I'm 37 and got it know or had it in the past. But the funny thing is that I never knew I had it was not feeling ichy. Know how werd is that not knowing you have it if you don't feel like it mmm. My dad has it my dad's mom had it and my greataunt has it so I guess what ever is on dad's side of the famliy I'm likely to get it myself.

So fair it's been like that.

Rene

 [ send green star]

the odds of developing Type 1 diabetes. Here are the facts:

If an immediate relative (parent, sibling, offspring) has type 1 diabetes, your risk is 10 to 20 times the risk of the general population. Your risk can go from 1 in 100 to roughly 1 in 10 or possibly higher, depending on which family member has diabetes and when they developed it.
If one child in a family has type 1 diabetes, their siblings have a 1 in 10 risk of developing it by age 50.
The risk for a child of a parent with type 1 diabetes is lower if it is the mother who has the diabetes rather than the father. If it is the father, the risk is 1 in 10 ( 10 percent) . If it's the mother the risk is 1 in 24 ( 4 percent), and if the mother is over age 25, the risk drops to 1 in 100, the same for the general American population.
If one of the parents developed type 1 diabetes before age 11, their child's risk is somewhat higher than the figures in #3 and somewhat lower, if the parents was diagnosed after age 11.
About 1 in 7 people with type 1 diabetes has a condition known as type 2 polyglandular autoimmune syndrome. In addition to type 1 diabetes, these people have thyroid disease, malfunctioning adrenal glands, and sometimes other immune disorders. For those with this syndrome, the child's risk of having the syndrome, including type 1 diabetes, is 1 in 2 according to the American Diabetes Association.
Caucasians have a higher risk of developing type 1 diabetes than any other race. Whether this is due to difference in environment or genes is unclear. Even in this population, most people who are susceptible do not develop diabetes. One gene which influences the immune system is thought to be HLA-DR. Most Caucasians with diabetes carry alleles (gene variants) 3 and/or 4 of the HLA-DR gene. The HLA-DR7 allele plays a role in diabetes in blacks, while HLA-DR9 allele is important in diabetes among Japanese.
Among Caucasians, the risk of diabetes varies geographically. In general, the risk is higher in Northern Europeans than Southern Europeans. While climate may have a part in this, the fact that there are higher rates in Sardinia which is in the Mediterranean, goes against this theory. In recent decades, there has been an increase of type 1 diabetes in the United States and Europe. While most of Asia has a lower rate of type 1, Japan is also experiencing increased numbers of diagnoses. Since the gene pool does not change that much over one generation, something else must be going on which may be environmental or behavioral. Temporal clusters of type 1 diabetes may be reason to suspect an environmental agent, but today, these are thought to be coincidence, as the autoimmune process leading to diabetes is quite a long process, so that those people who develop the disease may have lived in many different areas when the process began.

Some people have questioned whether a body trauma, like a car crash or a viral infection, like mumps, can trigger the onset of type 1 diabetes
There has been much written about the link between Coxsackie virus, which causes meningitis, and whether it triggers type 1 diabetes. To date, this connection remains unclear. Scientists do have clear information that mumps and diabetes are not connected. In a Maryland study even with a decline in the number of mumps cases after the vaccine was introduced. the incidence of type 1 diabetes did not change. Some researchers believe that early diet may have a role. For example, type 1 diabetes is less common in children who have prolonged breast feeding as infants. Some studies have linked cows' milk to diabetes. The final word here is less than final. Researchers seem to feel that if your child is at great risk, you may want to consider prolonged breast feeding with input from your physicians.

Now we will examine the genetic risks of Type 2 Diabetes:

Type 1 and type 2 diabetes are different diseases with very different incidence patterns. The general population's risk for developing type 1 is 1 in 100 before age 70, and one third develop it before age 20. For type 2 diabetes, one out of 9 Americans will develop it, and almost all will become ill in middle age. The Westernized lifestyle of obesity and sedentary behavior is one component of this disease. In the United States, Mexican Americans, blacks, and Native Americans have higher incidences than Caucasians. The disease is less common in these populations in regions where Westernized lifestyle is not common. Clustering of diabetes in families is more easily recognizable for type 2 diabetes than in type 1. If one sibling develops type 2 diabetes, their sibling's risk is doubled (to 1 in 4). If a parent has type 2, one's risk is also double the general population's risk. Although the research is ongoing, it is speculated that if both parents have type 2 diabetes, a child's risk may be as high as 50 percent. While type 2 diabetes may have a genetic basis, it is highly influenced by environmental and behavioral factors. Obesity is a strong factor in type 2, particularly in young adults and those who have been over weight for long periods of time. In fact, a study presented to the ADA annual meeting showed a marked increase in American and Japanese children aged 6 to 19 with type 2 diabetes believed to be linked to Western lifestyle.

Gestational diabetes is a kind of diabetes that develops during pregnancy. The condition occurs because the hormones made during pregnancy can increase the body's resistance to insulin. If a pregnant woman's body cannot produce enough insulin to offset the increased resistance, the result is a high blood sugar level. When gestational diabetes occurs, it is usually in the latter part of pregnancy.

After pregnancy, gestational diabetes often goes away. However, having gestational diabetes increases your risk of developing diabetes in the future.

If you already have diabetes and become pregnant, you do not have gestational diabetes; you still have whatever type was diagnosed before your pregnancy.

