The inside story on diabetes

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1 Did you know? Essential advice for people with diabetes from Accu-Chek There are two main types of diabetes type 1 and type 2 Signs are tiredness, excess thirst, urinating a lot, blurry vision and weight loss Regular testing, exercise and a healthy diet are very important Good blood glucose control helps put you in control The inside story on diabetes For more about the range of free diabetes information booklets, please log on to: or call the Accu-Chek Customer Careline: (UK) (ROI) ACCU-CHEK is a trademark of a Member of the Roche Group Roche Diagnostics Limited. Roche Diagnostics Limited, Charles Avenue, Burgess Hill, West Sussex RH15 9RY Company Registration Number:

2 What is diabetes?...just knowing you have diabetes isn t enough you have to really understand what it means. Angus, 39 Diabetes, or diabetes mellitus to give its full name, is where the body loses the ability to control blood glucose properly. There are two main types of diabetes, type 1 and type 2. People get diabetes for many different reasons and it can affect anyone, at any age. Although no-one really knows what causes it, we do know that type 2 can be linked to being overweight, inactive and can also be more common in certain ethnic groups. This booklet will help introduce you to some of the key topics, and advise you on the day-to-day realities of living with diabetes.

3 What s it all about? Glucose is a vital energy source for your body, but high levels over long periods can damage tissues and organs. This is why your body keeps tight control over its blood glucose levels unless you have diabetes. If you DO have diabetes, either your pancreas is unable to produce any, or enough, insulin to meet your needs, or your body is responding poorly to the insulin you have. What are the main symptoms? Extreme tiredness In people who DON T have diabetes, when food is digested glucose is absorbed into the bloodstream and the levels rise. To keep everything in check a gland beneath the stomach, called the pancreas, responds by producing just enough insulin to keep your blood glucose levels under control. Increased thirst Passing large quantities of urine Blurred vision Weight loss If you haven t been diagnosed with diabetes but are experiencing all of the above symptoms, make an early appointment to see your doctor.

4 Know your diabetes types...at first it feels like a lot of information, but there s a lot of help about and it gets easier. Patrick, 55 Type 1 Type 2 Type 1 diabetes is where your pancreas In type 2 diabetes your pancreas is still making stops producing any insulin at all. This type of diabetes usually starts earlier in life and is more common in younger people. Treatments involve changes to what you eat, and taking insulin. Insulin is either given with an injection pen or using an insulin pump. This bypasses the acids in your stomach, which would destroy the insulin if you took it by mouth. insulin, but either there isn t enough to meet your body s needs, or the insulin it produces is not used properly. This type of diabetes usually starts later in life. It can sometimes be controlled with exercise and simple changes to the type of food you eat. If a healthy diet isn t enough to control your blood glucose level (your dietician will advise you on this), you may be prescribed tablets, or insulin. You will, however, still need to stick to healthy eating.

5 Checking up on your diabetes Building a picture of what your body s doing is an important part of managing your diabetes. Regular testing will tell you if your blood glucose is high or low and will help you decide what action to take to keep it controlled. Blood glucose tests show the levels of glucose in your blood and there are two main types. Finger-prick tests you do yourself using a hand-held blood glucose meter system. They give a short-term picture of what s happening and allow you to act quickly if you get a hypo. HbA1C tests are done by your doctor or nurse and are a long-term measure of your diabetes control. If your HbA1C reading is well controlled, you can reduce your chances of diabetes-related problems later in life. Get the low-down on hypos Hypos mean your blood glucose has fallen very low, usually below 4mmol/L. It can be fixed by quickly eating something to boost your glucose levels. To find out more, call the Accu-Chek Customer Careline for our free Get the low-down on hypos booklet. Do not ignore the signs of a hypo, it won t go away and can lead to more urgent problems. Ketone tests alert you to a dangerous condition called diabetic ketoacidosis (DKA).* Ketones are highly toxic and mean your body has switched to an emergency energy source because it hasn t enough insulin to use the glucose in your body. If you find your blood glucose is over 15mmol/L, or you feel ill, test for ketones in your urine with a kit from your pharmacy if positive, contact your doctor or nurse immediately for advice. *Usually only occurs in type 1 diabetes.

