With threats of terrorist attacks and many natural disasters happening around the world, our awareness for the need to be prepared if a disaster strikes has recently increased. If you have diabetes it would be a good idea to create an emergency kit. It will only take a few minutes to collect what you need to be prepared for any unexpected event that may happen. The American Diabetes Association has prepared helpful tips on creating an emergency kit for people with diabetes.
They have suggested storing 3 days worth of diabetes supplies, which could include oral medication, insulin, insulin delivery supplies, lancets, extra batteries for your meter and/or pump, and a quick-acting source of glucose. All these items should be kept in an easy-to-identify container, and stored in a location that is easy to get to in an emergency.
Your emergency supply kit should also contain a list of emergency contacts and, if you are a parent of a child in school or daycare, physician’s orders that may be on file with your child’s school or day care provider. As always, it is a good idea to wear medical identification that will enable colleagues, school staff members, or emergency medical personnel to identify and address your medical needs.
If you are a parent of a child with diabetes, it is important that your child’s school has clearly identified the school staff members who will assist your child in the event of an emergency evacuation. For those who are away from home, consider informing your colleagues, friends, and family members about your diabetes and where your emergency supply kit is kept.
An insulin reaction is an excessively low blood sugar level. This condition is also known as hypoglycemia when blood sugar levels are lower than 50 mg/dL. Insulin reactions result from an excess of insulin via an injection or an excess of an insulin-stimulating oral hypoglycemic agent. Insulin reactions are more common in people with severe diabetes.
There are many factors that might bring on an insulin reaction. Some of them are increased activity, late or missed meals, eating fewer carbohydrates than usual, drinking alcohol without eating or errors in insulin dosage. To treat low blood glucose you will need to bring glucose levels back to normal. This requires 10-15 grams of sugar and then keep levels normal with food.
People with diabetes who experience signs and symptoms of an insulin reaction should attempt to raise their blood sugar levels as quickly as possible. Sugar is not absorbed in the stomach so taking forms of sugar that will pass through rapidly and do not need to be digested first is necessary. Some acceptable forms of sugar include fruit juice, milk, 4 ounces of regular soda, glucose tablets, or table sugar with water. Some people with diabetes carry absorbable sugar wafers that contain glucose or dextrose. These are also to be used in an emergency. Sugar wafers dissolve and act quickly when chewed or placed in the cheek.
If you experience repeated episodes of insulin reaction, you should see your doctor to determine if an adjustment in insulin dose is required. This is also true if signs and symptoms suggest hypoglycemia is occurring at night. The inability to control morning glucose values and the worsening of the problem by increasing amounts of evening or long-acting insulin require an urgent visit to the doctor.
Diabetes can damage nerves, kidneys, eyes, and blood vessels. Diabetes can also lead to decreases in the body’s ability to fight infection. When diabetes is not well controlled, damage to the organs and impairment of the immune system is likely. This can cause foot problems and they can quickly become serious. With damage to the nervous system, a person with diabetes may not be able to feel his or her feet properly. Normal sweat secretion and oil production that lubricates the skin of the foot is impaired. These factors together can lead to abnormal pressure on the skin, bones, and joints of the foot during walking and can lead to breakdown of the skin of the foot and sores commonly develop.
Damage to blood vessels and impairment of the immune system from diabetes make it difficult to heal these wounds. Bacterial infection of the skin, connective tissues, muscles, and bones can then occur. These infections can develop into gangrene. Because of the poor blood flow, antibiotics cannot get to the site of the infection easily. Often, the only treatment for this is amputation of the foot or leg. If the infection spreads to the bloodstream, this process can be life threatening.
People with diabetes must be fully aware of how to prevent foot problems before they occur, to recognize problems early, and to seek the right treatment when problems do occur. Good control of blood sugar is the best way to prevent problems.
Diabetics need to learn how to examine their own feet and how to recognize the early signs and symptoms of diabetic foot problems. They should also learn what is reasonable to do at home as far as routine foot care, how to recognize when to call the doctor, and how to recognize when a problem has become serious enough to seek emergency treatment.
