort.
Hungry.
Difficulty concentrating.
If you suspect hyperglycemia, check your blood sugar. You may need to adjust the meal plan or medication. If blood sugar is higher goals, management will need to "fix" using insulin or insulin through a pump. An additional dose of insulin for blood sugar levels back to normal. High blood sugar does not go down as fast as going up. Ask your doctor how long to wait until the check. If you use an insulin pump, random read high blood sugar can mean may need to change the dose pump.
If there are two measurements of continuous blood sugar over 250 mg / dL (13.9 mmol / L), ketone test using urine test strips. Do not exercise if your blood sugar is high or if ketones are present. If only a trace or small amounts of ketones are present, drink more water to discharge ketone.
If your blood sugar is continuous over 300 mg / dL (16.7 mmol / L), call your doctor or seek emergency care.
Increased ketones (ketoacidosis). If the cells are energy hungry, your body may begin to break down fat - producing toxic acids known as ketones.
The signs and symptoms of this serious condition include:
Nausea.
Vomiting.
Stomach pain.
Fruity breath.
Weight loss.
If you suspect ketoacidosis, check urine ketones excess with a ketone test kits. If you have large amounts of ketones in the urine, call your doctor immediately or seek emergency care. Also, call your doctor if you vomit more than once and have ketones in the urine.
Type 1 diabetes can affect many major organs in the body, including the heart, blood vessels, nerves, eyes and kidneys. Keep your blood sugar close to normal most of the time can reduce the risk of complications lot.
The long-term complications of type 1 diabetes develop gradually, over many years. Developed diabetes early - and less control blood sugar levels - the higher the risk of complications. Finally, the complications of diabetes can be disabling or even life-threatening.
Heart and blood vessel disease. Diabetes significantly increases the risk of heart disease, including coronary artery disease with chest pain (angina), heart attack, stroke, narrowing the arteries (atherosclerosis) and high blood pressure. In fact, about 65 percent of those who had died of diabetes due to some type of heart or vascular disease, according to the American Heart Association.
Nerve damage (neuropathy). Excess sugar can cause damage to the small blood vessels (capillaries) nourishing the nerves, especially in the legs. This can cause itching, numbness, or pain usually hot start toes or fingers and gradually spread upward. Hard to control blood sugar levels can cause loss of sensation in the affected limb. Damage to the nerves that control digestion can cause problems with nausea, diarrhea, vomiting or constipation. For men, erectile dysfunction can be a problem.
Damage to the kidneys. The kidneys contain millions of tiny blood vessels, cluster filtering wastes from the blood. Diabetes can damage the filter system. Serious damage can lead to kidney failure or end-stage renal disease can not be reversed, dialysis or a kidney transplant is required.
Damage to the eyes. Diabetes can damage the blood vessels of the retina (diabetic retinopathy), potentially leading to blindness. Diabetes also increases the risk of serious vision conditions, such as cataracts and glaucoma.
Damage legs. Nerve damage in the feet or poor blood flow increases the risk of foot complications. Without treatment, the wound can become serious infections. Serious damage toes, feet may require amputation.
Skin and mouth. Diabetes can be prone skin problems, including infections caused by bacteria and fungi. Oral infection may also be a concern, especially if there is a history of poor oral hygiene.
Osteoporosis. Diabetes can lead to lower bone density than normal, increasing the risk of osteoporosis.
Complications during pregnancy. High blood sugar can be dangerous for both mother and baby. The risk of stillbirth, miscarriage and birth defects is increased when diabetes is not well controlled. For the mother, diabetes increases the risk of diabetic ketoacidosis, diabetic retinopathy, pregnancy induced hypertension and preeclampsia.
Ear problems. Deaf occur more often in people with diabetes.
