diabetes- are you a victim bookbing.org
TRANSCRIPT
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
1/146
Take Chargeof Your
DIABETES
U.S. DEPARTMENT OF HEALTH
AND HUMAN SERVICES
Centers for Disease Control and Prevention
National Center for Chronic Disease
Prevention and Health Promotion Diabetes
TM
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
2/146
This book belongs to
_____________________________________________
If found, please call or write me at
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
3/146
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
4/146
The Centers or Disease Control and Preventions (CDCs)
Diabetes Program supports diabetes control programs in all
states, the District o Columbia, and eight U.S. territories orisland jurisdictions. You may contact your local program or
more inormation on diabetes.
To get contact inormation,
call toll ree 1-800-CDC-INFO (232-4636),
E-mail [email protected]. Inormation available in English,
and Spanish 24 Hours/Day, 7 Days/Week.
This book is in the public domain. Anyone may reproduce anyor all o the contents. It is also available on the Internet at
www.cdc.gov/diabetes, or you can call toll ree
1-877-CDC-INFO (232-4636) or more inormation or a copy
o this book and others. This book is also available
in Spanish.
Links or reerences to nonederal organizations mentioned in
this book or in the resource list are provided solely as a
service to our users. These links and reerences do not
constitute an endorsement o these organizations or theirprograms by CDC or the ederal government, and none
should be inerred. CDC is not responsible or the content o
the individual organization Web pages ound at these links.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
5/146
Many o us strive or a sense o balance in our
lives. We want to keep our goals in harmony with
our minds and souls. People with diabetes oten
have stories to share about their struggles orbalance and harmony in their lives. We can honor
people by listening to and learning rom their stories
to fnd meaning and hope or our own lives.
An old, well-loved story, told around the world,
is about the turtle and a sure-ooted animal, like
a rabbit. In this story, the turtle tricks the other
animal to win a racesimply by not giving up andby staying on its path. And it has to stick its neck
out! It takes determination like that to ace diabetes,
day ater day, reminding yoursel that you can
do it i you stick to it!
There are about 250 kinds o turtles, and almost
all have the same pattern on their top shell13
plates that ft together in harmony and balanceto orm a strong shell. The turtle and its shell can
remind us o the harmony and balance we seek in all
parts o our livesincluding living with diabetes.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
6/146
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
7/146
Some Words o Thanks . . . . . . . . . . . . . . . . . . . . . . vii
1 Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Controlling Your Diabetes . . . . . . . . . . . . . . . . 13
3 Keeping Track o Your Blood Glucose . . . . . . . 21
4 Feelings About Having Diabetes . . . . . . . . . . . 41
5 Eye Problems . . . . . . . . . . . . . . . . . . . . . . . . . . 43
6 Kidney Problems. . . . . . . . . . . . . . . . . . . . . . . . 47
7 Heart and Blood Vessel Problems . . . . . . . . . . 51
8 Nerve Damage. . . . . . . . . . . . . . . . . . . . . . . . . . 55
9 Foot Problems . . . . . . . . . . . . . . . . . . . . . . . . . . 59
10 Dental Disease . . . . . . . . . . . . . . . . . . . . . . . . . 65
11 Vaccinations . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
12 Pregnancy and Womens Health . . . . . . . . . . . 73
RECORDS
Records or Sick Days . . . . . . . . . . . . . . . . . . . . 79
Tests and Goals or Each Visit . . . . . . . . . . . . . 89
Tests and Goals or Each Year . . . . . . . . . . . . . 99Glucose Log Sheets . . . . . . . . . . . . . . . . . . . . . 105
Your Health Care Team . . . . . . . . . . . . . . . . . 109
GLOSSARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117
RESOURCES . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
8/146
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
9/146
This guide was written by sta in the Centers or
Disease Control and Preventions (CDCs) Division
o Diabetes Translation. The division is part o the
National Center or Chronic Disease Prevention
and Health Promotion, Department o Health and
Human Services. We work with partners who share
our mission to reduce the burden o diabetes in
communities.
William H. Herman, MD, MPH, was the general
editor o the frst book, Take Charge o Your
Diabetes: A Guide or Care, printed in 1991. We
asked people with diabetes who read the frst book
to help us make the second book even more useul.
For this ourth edition o the book, we have updated
the scientifc acts, resources, and art.
The American Association o Diabetes Educators
did a survey among people with diabetes and
diabetes educators to learn what people liked and
didnt like about the frst book. Focus groups made
up o people with diabetes were held by the Health
Promotion Council o SE Pennsylvania and Casals
and Associates o Washington, DC. The groups gave
us valuable input to help us make later books more
useul.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
10/146
Important support or this books emphasis on
glucose control came rom the Diabetes Control
and Complications Trial. Conducted by the
National Institute o Diabetes and Digestive andKidney Diseases, National Institutes o Health,
this important study provided scientifc proo
that glucose control can help prevent or delay
complications o diabetes.
Dawn Satterfeld, PhD, RN, CDE and Patricia
Mitchell o the CDC diabetes divisions Health
Communications Section were the lead writerso this book. Ann Constance, Claudia Martinez,
Hope Woodward, Margaret Fowke, Nancy Haynie-
Mooney, Melinda Salmon, Mike Engelgau, and the
Chattahoochee Nature Center also helped with the
writing. Rick Hull, Diana Toomer, Melissa Stankus,
and Kristina Ernst reviewed and edited the fnal
version o this guide. Most o the drawings were
provided by the Public Health Practice ProgramOfce, CDC, some o which were modifed or the
book Take Charge o Your Diabetes: A Shortened
Overview or Pacifc Basin Island Populations
through the National Diabetes Education Program.
Cygnus Corporation assisted with design and layout
o the second edition. Further publication support
or the third edition was provided by Palladian
Partners, Inc., under Contract 200-98-0415 or theNational Center or Chronic Disease Prevention and
Health Promotion, CDC, Department o Health and
Human Services.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
11/146
Diabetes touches almostevery part o your lie.
Its a serious, lielong
condition, but theres a
lot you can do to protect
your health. You can
take charge o your
healthnot only
or today, but or thecoming years.
Diabetes can cause
health problems over time. It can hurt your eyes,
your kidneys, and your nerves. It can lead to
problems with the blood ow in your body. Even
your teeth and gums can be harmed. Diabetes
in pregnancy can cause special problems. Manyo these problems dont have to happen. You can
do a lot to prevent them, and there are people in
your community who can help. This book can help
you fnd how to get the help you need to prevent
problems.
Today and every day, strive to balance your ood,
physical activity, and medicine. Test your own bloodglucose (also called blood sugar) to see how this
balance is working out. Then make choices that help
you eel well every day to protect your health.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
12/146
Feeling healthy can allow you to play a big part in
the lie o your amily and community. You may even
want to join a community group in which people
share their stories and help others deal with theirdiabetes.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
13/146
Take Charge of Your Diabetes was written to
help you take important steps to prevent problems
caused by diabetes. Youll learn many useul things:
What problems diabetes can cause.
