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LIVING WITH DIABETES: THE BASICSStaying well, enjoying life

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2Living with Diabetes: The Basics

Information provided by Franciscan Health Diabetes Center5230A E. Stop 11 Road, Suite 150, Indianapolis, IN 46237 • (317) 528-5904

I’ve just been told I have diabetes – what do I do now?

It’s hard to hear that you have diabetes. At the same time, you’ve learned some important information that will help you feel better and live a lon-ger, healthier life.

Now that you know you have diabetes, you will have a lot to do to take care of yourself. You will need to eat regularly, exercise, maybe take medicine and check your blood sugar. These are all physical things that need to be done.

You may also have a lot of different feelings about having diabetes like:

Denial I don’t believe this is happening to me. If I don’t think about this, it will go away.

Guilt If I just hadn’t eaten so much sugar… I must have done something to deserve this.

Fear What’s going to happen to me now? How is this going to change my life?

Depression I feel so alone. No one understands. I don’t feel like doing anything.

Anger Why me? This isn’t fair!

These feelings are all normal and it’s all right to have them, especially when you first learn that you have diabetes.

This booklet will help you manage your diabetes. Diabetes is never easy, but if you tackle it head-on and work with your health care providers, it can be managed.

And please know that you don’t have to manage diabetes on your own. If you have any questions or wish to make an appointment with a local doc-tor or patient educator specializing in diabetes care, call (317) 528-5904.

Remember: You are still the same person, you just have to do things in a different way to stay healthy. So, take a deep breath, and read on to learn how to manage your diabetes and take care of yourself.



TABLE OF CONTENTS

1. What do I need to know about diabetes? . . . . . . . . . . . . . . . . . . . . 4

2. How diabetes affects healing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

3. Eating for diabetes: Blood sugar control . . . . . . . . . . . . . . . . . . . . 8

4. How can exercise help me? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16

5. Watching your blood sugar at home . . . . . . . . . . . . . . . . . . . . . . .17

6. Hemoglobin A1C test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

7. Diabetes pills . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21

8. Injectable medicines (not insulin) . . . . . . . . . . . . . . . . . . . . . . . . . 24

9. Insulin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

10. Hypoglycemia: low blood sugar . . . . . . . . . . . . . . . . . . . . . . . . . . 32

11. Hyperglycemia: high blood sugar . . . . . . . . . . . . . . . . . . . . . . . . . 34

12. Sick days . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36

13. Take care of your feet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38

14. Standards of care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39

15. Dealing with feelings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

16. Diabetes education program resources . . . . . . . . . . . . . . . . . . . . 42

17. Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44



1 WHAT DO I NEED TO KNOW

ABOUT DIABETES?

Why do I have diabetes?

You have diabetes because the sugar in your blood cannot get into your body.

z You did not catch diabetes from someone else.

z You did not get diabetes by eating too much sugar.

z You did not get diabetes by being overweight, but you can increase your risk by being overweight.

z Your diabetes will not go away.

z You can control your diabetes but it cannot be cured.

z Diabetes is not “borderline.”

Keeping your blood sugar between 70 and 130 mg/dl before meals will give you a

better chance of not having complications from having diabetes.

What is insulin?

Insulin helps sugar move from your blood into your cells so it can be used for en-

ergy and for your tissues to work. You get sugar in your blood from the foods you

eat. If you have diabetes, your blood sugar levels should be between 70 mg/dl and

130 mg/dl before you eat a meal. Your blood sugar levels should be less than 180

mg/dl two hours after the start of your meal.

There are two types of diabetes;

Type 1 diabetes

z Used to be called juvenile diabetes

z Usually happens before the age of 40, but can happen at any age.

z Your pancreas is not making any insulin. You need insulin injections to stay alive.

z May be controlled by: diet, exercise and insulin



Type 2 diabetes

z Used to be called adult-onset diabetes

z Usually happens after the age of 40, but younger adults and children can also have Type 2 diabetes.

z Your pancreas still makes insulin, but you also become resistant to insulin. In other words, your pancreas may not produce enough insulin to keep up with your body’s needs, and your body can’t use the insulin the way it should.

z May be controlled by: diet, exercise, oral medication, injectable medicines and/or insulin

Liver andgallbladder

Pancreas

Stomach

Esophagus

Glucose fromdigested food

enters bloodstream

Insulin frompancreas

enters bloodstream

Glucose enterscells to be used for

energy

Not enoughinsulin produced

Insulin resistance

Excess glucose causesorgan damage

Glucose fromdigested food

enters bloodstream

NORMAL

TYPE 2 DIABETESCopyright graphisMedica.com, 2013



Taking care of your diabetes

You can do five things to take care of your blood sugar:

1. Eat a healthy diet and manage your weight.

2. Check your blood sugar as instructed by your doctor.

3. Take your diabetes medicine the way your doctor tells you to.

4. Exercise at least every other day.

5. Work with your doctor and/or diabetes educator to take care of your diabe-tes and live a healthy life.

Your doctor can help you, but YOU are in charge of your diabetes.

Things that could happen when you have diabetes that is not controlled:

Problem What happens

Eye problems Blindness, bleeding within the eye

Kidney problems Dialysis

Nerve problems Numbness or pain

Skin problems Open sores or infection

Large blood vessel problems Early heart attack or stroke

Foot problems Infections, removal of foot



2 HOW DIABETES AFFECTS HEALING

Healing can happen in many ways within our body, such as:

z healing inside the body after a surgical procedure

z healing an incision after a surgery or procedure

z healing inside the body where an infection has possibly damaged some tissue

z healing an open-sore on the body

When blood sugar is high, cells important for wound healing cannot function prop-

erly. This can happen when the blood sugar has been high for as little as one day.

Excellent blood sugar control will greatly improve your chances for healing!

1. The BS goal before meals is 80-130.

2. Know what your blood sugars are by checking blood sugar twice a day after a

surgery/procedure/infection or if you have an open sore. Write your blood sugar

on a log sheet.

3. Contact your MD if BS levels increase as follows. (Before meal blood sugar re-

sults, not after meals.)

z If blood sugars are between 150-200 for one week, call your doctor that takes care of your diabetes

z If blood sugars are between 200-250 for 2 days, call your doctor that takes care of your diabetes

z If your blood sugar is greater than 250, drink 8 oz. of water every hour and check your BS every 4 hours. If your blood sugar does not go down in 24 hours, call your doctor that takes care of your diabetes.

NOTE: If you have Congestive Heart Failure (CHF) and have a water restric-

tion, do NOT go over your allowed amount of water for the day.

z If your blood sugar is greater than 350, call your doctor that takes care of your diabetes right away.

