Diabetes Mellitus Type 1 In Adults

WHAT YOU SHOULD KNOW:

Diabetes mellitus type 1 is a disease that affects how your body makes insulin and uses glucose (sugar). Insulin helps move sugar out of the blood so it can be used for energy. Normally, when the blood sugar level increases, the pancreas makes more insulin. Type 1 diabetes develops because your immune system destroys pancreas cells that make insulin. Your pancreas cannot make enough insulin, so your blood sugar level continues to rise.

AFTER YOU LEAVE:

Medicines:

  • Insulin: You will need 1 or more doses of insulin each day. Insulin can be injected or given through an insulin pump. Ask your healthcare provider which method is best for you. You or a family member will be taught how to give insulin injections if this is the best method for you. Your family member can give you the injections if you are not able. Take your insulin as directed. Too much insulin may cause your blood sugar level to go too low.

  • Take your medicine as directed. Call your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Follow up with your healthcare provider or diabetes specialist as directed:

You will need yearly eye exams to check for retinopathy and yearly urine tests to check for kidney problems. Your healthcare provider may want you to have your A1c checked every 3 months. Write down your questions so you remember to ask them during your visits.

Check your blood sugar level as directed:

You will be taught how to use a glucose monitor. You will need to check your blood sugar level at least 3 times each day. Ask your healthcare provider when and how often to check during the day. If you check your blood sugar level before a meal , it should be between 70 and 130 mg/dL. If you check your blood sugar level 1 to 2 hours after a meal , it should be less than 180 mg/dL. Ask your healthcare provider if these are good goals for you. You may need to check for ketones in your urine or blood if your level is higher than directed. Write down your results, and show them to your healthcare provider. He may make changes to your medicine, food, or exercise schedules.


If your blood sugar level is too low:

Your blood sugar level is too low if it goes below 70 mg/dL. Eat or drink a small amount of fast-acting carbohydrate, or take 4 glucose tablets (15 to 20 grams of glucose). Check your blood sugar level again 15 minutes later. If it is above 70 mg/dL, eat a small snack. If it is still below 70 mg/dL, eat a small amount of fast-acting carbohydrate, or take 4 glucose tablets. Your healthcare provider or dietitian can tell you which fast-acting carbohydrates to eat, and how much is safe for you. Ask your healthcare provider for more information on diabetic hypoglycemia (low blood sugar level).


Medical alert identification:

Wear medical alert jewelry or carry a card that says you have diabetes. Ask your healthcare provider where to get these items.

Medical alert ID bracelet

Diabetes education:

Healthcare providers will teach you how to manage your diabetes. A caregiver may visit you at home to teach you more about diabetes, or you may attend classes. They will teach you what to do if your blood sugar level goes too high or too low. They will also help you plan sick day management. Ask how to dispose of used needles and syringes.

Foot care:

Long-term high blood sugar levels can damage nerves and blood vessels. You may lose feeling in your feet because of nerve damage. Check your feet each day for sores. Wear shoes and socks that fit correctly. Soak your feet in lukewarm, soapy water for 10 minutes before you cut your nails. Trim your toenails straight across to prevent ingrown toenails. Do not cut your nails into the corners or close to the skin. Do not dig under or around the nail. Ask your healthcare provider for more details about foot care.

Weight loss:

A healthy weight can help you control your diabetes. Ask your healthcare provider if you need to lose weight, and how much to lose. Ask him to help you with a weight loss program. Even a 10 to 15 pound weight loss can help you manage your blood sugar level.

Nutrition:

A dietitian will help you make a meal plan to keep your blood sugar level steady. Never skip meals. Your blood sugar level may drop too low if you have taken diabetes medicine and do not eat.

  • Keep track of carbohydrates (sugar and starchy foods): Your blood sugar level can get too high if you eat too many carbohydrates. Your dietitian will help you plan meals and snacks that have the right amount of carbohydrates.

  • Eat low-fat foods: Some examples are skinless chicken and low-fat milk.

  • Eat less sodium (salt): Some examples of high-sodium foods to limit are soy sauce, potato chips, and soup. Do not add salt to food you cook. Limit your use of table salt.

  • Eat high-fiber foods: Foods that are a good source of fiber include vegetables, whole grain breads, and beans.

Limit alcohol:

Alcohol affects your blood sugar level and can make it harder to manage your diabetes. Women should limit alcohol to 1 drink a day. Men should limit alcohol to 2 drinks a day. A drink of alcohol is 12 ounces of beer, 5 ounces of wine, or 1½ ounces of liquor.

Exercise:

Exercise can help keep your blood sugar level steady, decrease your risk of heart disease, and help you lose weight. Exercise for at least 30 minutes, 5 days a week. Work with your healthcare provider to create an exercise plan. You may need to eat a carbohydrate snack before, during, or after you exercise. If your blood sugar level is less than 100 mg/dL, have a carbohydrate snack before you exercise. Examples are 4 to 6 crackers, ½ banana, 8 ounces (1 cup) of milk, or 4 ounces (½ cup) of juice. If your blood sugar level is higher than directed, check your blood or urine for ketones before you exercise. Do not exercise if your blood sugar level is high and you have ketones in your urine or blood.

Quit smoking:

If you smoke, it is never too late to quit. Smoking can worsen the problems that may occur with diabetes. Ask your healthcare provider for information about how to stop smoking if you are having trouble quitting.

Vaccines:

Diabetes puts you at risk of serious illness if you get the flu, pneumonia, or hepatitis. Ask your healthcare provider if you should get a flu, pneumonia, or hepatitis B vaccine, and when to get the vaccine.

Contact your healthcare provider if:

  • You are vomiting or have diarrhea.

  • You have an upset stomach and cannot eat foods on your meal plan.

  • You feel weak or more tired than usual.

  • You feel dizzy or have headaches.

  • Your skin is red, dry, warm, or swollen.

  • You have a wound that does not heal.

  • You have questions or concerns about your condition or care.

Seek care immediately or call 911 if:

  • Your blood sugar level is lower than directed and does not improve with treatment.

  • You are having trouble staying awake or focusing.

  • You are shaking or sweating.

  • You have blurred or double vision.

  • Your breath has a fruity, sweet smell, or your breathing is shallow.

  • Your heartbeat is fast and weak.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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