Diabetes mellitus is one of the leading causes of irreversible blindness worldwide. It is the most common cause of blindness in people younger than 65 years. Also, diabetic eye disease encompasses a wide range of problems that can affect the eyes. Diabetes mellitus may cause a reversible, temporary blurring of the vision, or it can cause a severe, permanent loss of vision. It can increases the risk of developing cataracts and glaucoma.
Some people may not even realize they have had diabetes mellitus for several years until they begin to experience problems with their eyes or vision. Severe diabetic eye disease most commonly develops in people who have had diabetes mellitus for many years, but they have had little or poor control of their blood sugars over that period of time. It may also result in heart disease, stroke, kidney failure, and circulatory abnormalities of the legs.
There are some important steps you can take to help prevent your development of this disease. You can try to avoid the problems associated with diabetes mellitus by taking care of yourself. Some easy things you can do is watch your diet, maintain a healthy weight, participate in an exercise program and do not smoke.
If you have already been diagnosed with diabetes mellitus there are some things you can do to keep it under control. You need to monitor your blood sugars and your glycosylated hemoglobin carefully and take your diabetes medications as prescribed. Even if you are not experiencing any symptoms due to your diabetes mellitus, you should have an annual eye examination by an ophthalmologist. If you note any significant changes in your vision other than a mild temporary blurring, you should contact your ophthalmologist immediately.
Diabetic ketoacidosis is usually seen in people who have type 1 diabetes. It is a state of inadequate insulin levels resulting in high blood sugar and accumulation of organic acids and ketones in the blood. It is also common to have severe dehydration and significant alterations of the body’s blood chemistry.
Most often diabetic ketoacidosis happens in diabetics younger than 25 years, but the condition may occur in diabetics of any age. A person with diabetes can enter into a state of diabetic ketoacidosis for many reasons. Some of the most common are infection, missed insulin, or newly diagnosed or previously unknown diabetes. There are various other causes like a heart attack, stroke, trauma, stress, and surgery. Five to ten percent of the time there is no identifiable cause.
There are several steps you can take to prevent diabetic ketoacidosis. Close monitoring and control of blood sugars, especially during times of infection, stress, trauma, or other serious illness will help. Also by taking insulin injections on time. Always contact your physician when you think it may be needed.
In your the body sugar sticks, particularly to proteins. The red blood cells that circulate in the body live for about 3 months before they die off. When sugar sticks to these cells, it gives us an idea of how much sugar is around for the preceding 3 months. In most labs, the normal range is 4-5.9 %. In poorly controlled diabetes, its 8.0% or above, and in well controlled patients it’s less than 7.0%. The benefits of measuring A1c is that is gives a more reasonable view of what’s happening over the course of time, and the value does not bounce as much as finger stick blood sugar measurements.
Although there are no guidelines to use A1c as a screening tool, it gives the physician a good idea that someone is diabetic if the value is elevated. Right now, it is used as a standard tool to determine blood sugar control in patients known to have diabetes. The American Diabetes Association currently recommends an A1c goal of less than 7.0%.
Studies have shown that there is a 10% decrease in relative risk for every 1 % eduction in A1c. So, if a patients starts off with an A1c of 10.7 and drops to 8.2, though there are not yet at goal, they have managed to decrease their risk of microvascular complications by about 20%. The closer to normal the A1c, the lower the absolute risk for microvascular complications.
Exenatide is an injectable drug that reduces the level of sugar in the blood. It is used for treating type 2 diabetes. Exenatide belongs in a class of drugs called incretin mimetics because these drugs mimic the effects of incretins. Incretins are hormones that are produced and released into the blood by the intestine in response to food. It increases the secretion of insulin from the pancreas, slows absorption of glucose from the gut, and reduces the action of glucagon. Glucagon is a hormone that increases glucose production by the liver. All three of these actions reduce levels of glucose in the blood. In addition, it helps reduce appetite. Exenatide is a synthetic hormone that resembles and acts like incretins. In studies, exenatide-treated patients achieved lower blood glucose levels and experienced weight loss. Exenatide was approved by the FDA in May, 2005.