In addition, nutrition affects healing also. Focus on eating three meals a day (could

be small meals) with carbohydrate and protein.



3 EATING FOR DIABETES:

BLOOD SUGAR CONTROL

What should I know about my food?

Food has three parts that give your body energy and also affect your blood sugar.

1. Carbohydrate: Carbohydrates are in bread, grains, fruits, vegetables, beans, milk

and yogurt. They also are in food with added sugar, such as desserts and sweets.

Carbohydrate foods affect blood sugar the most because they break down into glu-

cose (sugar) very quickly. Eating the same amount of carbohydrate at each meal and

spacing meals evenly throughout the day will help you control your blood sugar.

2. Protein: Protein foods come from animals and plants. Beef, pork, poultry, fish,

eggs, cheese and nuts are protein foods. Choose leaner cuts of meat and low-fat

dairy foods so you don’t get too much saturated fat. Trim fat you can see from

meat and take skin off chicken and turkey.

3. Fat: You need fat in your diet, but you need the right kind and amount of fat

to keep you healthy. Choose monounsaturated and polyunsaturated fat, such as

canola oil, olive oil, nuts and avocado. Stay away from saturated and trans fats in

your food. Choose lean meats and low-fat dairy. Saturated and trans fats can block

your arteries. Read the nutrition facts label and ingredients list on foods you buy

to see if they have hydrogenated oils and trans fats. Generally avoid fried food.

How often should I eat?

Eat your meals every 4-5 hours. This will give your body time for insulin to clear the

sugar out of your blood after every meal. Eating too often could keep your blood

sugar above your goal range. If you take certain medications, waiting too long

between meals could drop your blood sugar below your goal range. It is best to try

to eat about the same time each day to help keep your blood sugar levels steady. If

your meals are more than 5 hours apart, eat a small snack to stop your blood sugar

from dropping too low. If you cannot space meals 4-5 hours apart, talk to your

dietitian or diabetes educator to make a meal plan that works for you.



CARBOHYDRATE FOODSEach Food Item = 1 Carbohydrate Choice = 15 grams of carbohydrate

1. Meals should be 4-5 hours apart; if you have more than 5 hours…then eat a snack.

2. Each meal: _______________ Carb choices (_________ grams)

3. Snacks: __________________ Carb choices (_________grams)

4. Eat protein (meat) with each meal.

Starch, Bread Fruit Milk More Carbs

Bagel, 4 oz, 1/4

Baked beans, 1/3 cup

Beans, dry, cooked, 1/2 cup

Bread, 1 slice

Bread (light), 2 slices

Cereal, cooked, 1/2 cup

Cereal, unsweetened, 3/4 cup

Corn, 1/2 cup

Crackers, snack, 4-5

English muffin, 1/2

Hamburger or Hot Dog Bun, 1/2

Lima beans, 1/2 cup

Pancakes, 4˝ across, 1/4˝ thick, 1

Pasta, cooked, 1/3 cup

Peas, cooked, 1/2 cup

Pita, 6˝ across, 1/2

Popcorn, plain, unbut-tered, 3 cups

Potato, 1/2 medium

Potato, mashed, 1/2 cup

Rice, cooked, 1/3 cup

Squash, winter, cooked, 1 cup

Tortilla or taco shell, 6˝ across, 1

Waffle, 1 small

Apple, 1 small

Apricots, 4 whole

Banana, 1 small

Blackberries/Blueber-ries, 3/4 cup

Canned fruit in juice or water, 1/2 cup

Dried fruit, see label

Fruit juice, 1/3 to 1/2 cup

Grapefruit, 1/2 large

Grapes, 17 small

Kiwi, 1

Mango, 1/2 small

Melon, 1 cup cubes

Nectarine, 1 small

Orange, 1 small

Peach, medium, fresh, 1

Pear, large, fresh, 1/2

Pineapple, fresh, 3/4 cup

Raisin, 2 Tablespoons

Raspberries, 1 cup

Plums, 2 small

Strawberries, whole, 1 1/4 cup

Tangerines, 2 small

Buttermilk, 1 cup

Evaporated skim, 1/2 cup

Goat’s milk, 1 cup

Kefir, 1 cup

Low fat or non-fat, 1 cup

Nonfat, dry, 1/3 cup

Soy milk, 1 cup

Yogurt, plain, sugar-free, fat-free, 2/3 cup

Yogurt, low fat, artifi-cially sweetened, 3/4 cup (6 oz)

Cake, no icing, 2˝ square, 1 piece

Casserole or hot dish, 1/2 cup

Chili, 1/2 cup

Cookie, 2 small

Cupcake, frosted, 1/2

Doughnut, glazed, 1/2 medium

Fruit juice bar, 1

Gingersnaps, 3

Ice cream, 1/2 cup

Syrup, honey, jelly, or table sugar, 1 Tbsp.

Muffin, large 1/5

Nonfat frozen yogurt, 1/3 cup

Pizza, thin crust, 12˝, 1/8

Potato chips, 9-13

Pudding, sugar-free, 1/2 cup

Soup, broth, milk, or bean based, 1 cup

Spaghetti or pasta sauce, canned, 1/2 cup

Tortilla chips, 9-13

Vanilla wafers, 5



Reading labels for carbohydrate information

Look for two items on the label:

1. Serving size (located under the words “Nutrition Facts”)

2. Total Carbohydrate (listed in grams)

Calculating carbohydrate grams into carbohydrate choices

Carbohydrate (grams) # of carbohydrate choices

0-5 Do Not Count

6-10 ½ Carbohydrate

11-20 1 Carbohydrates

21-25 1½ Carbohydrates






The serving size for the food is 1 cup (ignore the information in parentheses).

There are three servings or three cups in this container.

The total carbohydrate tells how many grams of carbohydrate are in one serving.

Sugar is already included in the total carbohydrate amount. This value shows the amount of natural or added sugar.



Additional websites for carbohydrate information

Many of these sites have mobile apps as well:

z www.LoseIt.com

z www.MyFitnessPal.com

z www.ChooseMyPlate.gov

z www.CalorieKing.com

z www.CalorieCount.com

z www.TheDailyPlate.com

z www.SparkPeople.com

z www.WeightWatchers.com

z www.dwlz.com (Dotti’s Weight Loss Zone)

z www.FitDay.com



How much should I eat?

The more carbohydrates you eat, the higher your blood sugar could go. Try to

stick to one 9-inch plate and try not to have second helpings. Talk to your dietitian

or diabetes educator to find out how much you should eat.