How to work with a health care team to prevent
problems.
Why it is important to get your blood glucose
and blood pressure closer to normal.
How to fnd out about resources in yourcommunity to help you prevent problems.
Its important to work with a primary health care
provider, as well as other members o a team who
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
14/146
care about your health. To fnd out about resources
in your community, contact one o the groups listed
below:
Diabetes organizations, listed on pages
127129 o this book.
Local diabetes programs or hospitals.
Your state health departments diabetes
prevention and control program, which you can
fnd by calling 800-CDC-INFO.
Ask your health care team to look over this book
with you. Stay in touch with them so you will know
the latest news about diabetes care.
Balance is the key word in living well with diabetes.
Strive or balance in all parts o your lie. With the
support o your amily and riends, your health care
team, and your community, you can take charge o
your diabetes.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
15/146
This book was mainly written or people who
ound out they had diabetes as an adult. You shoulduse it along with other inormation your health care
providers give you.
I youve just learned you have diabetes, youll
need more details than youll fnd in this book.
Ask your health care provider or help. See the
list beginning on page 127 or phone numbers,
addresses, and web sites o organizations whereyou can get more inormation. Find out as much as
you can about the three most important things or
controlling your diabetes: ood, physical activity, and
diabetes medicine.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
16/146
When youre reading this book, note these points:
Words in bold print are explained in theglossary, which starts on page 117.
The orms at the back o this book can help you
and your health care team keep records o your
care.
On pages 127129, youll fnd a list o health
organizations that you can call, write, or
E-mail or more inormation about diabetes.
When we say health care team, we include all
the people who work with you to help manage
your diabetes: primary doctor, dietitian, nurse,
diabetes educator, counselor, oot doctor, eye
doctor, dentist, pharmacist, community health
worker, and others.
The chapters in this book deal with many
topics. You may frst want to read the parts that
deal with your own special concerns. Take your
time reading this book. Theres a lot to read, but
you dont have to read it all at once.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
17/146
You can use this book to keep some records about
your health. The orms to write down details aboutyour health begin on page 79. You can cut out these
pages to take with you on your diabetes care visits.
You may also want to make extra copies to use in the
uture. Go over these records oten with your health
care team. Keeping track o your health is one o the
ways you can work together to control your diabetes.
On page 109, write down the names and telephonenumbers o your health care team. Theres enough
room on these pages to write questions and other
points you want to remember when you go to your
visits every 4 to 6 months. On page 116, you may
want to write down some contacts or community
groups that deal with diabetes.
Dr. B. Harper222-222-2222
What was my last A1C result?
When is my next eye exam due?
Aim for glucose 90-130 before eating. Less 180 1-2 hours after beginning to eat. Check my feet every day.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
18/146
Most o the ood we eat is turned into glucose
(sugar) or our bodies to use or energy. Thepancreas, an organ near the stomach, makes ahormone called insulin to help glucose get intoour body cells. When you have diabetes, your bodyeither doesnt make enough insulin or cant use its
own insulin very well. This problem causes glucose
to build up in your blood.
Diabetes means that a persons blood sugar is toohigh. Your blood always has some sugar in it be-
cause the body needs sugar or energy to keep you
going. But too much sugar in the blood can cause
serious damage to the eyes, kidneys, nerves, and
heart.
You may recall having some o these signs beore
you ound out you had diabetes:
Being very thirsty.
Urinating a lototen at night.
Having blurry vision rom time to time.
Feeling very tired much o the time.
Losing weight without trying.
Having very dry skin.
Having sores that are slow to heal.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
19/146
Getting more inections than usual.
Losing eeling or getting a tingling eeling in
the eet.
Vomiting.
There are two main types o diabetes:
Type 1.
Type 2.
Another type o diabetes appears during
pregnancy in some women. Its called gestationaldiabetes. See page 75 to learn more about this typeo diabetes.
One out o 10 people with diabetes has type 1
diabetes. These people usually fnd out they have
diabetes when they are children or young adults.
People with type 1 diabetes must inject insulinevery day to live. The pancreas o a person with
type 1 makes little or no insulin. Scientists are
learning more about what causes the body to attack
its own beta cells o the pancreas (an autoimmuneprocess) and stop making insulin in people withcertain sets o genes.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
20/146
Most people with diabetes9 out o 10havetype 2 diabetes. The pancreas o people with type 2
diabetes keeps making insulin or some time, but
the body cant use it very well. Most people with
type 2 fnd out about their diabetes ater age 30
or 40.
Certain risk actors make people more likely to
develop type 2 diabetes. Some o these are
A amily history o diabetes.
Lack o exercise.
Weighing too much.
Being o Arican American, American Indian,
Alaska Native, Hispanic/Latino, or Asian/PacifcIslander heritage.
Gestational diabetes history.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
21/146
You can help manage your diabetes by controlling
your weight, making healthy ood choices, and
getting regular physical activity. Ask or help rom
your health care team. Some people with type 2diabetes may also need to take diabetes pills orinsulin shots to help control their diabetes.
Some people with diabetes are concerned about
their amily members getting diabetes. A national
study shows that people may be able to prevent or
delay the onset o type 2 diabetes. To fnd out more,
talk to your health care provider, visit the CDCDiabetes Web site at www.cdc.gov/diabetes, or call
1-877-CDC-INFO.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
22/146
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
23/146
Theres good news or people with diabetes.Studies show that keeping your blood glucose (alsocalled blood sugar) close to normal helps preventor delay some diabetes problems.
Through careul control, many problems such as
eye disease, kidney disease, heart disease, nerve
damage, and serious oot problems can be prevented
or slowed. People who have type 1 diabetes as wellas people who have type 2 diabetes can beneft bykeeping their blood glucose levels closer to normal.
You can learn more about diabetes and ways to
help you control your blood sugar by calling the
National Diabetes Education Program (NDEP) at
1-800-438-5383.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
24/146
As the turtle makes steady progress, so too must
those with diabetes continue to maintain healthy
liestyles and stick to daily routines that involve
regular exercise, good nutrition, glucose monitoring,
and regular visits to health care providers.
To keep your glucose at a healthy level, you need
to keep a balance between three important things:
What you eat and drink.
How much physical activity you do.
What diabetes medicine you take (i your doctor
has prescribed diabetes pills or insulin).
This book gives you only some o the acts you
need. Your health care team can give you more.
Here are some tips or making healthy eating
choices:
Eat regular meals. Ask your health care team
to help you choose a meal plan. Your dietitianmay suggest you eat three meals and a snack or
two every day at about the same times. Eating
every 4 to 5 hours can help control blood sugar.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
25/146
Eat a variety of foods. Choose a variety o oods
to eat so that your body gets the nutrition it
Eat less fat. Avoid ried oods. Foods that are
baked, broiled, grilled, boiled, or steamed are
more healthy to eat. Eat meats that have little
at. When you eat dairy products (cheese, milk,
yogurt, and others), choose those that have
little or no at or cream.