It is prescribed when patients with type 2 diabetes have not achieved adequate blood glucose reduction while taking metformin or a combination of metformin and a sulfonylurea. Exenatide is not used in patients with type 1 diabetes or as a substitute for insulin in patients who require insulin. There has been some side effects the most common is nausea. Other common side effects include hypoglycemia (excessively low blood glucose), vomiting, diarrhea, headache, nervousness and stomach discomfort. Patients may also experience decreased appetite, acid reflux and increased sweating. Most side effect decreases over time.
The findings from a Veterans Affairs Diabetes Trial have showed that lowering blood sugar levels to near normal through intensive treatment may reduce the risk of cardiovascular disease and heart attacks for Type 2 diabetics, but only if treatment is begun relatively soon after diagnosis and if severe episodes of low blood sugar can be avoided. Data from three studies were presented over the weekend at a San Francisco meeting of the American Diabetes Assn., and although many questions remain unanswered, some generalizations are becoming possible.
All three studies suggest that the greatest reduction in the risk of heart attacks and cardiovascular disease is achieved by lowering cholesterol levels and by controlling high blood pressure. Controlling glucose can at best provide only a small further reduction in risk that may take many years to become apparent. But that does not mean that control of blood glucose levels is not a good idea.
Data from two of the studies confirmed that such control reduces the risk of kidney and eye disease, also complications of diabetes. New data from the VA study also show that severe hypoglycemic events should be avoided at all costs. And finally, data from the three studies may ease concerns about the oral diabetes drug rosiglitazone. An analysis last year of many previous studies suggested that the drug, sold under the brand name Avandia, increases the risk of heart attacks and death. But the new studies showed no such effects from the drug, which is still in wide use
Pre-diabetes means that the cells in your body are becoming resistant to insulin and your blood glucose levels are higher than they should be. Since the levels aren’t as high as they would be if you had Type 2 diabetes, the term “pre-diabetes” is used. Your doctor may also call this condition “impaired fasting glucose” or “impaired glucose tolerance. According to the Center of Disease Control and Prevention, 41 million adult Americans between the ages of 40 and 74 have pre-diabetes.
There are several risk factors. The risk factors are the same for pre-diabetes as they are for Type 2 diabetes. Some of them are being overweight or obese, having a sedentary lifestyle, family history, age, or having a previous diagnosis of gestational diabetes.
Often there are no signs or symptoms for pre-diabetes. Many times it is discovered during a routine physical with basic screening for fasting blood glucose levels. The normal level is below 100 mg/dl. If it’s 100 to 125 mg/dl, this indicates that you have impaired fasting glucose or pre-diabetes. Over 126 mg/dl most likely means a diagnosis of Type 2 diabetes.
If you are diagnosed with pre-diabetes, it will put you at a higher risk for Type 2 diabetes in the future. But it doesn’t have to mean that you will get Type 2 diabetes. A healthy lifestyle change can lower your risk and improve the way your body uses insulin. A low fat diet and calories can help you lose weight. The less fat and more muscle you have, the less resistant to insulin you will be. Exercising regularly not only helps you to lose weight, but also help lower your blood glucose level by using glucose as energy.
A report in the Archives of Disease in Childhood says there are a number of clues suggesting a link between low vitamin D Zipitis of Stockport National Health Service Foundation Trust and Dr. A. K. Akobeng of Booth Hall Children’s Hospital have reviewed all published research on vitamin D supplementation and diabetes risk. Overall, they found, infants who were supplemented with Vitamin D were 29 percent less likely to develop type 1 diabetes than children who had not received supplements.
Proper clinical trials are required to determine the optimal dose and formulation of vitamin D, as well as when and for how long children should be given the supplements, Zipitis and Akobeng conclude. In the meantime, Zipitis said, “I would advise parents to encourage their pediatricians to prescribe vitamin D supplements for their infants. However, parents can also obtain these over the counter and provided they are used as per manufacturer instructions they should be extremely safe to use.”