StepsSteps to Create a Balanced Meal

1. Create sections on your 9 inch

dinner plate by drawing an

imaginary line down the middle

of the plate. Then divide one

section in half so you have three

sections on your plate.

2. Start with the largest section.

Fill it with vegetables that are

not starchy. Some examples are:

z Broccoli

z Carrots

z Cauliflower

z Green Beans

z Peppers

z Lettuce or Salad Greens

z Mushrooms

z Sauerkraut or Cabbage

z Squashes, all varieties except winter

z Tomatoes

3. Next, using one of the small sections, place starches and or grains. Examples are

listed on page 9.



4. In the remaining small section, place the protein. Examples include:

z Beef, trimmed of fat: ground round or sirloin, chuck or rump roast, flank or sirloin steak, tenderloin

z Chicken or Turkey, without skin

z Eggs, egg whites or egg substitutes

z Fish: catfish, cod, haddock, salmon, tilapia, trout, tuna

z Hot Dog, 3g of fat or less per ounce

z Low Fat Cheese, 3g of fat or less per ounce

z Cottage Cheese

z Peanut Butter

z Pork: rib or loin chop, ham, tenderloin

z Sandwich meats, 3g of fat or less per ounce

5. On the side, include a serving of fruit. Examples are listed on page 9.

6. Don’t forget to include a serving of milk or dairy. Examples are listed on page 9.

7. Select healthy fats in small amounts.

z For cooking use oils, choose canola, olive or peanut oils.

z For salads, add nuts, seeds, avocado or vinaigrettes.

z Limit saturated fats such as butter, cream, mayonnaise, sour cream and cream cheese.

8. To finish your meal, include a low-calorie drink such as water, sugar-free drink

mix, unsweetened tea, unsweetened coffee, or diet soft drink.

NOTE: If you are having a casserole type meal like lasagna, 1 cup will count as your

meat and the starch. Fill half your plate with vegetables that are not starchy.



BALANCED MEAL IDEAS

Egg and Potatoes(3 carb choices or 45g carbohydrate)

Non-starchy vegetable: 1 cup sautéed pep-pers and onions (If you don’t want to eat the veggies at breakfast, add a vegetable serving for your midmorning snack.)

Starch or grain: 1/2 cup halved roasted yellow potatoes (1 carb choice or 15g carbohydrate)

Protein: 1 to 2 eggs, scrambled

Fruit: 1/2 cup pineapple (1 carb choice or 15g carbohydrate)

Dairy: 1 cup fat-free milk (1 carb choice or 15g carbohydrate)

Cheese and Crackers(3 carb choices or 45g carbohydrate)

Non-starchy vegetable: 1 cup spinach salad with 1/2 red sweet bell pepper

Starch or grain: 5 whole-wheat crackers (1 carb choice or 15g carbohydrate)

Protein: 2 to 3 ounces low-fat cheese

Fruit: 1 cup raspberries (1 carb choice or 15g carbohydrate)

Dairy: 2/3 cup fat-free yogurt (1 carb choice or 15g carbohydrate)

Chicken and Rice(4 carb choices or 60g carbohydrate)

Non-starchy vegetable: 1 steamed broccoli and carrot mix

Starch or grain: 2/3 cup cooked rice (2 carb choice or 30g carbohydrate)

Protein: 3 ounces cooked skinless chicken breast

Fruit: 1/2 cup unsweetened applesauce (1 carb choice or 15g carbohydrate)

Dairy: 1 cup fat-free milk (1 carb choice or 15g carbohydrate)



How does drinking alcohol affect blood sugar levels?

You may have lower blood sugar after drinking alcohol because alcohol stops your

liver from making the sugar that you need.

You may get low blood sugar if you drink alcohol and:

z You have not eaten much

z Your blood sugar is poorly controlled

There are about 100 calories in:

z 12 ounces of beer

z 1 ounce of mixed drinks

z 5 ounces of any red or white wine

If you choose to drink alcohol, drink it with a meal.

z If you are a woman, limit alcohol to 1 drink or less a day.

z If you are a man, limit alcohol to 2 drinks or less a day.

Always talk to your doctor first before drinking any alcohol.

5 oz. wine OR

12 oz. beer OR

1 oz. liquor (vodka, gin,scotch, bourbon, brandy or rum)

100 calories

Women: no more than onedrink daily, with meals

Men:no more than twodrinks daily, with meals



4 HOW CAN

EXERCISE HELP ME?

Exercise can help you control your blood sugar. By being more active, you could

lose weight, feel less stressed, and lower your cholesterol and triglycerides. Exer-

cise could also help your insulin work better and longer (up to several hours a day.)

It’s never too late to start an exercise program or to do more physical activity.

Be sure to talk to your doctor before you start any exercise program. Exercise by

itself may not be enough to control your diabetes. You may still need to manage

your diet and take medicine.

Your exercise plan z Talk to your doctor before you start.

z Think about asking an exercise professional for advice on exercise that is safe for you to do.

z Choose an activity you enjoy, such as walking, biking, running, water aerobics, etc.

z Find an exercise buddy.

z Keep a log of your progress.

z Choose different kinds of activities so you don’t get bored.

z Talk to your doctor if you have diabetes problems such as heart, eyes, kidney disease or problems with your feet.

z Check your blood sugar before and after exercise, and write down how exer-cise affects your blood sugar.

z If you take diabetes pills or insulin, carry glucose tablets or hard candy in case your blood sugar drops too low.

z Do it, but don’t overdo it! Set small goals and gradually increase your exer-cise. For example, walk for 5 minutes to start and then increase to 10 minutes.

z Try and exercise 20 to 30 minutes four to five days a week, with an eventual goal of 150 minutes per week.



5 WATCHING YOUR

BLOOD SUGAR AT HOME

Checking your blood sugar every day will:

z Help you keep track of what you eat and how your lifestyle affects your blood sugar.

z Make your diabetes real and keep you motivated to take care of yourself.

z Give information to you and your doctor or diabetes educator that can be used to help you take care of your diabetes.

REMEMBER: Your blood sugar goal is 80 to 130 before any meal and less than 180

two hours after the start of your meal.

Times you can check your blood sugars:

z Before breakfast

z Before lunch

z Before dinner

z Before bedtime snack

You should also check your blood sugar any time you feel “different” or feel any

signs/symptoms of hypoglycemia (low blood sugar) or hyperglycemia (high blood

sugar). Talk to your doctor or diabetes educator to find out the best times and

how often you need to check your blood sugar.

