Any questions on

diabetes? Common questions and

diabetes dictionary

www.withyoualltheway.info

At Novo Nordisk, we are changing diabetes. In our approach to developing treatments, in our commitment to operate profitably and ethically and in our search for a cure.

ALEKSEY EVSTRATOV, Russia

Aleksey has type 1 diabetes

This information is not designed to replace the advice of a healthcare professional. Please consult your doctor or nurse if you have any questions or concerns about managing your diabetes.

With you all the way is a patient support programme created by Novo Nordisk, providing practical information on diabetes and its management for children and young adults with diabetes.

This material has been reviewed by a panel of experts:

� Lead Diabetes Specialist Nurse – Nicola Lewis, UK

� Paediatric Endocrinologists – Prof Thomas Danne, Germany and Dr Nandu Thalange, UK

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Should I aim for higher blood glucose levels to avoid hypoglycaemia?Hypoglycaemia is not a pleasant experience and you may worry about it happening in front of other people. However, keeping blood glucose levels high can be dangerous and may lead to long-term complications.

Take a look at the ‘Why do I need to take insulin?’ leaflet for more information.

Will insulin make me fat?You may notice that you put on weight, particularly when you first start taking insulin.2 The best approach to maintain a healthy weight is to eat healthily and exercise regularly.

If you are concerned about your weight, speak to your doctor or nurse.

Take a look at the ‘How do I stay healthy?’ leaflet for more information.

Why do I need to take insulin every day? As your pancreas is no longer able to make insulin, you will need to take insulin every day.1 Taking insulin, either by injection or using a pump, helps to regulate your blood glucose levels.1 If you are receiving injections, you will need to inject insulin several times a day.1

Your doctor or nurse will advise when and how much insulin you need to take.

Take a look at the ‘Why do I need to take insulin?’ leaflet for more information.

Common questions on diabetesHere are answers to some of the most common questions about growing up with diabetes:

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How often should I exercise?You should try and be active for 30 to 60 minutes each day.3

Physical activity is an important part of diabetes management. Activity helps to lower your blood glucose levels and has other health benefits.

Benefits of regular exercise:3

� Makes you feel better

� Helps with weight management

� Improves general physical fitness

� Improves cardiovascular health

Even if you are not sporty, there are lots of other enjoyable ways to stay active, such as walking or dancing.

Take a look at the ‘How do I stay healthy?’ leaflet for more information.

Can I drive a car?When you are old enough, you may want to learn to drive a car. Having diabetes shouldn’t stop you from driving, but you will need to make sure your blood glucose levels are OK before you get behind the wheel.

When you have hypoglycaemia your reaction times and ability to drive can be affected.3 So it is important that you learn to assess the early signs of hypoglycaemia and test yourself before you drive!

National regulations differ, but you may need to notify your driving licence agency and insurance company of your diabetes.4

Take a look at the ‘How will diabetes affect me?’ leaflet for more information.

Can I go away on holiday?There is no reason why diabetes should stop you from enjoying your holidays. They will just need a bit more planning!

You will need a letter from your doctor to fly with your insulin pen and needles or pump. You will also need to make sure you have all the supplies you need to manage your diabetes for the duration of your stay (e.g. enough insulin, needles, lancets, blood and ketone test strips, a spare blood glucose meter and insulin pen).

Take a look at the ‘How will diabetes affect me?’ leaflet for more information.

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Can I drink alcohol?It is important that you are aware of the effects of alcohol on your body and look after yourself so you don’t put yourself in danger. Alcohol will affect your blood glucose levels and drinking too much may impair your ability to manage your diabetes properly. You should always eat before drinking because alcohol consumption may lead to delayed hypoglycaemia.

Take a look at the ‘How do I fit diabetes into my life?’ leaflet for more information.

Can I still go to parties?Having diabetes doesn’t mean you can’t go to parties and enjoy yourself.

