How To-56: "How to Improve Your Health as a Diabetic"

How to Improve Your Health as a Diabetic

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This is not a cure but rather tips for improving and preserving the health of a diabetic. According to health experts, type 1 diabetes cannot be cured, because it is a form of pancreatic dysfunction, which results when insulin producing cells cannot make enough insulin to process glucose in the body. Type 2 diabetes, however, can usually be prevented or controlled by diet and exercise, because Type 2 diabetes is typically the result of insulin resistance, which is caused by physical inactivity and poor diet.

Steps

1. Drink an ampalaya (bitter gourd/bitter melon) tea. It is well known for helping diabetic patients to maintain their blood sugar at healthy levels. Banaba tea is one of the best sources of plantisul (plant insulin). Consult your endocrinologist, diabetes educator, or dietitian before beginning this or any alternative treatment.
   
2. Maintain a healthy diet. Follow the advice of your doctor or diabetes educator.
   
3. Exercise. If it is medically safe, start exercising 30 minutes a day. A 30-minute walk at a good pace for the diabetic individual will help to reduce blood sugar, and possibly the amount of medication needed. Have a plan for exercise when taking insulin or using blood sugar lowering drugs, because exercise lowers blood glucose, and can possibly result in hypoglycemia.
   
4. Take doctor prescribed insulin regularly, and on time!
   
5. Attend all laboratory tests and doctors' appointments.
   
6. Have your hemoglobin A1c test done every 3 months or as directed by your physician. Aim for a value of 6.5% or less as recommended by the American Diabetes Association. This test measures your average blood sugar levels over a period of 2-3 months and is a strong indicator of overall glycemic control.
   
7. Stop smoking! Smoking raises blood sugar levels, damages blood vessels which can lead to heart disease and stroke, and adversely affects circulation due to constriction of blood vessels. Heart disease, stroke, and circulation problems are frequent complications of diabetes, even in non-smokers; a diabetic smoker is "adding fuel to the fire", greatly increasing his or her risk of developing these complications.
   
8. Be prepared for hypoglycemia and hyperglycemia. These conditions are more common in patients taking insulin, but can occur in other situations.
   
• Hyperglycemia, or high blood sugar, occurs when the blood sugar level is above 126mg/dL (7mmol/L). It can occur as a result of stress, insufficient insulin, too much food, or an issue with oral diabetes medication. Symptoms include frequent thirst, frequent urination, unusual hunger, fatigue, and irritability. Untreated hyperglycemia is a leading cause of complications from diabetes, thus it is important to recognize and treat hyperglycemia as directed by your physician. Treatment includes adjusting insulin treatment (frequently, patients using insulin will simply take a correction shot based on the level of their blood sugar), or adjusting oral medications. While patients taking insulin will typically adjust their insulin dosages to lower blood sugar, patients taking oral medication or patients using diet or exercise will typically have to adjust their carbohydrate intake to control blood sugar. Untreated hyperglycemia can rapidly progress into diabetic ketoacidosis (DKA), which is life-threating and frequently requires hospitalization. Symptoms may include nausea, vomiting, unquenchable thirst, diarrhea, and muscle cramps. If you are experiencing any of these symptoms of DKA, SEEK URGENT MEDICAL ATTENTION.
  
