What is Type I Diabetes?

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Robyn Simon
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2 What is Type I Diabetes? This handout answers common questions about your diabetes. If you want to learn more or if you have questions be sure to ask your health care provider. What is diabetes? Diabetes is a condition that causes the sugar level in your blood to become too high. In Type 1 diabetes, blood sugar levels rise out of control because the body has stopped making enough insulin (in suhl - in). Type 1 is most common in children and young adults. Someone with Type 1 diabetes has to take insulin shots at least twice a day to stay healthy and to keep their blood sugar level near normal. What is insulin? Insulin is a chemical substance in the body (hormone) that is needed to keep blood sugar levels normal. It also helps the body use fat and protein. It is made in the pancreas (pan cree - us), an organ near the stomach. How did I get diabetes? You don t catch diabetes, your body just stops making insulin. In some people the pancreas is damaged. And, over time the cells that make insulin are destroyed. Diabetes is an autoimmune (awe toe ih - mewn) process. Auto, at the start of the word autoimmune, means self. So, this disease process occurs when the body destroys its own cells the cells that produce insulin. At first the person does not know that anything is wrong. Only when nearly all the cells that produce insulin are destroyed does Type 1 diabetes develop. What are the signs of diabetes? You may have: Lost weight without trying. Had to use the bathroom a lot. Felt very hungry. Felt very thirsty. Started wetting the bed. Had trouble seeing. Felt tired. Is there a cure? No. There is no cure for diabetes. But if you work with your health care team, eat right and exercise you can live a great life and stay healthy.

3 What is Type I Diabetes? What do we do now? Start Treatment with Insulin The goal of treatment is to lower blood sugar levels. This is done with insulin shots, testing blood sugars, a healthy diet and exercise. Your doctor will tell you what kind of insulin to take. You need insulin to live. The shots replace the insulin your body no longer makes. If you are ready you can give yourself the shots. It might be scary at first, but believe it or not, you get used to it. A nurse will show you and your family how to do it. You ll get to practice on something like an orange. When drawing insulin into the syringe make sure that there are no air bubbles in the syringe. Sites for Insulin Shots Ask Questions This picture shows where to choose sites for shots. There is a lot to learn about this disease. Be sure to ask questions or talk to someone about your concerns. Write your questions down as they come up so you remember to ask them when you meet with someone on your care team. Keep the phone numbers you ll need in a handy place. Get a Medical ID Tag Ask your health care provider about how to order an ID (identification) tag that alerts others that you have diabetes. There are many styles. You can choose a necklace or a bracelet. There are also tags that can be put on watchbands or you could carry a wallet card. Eat Healthy Foods Medical ID Tag When you eat, your body turns food into glucose (glue - kohs). Blood glucose (or blood sugar) levels go up. You prevent this rise by taking shots before meals and by eating healthy foods. Eat about the same amount of carbohydrates (kar bow high drates) and to not skip meals. Check with your health care provider to see if you have to be this strict with your eating. You will likely meet with a dietician (die uh tish uhn) who will help work out a meal plan just for you. To make sure your plan fits your life, be sure to tell your dietician:

What is Type I Diabetes? What foods you do and don t like. What foods you often eat at home. What foods you eat when not at home. Your daily schedule and about your family s lifestyle.

It lowers the blood sugar levels in your body. So, exercise is good for most people with diabetes.

4 What is Type I Diabetes? What foods you do and don t like. What foods you often eat at home. What foods you eat when not at home. Your daily schedule and about your family s lifestyle. Your exercise habits. Who does the cooking and what they like to cook. About any other health problems you have. Get Exercise Being active helps your cells take in glucose. It lowers the blood sugar levels in your body. So, exercise is good for most people with diabetes. Talk to your care team about a plan that will work for you or you may check with your doctor before making a big change in your exercise habits or starting a new sport. When you exercise, or go on an outing: Check your blood sugar first. Take a backpack or duffel bag with you packed with: a water bottle glucose tablets, hard candy or juice a healthy snack such as crackers and cheese or a sandwich your diabetes supplies (meter, strips and other items you need to check your blood sugar). Bag of Supplies Test Your Blood Sugar Level Someone on your care team will explain how to test your blood sugar levels. Most people do the test using a drop of blood from the tip of their finger or arm. A machine called a glucose monitor (also called a glucometer glue kohm uh ter) will tell you how much glucose is in your blood. There are many styles of glucose monitors and they use different methods of reading the blood sample. You will also likely get a logbook to keep track of your blood sugar levels. Check your blood sugar level four to five times a day. Keep good records and bring them with you when you go for check-ups. Your health care provider will tell you the blood sugar levels that you should try to maintain. These levels are expressed with numbers. Blood Sugar Level Book Doing the testing helps you stay in control of your diabetes.

