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Type 1 Diabetes In Adults

WHAT YOU NEED TO KNOW:

Type 1 diabetes 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.

DISCHARGE INSTRUCTIONS:

Call 911 if:

  • You have chest pain or shortness of breath.

Seek care immediately if:

  • You have a low blood sugar level and it does not improve with treatment.
  • Your blood sugar level is above 240 mg/dL and does not come down after you take a dose of insulin.
  • You have ketones.
  • You have a fever.
  • You have nausea or are vomiting and cannot keep any food or liquid down.
  • You have blurred or double vision.
  • Your breath has a fruity, sweet smell, or your breathing is shallow.
  • You have symptoms of a low blood sugar level, such as trouble thinking, sweating, or a pounding heartbeat.

Contact your healthcare provider if:

  • Your blood sugar levels are higher than your target goals.
  • You often have low blood sugar levels.
  • 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.

Medicines:

  • You will need 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.
  • Glucose tablets may be given to increase your blood sugar if it has dropped too low from treatment.
  • Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him or her 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.

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 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. Your provider may make changes to your medicine, food, or exercise schedules.

How to check your blood sugar

If your blood sugar level is too low:

Your blood sugar level is too low if it goes below 70 mg/dL. If the level is too low, eat or drink 15 grams of fast-acting carbohydrate. These are found naturally in fruits and dairy products. Fast-acting carbohydrates will raise your blood sugar level quickly. Examples of 15 grams of fast-acting carbohydrate are 4 ounces (½ cup) of fruit juice or 4 ounces of regular soda. Other examples are 2 tablespoons of raisins or 3 to 4 glucose tablets. Check your blood sugar level 15 minutes later. If the level is still low (less than 100 mg/dL), eat another 15 grams of carbohydrate. When the level returns to 100 mg/dL, eat a snack or meal that contains carbohydrate and protein. This will help prevent another drop in blood sugar. Always carefully follow your healthcare provider's instructions on how to treat low blood sugar levels.


Wear 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

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 information about foot care.


Maintain a healthy weight:

Ask your healthcare provider how much you should weigh. A healthy weight can help you control your diabetes. Ask your provider to help you create a weight loss plan if you are overweight. Together you can set manageable weight loss goals.

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. Limit alcohol to 1 drink a day if you are a woman. Limit alcohol to 2 drinks a day if you are a man. A drink of alcohol is 12 ounces of beer, 5 ounces of wine, or 1½ ounces of liquor.

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. Work with your healthcare provider to create an exercise plan.

  • Check your blood sugar level before and after exercise. Healthcare providers may tell you to change the amount of insulin you take or food you eat. If your blood sugar level is high, check your blood or urine for ketones before you exercise. Do not exercise if your blood sugar level is high and you have ketones.
  • 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. Drink water or liquids that do not contain sugar before, during, and after exercise. Ask your dietitian or healthcare provider which liquids you should drink when you exercise.
  • Do not sit for longer than 90 minutes. If you cannot walk around, at least stand up. This will help you stay active and keep your blood circulating.

Do not smoke:

Nicotine and other chemicals in cigarettes and cigars can cause lung damage and make it more difficult to manage your diabetes. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products.

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 1 time each year to have your feet checked. You will need an eye exam 1 time each 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.

© 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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