If you test your blood sugar at least twice a day, you can have better control of

your diabetes. When you test your blood, you should change the time of day that

you test. For example, one day you could test before breakfast and before dinner.

The next day, test before lunch and before your bedtime snack.

REMEMBER: If you have a problem with your meter or have questions, meter com-

panies have toll-free help lines and are available 24 hours a day. Look for the num-

ber on the back of the meter.



How to check your blood sugar z Wash your hands with soap and warm water before pricking your finger.

z Don’t use alcohol on your fingertips. Alcohol can toughen your skin or change your test results if your fingertips are not dry.

z Load the lancing (needle) device with the lancet (needle.)

z Put a strip into your machine.

z Prick your fingertips at the edges to get the best drop of blood.

z Squeeze your finger to get a drop of blood.

z Touch the drop of blood to the tip of the strip. (With some strips, the blood is applied to the side of the strip.)

z Wait for the blood sugar (BS) result.

z Write the blood sugar down.

z Pull the strip out and throw it away.

z Remove the lancet from the lancing device and dispose of it properly.

Wait for result

After washing hands and checkingsupplies, prick fingertip

Squeeze blood and touch strip to blood; insert into device

Record result, discard strip and lancet



REMEMBER: Take the results of your tests with you to doctor appointments.

Write down:

z If you have been ill

z How active you’ve been

z If you ate any meals late

z If you’ve been stressed

z How you’ve been taking your medicine

About your supplies

Test strips: Strips expire faster after they are opened. Check the bottle or package

for the expiration time. Write the date on the bottle of strips when you open it.

Put the cap on tight after you’ve used the strips.

Lancets: Put used lancets in a plastic laundry detergent bottle. When the bottle is

full, tape the lid shut. Write “Do not recycle,” on the bottle and put it in the trash.

REMEMBER: If you need assistance with checking your blood sugars or with meters

or supplies, our diabetic educators are happy to assist you. Call the Franciscan

Physician Network Diabetes & Endocrinology Specialists at (317) 528-5904 to

schedule an appointment a diabetic educator.



6 HEMOGLOBIN A1C TEST

What is a Hemoglobin A1C test?

The Hemoglobin A1C test is:

z A special blood glucose test that can tell the average blood glucose level over a two- or three-month period. An A1C of 6.5% or higher indicates diabetes.

z Your A1C result is ___________ on (date) ____________

z An important tool for you to use to see how well your diabetes is controlled.

Franciscan Health — Hospital Lab

Hemoglobin A1C levels should be…

z Taken every 3 to 6 months at the same laboratory.

z Goal: 7% or less. Every 1% drop in A1C reduces the risk of complications by 30%.

z Goal: less than 8% if you have a history of severe hypoglycemia (low blood sugar when someone else needed to help you because you were not able to help yourself), you are 80 years of age or older or have other health concerns, such as heart problems.

Why is it important to control my blood glucose levels?

If you keep your blood glucose levels near normal, you will have a smaller chance of

damage to your body.

Hemoglobin A1C EAG (Estimated Average Glucose)

Hemoglobin A1C EAG (Estimated Average Glucose)

5% 97 mg/dl 9% 212 mg/dl

6% 126 mg/dl 10% 240 mg/dl

7% 154 mg/dl 11% 269 mg/dl

8% 183 mg/dl 12% 298 mg/dl

Problems Your risk will be reduced by:

Problems Your risk will be reduced by:

Eye problems 76% Nerve complications

60%

Severe eye damage 47% Severe kidney problems

56%



7 DIABETES PILLS

What should I know about diabetes pills? z You must still follow a food and exercise plan if you are taking pills.

z Diabetes pills are not insulin. Each type of pill helps lower blood sugar in a dif-ferent way.

z Take diabetes pills at the same time each day, unless your doctor tells you to do something different.

z Ask your doctor to tell you about the possible side effects of diabetes pills.

z Know the signs of hypoglycemia (low blood sugar) to look out for, and learn how to treat hypoglycemia. If you have hypoglyciemia or take a medication that can cause hypoglycemia, check your blood sugar before driving or operat-ing machinery.

z If you miss a dose of your medicine, do not double up at your next dose. Just be sure to write it on your blood sugar record.

See next page for commonly prescribed pills for diabetes, how they work, and what side effects they may have.

Glucose fromdigested food or

liver storageenters bloodstream

Insulin frompancreas

enters bloodstream

Glucose enterscells to be used for

energy

Copyright graphisMedica.com, 2013

Sugar passed into urine

Hormone stimulatespancreas to release

insulin

Causes release of more insulin:Micronase

DiabetaGlynase,GlucotrolAmarylPrandinStarlix

Slows release of sugar from liver:

GlucophageGlumetzaFortametRiomet

Slows absorptionof carbohydrate foods:

PrecoseGlyset

Improves insulin use:

AvandiaActos

Increases insulin-stimulation hormone,

decreases liver release:JanuviaOnglyzaTradjentaNesina

Increases sugarin urine:Invokana



Brand name Generic name How it works Possible side effects

Micronase Diabeta Glynase

Glyburide Causes the pancreas to release more insulin

Low blood sugar Allergy to sulfa

Glucotrol Glucotrol XL Amaryl

Glipizide Glimepiride

Causes the pancreas to release more insulin

Low blood sugar Allergy to sulfa

Prandin Starlix

Repaglinide Natelinide

Causes the pancreas to release more insulin

Low blood sugar

Glucophage Glucophage XR Glumetza Fortamet Riomet (liquid form)

Metformin Keeps the liver from releasing excess sugar

Stomach or intestinal problems

Precose Glyset

Acarbose Miglitol

Slows the absorp-tion of carbohydrate foods

Stomach or intestinal problems

Avandia Actos

Rosiglitazone Pioglitazone

Helps the body use insulin better

Swelling in feet/hands Weight gain Liver problems

Cycloset Bromocriptine Increases morning dopamine level

Nausea Headache Fatigue

Januvia Onglyza Tradjenta Nesina

Sitagliptin Saxagliptin Linagliptin Alogliptin

Increases hormone that helps pancreas make insulin and decreases how much sugar the liver re-leases

Runny nose Sore throat

Invokana Farxiga Jardiance

Canagliflozin Dapaglifozin Empagliflozin

Reduces reabsorp-tion of sugar in the kidney so that more is passed through urine

Genital yeast infection Urinary tract infection Increased urination

Pills prescribed for diabetes



Combination diabetes pills

Your doctor may ask you to take more than one diabetes medicine at a time. Some

diabetes medicines that lower blood sugar work well together. Combination pills

are two diabetes medicines in one pill. They can have the same benefits and side

effects as the pills individually.