5 What is Type I Diabetes? Follow a Schedule Every Day You may need to stick to a schedule each day. Your health care provider can help you set up a routine that works best for you. Your schedule depends on the kind of insulin you take and your family s needs. Good morning Check blood sugar Give insulin Breakfast Snack Check blood sugar Lunch Snack Check blood sugar Give insulin Dinner Check blood sugar Snack Goodnight Check blood sugar Remember to get some exercise everyday! Know What to Do if Something Goes Wrong Diabetes can cause four types of problems: Low blood sugar (also called hypoglycemia high-poh-gligh-see-mee-uh). High blood sugar (also called hyperglycemia high-per-gligh-see-mee-uh). Health problems with your eyes, heart, kidneys, nerves and feet. Ketoacidosis (kee toe ass ih doh sis. Ketones building up in your body usually due to not enough insulin). We have handouts about low and high blood sugar. They explain what causes each of these problems and what to do about them. Know What to Do if You are Sick Most times when you are sick it will affect your blood sugar levels.

6 What is Type I Diabetes? Follow these steps when you are sick: 1. Test your blood sugar every 2 to 4 hours or 1/2 to 1 hour when vomiting. 1. Never skip or stop insulin even if you don t feel like eating or you are throwing up (vomiting). 1. Call your health care provider if you think you need to adjust your insulin dose. 1. When your stomach is upset these sick day foods will give you 15 grams of carbohydrates. 15 grams of carbohydrates has been found to be the amount that will help start to bring up your blood sugar level if it is too low. 1/2 cup apple juice 1/2 cup Jell-O 3/4 cup soda with sugar in it 1/4 cup sherbet 6 saltine crackers 12 ounces of Gatorade 1 slice toast 6 ounces of All Sport frozen fruit bar Pedialyte (buy at drug store) 1. Watch for signs of high blood sugar such as upset stomach, vomiting, moderate or large ketones in the urine, stomach pain and feeling tired or confused. Call your health care provider if you have any of these signs. 1. Drink more liquids. Sport drinks are a good choice.

7 What is High Blood Sugar? Hyperglycemia This handout explains the causes, signs and treatment for high blood sugar in diabetes. High blood sugar is also called hyperglycemia (high-per-gligh-see-mee-uh). What is high blood sugar? Your blood sugar is high if it stays over 200 mg/dl (using a serum-based glucose monitor). A glucose monitor is also called a glucometer (glue kohm uh ter). Most times high blood sugar starts slowly. What causes high blood sugar? High blood sugar can be caused by: Eating too much food or drinking too much of a drink that contains carbohydrates. (kar bow high drates). Carbohydrates are a form of sugar or starch and are a major source of energy for the human body. Not taking enough insulin. Having the flu or being sick. Having stress in your life. Decrease in exercise or activity.

8 What is High Blood Sugar? Hyperglycemia What are the signs of high blood sugar? Circle or point to any signs you ve had and learn to recognize them early. The signs of high blood sugar may be: Extreme Thirst Hunger Headache Going to the bathroom a lot Blurred vision Dry skin Feeling drowsy

9 What is High Blood Sugar? Hyperglycemia How do I treat high blood sugar? To treat high blood sugar, follow these steps: 1. Drink plenty of water and do what your health care team instructs you to do. 1. Look for patterns in blood sugars. If blood sugar is high call your doctor for an insulin dose adjustment. What happens if my blood sugar level stays really high? If your blood sugar level keeps staying high you may develop DKA (diabetic ketoacidosis kee-toe-ass-ihdoh-sis). This is rare. But if you get DKA you may need to go to the hospital. When you are sick, test your blood sugar often and check for ketones in your urine. Call your doctor or health care provider right away if you have these emergency symptoms: Moderate to large ketones in urine. Upset stomach. Vomiting. Deep breathing. Stomach pain. Feeling tired or confused. Fruity smelling breath.

10 What is Low Blood Sugar? Hypoglycemia This handout explains the causes, signs and treatment for low blood sugar in diabetes. Low blood sugar is also called hypoglycemia (high-poh-gligh-see-mee-uh). What is low blood sugar? Your blood sugar is low if it falls below 80 mg/dl (using a serum-based glucose monitor). A glucose monitor is also called a glucometer (glue kohm uh ter). Low blood sugar can come on very fast. If it is not treated you could pass out (become unconscious) or have a seizure (convulsion). What causes low blood sugar? Low blood sugar can be caused by: Not eating enough food or not eating at the right time. Taking too much insulin. Extra exercise or activity.

11 What is Low Blood Sugar? Hypoglycemia What are the signs of low blood sugar? Circle or point to any signs you ve had and learn to recognize them early. The signs of low blood sugar may be: Fast heartbeat Sweating Shaking Headache Chills and cold sweat Hunger Vision problems Feeling sick to your stomach Feeling cranky, low or like crying Feeling dizzy or lightheaded Feeling nervous or anxious Feeling weak or tired Tingling or a numbness of your lips or tongue