Tests and diagnosis
In June 2009, an international panel of experts from the American Diabetes Association, European Association for the study of diabetes and diabetes International. Recommend checking Type 1 diabetes include:
Glycated hemoglobin (HbA1c). This shows that the average level of blood sugar in the past two to three months. By measuring the rate of blood sugar attached to hemoglobin, the protein that carries oxygen in red blood cells. High blood sugar, sugar attached to the hemoglobin more. HbA1c level of 6.5 percent or higher on two separate tests indicates diabetes. results between 6 and 6.5 percent is considered prediabetes, indicating the risk of developing diabetes.
If HbA1c test is not available, or if certain conditions can cause the incorrect HbA1c tests - such as if you are pregnant or have abnormal form of hemoglobin (hemoglobin variant called) - doctor she can use the test to diagnose diabetes:
Random blood glucose testing. A blood sample will be taken at a random time. Glycemic values is shown mg / dL or millimoles / liter (mmol / L). Regardless of when to eat, blood sugar level of 200 randomly mg / dL (11.1 mmol / L) or higher indicates diabetes, especially when combined with any of the signs and symptoms of diabetes sugar, such as frequent urination and extreme thirst.
Test your blood sugar while fasting. A blood sample will be taken after fasting overnight. Fasting blood glucose levels below 100 mg / dL (5.6 mmol / L) is normal. The level of fasting blood glucose 100-125 mg / dL (5.6 to 6.9 mmol / L) is considered prediabetes. If the 126 mg / dL (7 mmol / L) or higher on two separate tests, have diabetes.
If you are diagnosed with diabetes, your doctor will also run blood tests to check for common autoantibodies in diabetes type 1. These tests help doctors distinguish between type 1 diabetes and type 2 . The presence of ketones - a byproduct of the breakdown of fat - in urine also showed type 1 diabetes, type 2 is more.
After diagnosis
Once you have been diagnosed with Type 1 diabetes, visit your doctor regularly to ensure good diabetes management. During the visit, the doctor will also check A1c levels. A1c goals may vary depending on the age and different factors, but in general the American Diabetes Association recommended HbA1c levels were below 7 percent, translated into an estimated average sugar is 154 mg / dL ( 8.5 mmol / L).
Compared with blood tests repeated daily, A1c test showed better treatment plan is good diabetes. High A1c may signal the need for a change in insulin regimen or diet plan.
In addition to the HbA1c test, the doctor will also take blood and urine samples periodically to check cholesterol levels, thyroid function, liver function and kidney function and to test for celiac disease. The doctor will also check to assess blood pressure, and check your blood sugar and insulin supply.
Treatments and drugs
Treatment of Type 1 diabetes is a lifelong commitment:
Using insulin.
Exercise regularly and maintain a healthy weight.
Eat healthy foods.
Monitoring blood sugar
The goal is to keep blood sugar levels as close to normal one, can delay or prevent complications. Although there are exceptions, in general, the goal is to keep blood levels between 80 during the day and 120 mg / dL (4.4 to 6.7 mmol / L) and the number of hours of sleep between 100 and 140 mg / dL (5.6 to 7.8 mmol / L).
If managing diabetes seems overwhelming, check out one day at a time. And remember that not alone. Working closely with the group treated diabetes - doctors, educators and diabetes dietitian registered - to keep blood sugar levels as close to normal as possible.
Insulin and other drugs
Anyone who has Type 1 diabetes, insulin therapy to survive.
The types of insulin are many and include the effect of fasting insulin, insulin-mediated effects and options. For example, regular insulin (Humulin R, Novolin R, others), isophane insulin (Humulin N, Novolin N), insulin lispro (Humalog), insulin aspart (Novolog), insulin glargine (Lantus) and insulin detemir (Levemir ). Depending on your needs, your doctor may prescribe a mixture of insulin types to use throughout the day and night.
Inhaled insulin (Exubera) previously available, but the manufacturer has stopped selling because too few people were using it. Since it was launched, this drug is related to the increase of lung cancer in people with a history of cigarette smoking. However, due to the number of additional cases of lung cancer is very small, not clear if there is a link to the drug. If using Exubera and a history of smoking, discuss these issues with your doctor.