If your medication is not listed here, it may be new. Ask your doctor, nurse practi-

tioner, or diabetes educator for information.

Brand name Generic name

Actoplus Met Actos and metformin

Avandamet Avandia and metformin

Avandaryl Avandia and Amaryl (glimepiride)

Duetact Actos and glimepiride

Glucovance Glyburide and metformin

Janumet Januvia and metformin

Jentadueto Tradjenta and metformin

Kazano Nesina and metformin

Kombiglyze Onglyza and metformin

Metaglip Glipizide and metformin

Oseni Nesina and pioglitazone

Prandimet Prandin and metformin



8 INJECTABLE MEDICINES (NOT INSULIN)

Group 1

These medicines may increase your risk of hypoglycemia (low blood sugar.) Always

carry a fast-acting form of carbohydrate with you.

For example:

z 3 to 4 glucose tablets

z 7 Life Savers™

z 1 tube of cake decorating gel

z 3 to 4 hard candies

Symlin z Is an injectable medication for adults with type 1 and type 2 diabetes

z Can be taken with insulin.

z Helps to lower blood sugars after meals.

z Slows down the movement of food through your stomach, which slows down how fast sugar enters your bloodstream.

z Reduces the amount of stored sugar being released from your liver.

Byetta, Victoza, Bydureon z Are injectable medications used to improve blood sugar control in adults with type 2 diabetes.

z Helps your pancreas make insulin.

z Reduces the amount of stored sugar released from your liver.

z Slows down the movement of food through your stomach which slows down how fast sugar enters your blood after eating.

z Can make you feel less hungry so you eat less, which could help you lose weight.

Group 2

These drugs will cause hyperglycemia (high blood sugar)



Glucagon z Is a hormone made in the pancreas that can be used with type 1 and type 2 diabetes.

z Has the opposite effect of insulin — it raises blood sugars.

z When you inject Glucagon, it makes sugar stored in your liver go into your bloodstream. This makes your blood sugars rise.

z Is used to treat severely low blood sugar reactions, such as when a person loses consciousness or is unable to help themselves.

REMEMBER: Your doctor may ask you to take more than one diabetes medicine.

Medicine How it is delivered

Days of use When to inject Injection site Side effects

Symlin pre-filled pen

28 days room temp

Immediately before meals or snacks containing at least 30g Carbohydrate or 250 calories

Stomach, upper thigh

(at least 2” away from insulin injection site)

Low Blood Sugars Nausea

Byetta pre-filled pen

30 days room temp

Twice daily before morning and eve-ning meals at least 6 hours apart; eat within 60 minutes

Stomach, thigh, upper arm

Nausea**

Victoza pre-filled pen

30 days room temp

Once daily with or without food


Nausea**

Bydureon Tanzeum Trulicity

pre-filled pen

Keep Refrig-erated or good for up to 4 weeks at room temp

Once weekly on the same day each week; do not take 2 doses less than 3 days apart if you forget a dose


Nausea, raised Bumps**

Glucagon syringe kit Use until ex-piration date on kit, store at room temp

In cases of severe hypoglycemia when the patient is unable to help themselves

Buttock, Arm, Upper Thigh

Nausea

** May cause hypoglycemia when used with other oral medications that cause low blood sugars. Your doctor may lower the dose of your other diabetes pills to reduce episodes of hypoglycemia.

Injectable Medicines



9 INSULIN

Different insulins are used to control diabetes. Some of these insulins are

fast-acting and some are long-acting.

How to store insulin z Clear insulin that is being used can be stored at room temperature in a cool, dry place or in a refrigerator for no more than 28 days. Levemir can be stored at room temperature for 42 days. Cloudy insulin can be stored for 14 days.

REMEMBER: Always write the date on your pen or bottle of insulin as soon as you open it and make sure you use it before it expires.

z Keep unopened pens or bottles of insulin in your refrigerator. They will be good until the expiration date.

z If clear insulin becomes cloudy, do not use it. Throw it away.

z If a cloudy insulin becomes clumped or crystallized, do not use it. Throw it away.

When to take insulin

Humalog, NovoLog, Apidra, Humalog 75/25 and NovoLog 70/30, Humalog 50/50

z Should be taken right before you start eating, “When your plate is hot, take your shot.”

HumulinR, Novolin R, Humulin 70/30, Novolin 70/30

z Should be taken about 30 minutes before you begin eating

Lantus or Levemir

z Clear insulin, usually given once a day at about the same time each day.

z Never mix Lantus or Levemir with any other insulin in the same syringe.

Tresiba

z Can be taken once a day and any time of day. If you miss or delay a dose, take it as soon as you remember, making sure there is at least 8 hours between doses.



Comparison of insulins

Type Name(s)

Length of storage time at room temperature

(vial/pen)

Color Begins

When working

the hardest (hours)

Ends (hours)

U-100 (concentration/strength)

Rapid acting Apidra Humalog Novolog

28 / 28 days Clear 5-15 minutes

1-2 4-6

Short-acting R (regular) 28 / 31 days Clear 30 minutes- 1 hour

2-4 6-10

Intermediate-acting

N (NPH) 28 / 14 days Milky-white 1-2 hours 4-8 10-18

Long-acting Basaglar Lantus Levemir

28 days (pen only) 28 / 28 days 42 / 42 days

Clear 1-2 hours Evenly absorbed

Up to 24

Long-acting Trebisa 56 days (pen only)

Clear 1 hour Evenly absorbed

42

Mixed insulins Humalog 75/25 Humalog 50/50 Novolog 70/30

28 / 10 days 28 / 10 days 28 / 14 days

Milky-white 5-15 minutes

1-4 18

Mixed insulins Humulin 70/30 Humulin 50/50 Novolin 70/30

28 / 10 days 28 / 10 days 30 / 14 days

Milky-white 30 min 2-8 18


Rapid Acting Humalog U200 28 days (pen only)

Clear 5-15 minutes

1-2 4-6

Long-acting Tresiba 56 days (pen only)

Clear 1 hour Evenly absorbed

42


Long Acting Toujeo 28 days (pen only)

Clear 6 hours Evenly absorbed

36


Regular-Intermediate Acting

Regular U-500 40 days / 28 days) Clear 30-45 minutes

4 6-11.5

Inhaled insulin

Rapid Acting Afrezza 15 days (inhaler)

Powder up to 15 minutes

12-15 minutes

3



Injecting insulin

Your abdomen is the fastest and best place to give your insulin. You will need to

rotate injection sites.

z Stay 2 inches away from any scars and your belly button.

z Put used syringes or pen needles into an empty, heavy-duty plastic laundry detergent bottle with a lid. When the bottle is full, tape the top shut. Write “Do not recycle” on the bottle and put it in the trash.



