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DIABETES

When Low Blood Glucose Gets Serious

Tight diabetes management is good for your health, but it can put you at risk for low blood glucose. If you're trying for tight management, keep glucagon handy for emergencies. If it is not an emergency, food is a better, and less expensive option.
Glucagon raises blood glucose. In many ways, it does the opposite of what insulin does. You can get glucagon with a prescription from your doctor. Someone in your household must know how to mix up the glucagon and inject it if you become severely hypoglycemic, confused, and unable to swallow food. This will need to be done quickly.

Glucagon will raise your blood glucose within 10 to 15 minutes, but its effect doesn't last long. Eat some crackers after you become fully conscious again. Some people are nauseated after receiving glucagon. Most severe episodes of low blood glucose happen while you sleep, so always keep it in one place, such as the refrigerator door. Your caregiver will be able to find it quickly.

Getting a Diabetes Education

Learning that you have diabetes can be an overwhelming experience. You're likely to have dozens of questions about how to manage this new responsibility. This is why you should see a diabetes educator as soon as you find out that you have the disease. Diabetes educators are key members of your diabetes treatment team. You should be able to find one in your town or in a larger community nearby. Most diabetes educators are nurses or dietitians, but any health care professional with an interest in diabetes management may become trained as a certified diabetes educator (CDE).
An educator can teach you how to monitor your blood glucose, give yourself insulin injections, treat and recognize low and high blood glucose, take pills, and make successful lifestyle changes.

Follow-up visits are important, too. See an educator when you need to make major lifestyle changes or if you have problems with diabetes management. An educator can help you adjust your meal plan and medication if you start exercising, for example. Or he or she could help you make changes if you develop other health problems, or if you're going through a major life event, or retiring. Even if everything is going smoothly, an educator can teach you the latest developments in diabetes care. Education, in general, can make you much healthier

Slow Digestion, Low Blood Glucose?

If you've had diabetes for many years, you may digest food very slowly. This is usually due to nerve damage in and around your stomach — a condition called gastroparesis. This condition, and the unpredictable digestion patterns that go along with it, can make it difficult to achieve normal blood glucoses.
If it takes many hours for your stomach to empty after a meal, you risk low blood glucose, especially if you normally take your insulin 45 minutes before you eat. If you're on this regimen, the insulin's effects will peak before all the food in your stomach is completely digested. When this happens, you may have high blood glucose for many hours after you eat.

There are several medications available that can improve your digestion. Discuss these medications with your health care team.

Tailored Treatment for Type 1

Diabetes meal plans have changed quite a bit in the last decade. In the past, people with type 1 diabetes were told to follow strict eating patterns. Rich foods like pizza and ice cream were strictly off limits. The timing, amount, and kind of meals people could eat were restricted, and the food you ate had to be matched to your insulin dose.
Luckily, things are a little more flexible now. Since rapid-acting insulin became readily available, people with type 1 diabetes can follow a normal, balanced diet. Insulin can be matched to your daily lifestyle, instead of the other way around. For example, a salad with chicken strips and a diet cola might require one or two units of insulin. Two slices of pizza, a glass of milk, and ice cream might require 10 units.

With training from your diabetes care team and a little personal experience, you can learn how much insulin you need to control your blood glucoses for different types of meals. If you are using the old-style therapy of pattern control, talk to your diabetes care team about how to adapt your dosage to the food you eat. You may also contact the American Association of Diabetes Educators at (800) 832-6874 to find someone who can help you with your diabetes meal plans.

Type 1 or 2?

If you're just learning about diabetes, you should know that the disease is categorized into two types, called type 1 and type 2.
If a person has type 1 diabetes, their body stops producing insulin, a substance in the body that's essential for using and storing nutrients. This usually occurs at a young age. People with type 1 diabetes will require insulin injections for life. Without it, they would go into diabetic coma within a day or two. In the past, this disease was called insulin-dependent diabetes mellitus (IDDM).

People with type 2 diabetes produce enough insulin, especially when they first develop the disease, but their bodies are unable to use it correctly to lower blood glucose. (This is called insulin resistance.) Many people with type 2 diabetes are able to control their blood glucose with diet, exercise, and oral medications. In the past, this type of diabetes was called non-insulin-dependent diabetes mellitus (NIDDM). After several years with type 2 diabetes, many people will stop producing insulin and will need to inject it on a regular basis