Currently, the only option to get insulin into the body by injection or transfer. Insulin can not be taken orally to lower blood sugar because stomach enzymes interfere with insulin action.
Insulin injections can be done using a fine needle and syringe or pen - a device that looks like a pen.
Insulin pumps can also be an option. Pump is a device the size of a mobile phone worn on the outside of the body. A tube connects insulin by a catheter inserted under the abdominal skin. There is also wireless pumps available. Filled into subcutaneous insulin. The insulin can be worn on the abdomen, lower back, or legs or arms. This program is implemented with a wireless communication device with this result. Whether to use the pump, programmed to specific division automatic rapid-acting insulin. Stable dose of insulin is called the basic rate, and it supersedes any acting insulin is used.
Other drugs are sometimes prescribed, such as:
Pramlintide (Symlin). Injection before eating may slow down the movement of food through the stomach to limit the sharp rise in blood sugar after a meal occurs.
Low-dose aspirin. The doctor may prescribe a low dose aspirin therapy to prevent heart disease and blood vessels.
Blood pressure. Even if you do not have high blood pressure, your doctor may prescribe medications called angiotensin converting enzyme inhibitors (ACE) inhibitors or angiotensin II receptor blockers (ARBs), because these drugs may help keep a healthy kidney in reducing blood pressure. It is recommended to people with diabetes have lower blood pressure of 130/80 millimeters of mercury (mm Hg).
Cholesterol-lowering drugs. As with high blood pressure medicines, doctors have cholesterol-lowering drugs called statins. This guide is harder for people with diabetes because of the high risk of heart disease. The American Diabetes Association recommends that the density of low-density lipoprotein (LDL, or "bad") cholesterol below 100 mg / dL and high density lipoprotein (HDL, or "good") cholesterol above 50 mg / dL. Triglycerides, a type of fat in the blood, is ideal when less than 150 mg / dL.
Healthy Eating
Contrary to popular perception, it is not a diet diabetes. Not restricted. Instead, it will need a lot:
Fruits.
Rau.
The grains.
These foods are high in nutrients and low in fat and calories. This means that animal products and sweets less. This really is the best diet plan, even for people without diabetes.
Will need to learn to eat foods can give yourself enough insulin to metabolize carbohydrates properly. A dietitian can help create a meal plan in line with the objectives of health, food preferences and lifestyle.
Physical Activity
Everyone needs regular aerobic exercise, and people with type 1 diabetes are no exception. Then select the proper operation, such as swimming, walking or cycling. The most important is to make physical activity a part of daily routine. The goal of at least 30 minutes of aerobic exercise a day and most of the week. Episode lasting and strength are important. If no activity for a while, start slowly and build up gradually.
Remember that physical activity reduces blood sugar levels, often for long periods after implementation. If starting a new activity, check your blood sugar more often than usual until the said activities that affect blood sugar. You may need to adjust the meal plan or insulin to compensate for the increased activity. If you use an insulin pump, may establish a temporary bottom to keep blood sugar levels. Ask your doctor to see how.
Monitoring blood sugar
Depending on the type of insulin therapy or select required - single dose, multiple injection or insulin pump - may need to check and record blood glucose at least four times a day, and maybe more . Careful monitoring is the only way to ensure blood sugar levels remain within the target range. Be sure to wash your hands before you check your blood sugar to get the most accurate.
Even when insulin and eat in a rigid schedule, blood sugar levels can fluctuate. With help from the group treated diabetes, learn how to alter blood sugar levels in response to:
Food. What type and how much will affect your blood sugar. Blood sugar levels are often highest in 1-2 hours after a meal.
Physical activity. Physical activity moves sugar from the blood into the cells. Lower blood sugar levels. To compensate, you may need to reduce the dose of insulin before physical activity.