How to use your insulin pen1. Roll the pen to mix the insulin if it is a cloudy insulin.

2. Attach the needle and remove both caps.

3. Fill the needle.

z Turn the knob clockwise until 2 appears

z Point the pen upwards and tap the clear plastic lightly

z Push the injection button all the way up and watch the needle to see if

insulin comes out.

z If you don’t see a drop at the tip of the needle, repeat until you do see a

drop.

4. Dial the dose.

5. Inject the insulin. z If you are using a mini (3/16”) or nano (5/32”) pen needle, you do not need to “pinch an inch” of fat before injecting. z If you are using a short or 5/16” pen needle, you do need to “pinch an inch” of fat before injecting.

(a) Wipe the area with alcohol. Insert the needle straight into your skin

and all the way in.

(b) Push the plunger all the way in and count to 10.

(c) Pull the needle all the way out of your skin.

(d) Wipe the area of skin again with an alcohol swab.

6. Store the pen.

z Put the large cap back on the needle and then unscrew the needle.

z Put the pen cap back on so you can store it.

Important:

z Do not use a needle more than one time.

z Never leave a needle attached to a pen that is being stored.

z A pen that is being used can be kept at room temperature.

z Pens that are not being used need to be kept in a refrigerator.

z If you dial your dose too high, turn the knob backwards until you see the right dose.

REMEMBER: Call Franciscan Physician Network Diabetes & Endocrinology Specialists

at (317) 528-5904 if you have questions about using your insulin pen.



How to measure a single dose of insulin1. Wash your hands.

2. If insulin is cloudy, roll the cloudy bottle of insulin between your hands, upside-down and sideways.

3. Wipe off the top of the bottle with an alcohol swab.

4. Pull the plunger to the number of units of insulin you are using _______. Put the needle through the top of the bottle and push the plunger down, putting air into the bottle of insulin.

5. With the needle in the bottle, turn the bottle upside-down.

6. Pull the plunger half-way down. Push all the insulin back into the bottle. Pull the plunger to the number of units. Take the needle out of the bottle.

7. Wipe your skin with an alcohol swab and pinch an inch.

8. Pick up the syringe like a pencil and push the needle straight into your skin. Push the plunger down and count to 10.

9. Release your pinch. Remove the needle. Do not rub the place where you gave the injection.

Notes

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________



Syringe information

Pay attention to the size of the syringe you receive to make sure you measure out

the right amount of insulin.

100-unit syringe (1 cc or mL) each line is

2 units

50-unit syringe (1/2 cc or mL)

each line is 1 unit

30-unit syringe (3/10 cc or mL)

each line is 1 unit

The top line → is always zero

← Measure from the TOP of the black

plunger



10 HYPOGLYCEMIA:

LOW BLOOD SUGAR

Hypoglycemia refers to a low blood sugar of less than 70 mg/dL. Symptoms of

hypoglycemia may begin at 100 mg/dl or less.

Questions and answers

What can make my blood sugar low? z Not eating enough food or eating later than usual

z Too much insulin or diabetes medicine

z Extra exercise or more activity

z Drinking alcohol

How quickly does blood sugar drop?

It can drop slowly. It also can drop suddenly, and you could become uncon-

scious.

What are the symptoms of low blood sugar?z shaking z hunger z sweating

z impaired vision z fast heartbeat z headache

z anxiety z weakness/fatigue z irritability

z confusion z dizziness



What should I do if I have low blood sugar?1. Test, if you can, when your blood sugar is below 70 mg/dl. Then:

2. Treat with 15 grams of carbohydrate (choose one example from below)

z ½ cup fruit juice

z 6 oz. regular soda (1/2 can)

z 3 to 4 glucose tablets/glucose liquid

z 7 Lifesavers® candies

z 8 ounces of skim, 1 percent or

2 percent milk

z 3-4 hard candies

z 1 tablespoon of sugar, honey or maple syrup Do not use other candies or any type of food that contains fat, such as choco-late, candy bars or peanut butter. The fat in these products will slow down the rate that your blood sugar rises back to normal. NOTE: If your blood sugar is less than 40, treat with 30 grams of carbohydrate, or double the amounts listed above.

3. Wait 15 minutes and test again. If your blood sugar is not more than 70 mg/dL, treat again with 15 grams of carbohydrates and retest in 15 minutes.

4. If your blood sugar is more than 70 mg/dL, eat a snack or small meal within 30 minutes (For example: 1/2 sandwich or 1 piece of string cheese with 5 to 6 crackers). If you still have symptoms, even if your blood sugar is above 70 mg/dL, wait before treating further. Many times, symptoms continue for a while but will go away after your blood sugar is better.

REMEMBER: In cases of severe low blood sugar, when the person is unconscious or

unable to help themselves, Glucagon can be injected by another person so that the

blood sugar is raised quickly. Or, if this is not possible, call 911.

Always carry a treatment for low blood sugar with you!

If you are taking Precose or

Glyset, you must use:

z 3-4 glucose tablets

z ½ cup (4 oz.) fruit juice

z 1 cup (8 oz.) milk



11 HYPERGLYCEMIA:

HIGH BLOOD SUGAR

Questions and answers

What can make my blood sugar high? z Eating too much food

z Not taking enough insulin or diabetes medicine

z Stress

z Illness

z Being less active

How quickly does blood sugar rise?

Slowly, and you may go into a diabetic coma.

What are the symptoms of high blood sugar? z blurred vision z hunger z drowsiness z extreme thirst

z frequent urination z dry skin z nausea

At what blood sugar level should I call my doctor?

These guidelines represent blood sugar results before meals:

z If blood sugars are between 150-200 for one week, call your doctor who takes care of your diabetes.

z If blood sugars are between 200-250 for 2 days, call your doctor who takes care of your diabetes.

z If your blood sugar is greater than 250, drink 8 oz. of water every hour and check your blood sugar every 4 hours. If your blood sugar does not go down in 24 hours, call your doctor who takes care of your diabetes. Note: If you have Congestive Heart Failure (CHF) and have a water restriction, do NOT go over your allowed amount of water for the day.

z If your blood sugar is greater than 350, call your doctor who takes care of your diabetes right away.



General guidelines for when to call your doctor (even when you’re not sick)

REMEMBER: When you are worried, always call your doctor. You hopefully will be

able to prevent having to go the hospital.