12 What is Low Blood Sugar? Hypoglycemia How do I treat low blood sugar? Follow these steps to treat low blood sugar: 1. Check your blood sugar to see if it is below 80mg/dl. 1. Eat or drink something with sugar in it. A simple carbohydrate (kar bow high drate) contains sugar. A carbohydrate is a form of sugar or starch that is a major energy source for the human body. 1. Items that provide 10 to 15 grams of simple carbohydrates to eat or drink when your blood sugar is low are listed under step 5. This is the amount of carbohydrate needed to help bring your blood sugar level back up when it gets too low. 1. Wait about 15 minutes, then check your blood sugar. 1. If your blood sugar is still too low (or if you don t feel better), eat another gram serving of carbohydrate and test again after 15 minutes. 1. Once your blood sugar begins to return to normal, eat an extra snack. Your snack should include a carbohydrate and a protein (like cheese and crackers). Foods and Drinks with 10 to 15 grams of Simple Carbohydrates: 1/2 - ~ cup of fruit juice 1/2 - ~ cup of soda pop with sugar in it 4-6 sugar cubes 5-6 Lifesavers 2-3 glucose tablets 1 Tablespoon of cake frosting (or gel) that comes in a tube 1 Tablespoon of sugar 1 Tablespoon of honey 1 Tablespoon of corn syrup If blood sugar is so low that you can t drink or swallow, give Glucagon and call 911.

13 GUIDELINES These guidelines will help you take your medication. Taking your medication properly can make the difference in your health. The following care some problems that might tempt you to stop taking your medication and some solutions to help you stay on track. TO TAKE MEDICATIONS PROPERLY 1. Be sure you understand: a. Each medication s name b. Why you are taking the medication. c. How much medication should take d. How to take the medication: With meals or on an empty stomach The same time each day The number of hours between dosages e. The side effects f. The side effects (symptoms) you should report to your nurse or doctor. 1. Always ask your nurse or doctor about any questions you have. 1. Take your medications exactly as instructed. a. Do not take anyone else s medications. b. Do not take medications you can not without a prescription (over the counter) unless they are approved by your nurse or doctor. c. Follow any special safety precautions, such as: Avoid taking aspirin with certain medications. Keep your medications separate from other family members medications. 1. Let your family and friends help you. 1. Ask your nurse or doctor about community groups that may be able to help you. 1. Your nurse can help you with: a. Fitting your medications into your daily routine b. Tips to help you remember to take your medication, such as: Using a calendar or checklist with the medication times marked, Using an egg carton to arrange medication for the day, Scheduling your medications around usual routines like meals.

14 PROBLEM 1. You think you do not need the medication because: a. You are feeling better; you do not feel ill b. You do not understand the reason for taking medication 2. You experience side effects from the medication. 3. The child-proof bottles are too hard to open. 4. You are tired of taking the medications; you illness has lasted a long time. 5. You do not understand how to take the medication, especially when: a. You must take 3 or more medications at different times of the day. b. There have been new changes in the medications. c. You must adjust the dosage. SOLUTION 1a. Do not stop taking medication unless instructed to do so by your nurse or doctor. 1b. Ask your nurse or doctor why the medication has been prescribed for you. 1. Tell your nurse or doctor about the symptoms of any side effects you experience. 2. Get a different bottle from your pharmacy. 3. Talk to your nurse or doctor about how you feel. 4. Ask your nurse or doctor about ways to remember when to take your medications. Ask your nurse or doctor any questions you have.

15 ANALGESICS ASA (Aspirin, Empirin) May cause stomach upset. Take with milk or food. Narcotics (Morphine, Codeine, Demerol) Take on an empty stomach. Causes drowsiness. Avoid alcoholic beverages. Phenazophyridine (Pyridium) ANTIBIOTICS Take ½ hour before meals with a full liquid. Cephalosporins (Ceclor, Keflex) For best results, take on an empty stomach (one hour before meals or 2 hours after meals.) If stomach irritation occurs, take with food or milk. Chloramphenicol (Chloromycin) Same as Cephalosporins. Erythromycin Base (Emycin, Erytab, EryStearate ) Take on an empty stomach or immediately before meals. Absorption unaffected by food. Metronidazole (Flagyl) May cause stomach upset. Take with food. Nausea and vomiting may occur if taken with alcoholic beverages. Nitrofurantoin (Furadantin, Macrodantin) May cause stomach upset. For best results, take with food or milk. Penicillins and Derivatives (Pen G, Pen VeeK) Take on an empty stomach, an hour before meals or 2 hours after meals. Take with a full glass of water. (Pentids, Ampicillin, Amoxicillin) Avoid citrus foods and juices and carbonated beverages. Tetracyclines (Achromycin) Avoid milk and milk products. For best results, take on an empty stomach, 1 hour before meals or 2 hours after meals.

16 ANTI-DEPRESSANTS MAO INHIBITORS Isocarboxazid (Marplan) Avoid foods high in Tyramine Tranylcypromine (Parnate) Avoid foods high in Tyramine Phenelzine (Nardil) Avoid foods high in Tyramine FOODS HIGH IN TYRAMINE: Aged Cheese Anchovies Avocado Bananas Beer Caffeine Canned Figs Chicken Liver Chocolate Cola Drinks Mushrooms Raisins Sausages Sour Cream Soy Sauce Wine Yeast Extract

Type 1 Diabetes. Insulin

Type 1 Diabetes. Insulin Type 1 Diabetes Introduction Type 1 diabetes prevents the body from removing sugar from the blood stream normally. Diabetes can lead to serious health problems if it is not treated. Currently, there is