Eat less sugar. You may fnd that eating less
sugar helps you control your blood glucose level.Here are some things you can do to eat less
sugar:
Eat more high-fber oods, like vegetables,
dried beans, ruit, and whole grain breads
and cereals.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
26/146
Drink water and other drinks that have no
added sugar.
Eat ewer oods that have extra sugar, such
as cookies, cakes, pastries, candy, brownies,
and sugared breakast cereals.
Talk with your health care team about ways
to sweeten ood and drinks without using
sugar.
See pages 2832 or more on ways to prevent
problems when your blood glucose levels are too
high or too low.
Eat less salt. Eating less salt may help control
your blood pressure. Here are some ways to eat
less salt:
Use less salt when you prepare oods.
Cut down on processed oods, such as oods
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
27/146
you buy in cans and jars, pickled oods, lunch
meats (cold cuts), and snack oods, such as
chips.
Taste your ood frst beore adding salt. You
may not need to add any.
Use herbs and spices instead o salt to avor
your ood.
A word about drinking alcohol:Alcohol can
cause health problems, especially or peoplewith diabetes. It adds calories and doesnt give
your body any nutrition. Drinking alcohol may
cause dangerous reactions with medicines you
take. Your blood glucose can go down too low
i you drink beer, wine, or liquor on an empty
stomach. I you want to include a drink in your
ood plan once in a while, ask your health care
team how to do so saely.
Its important to be active. Physical activity
has many benefts. It can help you control your
blood glucose and your weight. Physical activity
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
28/146
can help prevent heart and blood ow problems.
Many people say they eel better when they get
regular exercise.
Start with a little. I you havent been doing
any physical activity, talk to your health care
team beore you begin. Walking, working in the
yard, and dancing are good ways to start. As
you become stronger, you can add a ew extra
minutes to your physical activity. I you eel
pain, slow down or stop and wait until it goes
away. I the pain comes back, talk with your
health care team right away.
Do some physical activity
every day. Its better to walk
10 or 20 minutes each day
than one hour once a week.
Choose an activity you enjoy.
Do an activity you really like.The more un it is, the more
likely you will do it each day.
Its also good to exercise with
a amily member or riend.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
29/146
I youre already active now, but want to become
more active, talk to your health care team about a
sae exercise plan.
I you take diabetes pills or insulin injections to
control your diabetes, ask your health care provider
to explain how these work. Its important to know
how and when to take diabetes medicine. I you
take other medicines that are sold with or without
a prescription, ask your doctor how these can
aect your diabetes control. When you take insulin
injections or diabetes pills, your blood glucose levels
can get too low. See pages 2832 or how to prevent
levels that are too low or too high.
I you inject insulin, your health care team should
be able to tell you:
How to give yoursel injections.
When you need to change your insulin dose.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
30/146
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
31/146
Its important to
your health to control
your blood glucose(also called bloodsugar). Keeping yourglucose level close to
normal helps prevent
or delay some diabetesproblems, such as
eye disease, kidney
disease, and nerve damage. One thing that can help
you control your glucose level is to keep track o it.
You can do this by:
Checking your own glucose a number o times
each day (sel-monitoring blood glucose).Many people with diabetes check their glucose
2 to 4 times a day.
Getting anA1C test rom your health careprovider about every 3 months.
Youll learn more about these tests on the next
pages. These tests can help you and the rest oyour diabetes health care teamdoctor, diabetes
educator, and otherswork together to help you
control your blood glucose.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
32/146
You can do a test to fnd out what your blood
glucose is at any moment. Your health care team canshow you how to do the test yoursel. Using a fnger
prick, you place a drop o blood on a special coated
strip, which reads your blood glucose. Many people
use an electronic meter to get this reading.
Blood glucose testing can help you understand
how ood, physical activity, and diabetes medicine
aect your glucose levels. Testing can help you
make day-to-day choices about how to balance these
things. It can also tell you when your glucose is too
low or too high so that you can treat these problems.
Ask your health care team to help you set a goalor your glucose range and show you how to record
your glucose readings in a logbook or record sheet.
I you need a daily logbook, ask your health care
provider or one. Or you can make copies o page
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
33/146
108 i you take insulin or page 106 i you dont take
insulin. A sample log sheet is flled out to show you
how to use each.
Be sure to write down
each glucose reading and
the date and time you
took it. When you review
your records, you can see
a pattern o your recent
glucose control. Keeping
track o your glucose on aday-to-day basis is one o
the best ways you can take
charge o your diabetes.
By perorming an A1C test, health providescan sum up your diabetes control or the past ew
months. An A1C test measures how much glucose
has been sticking to your red blood cells. Since
each red blood cell is replaced by a new one every
3 to 4 months, this test tells you how high the
glucose levels have been during the lie o the cells.
I most o your recent blood glucose readings havebeen near normal (70 to 140 milligrams per deciliter
or mg/dL, with the higher reading mainly ater
meals), the A1C test will be near normal (usually
about 6%7%). I youve had many readings above
normal, the extra glucose sticking to your red blood
cells will make your A1C test read higher.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
34/146
You should get an A1C test every 3 months i your
test results are not yet at goal. You should get an
AIC test at least 2 times a year i your AIC results
are at goal. Ask your health care provider or theresults and record them on page 91.
Ask your team to tell you the normal range o
values and help you set a goal or yoursel. Write
your goal down on page 91 o this guide.
I your A1C test results
are high, work with
your team to adjustyour balance o ood,
physical activity, and
diabetes medicine.
When your A1C test
result is near your
goal, youll know youve
balanced things well.
In general, a blood glucose reading lower than 70
mg/dL is too low. I you take insulin or diabetespills, you can have low blood glucose (also calledhypoglycemia). Low blood glucose is usually
caused by eating less or later than usual, beingmore active than usual, or taking too much diabetes
medicine. Drinking beer, wine, or liquor may also
cause low blood glucose or make it worse.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
35/146
Low blood glucose happens
more oten when youre
trying to keep your glucose
level near normal. This isno reason to stop trying to
control your diabetes. It just
means you have to watch
more careully or low levels.
Talk this over with your
health care team.
Some possible signs o low
blood glucose are eeling
nervous, shaky, or sweaty.
Sometimes people just eel
tired.
The signs may be mild atfrst. But a low glucose level
can quickly drop much lower
i you dont treat it. When
your glucose level is very
low, you may get conused,
pass out, or have seizures.
