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Type 2 Diabetes In Adults

AMBULATORY CARE:

Type 2 diabetes

is a disease that affects how your body 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 2 diabetes develops because either the body cannot make enough insulin, or it cannot use the insulin correctly. After many years, your pancreas may stop making insulin.

Common symptoms include the following:

  • More hunger or thirst than usual
  • Frequent urination
  • Weight loss without trying
  • Blurred vision

Call 911 if you have any of the following:

  • You have any of the following signs of a stroke:
    • Numbness or drooping on one side of your face
    • Weakness in an arm or leg
    • Confusion or difficulty speaking
    • Dizziness, a severe headache, or vision loss
  • You have any of the following signs of a heart attack:
    • Squeezing, pressure, or pain in your chest that lasts longer than 5 minutes or returns
    • Discomfort or pain in your back, neck, jaw, stomach, or arm
    • Trouble breathing
    • Nausea or vomiting
    • Lightheadedness or a sudden cold sweat, especially with chest pain or trouble breathing

Seek care immediately if:

  • You have severe abdominal pain, or the pain spreads to your back. You may also be vomiting.
  • You have trouble staying awake or focusing.
  • You are shaking or sweating.
  • You have blurred or double vision.
  • Your breath has a fruity, sweet smell.
  • Your breathing is deep and labored, or rapid and shallow.
  • Your heartbeat is fast and weak.

Contact your healthcare provider if:

  • You are vomiting or have diarrhea.
  • You have an upset stomach and cannot eat the foods on your meal plan.
  • You feel weak or more tired than usual.
  • You feel dizzy, have headaches, or are easily irritated.
  • Your skin is red, warm, dry, or swollen.
  • You have a wound that does not heal.
  • You have numbness in your arms or legs.
  • You have questions or concerns about your condition or care.

Treatment for type 2 diabetes

includes keeping your blood sugar at a normal level. You must eat the right foods, and exercise regularly. You may need medicine if you cannot control your blood sugar level with nutrition and exercise. You may also need medicine to prevent heart disease, a complication of type 2 diabetes. You may need any of the following:

  • Hypoglycemic medicines or insulin may be given to decrease the amount of sugar in your blood.
  • Blood pressure medicine may be given to lower your blood pressure. Your blood pressure should be less than 140/90.
  • Cholesterol lowering medicine may be given to prevent heart disease.
  • Antiplatelets , such as aspirin, help prevent blood clots. Take your antiplatelet medicine exactly as directed. These medicines make it more likely for you to bleed or bruise. If you are told to take aspirin, do not take acetaminophen or ibuprofen instead.
  • 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:

You will be taught how to check a small drop of blood in a glucose monitor. You will need to check your blood sugar level at least 3 times each day if you are on insulin. 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. Write down your results, and show them to your healthcare provider. He may use the results to make changes to your medicine, food, and exercise schedules.

How to check your blood sugar

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.


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. You should have less than 2,300 mg of sodium per day.
  • 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.

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.

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. Include muscle strengthening activities 2 days each week. Increase your daily activity during travel, at work, and during your free time. 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.

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.

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. 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. You may need tests to monitor for heart disease such as an EKG, stress test, blood pressure monitoring, and blood tests. 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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