Medicines. For insulin to reduce blood sugar levels. However, other medicines may affect blood sugar levels, sometimes requiring changes in the treatment plan diabetes.
Illness. A cold or illness, the body produces hormones that increase blood sugar levels. This may require a change in treatment plan diabetes.
Alcohol. Alcohol can cause either high or low blood sugar, depending on how much drinking and eating at the same time. If you choose to drink, do so in moderation, which means no more than one drink per day for women and two drinks daily or less for men.
Stress. The hormones your body may produce in response to prolonged stress may prevent insulin function properly.
Women, hormone fluctuations. For hormone levels fluctuate during the menstrual cycle, possibly blood sugar level changes - especially in the week before menstruation. Menopause can cause fluctuations in blood sugar levels.
Continuous Glucose Monitoring (CGM). A new way to monitor blood sugar levels, and may be useful for those who have no awareness of hypoglycaemia. Continuous glucose monitoring using a small needle under the skin to test blood glucose levels every few minutes. CGM has not been considered in blood glucose monitoring accuracy standards, so do not be regarded as an alternative method for monitoring blood sugar levels, but more a measure.
Related situations
Certain life circumstances considered different.
Driving. Hypoglycemia can occur at any time, even while driving. Check your blood sugar anytime're behind the wheel. If it is less than 70 mg / dL (3.9 mmol / L), have a snack and then check again in 15 minutes to make sure it rises to a level of safety. Low blood sugar may make it difficult to concentrate or to react as fast as possible to reach while driving.
Work. In the past, people with type 1 diabetes often refuse certain jobs because they have diabetes. Fortunately, advances in the management of diabetes and anti-discrimination law has implemented a ban. However, type 1 diabetes can cause a number of challenges in the workplace. For example, if you work in jobs related to driving or operating heavy machinery, hypoglycemia can cause serious danger.
Pregnancy. Because of the risk of complications during pregnancy for women with diabetes type 1, the experts recommend that women have rated prejudices and A1c less than 7 percent before trying to get pregnant. Some medications such as high blood pressure and cholesterol lowering drugs, may need to stop before pregnancy. The risk of birth defects increased for women with type 1 diabetes, especially when poorly controlled diabetes in the first week from six to eight of pregnancy, therefore, planned pregnancy is important . Careful management of diabetes in pregnancy may reduce the risk of complications.
Elderly. When still active and have normal cognitive abilities, goals of diabetes management can be like when young. However, for those weak, ill or impaired cognition, strict control of blood sugar may not be practical. If you are caring for a person with type 1 diabetes, ask your doctor what is the goal of diabetes need.
Treatments reference
Pancreas transplantation. With successful pancreas transplant, ó may not need insulin. But pancreas transplants are not always successful - and the procedure poses serious risks. Need lifetime powerful immunosuppressive drugs to prevent organ removal. These drugs can have serious side effects, including increased risk of infection and organ injury. Because these side effects can be more dangerous than diabetes, pancreas transplant is often very difficult for people to control diabetes.
Cell transplantation. Researchers also are experimenting with islet cell transplantation, providing new insulin-producing cells from a donor pancreas. Although this experimental procedure had problems in the past with the technology, and better drugs to prevent islet cell removal may improve the chances for success in the future. However, islet cell transplantation still requires the use of immunosuppressant drugs, and just as it did with its natural cells, the body often destroys transplanted islet cells. In addition, a sufficient supply of islet cells are not available for this treatment became popular.
Stem cell transplantation. In a study of Brazil in 2007, a handful of people newly diagnosed with type 1 diabetes can stop using insulin after being treated with stem cells from his blood. Although stem cell transplantation - is related to the closure of the immune system and then build it up again - can be dangerous, may be one of those providing additional treatment options for patients Type 1 diabetes.
Signs of trouble
Despite our best efforts, sometimes problems will arise. Some short-term complications of type 1 diabetes need to take care of immediately. If untreated, these conditions can cause seizures and loss of consciousness (coma).