I you have any signs thatyour glucose may be low, test
it right away. If its less than
60 to 70 mg/dL, you need
to treat it right away. See
below or ways to treat low
blood glucose.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
36/146
I you eel like your blood glucose is getting
too low but you cant test it right then, play itsaego ahead and treat it. Eat 10 to 15 grams o
carbohydrate right away. See the box below orexamples o oods and liquids with this amount o
carbohydrate.
Check your blood glucose again in 15 minutes.
Eat another 10 to 15 grams of carbohydrate every
15 minutes until your blood glucose is above 70 mg/dL.
Eating or drinking an item rom the list on this
page will keep your glucose up or only about
30 minutes. So i your next planned meal or snack
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
37/146
is more than 30 minutes away, you should go ahead
and eat a small snack, something like crackers and
a tablespoon o peanut butter.
In your glucose logbook or record sheet, write
down the numbers and the times when low levels
happen. Think about what may be causing them. I
you think you know the reason, write it
beside the numbers you recorded. You
may need to call your health care
provider to talk about changing
your diet, activity, or diabetes
medicine.
Tell amily members,
close riends, teachers, and
people at work that you
have diabetes. Tell them
how to know when your
blood glucose is low. Show
them what to do i you cant
treat yoursel. Someone will
need to give you ruit juice,
soda pop (not diet), or sugar.
I you cant swallow, someone will need to give you
a shot oglucagon and call or help. Glucagon is aprescription medicine that raises the blood glucose
and is injected like insulin. I you take insulin, youshould have a glucagon kit handy. Teach amily
members, roommates, and riends when and how to
use it.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
38/146
Waiting to treat low
blood glucose is not
sae. You may be in
danger o passing out.I you get conused,
pass out, or have a
seizure, you need
emergency help. Dont
try to drive yoursel to
get help. Be prepared
or an emergency.
Try to stay close to your usual schedule o eating,
activity, and medicine. I youre late getting a meal
or i youre more active than usual, you may need
an extra snack. See page 37 or more ideas aboutmanaging your diabetes.
Keeping track o your blood glucose is a good way
to know when it tends to run low. Show your logbook
or record sheet to your health care providers. Be
sure to let them know i youre having a number olow blood glucose readings a week.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
39/146
To be sae, always check your blood glucose beore
doing any o these things:
Driving a vehicle. Using heavy equipment.
Being very physically active.
Being active or a long time.
Ask your health care team whether you should
check your glucose beore (or during) any other
activities. Write these in the space below.
Always carry some
type o carbohydrate
sugar ood or drink with
you so youll be ready at
any time to treat a low
glucose level. See the list
on page 26 or snacks
that have 15 grams o
carbohydrate.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
40/146
Always wear something (like an identifcation
bracelet) that says you have diabetes. Carry a card
in your wallet that says you have diabetes and tells
i you use medicine to treat it.
For most people, blood glucose levels that stay
higher than 140 mg/dL (beore meals) are too high.Talk with your health care team about the glucose
range that is best or you.
Eating too much ood, being less active than
usual, or taking too little diabetes medicine are
some common reasons or high blood glucose (orhyperglycemia). Your blood glucose can also go up
when youre sick or under stress.
Over time, high blood glucose can damage body
organs. For this reason, many people with diabetes
try to keep their blood glucose in balance as much as
they can.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
41/146
Some people withtype 2 diabetes may not eel thesigns o high blood glucose until their blood glucose
is higher than 300. People with blood glucose higher
than 300 are more likely to have dehydration.Dehydration can become a serious problem i nottreated right away.
Your blood glucose is more likely to go up when
youre sickor example, when you have the u
or an inection. Youll need to take special care o
yoursel during these times. The guide that begins
on page 33 can help you do this.
Some common signs o high blood glucose are
having a dry mouth, being thirsty, and urinating
oten. Other signs
include eeling tired,
having blurred vision,
and losing weight
without trying. I your
glucose is very high, you
may have stomach pain,
eel sick to your stomach,
or even throw up. This
is an emergency and you
need to go to the hospital
right away.
I you have any signs that your blood glucose is
high, check your blood. In your logbook or on your
record sheet, write down your glucose reading and
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
42/146
the time you did the test. I your glucose is high,
think about what could have caused it to go up. I
you think you know o something, write this down
beside your glucose reading.
Try to stay with
your ood and activityplan as much as you
can. Drink water.
Take your diabetes
medicine about the
same time each day.
Work with your
health care team to
set goals or weight,blood glucose level,
and activity.
Keep track o your blood glucose and go over
your records oten. Youll learn how certain oods or
activities aect your glucose.
Show your records to your health care team.
Ask how you can change your ood, activity, and
medicine to avoid or treat high blood glucose.
Ask when you should call or help.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
43/146
Be sure to keep taking your diabetes pills or
insulin. Dont stop taking them even i you cant eat.
Your health care provider may even advise you to
take more insulin during sickness.
Try to eat the same amount o ruits and breads
as usual. I you can, eat your regular diet. I youre
having trouble doing this, use carbohydrate
choices or servings: eat enough sot oods or drinkenough liquids to take the place o the ruits and
breads you usually eat.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
44/146
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
45/146
Drink extra liquids. Try to drink
at least1
/2 cup (4 ounces) to3
/4 cup(6 ounces) every hal-hour to hour,
even i you have to do this in small
sips. These liquids should not have
calories. Water, diet soda pop, or tea
without sugar are good choices.
Weigh yoursel every day. Losing weight
without trying is a sign o high blood glucose.
Check your temperature every morning and
evening. A ever may be a sign o inection.
Every 4 to 6 hours, check how youre breathing
and decide how alert you eel. Having trouble
breathing, eeling more sleepy than usual, ornot thinking clearly can be danger signs.
Use the Records or Sick Days, starting on page
79. Ask a amily member or riend to help i you
need it.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
46/146
Ask your health
care provider whenyou should call.
During your sick
times, you may need
to call every day or
advice.
You should call your
health care provideror
go to an emergency
room i any o the
ollowing happens:
You eel too sick to eat normally and or more
than 6 hours cant keep ood or liquids down.
You have severe diarrhea (loose bowel movement).
You lose 5 pounds or more without trying to.
Your temperature is over 101F.
Your blood glucose level is lower than 60 mg/dL
or stays over 300 mg/dL.
Youre having trouble breathing.
You eel sleepy or cant think clearly.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
47/146
Staying in charge o your diabetes no matter whatyour day holdswork, school, travel, or special
eventstakes planning ahead. Many days will go
smoothly, but some days will hold surprises, such as
extra activity or delays that throw your schedule o.
Plan ahead or these times by always keeping a
treatment orlow blood glucosewith you (see page
26 or some choices). I you have any signs that your
glucose may be low (see page 25), go ahead and treat
it right away.
Stay as close to your eating, activity, and medicine
schedule as you can. Keep track o your blood
glucose so you can pick up changes early. Always
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
48/146
wear or carry identifcation that says you have
diabetes.