You can still eat party food and drink, as long as you monitor your blood glucose levels and adjust your insulin if necessary. If there is alcohol at the party, try and drink in moderation and eat snacks.

You should test your blood glucose after the party and again at bedtime to check your levels. You may need to adjust your insulin dose to help keep the balance.5

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How do I tell my friends about my diabetes?Speaking to friends about diabetes can be difficult. You may worry that it will change your friendship. But your friends will soon see that you are no different now than you were before you were diagnosed. Your friends may not have heard of diabetes before, so they will probably be interested in finding out more.

With a better understanding of diabetes they may be able to help support you when you are out together.

Take a look at the ‘How do I fit diabetes into my life?’ leaflet for more information.

When should I tell my boyfriend/girlfriend about my diabetes?There is no set time when you should tell your boyfriend/girlfriend about your diabetes. However, you should probably discuss it with them before you start to have an intimate relationship.

Take a look at the ‘How do I fit diabetes into my life?’ leaflet for more information.

Can I take other medications with my insulin?Some medicines may lead to increases or decreases in blood glucose levels. For example, some oestrogen-containing contraceptive pills may affect blood glucose levels.6

The information leaflet that comes in the packet with your insulin will list which medications can affect glucose control. Speak to your doctor or nurse for further information and advice.

SUDE IĞDIR, Turkey

Sude has type 1 diabetes5

Can I take my insulin pump off?You may want to remove your pump during some activities, such as swimming and other sports, or sex. This is usually OK for a short time (maximum of 2 hours) – but you should speak to your doctor or nurse before you do this.7

When you are disconnected from the pump and not receiving insulin, your blood glucose levels may rise. But physical activity will lower blood glucose levels.7 If you can, it may be a good idea to test your blood afterwards to check your levels.7

Remember to reconnect your pump properly after your activity and before you go to sleep.

Your doctor or nurse will be able to advise you on how to manage your diabetes when you are disconnected from your pump.

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Diabetes dictionary

Blood glucose The concentration of glucose in the bloodstream – the body’s main source of energy.8

Carbohydrate A type of food that provides the body with energy. Carbohydrates are mainly sugars and starches that are broken down into glucose, a simple sugar that the body’s cells use as fuel.9

Complex carbohydrate Complex carbohydrates have a long-acting effect on blood glucose. Starchy foods and fibre are examples of complex carbohydrates.10

Diabetic ketoacidosis (DKA) Diabetic ketoacidosis is a life-threatening condition which happens when there is a lack of insulin and fats are broken down to provide energy. This results in the body producing chemicals called ‘ketones’.11

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Fast-acting insulin This type of insulin acts quickly. It is typically given around mealtimes to help prevent high blood glucose levels.11

Glucose Glucose is a type of sugar. People with diabetes have a high level of blood glucose (without insulin treatment).12

Insulin Insulin is a hormone which helps the body to deliver blood glucose to cells that need it.12

HbA1c This is a blood test to measure your blood glucose levels and work out how well controlled your diabetes has been over the last 2–3 months.13

Hormone A chemical released in the body which helps to control functions in other cells in the body. Insulin is a hormone which helps cells to remove blood glucose from the bloodstream so other cells can use it for energy.13

Hyperglycaemia This term is used for high blood glucose or sugar levels. This occurs when there is a lack of insulin so glucose is not removed from the bloodstream.12

Hypoglycaemia This term is used for low blood glucose or sugar levels. Hypoglycaemia can be caused by taking too much insulin, not eating enough or by being more active than usual (without eating a snack or changing the insulin dose).14

Ketones Chemical produced when there is a shortage of insulin in the blood and the body breaks down body fat for energy. High levels of ketones make you unwell.8

Long-acting/intermediate insulin This type of insulin is usually given once or twice each day to provide a constant supply of insulin.11

Pancreas The pancreas is an organ found next to your stomach which produces insulin.1

Premixed insulin A mixture of a fast-acting insulin and a longer acting insulin, usually injected before breakfast and dinner.11

Pump A device that delivers insulin via a tube that is inserted under the skin in the abdomen.5

Simple carbohydrate Simple carbohydrates are fast-acting and increase blood glucose levels quickly. Fruit and cake are examples of simple carbohydrates.10

Type 1 diabetes Type 1 diabetes happens when your body stops making insulin.12

Type 2 diabetes Type 2 diabetes happens when not enough insulin is made by the body or the body cannot use insulin properly.12

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LARS MYHRER, Norway Lars has type 1 diabetes

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References 1. NIH Medline Plus Library. Type 1 diabetes.