Call your doctor if:

z Your blood sugar is over 250 for more than one day.

z You have a very dry mouth, increased thirst and urination for more than one day and your blood sugar is greater than 250.

z Your blood sugar drops below 70 twice in one day.

z You have low blood sugars (less than 70) 3 times in one week.

z You have symptoms of hypoglycemia (low blood sugar) that do not get better when you eat. The symptoms might include: shakiness or a nervous feeling; sweating; rapid heart rate; light-headedness; or confusion.

z You have blisters, redness, swelling, bleeding or oozing of fluid or black-and-blue marks on your feet. Call your doctor even if you do not have any pain.

z You have an open sore on your foot that does not heal in 1 week or it be-comes red.



12 SICK DAYS

Plan ahead

If you have type 1 or type 2 diabetes, have a plan for sick days before you get sick.

Do not wait until you are too sick to find out where to call for help.

REMEMBER: Have your doctor’s name, office phone number and after-office-hours

phone number in a place where you can easily find them.

If you are not feeling well1. Never stop taking your diabetes medicine (pills or insulin) unless your doctor

tells you to stop.

2. Check your blood sugar every 4 hours throughout the day.

3. If you can eat…stay on your regular meal plan.

4. If you cannot eat, then drink fluids contain-ing 15 grams of carbo-hydrate every hour. Examples are:

z½ cup of regular soda

z½ cup of apple juice

z½ cup orange juice

z½ cup Jell-O with sugar

z 1 twin popsicle with sugar

z ¼ cup sherbet

(continued on next page)



5. Take your temperature at least once or twice a day and record it on your blood sugar diary.

6. Rest and do not exercise during sick days.

Call your doctor immediately if: z You are vomiting and cannot keep down any food or fluids for more than 2 hours.

z You have the flu or are sick for more than 24 hours.

z You have a fever of 101° F or more.

z If your blood sugar is greater than 250, drink 8 oz. of water every hour and check your blood sugar every 4 hours. If your blood sugar does not go down in 24 hours, call your doctor who takes care of your diabetes. Note: If you have Congestive Heart Failure (CHF) and have a water restriction, do NOT go over your allowed amount of water for the day.

z If your blood sugar is greater than 350, call your doctor who takes care of your diabetes right away.

If you have type 1 diabetes: z If your blood sugar is 240 or more, test your urine for ketones.

z Call your doctor if ketones are moderate or large.

z Do not stop taking your insulin.



13 TAKE CARE OF YOUR FEET

When you have diabetes, it is very important to take care of your feet and to wear

the right shoes.

Daily foot care z Look at and feel your feet every day. Look for cuts, blisters, open or red areas. Feel for calluses, “hot spots” or corns. Check between your toes.

z Wash your feet with warm water and mild soap. Pat your skin dry – don’t rub your feet hard.

z Use a moisturizer if you have dry skin. Do not put lotion between your toes.

z Trim your toenails straight across and not too short. Use an emery board to file sharp edges.

z Never go barefoot, except in bed or in the bathtub or shower.

z Check your shoes for pebbles before you put them on.

Shoes z Buy shoes early in the day when your feet are less swollen. Have your feet measured.

z Look for diabetes socks.

z Break in new shoes slowly. Wear new shoes one to two hours at a time. Carry an old pair to switch to after one to two hours.

z You may need orthotics (special shoe inserts made just for you) if the shape of your foot changes.

REMEMBER: Take off your shoes and socks every time you see your doctor so your

feet can be checked. A podiatrist (foot doctor) can help you with toe nail, callus,

sores, or other foot problems.



14 STANDARDS OF CARE

The American Diabetes Association writes standards of medical care for people

with diabetes for two reasons:

1. To give your doctor the most up-to-date information on how to take care of you and your diabetes.

2. To help you know what to expect from your doctor.

You will need to see your doctor at least every six months. Sometimes, you will

need to see your doctor more often, especially if your treatment goals are not met.

Things to do at EACH VISIT with your doctor or other health care provider:

(Record dates and results.)

Tests, Other Services Date Date Date Date Date Date

Blood glucose (mg/dl)

Hemoglobin A1C (%)

Weight (lbs.)

Blood pressure

Foot check

At least once a year

(Record dates and results.)

Tests, Other Services Date Date Date Date Date Date

Flu shot (check with your

doctor)

Microalbumin (urine test)

Total cholesterol (mg/dl)

HDL cholesterol (mg/dl)

LDL cholesterol (mg/dl)

Triglycerides (mg/dl)

Eye exam (dilated)



15 DEALING WITH FEELINGS

When you have diabetes, you have a lot to do to take care of yourself. You need

to eat regularly, exercise, take medicine and check your blood sugar. These are all

physical things that need to be done.

You will also have a lot of different feelings about having diabetes to deal with.

Some of the feelings you might have are:

Denial

“I don’t believe this is happening to me.”

“If I don’t think about this, it will go away.”

Guilt

“If I just hadn’t eaten so much sugar…”

“I must have done something to

deserve this.”

Fear

“What’s going to happen to me

now?”

“How is this going to change my

life?”

Depression

“I feel so alone. No one under-

stands.”

“I don’t feel like doing anything.”

Anger

“Why me? This isn’t fair!”



These feelings are normal and it’s OK to have them.

Your feelings can get in the way of taking care of yourself. There are two things to

look at to see if feelings are getting in the way of being healthy:

z Feelings that last too long. For example, it is normal to deny or not want to

think about diabetes right after being told you have it. If you deny that you

have diabetes for years, your health will be in danger.

z Really strong feelings. Feelings can change. For example, you may feel de-

pressed at some time, a little sad at another time and not depressed at all

another time. It is when you have a feeling so strongly that it stops you taking

care of yourself that the feeling is unhealthy.

REMEMBER: It is normal and OK for you to have feelings. Do your best to not let

them get in the way of taking care of yourself.

Here are some ideas to help you work through your feelings:

z Use exercise, sports, hobbies or other activities you enjoy to work through

the feelings.

z Choose one or two people you trust and who will listen when you need to

talk about how you are feeling. Members of your health care team are always

there to help you.

z Look for support. Support groups made up of other people with diabetes can

be helpful. Franciscan Physician Network Diabetes & Endocrinology Specialists

have a monthly support group meeting. Call (317) 528-5904 to find out how

you can join.

z If your feelings are stopping you from taking care of yourself, talk to your doc-

tor. Your doctor can help you see a counselor, social worker or psychologist if

you need to. See the Diabetes Education Program Resource List for addresses

and telephone numbers of professionals who could help you.

z Ask your doctor or a certified diabetes educator about counseling.



