Seek medical care immediately if you develop symptoms of diabetic ketoacidosis. Diabetic ketoacidosis is a true emergency. Call a doctor if you have:
- fruity breath
- difficulty breathing
- dry mouth
- abdominal pain
- excessive urination
- extreme thirst
Also, be sure to notify your doctor if you have tested your urine and detected ketones, and have not been able to rectify the problem with recommended measures.
Follow a healthful eating plan. A proper diet can help keep your blood sugar under control. Anywhere from 50% to 60% of your daily calories should come from carbohydrates (preferably complex carbohydrates), and less than 30% should come from fat. Be sure to include plenty of fiber—at least 25 grams per day. Fiber slows the absorption of sugar from the gut, which will help keep your blood sugar from spiking. Oats, whole grains, beans, fruits, and vegetables are all excellent sources. You don’t have to eliminate sugar (sucrose) and sweets. However, sugar-laden foods usually lack vitamins and minerals and other important nutrients, and should not be substituted for healthier complex carbohydrates on a regular basis. If you drink alcohol, do so in moderation. Try to follow a regular meal/snack schedule, and do not skip meals.
Get plenty of exercise, but be careful to avoid blood sugar pitfalls. A sensible exercise regimen can help stabilize your condition and cut down on your need for insulin. Try to do at least 30 minutes of aerobic activity (walking, jogging, swimming, biking—even yard work and housework count) most days of the week. When your body is active, its need for glucose goes up, and the glucose circulating in your blood will be the first to get used.
The timing of your workouts can help you avoid hypoglycemia—a sharp fall in blood sugar characterized by sweating, hunger, dizziness, weakness, and shaking. Before you start exercising, make sure your blood sugar is under control and avoid exercise when insulin is at its peak. Decrease your insulin dose before a long workout, and be sure to eat something and drink water at least 1 hour beforehand. Always keep a snack or sports drink handy in the event that you need a quick energy boost. Watch out for the warning signs of hypoglycemia, and stop exercising immediately if you notice them.
Monitor your blood sugar and ketones. This information is critical for helping you and your doctor make the necessary adjustments to your diet, exercise regimen, and insulin dosages. Your doctor can help you come up with an appropriate monitoring schedule. To test your blood sugar, you will have to prick your finger and place a drop of blood on a strip that changes color when inserted into a meter. This meter provides a readout in less than 2 minutes. Write down the results (along with the dates and times)—this can show you how your treatment plan is working, and how eating and exercise affect you. If your blood sugar is low, eat or drink something that contains 15 grams of sugar (half a cup of juice, one cup of skim milk). Test your urine for ketones (kits can be purchased at a drugstore) when you have symptoms, your glucose levels are higher than 240 mg/dL, or you are sick.
Your doctor is the best source of information on the drug treatment choices available to you.
If your diabetes is extremely hard to control and starts to jeopardize your health, a pancreas transplant may be in order. Pancreas transplantation is only recommended for people who have life-threatening problems associated with diabetes. A new pancreas can eradicate your diabetes and free you from daily insulin injections, but there are other things to contend with. You will need to take drugs that suppress the immune system for the rest of your life to keep your body from rejecting the new organ. This increases your risk for infection, cancer, and many other things.
There are many alternative therapies on the market that claim to help people with diabetes, but none has proven to be more effective than insulin therapy. Some doctors recommend taking B vitamins to help prevent nerve damage caused by diabetes. The mineral chromium seems to lower blood sugar and cholesterol in people with the condition. The Indian herb Gymnema sylvestre may improve blood sugar control and lower the need for insulin. If you decide to take any supplements, be sure to tell your doctor because your insulin dose may need to be adjusted.
Although diabetes cannot be cured, most patients can manage their symptoms effectively. Taking daily insulin and adhering to the right diet and exercise plan enables most people with type 1 diabetes to lead full, productive lives.
If you are taking insulin, you should see your doctor at least four times a year. During a follow-up visit, your doctor will examine you and run tests to fine-tune your treatment program. He or she may refer you to a specialist if you have special needs. Your doctor will ask to see the blood sugar and ketone records you have been keeping, and will ask if you’ve had problems following your management plan.
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