Talk with your health care team about yourplanned schedule and activities. Ask or help in
planning ahead or work, school, travel, and special
events. When you read the rest o this section, you
may think o more questions to ask.
Talk with your healthcare team about the type o
activity you do at work or at
school. From time to time,
you and your health care
team may need to make
changes in your activity,
medicine, or eating.
Many people take supplies
or checking their glucose
to school or work so they
can check i at regular
break times. Some people
choose to show their ellow
workers, their teachers, or their classmates how to
help i they should ever have a problem. They teachthem how to tell when their glucose is low and how
to treat it (see pages 2528). Some people like to
have written steps on fle at their place o work or
with their teacher.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
49/146
When you plana trip, think about
your day-to-day
schedule and try
to stay as close to
it as you can. For
example, i you
usually check your blood glucose at noon and then
eat lunch, plan to do this on your trip, as well. Tripscan hold surprisesin delays and changes. Even the
types o ood and supplies you can buy on your trip
may not be the same as those you get at home.
Beore you travel, work with your health care
provider to plan your timing or medicine, ood, and
activity. Talk about what to do i you fnd changes in
your glucose readings.
Plan ahead or trips:
Keep snacks with you that could be used to
preventor treatlow blood glucose.
Carry extra ood and drink supplies with you,
such as cracker packs and small cans o juices
or bottled water. Carry blood glucose testing supplies with you.
Take along all the diabetes medicine youll
need. Keep medicines in the original pharmacy
container with the printed label that clearly
identifes the medicine.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
50/146
When you travel, be sure to
Test your blood glucose often and keep track of it.
Wear identifcation that says you have diabetes.
Let others know how they can help you.
Check new airline travel tips by contacting the
I youre traveling in a dierent time zone, youmay need to change your timing o ood, medicine,
and activity. Ask your health care provider to help
you with this. Talk about the ood and drink choices
that would be healthy or you. I youll be in another
country, ask your doctor to write a letter explaining
that you have diabetes. Its also a good idea to get
your doctor to write a prescription or you to get
insulin or supplies i needed.
Federal Aviation Administration (FAA) athttp://www.aa.gov or 800-322-7873.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
51/146
Living with diabetes isnt easy. Its normal to eel
troubled about it. Tell your health care team how
you eel. Point out any problems you have with your
diabetes care plan. Your diabetes educator or other
health care provider may be able to help you think
o ways to deal with these problems.
Talk about the stresses you eel at home, school,and work. How do you cope with these pressures? I
your eelings are getting in the way o taking care o
yoursel, you need to ask or help.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
52/146
It helps to talk with other people who have
problems like your own. You may want to think
about joining a diabetes support group. In supportgroups, people who have just ound out they have
diabetes can learn rom people who have lived with
it or a long time. People can talk about and share
how they deal with their diabetes. They can also talk
about how they take care o their health, how they
prepare ood, and how they get physical activity.
Family members who do not have diabetes may want
to join a support group, too. Ask your health care
team about support groups or people with diabetes
and their amilies and riends.
I there is
not a support
group in
your area,
you may
want to call
a diabetes
organization
(see the list
on pages
127129)
about start-
ing a group.
One-on-one and amily counseling sessions may
also help. Be sure to see a counselor who knows
about diabetes and its care. Ask your health care
provider to help you fnd a counselor.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
53/146
Diabetic eye disease (also called diabetic
retinopathy) is a serious problem that can leadto loss o sight. Theres a lot you can do to take
charge and prevent such problems. Research shows
that keeping your blood glucose level closer tonormal can prevent or delay the onset o diabetic eye
disease. Keeping your blood pressure under control
is also important. Finding and treating eye problems
early can help save sight.
Since diabetic
eye disease may
be developing
even when your
sight is good,
regular dilatedeye exams are
important or
fnding problems
early. Some
people may
notice signs o
vision changes.
I youre havingtrouble reading, i
your vision is blurred, or i youre seeing rings
around lights, dark spots, or ashing lights, you may
have eye problems. Be sure to tell your health care
team or eye doctor about any eye problems you may
have.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
54/146
High blood glucose can damage your eyes astime goes by. Work with your health care team to
keep your blood glucose levels in the target range.
High blood pressure can damage your eyes.
Have your health care provider check your bloodpressure at least 4 times a year. I your bloodpressure is higher than 130/80, ask your health
care provider how to keep your blood pressure at a
healthy level. You may need medicine to keep your
blood pressure at a healthy level.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
55/146
Even i youreseeing fne, you need
regular, complete
dilated eye examsto protect your sight.
Ask your health care
provider to help you
fnd an eye doctor
who cares or peoplewith diabetes. Beore
the exam, a doctor or nurse will put drops in your
eyes to dilate the pupils.
You should have your eyes dilated and examinedat least once a year. Keep track o these exams by
using the record sheets starting on page 101. Even i
youve lost your sight romdiabetic eye disease, youstill need to have regular eye care. I you haventalready had a complete eye exam, you should have
one now i any o these conditions apply to you:
Youve had type 1 diabetes or 5 or moreyears.
You have type 2 diabetes.
Youre going through puberty and you have
diabetes.
Youre pregnant and you have diabetes.
Youre planning to become pregnant and you
have diabetes.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
56/146
I you cant aord an eye
exam, ask about a payment
plan or a ree exam. I youre
65 or older, Medicare may payor diabetic eye exams (but
not glasses). Ask your eye
doctor to accept the Medicare
ee as ull payment.
I you have diabetic eye
disease, talk with your health
care provider about the kind
o physical activity that is
best or you.
Treating eye problems early can help save
sight. Laser surgery may help people who haveadvanced diabetic eye disease. An operation called
a vitrectomy may help those who have lost theirsight rom bleeding in the back o the eye.
I your sight is poor, an eye doctor who is an expertin low vision may be able to give you glasses or other
devices that can help you use your limited vision
more ully. You may want to ask your health care
provider about support groups and job training or
people with poor vision.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
57/146
Diabetes can cause diabetic kidney disease
(also called diabetic nephropathy), which canlead to kidney ailure. Theres a lot you can do to
take charge and prevent kidney problems. A recent
study shows that controlling your blood glucosecan prevent or delay the onset o kidney disease.
Keeping your blood pressure under control is also
important.
The kidneys keep the right amount o water inthe body and help flter out harmul wastes. These
wastes, called urea, then pass rom the body inthe urine. Diabetes can cause kidney disease by
damaging the parts o the kidneys that flter out
wastes. When the kidneys ail, a person has to
have his or her blood fltered through a machine (a
treatment called dialysis) several times a week or
has to get a kidney transplant.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
58/146
Your health care provider can learn how well your
kidneys are working by testing or microalbumin
(a protein) in the urine. Microalbumin in the urineis an early sign o diabetic kidney disease. You
should have your
urine checked or
microalbumin
every year.