16 DIABETES EDUCATION PROGRAM RESOURCES

Adult and child mental health services, Marion County/Johnson County8320 Madison Ave.Indianapolis, IN 46227(317) 882-5122

Adult Protective Services251 E. Ohio Street Indianapolis, IN 46204

Academy of Nutrition and DieteticsConsumer Nutrition Hotline(800) 366-1655www.EatRight.org

American Association of Diabetes Educators(800) 338-3633www.AADEnet.org

American College of Sports Medicinewww.acsm.org

American Council on Exercisewww.ACEfitness.org

American Diabetes Association (800) DIABETES (342-2383)

American Diabetes Association Indiana Affiliate8604 Allisonville Road, Suite 140Indianapolis, IN [email protected]

American Heart Associationwww.heart.org

Baxter YMCA7900 S. Shelby St.Indianapolis, IN 46227(317) 881-9347

Beech Grove Senior Center Transportation602 Main St.Beech Grove, IN 46107

Behavioral Health Services, Franciscan St. Francis Health (317) 783-8983

CarDon & AssociatesWalking ClubRegister anytime at the Greenwood Park Mall Guest Services desk or by sending an email to [email protected]

Centers for Disease Control and PreventionDiabetes Public Health Resourcewww.cdc.gov/diabetes

CICOA 4755 Kingsway Dr.Indianapolis, IN 46205(317) 254-5466

Cornerstones for Carewww.cornerstones4care.com

Diabetes netwww.DiabetesNet.com

Diabetes Support GroupFranciscan Physicians’ NetworkDiabetes & Endocrinology(317) 528-5904



D-Lifewww.dLife.com

Family Services Association6145 N. Alabama St.Indianapolis, IN 46204(317) 634-6341

Indiana Department of Insurance, Consumer Assistance(800) 622-4461

Indiana State Department of Health,Diabetes Prevention and Control Programwww.in.gov/isdh/24966.htm

Johnson County Senior Services731 State St.Franklin, IN 46131(317) 738-4544

Juvenile Diabetes Research Foundation1-800-533-CURE (2873)www.JDRFCure.org

Marion County Health Department3838 N. RuralIndianapolis, IN 46205(317) 633-6325

Meals on Wheels of Central Indiana708 E. Michigan St.,Indianapolis, IN 46202(317) 252-5558www.mealsonwheelsindy.org

National Federation of the Blind(410) 659-9314www.NFB.org

National Kidney Foundationwww.kidney.org

PACE (Program of All-Inclusive Care for the Elderly)Franciscan Senior Health & Wellness (317) 528-7223

Senior Stretch ‘N’ Flex, Franciscan Health(317) 528-6864

Senior Promise, Franciscan Health (317) 528-6660

Franciscan HealthHome Health (317) 528-2080

Franciscan Visiting Nurse Service (VNS)(317) 722-8200



Atherosclerosis. Fat builds up in large

and medium-sized blood vessels. This

build-up of fat may slow down or stop

blood flow. This disease can happen

to anyone. People who have diabetes

tend to develop it more often and at a

younger age than other people.

CDE (Certified Diabetes Educator). A

CDE is a health care professional who

has passed a test given by the National

Certification Board for Diabetes Educa-

tors. The test asks questions on all areas

of diabetes care and on teaching meth-

ods.

Cholesterol. A fat-like substance made

by the bodies of people and animals.

Cholesterol is found in blood, muscle,

liver, brain and other tissues. In the

right amounts, it plays an important

part in the body. When the level of

cholesterol in the bloodstream becomes

too high, it can build up on blood vessel

walls. Having a blood cholesterol level

greater than 200 mg/dl raisies a per-

son’s risk for heart disease.

Endocrinologist. A medical doctor who

specializes in treating people with dia-

betes.

Dietitian. A health care professional

who helps people plan the kinds and

amounts of foods to eat to help with

special health needs. A registered dieti-

tian (R.D.) has special qualifications and

has passed the examination given by the

Academy of Nutrition & Dietetics.

Hemoglobin A1C. Hemoglobin is the

substance in red blood cells that carries

oxygen to the body tissues. Sugar in

the blood cells attaches to hemoglobin

and stays attached to it for the life of

the red blood cell. These cells live in the

body for about three months. The more

sugar there is in the blood, the more

becomes attached to the red blood

cells. By measuring the amount of sugar

attached to these cells, an average

blood sugar level for a two- to three-

month period can be found.

17 GLOSSARY



Ketone. A chemical produced in the

body when fat is burned for energy.

When too little insulin is available to

get sugar into body cells, the body is

forced to use fat for energy, and ke-

tones are produced. Ketones from the

blood spill over into the urine, where

they can be found with a simple test.

Ketones also leave the body through

the lungs. This makes the breath of a

person who is producing ketones smell

sweet and fruity.

Lipid. A name for fat. There are many

types of lipids in the body. Some have

special jobs, like cholesterol. Others are

used to store extra energy to be used

later.

Nephropathy. Damage to the nephrons

or filtering portions of the kidneys. Ne-

phropathy is one of the possible long-

term problems of having diabetes. Ne-

phropathy makes the kidneys lose their

filtering ability. When this happens,

some substances that should remain

in the body are lost in the urine. Also,

some wasted products are stopped

from leaving the body as they should.

Neuropathy. Damage to the nerve tis-

sues. Neuropathy is one of the possible

long-term problems of having diabetes.

Nerve damage can affect many parts

of the body. Neuropathy often causes

pain in the feet and legs or tingling and

numbness in those areas. Other forms

of neuropathy can cause double vision,

diarrhea and loss of feeling or response

during sexual activity.

Ophthalmologist. A medical doctor

trained to diagnose and treat diseases

and other problems of the eyes.

Retinopathy. Damage to the back lining

of the eye due to high blood sugar, high

blood pressure and/or smoking. If the

retina is damaged, it is very possible to

go blind.

For more about diabetes, visit www.FranciscanHealth.org and search for “diabetes.”



NOTES

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5230A E. Stop 11 Road, Suite 150Indianapolis, IN 46237

(317) 528-5904 11/16

10715611-10051

Affecting more than 20 million Americans,

diabetes is a chronic (lifelong) disease marked by

high levels of sugar in the blood. While there is

no cure, many of the complications associated

with diabetes can be prevented. Learning to live

successfully with diabetes requires specific skills,

self-care knowledge and a positive outlook.

living with diabetes: the basics - franciscan health · when blood sugar is high, cells important...

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