Low blood sugar (hypoglycemia). This occurs when blood glucose levels fell much below the target. Ask your doctor what is considered low blood sugar levels. Blood sugar levels can be reduced for many reasons, including skipping a meal, the more physical activity than normal or injecting too much insulin.
Learn the symptoms of low blood sugar, and blood sugar checks if thought reduce blood sugar levels. When in doubt, always check your blood sugar. Signs and symptoms of low blood sugar include:
Sweating.
Run.
Hungry.
Weakness.
Worried.
Dizziness.
Pale.
Fast or irregular heartbeat.
Tired.
Headache.
Blurred vision.
Discomfort.
Then, signs and symptoms of low blood sugar, which can sometimes be mistaken for alcohol intoxication in teens and adults include:
The lethargy.
Confusion.
Behavior change, sometimes dramatically.
Poor coordination.
Seizures.
If you develop hypoglycemia at night, may wake up with headaches or sweat. Thanks to the effects of natural recovery, nighttime hypoglycemia can cause high blood sugar abnormalities in the morning.
If you have low blood sugar, some juice, sugar, hard candy, soda, or other sources of sugar. Then check blood sugar in about 15 minutes to make sure it has increased to normal levels. If it is not in the normal range, with more sugar (juice, candy, glucose member or another source of sugar) and then check back in 15 minutes. Keep doing this until you get normal results. A good idea to eat a meal or snack when received normal results. A feed mixture, such as peanut butter and crackers, can help stabilize blood sugar.
If the blood glucose meter is not available, the treatment of low blood sugar if you have symptoms of hypoglycemia, and then test as soon as possible.
Always carry a quick source of sugar effect. If untreated, low blood sugar will cause loss of consciousness. If this happens, you may need an emergency injection of glucagon - a hormone that stimulates the output of sugar in the blood. Be sure to always have a glucagon emergency kit - at home, at work, when out - and make sure it does not expire.
Hypoglycemia without awareness. Some people may lose the ability to sense blood sugar levels are going down, because they have developed a condition called awareness of hypoglycaemia. With no awareness of hypoglycemia, the body no longer respond to low blood sugar with symptoms such as dizziness or headache. The more experience low blood sugar, many do not have the ability to develop awareness of hypoglycaemia. The good news is that if you can avoid hypoglycemia in a few weeks, may start to become more aware of the impending low.
High blood sugar (hyperglycemia). Sugar can increase for many reasons, including eating too much, eating the wrong foods, not enough insulin, or illness.
Frequent urination.
Thirst.
Blurred vision.
Tired.
Nausea.
Discomfort.
Hungry.
Difficulty concentrating.
If you suspect hyperglycemia, check your blood sugar. You may need to adjust the meal plan or medication. If blood sugar is higher goals, management will need to "fix" using insulin or insulin through a pump. An additional dose of insulin for blood sugar levels back to normal. High blood sugar does not go down as fast as going up. Ask your doctor how long to wait until the check. If you use an insulin pump, random read high blood sugar can mean may need to change the dose pump.
If there are two measurements of continuous blood sugar over 250 mg / dL (13.9 mmol / L), ketone test using urine test strips. Do not exercise if your blood sugar is high or if ketones are present. If only a trace or small amounts of ketones are present, drink more water to discharge ketone.
If your blood sugar is continuous over 300 mg / dL (16.7 mmol / L), call your doctor or seek emergency care.
Increased ketones (ketoacidosis). If the cells are energy hungry, your body may begin to break down fat - producing toxic acids known as ketones.
The signs and symptoms of this serious condition include:
Nausea.
Vomiting.
Stomach pain.
Fruity breath.
Weight loss.
If you suspect ketoacidosis, check urine ketones excess with a ketone test kits. If you have large amounts of ketones in the urine, call your doctor immediately or seek emergency care. Also, call your doctor if you vomit more than once and have ketones in the urine.
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