Available at: www.nlm.nih.gov/medlineplus/ency/article/000305.htm Accessed October 2012.

2. American Diabetes Association. Deborah Young-Hyman, PhD: Evaluating the risk of eating disorders in teenagers with type 1 diabetes. Available at: www.diabetes.org/news-research/research/research-discoveries/in-the-news/evaluating-the-risk-of- eating.html Accessed October 2012.

3. Silverstein J et al. Care of children and adolescents with type 1 diabetes. Diabetes Care 2005; 28(1): 186–212.

4. Diabetes UK. Driving. Available at: www.diabetes.org.uk/Guide-to-diabetes/Living_with_diabetes/Driving/ Accessed October 2012.

5. Diabetes UK. My life (Teens). Available at: www.diabetes.org.uk/Guide-to-diabetes/My-life/Teens/ Accessed October 2012.

6. American Diabetes Association. Tips: Women’s Health. Available at: www.diabetes.org/diabetes-basics/tips/ Accessed October 2012.

7. Diabetes.co.uk. Sex and insulin pumps. Available at: www.diabetes.co.uk/sex-and-insulin-pumps.html Accessed October 2012.

8. American Diabetes Association. Common terms. Available at: www.diabetes.org/diabetes-basics/common-terms/ Accessed October 2012.

9. Children with diabetes. Diabetes dictionary. Available at: www.childrenwithdiabetes.com/dictionary/b.htm Accessed October 2012.

10. NIH Medline Plus Library. Carbohydrates. Available at: www.nlm.nih.gov/medlineplus/ency/article/002469.htm Accessed October 2012.

11. Diabetes UK. Children and diabetes. Available at: www.diabetes.org.uk/Information-for-parents/ Accessed October 2012.

12. NIH Medline Plus Library. Diabetes. Available at: www.nlm.nih.gov/medlineplus/ency/article/001214.htm Accessed October 2012.

13. NIH MedlinePlus Merriam-Webster Medical Dictionary. Available at: www.merriam-webster.com/medlineplus/ Accessed October 2012.

14. Novo Nordisk website. Available at: www.novonordisk.com Accessed October 2012.

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www.withyoualltheway.info

This information is not designed to replace the advice of a healthcare professional. Please consult your doctor or nurse if you have any questions or concerns about managing your diabetes.

APROM ID#4596; approval date: December 2012.

Changing Diabetes® and the Apis bull logo are registered trademarks of Novo Nordisk A/S. Novo Nordisk A/S Novo Alle 2880 Bagsværd Denmark

About Novo Nordisk

This information was developed by Novo Nordisk, a global healthcare company specialising in the care of people with diabetes.

Novo Nordisk was started up almost 90 years ago by a Danish couple with a passion for changing diabetes. August Krogh was a professor at the University of Copenhagen and Nobel Prize winner and his wife Marie, a doctor and researcher into metabolic diseases, suffered from type 2 diabetes. They learned of insulin being developed in Canada and were determined to ensure access to insulin for everyone with diabetes, hence in 1923 Novo Nordisk was born.

Since then Novo Nordisk has grown to become a world leader in the provision of diabetes products and support for patients of all ages.14

We fully understand the challenges that children with diabetes face and are working together with parents, schools and healthcare professionals to improve the care of children with diabetes, as they grow up and develop.

For more information about Novo Nordisk, please visit: www.novonordisk.com