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Diabetes Mellitus Type 1 In Adults, Ambulatory Care

Diabetes mellitus type 1

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

Common symptoms include the following:

  • More thirst than usual
  • Frequent urination
  • Hunger most of the time
  • Weight loss without trying
  • Blurred vision

Seek immediate care for the following symptoms:

  • Blood sugar level that is lower than directed and does not improve with treatment
  • Trouble staying awake or focusing
  • Shaking or sweating
  • Blurred or double vision
  • Fruity, sweet smell to your breath, or shallow breathing
  • A heartbeat that is fast and weak

Check your blood sugar level as directed:

You will be taught how to check a small drop of blood with 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 80 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 use the results to 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 the 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.

Manage diabetes mellitus type 1:

Type 1 diabetes cannot be cured, but it can be controlled. The goal is to keep your blood sugar at a normal level.

  • Take your insulin as directed. You may 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. You will be taught how to adjust each insulin dose you take with meals. Always check your blood sugar level before the meal. The dose will be based on your blood sugar level, carbohydrates in the meal, and activity after the meal.
  • Check your feet each day for sores. Wear shoes and socks that fit correctly. Do not trim your toenails. Ask your healthcare provider for more info about foot care.

  • Follow your meal plan. A dietitian will help you make a meal plan to keep your blood sugar level steady. Do not 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 , such as skinless chicken and low-fat milk.
    • Eat less sodium (salt). Limit high-sodium foods, such as soy sauce, potato chips, and soup. Do not add salt to food you cook. Limit your use of table salt.
    • Eat high-fiber foods , such as 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.
  • Maintain a healthy weight. Ask your healthcare provider how much you should weigh. A healthy weight can help you control your diabetes. Ask him to help you create a weight loss plan if you are overweight. Even a 10 to 15 pound weight loss can help you manage your blood sugar level.
  • Exercise as directed. 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. Do not sit for longer than 90 minutes. 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.
  • Do not smoke. Nicotine can damage blood vessels and make it more difficult to manage your diabetes. Do not use e-cigarettes or smokeless tobacco in place of cigarettes or to help you quit. They still contain nicotine. Ask your healthcare provider for information if you currently smoke and need help quitting.
  • Ask about vaccines. You have a higher risk for 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.

Follow up with your healthcare provider as directed.

You may need to return to have your A1c checked every 3 months. Your healthcare provider will tell you the A1c level that is right for you. Most people should have an A1c less than 7%. You will need to return at least once each year to have your feet checked. You will need an eye exam once a year to check for retinopathy. You will also need urine tests every year to check for kidney problems. Write down your questions so you remember to ask them during your visits.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. 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.

© 2016 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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