Your health care
provider can also doa yearly blood test to
measure your kidney
unction. I the tests
show microalbumin
in the urine or i your
kidney unction isnt
normal, youll need to
be checked more oten.
Starting on page 101, write down the dates and
the results o these tests. Ask your health care
provider to explain what the results mean.
High blood glucose can damage your kidneysas time goes by. Work with your health care team to
keep your glucose levels as close to normal as you
can.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
59/146
High blood pressure (or hypertension) can
damage your kidneys.You may want to check
your blood pressureat home to be sure it
stays lower than 130/80.
Have your health care
provider check your
blood pressure at least
4 times a year. Yourdoctor may have you
take a blood pressure
pill, called anACE
inhibitor, to help
protect your kidneys.
Maintain a healthy weight.
Be acive every day.
Eat ewer oods high in salt and sodium.
Eat more ruits and vegetables, whole grainbreads and cereals, and lowat dairy products.
2. Take your medicine the way your doctor tells you.
3. Have your blood pressure checked oten.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
60/146
Call your health care provider right away i you
have any o these signs o kidney inections:
Back pain.
Chills.
Fever.
Ketones in the urine.
Your health care provider will test your urine.
I you have a bladder or kidney inection, youll be
given medicine to stop the inection. Ater you take
all the medicine, have your urine checked again to
be sure the inection is gone.
I you have kidney disease, ask your health
care provider about the possible eects that some
medicines and X-ray dyes can have on your kidneys.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
61/146
Heart and blood vessel problems are the main
causes o sickness and death among people with
diabetes. These problems can lead to high bloodpressure, heart attacks, and strokes. Heart andblood vessel problems can also cause poor circulation
(blood ow) in the legs and eet.
Youre more likely to have heartand blood vessel problems i
you smoke cigarettes, have high
blood pressure, or have too much
cholesterol or other ats in yourblood. Talk with your health care
team about what you can do to
lower your risk or heart and blood
vessel problems. Ask about takinga daily aspirin to help prevent
heart and blood vessel problems.
I you eel dizzy, have sudden loss o sight, slur
your speech, or eel numb or weak in one arm or leg,
you may be having serious heart and blood vessel
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
62/146
problems. Your blood may not be getting to your
brain as well as it should.
Danger signs o circulation problems to the heartinclude chest pain or pressure, shortness o breath,
swollen ankles, or irregular heartbeats. I you have
any o these signs, go to an emergency room or call
your health care provider right away.
Signs o circulation problems to your legs are
pain or cramping in your buttocks, thighs, or calves
during physical activity. Even i this pain goes awaywith rest, report it to your health care provider.
Choose a healthydiet, low in salt. Work
with a dietitian to plan
healthy meals. I youre
overweight, talk about
how to saely lose weight.
Ask about a physical
activity or exercise
program or you. See pages1418 to read more about
healthy choices or ood
and physical activity.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
63/146
Smoking cigarettes causes hundreds o thousands
o deaths each year. When you have diabetes andalso use tobacco, the risk o heart and blood vessel
problems is even greater. One o the best choices you
can make or your health is to
never start smokingor i you
smoke, to quit.
At least once a year, your
health care provider will askyou about tobacco use. I you
smoke, talk to your provider
about ways to help you stop.
Get your blood pressure
checked at each visit. Record these numbers onthe record sheets starting on page 91. I your blood
pressure is higher than 130/80, ask what steps to
take to reach your goal.
I your blood pressure is still high ater 3 months,
you may need medicine to help control it. Many
medicines are available to treat high blood pressure.
I you have side eects rom the medicine, ask yourhealth care provider to change it. Talk to your
health care team about whether you need medicine
to take charge o your blood pressure.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
64/146
Get your cholesterol
checked once a year. Record
the results on page 101.
Your total cholesterol should
be lower than 200 mg/dL
(milligrams per deciliter).
Ask your health care team
to explain what your HDLand LDL levels are.
I your cholesterol ishigher than 200 mg/dL on two or more checks, you
can do several things to lower it. You can work
with your health care team to improve your bloodglucose control, you can lose weight (i youreoverweight), and you can cut down on oods that
are high in at and cholesterol. Ask your health care
team about oods that are low in ats. Also ask about
a physical activity program.
Ask your health care provider what steps to take
to reach your LDL cholesterol goal. You may need a
medicine to help control it. Ask i you need aspirin
to prevent heart attack or stroke.
I youre having heart and blood circulation
problems, an EKG may help you and your healthcare provider know i you need to change your
treatment.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
65/146
Diabetic nerve damage (also called diabetic
neuropathy) is a problem or many people withdiabetes. Over time, high blood glucose levelsdamage the delicate coating o nerves. This damage
can cause many problems, such as pain in your eet.
Theres a lot you can do to take charge and prevent
nerve damage. A recent study shows that controlling
your blood glucose can help prevent or delaythese problems. Controlling your blood glucose may
also help reduce the pain rom some types o nervedamage.
Some signs o diabetic
nerve damage are pain,
burning, tingling, or loss o
eeling in the eet and hands.It can cause you to sweat
abnormally, make it hard or
you to tell when your blood
glucose is low, and make you
eel light-headed when you
stand up.
Nerve damage can leadto other problems. Some
people develop problems
swallowing and keeping
ood down. Nerve damage can also cause bowel
problems, make it hard to urinate, cause dribbling
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
66/146
with urination, and lead
to bladder and kidney
inections. Many people
with nerve damage havetrouble having sex. For
example, men can have
trouble keeping their
penis erect, a problem
called impotence(erectile dysunction).
I you have any o these
problems, tell yourhealth care provider.
There are ways to help
in many cases.
High blood glucose can damage your nerves as
time goes by. Work with your health care team to
keep your glucose levels as close to normal as you
can.
Physical activity or exercise may help keep some
nerves healthy, such as those in your eet. Ask your
health care team about an activity that is healthy
or you.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
67/146
Nerve damage
can happen slowly.You may not even be
aware youre losing
eeling in your eet.
Ask your health care
provider to check your
eet at each visit. At
least once a year, your
provider should testhow well you can sense
temperature, pinprick, vibration, and position in
your eet. I you have signs o nerve damage, your
provider may want to do more tests. Testing can
help your provider know what is wrong and how to
treat it. Keep track o your oot exams on the record
sheets starting on page 101.
For more inormation on oot care, call the
National Diabetes Inormation Clearinghouse at
1-800-860-8747.
I youve lost eeling in your eet, youll need to
take special care o them. Check your eet each day.Wear shoes that ft well. Youll read more about oot
care in the next chapter.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
68/146
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
69/146
Nerve damage, circulation
problems, and inections cancause serious oot problems
or people with diabetes.
Theres a lot you can do to
prevent problems with your
eet. Controlling your bloodglucose and not smokingor using tobacco can help
protect your eet. You canalso take some simple saeguards each day to care
or and protect your eet. Over hal o diabetes-
related amputations can be prevented with regular
exams and patient education.