6 How to treat diabetes Type 2 diabetes There are several types of medications to treat patients with type 2 diabetes. They work in different ways and some may be used together to give you better control. They are usually tablets but some may be injections. Tablets that cause you to produce more insulin: Sulphonylureas Meglitinides DPP-4 inhibitors (gliptins) Tablets that help your insulin work harder: Biguanides Thiazolidinediones (glitazones) Tablets that slow glucose entering your body after eating: Alpha-glucoside inhibitors e.g. acarbose Injections that causes you to produce more insulin and helps with weight loss: GLP-1 analogues Type 1 and some type 2 diabetes Insulin can be used as a substitute for your body s own insulin production. It may be made in the lab to match natural human insulin or modified versions called analogues. It can be made from animal insulin (usually pork but occasionally beef). Human insulin and insulin analogues are most commonly used today. You can either inject them or use an insulin pump. There are four main types of insulin: Rapid-acting insulin works very fast and can control the glucose peak for a meal Short-acting insulin works less quickly and can last between 4-8 hours Medium and long-acting insulin provides the background level needed between meals Mixed insulins are combinations of short and medium acting Insulin pump therapy An insulin pump acts like your pancreas giving you continuous insulin during the day and night. It is a small device (about the size of a mobile phone) attached to you by a thin plastic tube under your skin. For some people it can help to improve their control and prevent hypos. You will need to learn how to adjust this dose depending on your blood glucose level, diet and activity. Insulin jet This allows you to inject insulin without using a needle. The jet forces a dose of insulin out at a very high speed and it goes through your skin. For more information please visit

7 How do blood glucose tests help?...i used to ignore my test results, but not any more my control s improved and I feel loads better. Emma, 31 Although diabetes is a naturally progressive Remember, if you find your fingertips get sore condition, long periods with high blood glucose are linked with various health problems later in life, like poor vision, heart disease and kidney problems. By keeping your blood glucose from regular testing, there could be another way. Alternative Site Testing (AST) allows you to use other parts of your body to check-up on your blood glucose, which means you could give your fingertips a well-deserved rest. under control you can reduce the risk of getting these diabetes complications. That s why it s vitally important you measure your levels frequently and act on the results. For a free copy of the AST booklet, Give your fingertips a rest from testing, call the Accu-Chek Customer Careline number on the back cover.

8 Your health and diabetes Whether you re going on holiday or are ill in bed, there are some health matters that people with diabetes need to take extra care with. Below is a guide to some of the key issues you may face, how they affect your diabetes and what to do about it. Health matter Effect on your diabetes Dose adjustment and extra testing needed * Specific advice Hormone Replacement Therapy Slight Yes Consult your healthcare professional Family planning Caution Yes The contraceptive pill doesn t suit all women with diabetes. It is not suitable if: - you are older, smoke or are overweight - you have high blood pressure, heart, circulation or blood-clotting problems Speak to your doctor or nurse about alternatives Vaccines & immunisations Slight Yes Some travel destinations may require specialist vaccines and should be checked by your doctor Flu jabs Slight Yes (for a few days) Strongly recommended for people with diabetes Illness Caution Yes DO NOT stop taking your medication if you re unwell with flu, a cold or fever If you are being sick and unable to keep your medicines down, then contact your doctor or nurse immediately Heart disease Slight No Diabetes is linked to a greater risk of developing heart disease. Eat healthily and exercise regularly. Speak to your dietician for advice Dental Caution Seek advice from your doctor or nurse Always inform your dentist that you have diabetes *Consult your doctor or nurse before making adjustments to your treatment.

9 Getting on with your life...i ve never been one to let things hold me back, it s just the way I approach things. John, 61 Employment Diabetes doesn t have to affect your work. If you re free from any complications of diabetes and not being treated with insulin, most jobs are possible. However, if you do take insulin some high-risk professions are unsuitable, for example, emergency services, armed forces and passenger transport. Remember to be honest with your employer when asked about your health. This helps in an emergency and can avoid awkward questions at a later date. If your concealment leads to the harm of others you may also face prosecution. Your rights Caring for your diabetes is a joint responsibility between you and your diabetes healthcare team. You should decide together an individual care plan. You should include: Diabetes education and advice on your diet Information on types of treatment Advice on monitoring your blood glucose control Regular checks on your general health (blood pressure, blood lipids, eyes, feet and kidneys) Treatment for special problems and in an emergency How often you should see your nurse or doctor If you re unhappy with your level of care, contact Diabetes UK ( ), or The Diabetes Federation of Ireland ( ) for further advice.

10 Taking control of your diabetes...there s no doubt about it, I feel my best when I m on top of my diabetes. Lara, 42 Staying in control of your diabetes can be difficult, but it s definitely worth sticking at it. Regular monitoring, good blood glucose control and a healthy diet/lifestyle can really help reduce the effect diabetes has on your life. You are also less likely to get a hypo and there s a lower risk of getting diabetes-related problems later in life. Tips and advice Look after your heart and circulation eat healthily and exercise regularly DO NOT SMOKE Keep a record of your blood glucose tests and act on them Avoid being overweight Eat more starchy and high-fibre foods (e.g. wholemeal bread, cereals, pasta) Cut down on fatty and sugary foods like jams, red meat and biscuits Get a blood pressure & eye check-up at least once a year Check your feet regularly for cuts and bruises Get a cholesterol check-up at least every 3 years