pressure. It’s recommended that people with diabetes have blood pressures less than 130/80 millimeters of mercury (mm Hg). • Cholesterol-lowering drugs. As with high blood pressure drugs, your doctor may not wait until your cholesterol is elevated before he or she prescribes cholesterol-lowering agents known as statins. Cholesterol guidelines are more aggressive for people with diabetes because of the elevated heart disease risk. The American Diabetes Association recommends that low-density lipoprotein (LDL, or “bad”) cholesterol be below 100 mg/dL (2.6 mmol/L) and that high-density lipoprotein (HDL, or “good”) cholesterol be over 50 mg/dL (1.3 mmol/L). Triglycerides, another type of blood fat, are ideal when they’re less than 150 mg/dL (1.7 mmol/L). Healthy eating and counting carbohydrates
Contrary to popular perception, there’s no such thing as a diabetes diet. You won’t be restricted to a lifetime of boring, bland foods. Instead, you’ll need plenty of: • Fruits • Vegetables • Whole grains These foods are high in nutrition and low in fat and calories. And they mean fewer animal products and sweets. This is actually the best eating plan, even for people without diabetes. You’ll need to learn how to count the carbohydrates in the foods you eat so that you can give yourself enough insulin to properly metabolize those carbohydrates. A registered dietitian can help you create a meal plan that fits your health goals, food preferences and lifestyle. Everyone needs regular aerobic exercise, and people who have type 1 diabetes are no exception. Get your doctor’s OK to exercise. Then choose activities you enjoy, such as walking, swimming or biking. What’s most important is making physical activity part of your daily routine. Aim for at least 30 minutes of aerobic exercise most days of the week. Stretching and strength training exercises are important, too. If you haven’t been active for a while, start slowly and build up gradually. Remember thatphysical activity lowers blood sugar, often for long after you’re done working out. If you begin a new activity, check your blood sugar level more often than usual until you know how that activity affects your blood sugar levels. You might need to adjust your meal plan or insulin doses to compensate for the increased activity. If you use an insulin pump, you can set a temporary basal rate to keep your blood sugar from dropping. Ask your doctor or diabetes educator to show you how. Depending on what type of insulin therapy you select or require — single-dose injections, multiple-dose injections or insulin pump — you may need to check and record your blood sugar level at least four times a day, and probably more. Careful monitoring is the only way to make sure that your blood sugar level remains within your target range. Be sure to wash your hands before checking your blood sugar levels to get the most accurate reading. Even if you take insulin and eat on a rigid schedule, the amount ofsugar in your blood can change unpredictably. With help from your diabetes treatment team, you’ll learn how your blood sugar level changes in response to: • Food. What and how much you eat will affect your blood sugar level. Blood sugar is typically highest one to two hours after a meal. • Physical activity. Physical activity moves sugar from your blood into your cells. The more active you are, the lower your blood sugar level. To compensate, you might need to lower your insulin dose before unusual physical activity. • Medication. You need insulin to lower your blood sugar level. But other medications you take may affect your blood sugar level as well, sometimes requiring changes in your diabetes treatment plan. • Illness. During a cold or other illness, your body will produce hormones that raise your blood sugar level. This might require changes in your diabetes treatment plan. • Alcohol. Alcohol can cause either high or low blood sugar, depending on how much you drinkand if you eat at the same time. If you choose to drink, do so in moderation, which means no more than one drink a day for women and two drinks or fewer daily for men. • Stress. The hormones your body may produce in response to prolonged stress may prevent insulin from working properly. • For women, fluctuations in hormone levels. As your hormone levels fluctuate during your menstrual cycle, so can your blood sugar level — particularly in the week before your period. Menopause may trigger fluctuations in your blood sugar level as well. Continuous glucose monitoring (CGM) is the newest way to monitor blood sugar levels, and may be most helpful for people who have developed hypoglycemia unawareness. Continuous glucose monitors attach to the body using a fine needle just under the skin that checks blood glucose level every few minutes. CGM isn’t yet considered as accurate as standard blood sugar monitoring, so it’s not considered a replacement method for keeping track of bloodsugar, but an additional measure. Possible Complications Type 1 diabetes can affect many major organs in your body, including your heart, blood vessels, nerves, eyes and kidneys. • Long-term complications include: • heart and blood vessel disease • nerve damage (neuropathy) • kidney damage (nephropathy) • eye damage • foot damage • skin and mouth conditions • osteoporosis • pregnancy complications • hearing problems When to Contact a Medical Professional Call 911 if you have: • Chest pain or pressure, shortness of breath, or other signs of angina • Loss of consciousness • Seizures Call your health care provider or go to the emergency room if you have symptoms of diabetic ketoacidosis. Also call your doctor if you have: • Blood sugar levels that are higher than the goals you and your doctor have set • Numbness, tingling, or pain in your feet or legs • Problems with your eyesight • Sores or infections on your feet • Symptoms thatyour blood sugar is getting too low (feeling weak or tired, trembling, sweating, feeling irritable, having trouble thinking clearly, fast heartbeat, double or blurry vision, feeling uneasy) • Symptoms that your blood sugar is too high (being very thirsty, having blurry vision, having dry skin, feeling weak or tired, needing to urinate a lot) • You are having blood sugar readings below 70 mg/dL You can treat early signs of hypoglycemia at home by eating sugar or candy, or by taking glucose tablets. If your signs of hypoglycemia continue or your blood glucose levels stay below 60 mg/dL, go to the emergency room. Preventions There’s nothing you could have done to prevent type 1 diabetes; there is currently no known way to prevent the disease. Natural Remedies Diabetes requires regular blood sugar tests and medical intervention. According to research or other evidence, the following self-care steps may be helpful. What You Need To Know: • Go for the chromium Under the supervision ofa doctor, take 200 mcg a day of this essential trace mineral to improve glucose tolerance • Fight back with fiber Under a doctor’s supervision, stabilize your blood sugar by eating fiber from whole grains, beans (legumes), vegetables, and fruit, and consider using a fiber supplement such as psyllium or guar gum • Protect with alpha lipoic acid Protect against diabetic complications, such as nerve and kidney damage, by taking 600 to 1,200 mg of this supplement per day • Discover EPO Help relieve pain from diabetic neuropathy by taking 4 grams of evening primrose oil supplements per day • Get to know niacinamide Talk to a knowledgeable healthcare provider to determine if taking large amounts of the supplement niacinamide might prevent or limit the severity of type 1 diabetes in your family. These recommendations are not comprehensive and are not intended to replace the advice of your doctor or pharmacist. Continue reading the full diabetes article for more in-depth, fully-referencedinformation on medicines, vitamins, herbs, and dietary and lifestyle changes that may be helpful.