Its helpul to understand why oot problems
happen. Nerve damage can cause you to lose eeling
in your eet. Sometimes nerve damage can deorm ormisshape your eet, causing pressure points that can
turn into blisters, sores, or ulcers. Poor circulationcan make these injuries slow to heal.
Your eet may tingle, burn, or hurt. You may not be
able to eel touch, heat, or cold very well. The shapeo your eet can change over time. There may even
be changes in the color and temperature o your
eet. Some people lose hair on their toes, eet, and
lower legs. The skin on your eet may be dry and
cracked. Toenails may turn thick and yellow. Fungus
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
70/146
inections can grow between your toes. Blisters,
sores, ulcers, inected corns, and ingrown toenailsneed to be seen by your health care provider or oot
doctor (podiatrist) right away.
Ask your health care provider to look at your eet
at least 4 times a year. As a reminder, take o yourshoes and socks when youre in the exam room.
Have your sense o eeling and your pulses checked
at least once a year. I you have nerve damage,
deormed or misshaped eet, or a circulation
problem, your eet need special care. Ask your health
care provider to show you how to care or your eet.
Also ask i special shoes would help you.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
71/146
You may have serious oot problems yet eel no
pain. Look at your eet every day to see i you havescratches, cracks, cuts, or blisters. Always check
between your toes and on the bottoms o your eet. I
you cant bend over to see the bottoms o your eet,
use a mirror that wont break. I you cant see well,
ask a amily member or riend to help you. Call your
health care provider at once i you have a sore on
your oot. Sores can get worse quickly.
Wash your eet every day.
Dry them with care, especially
between the toes. Dont soak
your eetit can dry out your
skin, and dry skin can lead to
inections. Rub lotion or creamon the tops and bottoms o your
eetbut not between your
toes. Moisture between the toes
will let germs grow that could
cause an inection. Ask your
health care provider or the
name o a good lotion or cream.
Trim your toenails ater youve washed and dried
your eetthe nails will be soter and saer to cut.
Trim the nails to ollow the natural curve o your
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
72/146
toes. Dont cut into the corners. Use an emery board
to smooth the edges.
I you cant see well, or i your nails are thickor yellowed, get them trimmed by a oot doctor
or another health care provider. Ask your health
care provider or the name o a oot doctor. I you
see redness around the nails, see your health care
provider at once.
Dont cut corns and calluses. Ask your healthcare provider how to gently use a pumice stone torub them. Dont use razor blades, corn plasters, or
liquid corn or callus removersthey can damage
your skin.
Hot water or hot suraces are
a danger to your eet. Beore
bathing, test the water with a
bath thermometer (90 to 95F
is sae) or with your elbow.
Wear shoes and socks when you
walk on hot suraces, such as
beaches or the pavement aroundswimming pools. In summer,
be sure to use sunscreen on the
tops o your eet.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
73/146
You also need to protect your eet rom the cold.
In winter, wear socks and ootwear such as eece-
lined boots to protect your eet. I your eet are cold
at night, wear socks. Dont use hot water bottles,heating pads, or electric blanketsthey can burn
your eet. Dont use strong antiseptic solutions or
adhesive tape on your eet.
Wear shoes and socksat all times. Dont walk
bareootnot even indoors.
Wear shoes that ft well
and protect your eet. Dont
wear shoes that have plastic uppers, and dont wear
sandals with thongs between the toes. Ask your
health care provider what types o shoes are goodchoices or you.
New shoes should be comortable at the time you
buy themdont expect them to stretch out. Slowly
break in new shoes by wearing them only 1 or 2
hours a day.
Always wear socks or stockings with your shoes.Choose socks made o cotton or woolthey help keep
your eet dry.
Beore you put on your shoes each time, look and
eel inside them. Check or any loose objects, nail
points, torn linings, and rough areasthese can
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
74/146
cause injuries. I your shoes arent smooth inside,
wear other shoes.
Physical activity can help increase the circulation
in your eet. There are many ways you can exercise
your eet, even during times youre not able to walk.
Ask your health care team about things you can do
to exercise your eet and legs.
For more inormation on oot care, call theNational Diabetes Inormation Clearinghouse at
1-800-860-8747.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
75/146
Because ohigh bloodglucose, people with diabetesare more likely to have
problems with their teeth and
gums. Theres a lot you can
do to take charge and prevent
these problems. Caring or
your teeth and gums every
day can help keep themhealthy. Keeping your blood
glucose under control is also
important. Regular, complete
dental care helps prevent
dental disease.
Sore, swollen, and red gums that bleed when
you brush your teeth are a sign o a dental
problem called gingivitis. Another problem, calledperiodontitis, happens when your gums shrink orpull away rom your teeth. Like all inections, dental
inections can make your blood glucose go up.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
76/146
High blood glucose can cause problems with your
teeth and gums. Work with your health care team
to keep your glucose levels as close to normal as you
can.
Brush your teeth at least twicea day to prevent gum disease
and tooth loss. Be sure to brush
beore you go to sleep. Use a sot
toothbrush and toothpaste with
uoride. To help keep bacteria rom
growing on your toothbrush, rinse
it ater each brushing and store it
upright with the bristlesat the top. Get a new toothbrush
at least every 3 months.
Besides brushing, you need to oss between
your teeth each day to help remove plaque, a flm
that orms on teeth and can cause tooth problems.Flossing also helps keep your gums healthy. Your
dentist or dental hygienist will help you choose a
good method to remove plaque, such as dental oss,
bridge cleaners, or water spray. I youre not sure o
the right way to brush or oss, ask your dentist or
dental hygienist or help.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
77/146
Get your teeth cleaned
and checked at yourdentists ofce at least
once every 6 months. I
you dont have a dentist,
fnd one or ask your
health care provider or
the name o a dentist in
your community.
See your dentist right
away i you have trouble
chewing or any signs o dental disease, including
bad breath, a bad taste in your mouth, bleeding
or sore gums, red or swollen gums, or sore or loose
teeth.
Give your dentist the name and telephone numbero your diabetes health care provider. Each time you
visit, remind your dentist that you have diabetes.
Plan dental visits so they dont change the times
you take your insulin and meals. Dont skip a mealor diabetes medicine beore your visit. Right ater
breakast may be a good time or your visit.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
78/146
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
79/146
I you have diabetes, take extra care to keep
up-to-date on your vaccinations (also calledimmunizations). Vaccines can prevent illnessesthat can be very serious or people with diabetes.
This section talks about some vaccines you need to
know about.
Infuenza (oten called the fu) is not just a badcold. Its a serious illness that can lead to pneumonia
and even death. The u spreads when inuenza
viruses pass rom one person to the nose or throat
o others. Signs o the u may include sudden high
ever, chills, body aches, sore throat, runny nose, dry
cough, and headache.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
80/146
People with diabetes who come down with the u
may become very sick and may even have to go to a
hospital. I you get the u, youll need to take special
care o yoursel (see pages 3336).