• Hypoglycemia, or low blood sugar, occurs when the blood sugar level is below 70mg/dL (3.9mmol/L). It can occur as a result of stress, too much insulin, too little food, or an issue with oral diabetes medication. Symptoms include shakiness, tremor, rapid heart beat, sweating, and clamminess. Untreated hypoglycemia can rapidly progress into seizures, coma, or death; thus, it is very important that hypoglycemia is quickly recognized and treated as directed by your physician. In any situation where the patient believes that he or she is suffering from hypoglycemia, the patient should confirm with a blood sugar test; however, the patient should treat immediately if they feel that the hypoglycemia is severe and it would take too long to test. Treating the low blood sugar is paramount. Mild hypoglycemia can be treated by the patient and usually involves consuming 15 grams of carbohydrates, in the form of sugary (not diet) soda, juice, glucose tablets/gel, or occasionally a small snack in the form of crackers, pretzels, hard candy, etc. It is important to note that candy bars such as Snickers, Twix, Milky Way, etc. contain a high amount of fat and can slow the absorption of sugar from the candy bar; therefore, it is not advised that patients use high-fat candy bars to treat hypoglycemia as the blood sugars may not rise fast enough to prevent any further and possibly severe drops in blood sugar. Once the patient has treated, they should wait 10-15 minutes and test his or her blood sugar to confirm that blood sugar levels have risen above 70mg/dL (3.9mmol/L). If the blood sugar levels are still below 70mg/dL (3.9mmol/L), the patient should repeat the treatment process, and if upon testing again after 10-15 minutes blood sugar levels are still below 70mg/dL (3.9mmol/L), the patient should treat once again and consult his/her physician immediately. If the patient has a meal planned within the next 30 minutes, the patient should continue as normal and continue to monitor his or her blood glucose to check for any additional episodes of hypoglycemia. If his/her next meal is beyond 30 minutes, the patient should consume a small snack (1/2 of a sandwich and an 8oz glass of milk, or a pack of peanut butter crackers). Severe hypoglycemia is an urgent medical condition that requires immediate intervention, and can frequently require intervention from a third-party. It can occur when blood sugars fall very rapidly, or when the patient suffers from hypoglycemia unawareness. Severe hypoglycemia can result in fainting, seizures, or death. Treatment may or may not be possible by the patient themselves due to significant impairment, however, the main idea is still the same: raise blood sugar levels as rapidly as possible. This can be achieved using oral carbohydrates, but in a situation where a patient is unconscious, unable to swallow, or having a seizure, outside intervention is necessary. Two types of injections are used to treat severe hypoglycemia: glucagon and intravenous dextrose solution (D50). Glucagon is a hormone produced in the body that acts an opposite to insulin; it blocks the blood sugar lowering ability of insulin and stimulates the liver to release glucose into the blood from energy reserves. When used as treatment for severe hypoglycemia, the solution is injected intramuscularly and produces results in 1-2 minutes. The patient will typically feel nauseated and may vomit shortly after injection. However, this treatment is ineffective if the liver is depleted of glucose stores and in such cases, intravenous dextrose (sugar) solution is necessary. IV dextrose will awaken an unconscious person whom is suffering from severe hypoglycemia in seconds. IV dextrose is commonly referred to as "D50" by emergency medical technicians and paramedics.

Tips

• Always follow your doctor's prescriptions and guidelines, including, but not limited to: checking blood sugar as directed, taking insulin/medication as directed, following a meal schedule if necessary, and attending all doctors' appointments and laboratory tests.
  
• Regular eye, kidney, and foot checkups are advisable.
  
• Communication with one's health care professional is essential in developing an effective treatment plan for diabetes; by working together with one's health team, a diabetic is much better prepared to handle the illness.
  
• Have and know how to use a glucagon emergency kit, and instruct family members and roommates on how to use it. It may save your life if you have severe low blood sugar and are unconscious. The paramedics may not arrive in time.

Warnings

• This is not a substitute for professional medical care.
  
• If you have "cotton-mouth" and are urinating frequently, you may be in ketoacidosis: seek urgent medical attention!
  
• If you feel faint/lightheaded, have a quickened heart rate, and are clammy, you may be having an insulin reaction - immediately treat for hypoglycemia as directed by your physician.

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Sources and Citations

• http://www.joslin.org/
  
• www.cdc.gov/diabetes/index.htm
  
• www.jdf.org
  
• www.diabetes.org
  
• www.stormpages.com/sbhagwat/ "It's Your Life - A Practical Handbook for Chronic Ailments" & "The Caregiver's Manual" (free ebooks)

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Wikipedia articles on "Diabetes mellitus":

http://en.wikipedia.org/wiki/Diabetes

Detailed information about Diabetes from NDEP(National Diabetic Education Program):

http://ndep.nih.gov/

All about diabetes from American Diabetes Association:

http://www.diabetes.org/home.jsp

Article on "Diabetes" from Medline Plus:

http://www.nlm.nih.gov/medlineplus/diabetes.html

Grateful thanks to wikiHow, NDEP, American Diabetes Association, Medline Plus and Wikipedia, the free encyclopedia.