You can help keep yoursel rom getting the u
by getting a u shot every year. Everyone with
diabeteseven pregnant womenshould get a
yearly u shot. The best time to get one is between
October and mid-November, beore the u season
begins. This vaccine is ully covered under Medicare
Part B.
Pneumococcal disease is a major source o illness
and death. It can cause serious inections o the
lungs (pneumonia), the blood (bacteremia), and the
covering o the brain (meningitis). Pneumococcal
polysaccharide vaccine (oten called PPV) can helpprevent this disease.
PPV can be given at the same time as the u
vaccineor at any time o the year. Most people only
have to take PPV once in their lie. Ask your health
care provider whether you might need a second
vaccination. This vaccine is ully covered under
Medicare Part B.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
81/146
Tetanus (or lockjaw) and diphtheria are serious
diseases. Tetanus is caused by a germ that entersthe body through a cut or wound. Diphtheria
spreads when germs pass rom one person to the
nose or throat o others.
You can help prevent tetanus and diphtheria
with a combined shot called Td toxoid. Most people
get Td toxoid as part o their routine childhood
vaccinations, but all adults need a Td booster shotevery 10 years. Other vaccines may be given at the
same time as Td toxoid.
You may need vaccines to protect you against
other illnesses. Ask your health care provider i you
need any o these:
Measles/Mumps/Rubella vaccine.
Hepatitis A and B vaccines.
Varicella (chicken pox) vaccine.
Polio vaccine.
Vaccines or travel to other countries.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
82/146
Call the immunization program in your state
health department to fnd out where you can getvaccinations in your area. Keep your vaccination
records up-to-date so you and your health care
provider will know what vaccines you may need.
You can record this inormation on the record sheets
starting on page 101 o this book.
For more inormation on
vaccination, call the CDCNational Immunization
Hotline at 1-800-CDC-INFO
(English and Spanish). This is
a toll-ree call.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
83/146
Women with diabetes can
have healthy babies, but it
takes planning ahead and
eort. Pregnancy can make
both high and low bloodglucose levels happen moreoten. It can make diabeticeye disease and diabetickidney disease worse.High glucose levels during
pregnancy are dangerous or
the baby, too.
I you dont want to
become pregnant, talk with
your health care provider
about birth control.
Keeping your glucose levels near normal beore
and during pregnancy can help protect you and
your baby. Thats why its so important to plan your
pregnancies ahead o time.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
84/146
I you want to have a baby, discuss it with your
health care provider. Work with your diabetes care
team to get and keep your blood glucose in the
normal or near-normal range beore you become
pregnant. Your glucose records and yourA1C test
results will show when you have maintained a saerange or a period o time.
You may need to change your meal plan and yourusual physical activity, and you may need to take
more requent insulin shots. Testing your glucoseseveral times a day will help you see how well youre
balancing things. Record the test results in your
logbook or on a log sheet (see sample pages on107108).
Get a complete check o your eyes and kidneysbeore you try to become pregnant. Dont smoke,
drink alcohol, or use drugsdoing these things can
harm you and your baby.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
85/146
All women who could become pregnant should
take olic acid (400 micrograms) every day. An easy
way to be sure youre getting enough olic acid is to
take a vitamin with olic acid in it.Think about breast eeding your baby. Breast
eeding has many benefts or you and your baby.
Some women have diabetes only when theyre
pregnant. This condition, which is calledgestational diabetes, can be controlled just likeother kinds o diabetes. Glucose control is the key.
Your health care team can help you take charge o
gestational diabetes. You are more likely to develop
type 2 diabetes. Check again or diabetes at least 6
weeks ater your baby is born and at regular times
or the rest o your lie.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
86/146
Some women with diabetes may have special
problems, such as bladder inections. See pages4950 to fnd out about the signs o bladder and
kidney inections. I you have an inection, it needs
to be treated right away. Call your doctor.
Some women get yeast inections in theirvagina, especially when their blood glucose is high.
A sign o a yeast inection may be itching in the
vagina. I you notice vaginal itching, tell your healthcare provider, who can tell you about medicines you
can buy at the drugstore and about how to prevent
yeast inections.
Some women with diabetes may have trouble
with sexual unction. Discomort caused by vaginal
itching or dryness can be treated.
Ask your doctor how
oten you should get
a Pap smear and a
mammogram (breast
X-ray). Regular
Pap smears and
mammograms help
detect cervical andbreast cancer early.
All womenwhether
or not they have
diabetesneed to
have these tests
regularly.
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
87/146
Records for Sick Days 79
Checks and Goals for Each Visit 89
Checks and Goals for Each Year 99
Glucose Record Sheets 105
Your Health Care Team 109
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
88/146
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
89/146
!
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
90/146
n
n
n
n
n
n
n
n
!
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
91/146
!
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
92/146
n
n
n
n
n
n
n
n
!
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
93/146
!
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
94/146
n
n
n
n
n
n
n
n
!
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
95/146
!
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
96/146
n
n
n
n
n
n
n
n
!
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
97/146
!
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
98/146
n
n
n
n
n
n
n
n
!
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
99/146
n
n
n
n
n
n
n
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
100/146
!
2/1/2000
145
6/
11/2000
118
9/28/2000
180
1/5/2001
105
4/3/2001
110
9.0
8.0
8.9
8.0
8.2
7.5
notdon
8.4
7.5
165
160
170
165
172
165
175
165
180
170
140/90
140/86
138/84
136/82
124/80
3
3
3
3
3
120
80
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
101/146
!
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
102/146
!
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
103/146
!
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
104/146
!
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
105/146
!
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
106/146
!
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
107/146
!
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
108/146
!
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
109/146
n
n
n
n
n
n
n
n
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
110/146
!
10/2/1999
10/2/1999
40 1.0
190
10/20
/2000
10/20
/2000
5
0
1.2
11/1/2001
11/1/2001
55 1.1
175
30
35
40
150
140
135
338
3
00
250
5cigrsdy
2cigrs
0
8/11/1999
10/1/200010/20/2001
10/2/199910/20
/200011/1/2001
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
111/146
!
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
112/146
!
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
113/146
!
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
114/146
!
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
115/146
My26,2
001
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
116/146
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
117/146
SaMple
My26,2
001
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
118/146
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
119/146
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
120/146
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
121/146
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
122/146
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
123/146
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
124/146
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
125/146
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
126/146
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
127/146
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
128/146
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
129/146
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
130/146
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
131/146
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
132/146
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
133/146
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
134/146
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
135/146
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
136/146
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
137/146
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
138/146
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
139/146
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
140/146
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
141/146
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
142/146
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
143/146
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
144/146
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
145/146
-
8/9/2019 Diabetes- Are You A Victim BookBing.Org
146/146