In a test for gestational diabetes, a woman is asked to drink a glucose solution. One hour later, blood is drawn and its glucose level measured. If the level is at least 130 to 140 mg/dl, the woman may be asked to continue the test. In this case, blood will be drawn and tested several times during three hours. The diagnosis is gestational diabetes if the blood glucose level is higher than at least two of the following levels:

• 95 mg/dl before drinking the glucose solution
• 180 mg/dl one hour after drinking the solution
• 155 mg/dl two hours after drinking the solution
• 140 mg/dl three hours after drinking the solution

If you are diagnosed with gestational diabetes, talk to your doctor about treating the condition.

Although gestational diabetes usually goes away after pregnancy, a woman who has the condition once may be at risk for gestational diabetes in future pregnancies. Many women who have had gestational diabetes develop diabetes years later. Lower your risk of diabetes later in life by keeping your weight normal, eating healthful foods, and staying physically active.

Facts about Diabetes  
 

 The onset of Type 2 Diabetes usually occurs after the age of 45, although the incidence of the disease in younger people is growing rapidly.

Approximately 11.4% of all African Americans aged 20 years or older have diabetes
Approximately 700,000 Hispanic Americans have diabetes and don’t know it.
There is currently no cure for type 2 diabetes and the exact cause of the disease is unknown. Researchers are currently investigating medications that may eventually benefit those living with diabetes.
Every year, about 1 million people learn they have diabetes
Diabetes is the sixth leading cause of all deaths caused by a disease
Diabetes is the leading cause of new cases of blindness among adults
The risk of heart attack and stroke is 2 to 4 times higher among people with diabetes
Long-term complications include: kidney disease, nerve disease, dental disease and lower-limb amputation
 

Where to Get More Help With Your Diabetes
Chapter 6 of 6

 
People Who Can Help You
Your doctor. He or she may be your doctor at the clinic where you go for health care, your family doctor, or someone who has special training in caring for people with diabetes. A doctor with that kind of special training is called an endocrinologist or diabetologist.

You'll talk with your doctor about what kind of medicine you need and how much you should take. You'll also agree on a target blood glucose range and blood pressure and cholesterol targets. Your doctor will do tests to be sure that your blood glucose, blood pressure, and cholesterol are staying on track and that you're staying healthy. Ask your doctor if you should take aspirin every day to help prevent heart disease.

Your diabetes educator. A diabetes educator may be a nurse, a dietitian, or another kind of health care worker. Diabetes educators teach you about meal planning, diabetes medicines, physical activity, how to check your blood glucose, and how to fit diabetes care into your everyday life.

Don't be shy about asking your doctor or diabetes educator about the information in this guide. Ask questions if you don't understand something. After all, it's your health!

Your family and friends. Taking care of your diabetes is a daily job. You may need help or support from your family or friends. You may want to bring a family member or close friend with you when you visit your doctor or diabetes educator. Taking good care of your diabetes can sometimes be a family affair!

A counselor or mental health worker. You might feel sad about having diabetes or get tired of taking care of yourself. Or you might be having problems because of work, school, or family. If diabetes makes you feel sad or angry or if you have other problems that make you feel bad, you can talk to a counselor or mental health worker. Your doctor or diabetes educator can help you find a counselor if you need one.

Organizations That Can Help You
How to find a diabetes educator

To find a diabetes educator near you, call the American Association of Diabetes Educators toll-free at 1–800–832–6874, or look on the Internet at www.diabeteseducator.org and click on "Find a Diabetes Educator."

How to find a dietitian

To find a dietitian near you, call the American Dietetic Association toll-free at 1–800–366–1655, or look on the Internet at www.eatright.org and click on "Find a Dietitian."

How to find programs about diabetes

To find programs about diabetes or for additional information, contact

American Diabetes Association
1701 North Beauregard Street
Alexandria, VA 22311
Phone: 1–800–342–2383
Internet: www.diabetes.org

Juvenile Diabetes Research Foundation International
120 Wall Street, 19th Floor
New York, NY 10005
Phone: 1–800–533–2873
Internet: www.jdrf.org

Both these organizations have magazines and other information for people with diabetes.

They also have local groups in many places where you can meet other people who have diabetes.

How to get more information about diabetes

To get more information about taking care of diabetes, contact

National Diabetes Information Clearinghouse
1 Information Way
Bethesda, MD 20892–3560
Phone: 1–800–860–8747
Fax: 703–738–4929
Email: ndic@info.niddk.nih.gov
Internet: www.diabetes.niddk.nih.gov

National Diabetes Education Program
1 Diabetes Way
Bethesda, MD 20892–3600
Phone: 1–800–438–5383
Fax: 703–738–4929
Internet: http://ndep.nih.gov

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Taking Care of Your Diabetes at Special Times
Chapter 5 of 6

Diabetes is part of your life. It's very important to take care of it when you're sick, when you're at school or work, when you travel, or when you're pregnant or thinking about having a baby. Here are some tips to help you take care of your diabetes at these times.

When You're Sick
Take good care of yourself when you have a cold, the flu, an infection, or other illness. Being sick can raise your blood glucose. When you're sick, do the following:

Check your blood glucose every 4 hours. Write down the results.

Keep taking your insulin and your diabetes pills. Even if you can't keep food down, you still need your diabetes medicine. Ask your doctor or diabetes educator whether to change the amount of insulin or pills you take.

Drink at least a cup (8 ounces) of water or other calorie-free, caffeine-free liquid every hour while you're awake.

If you can't eat your usual food, try drinking juice or eating crackers, popsicles, or soup.

If you can't eat at all, drink clear liquids such as ginger ale. Eat or drink something with sugar in it if you have trouble keeping food down.

Test your urine for ketones if
your blood glucose is over 240
you can't keep food or liquids down

Call your health care provider right away if
your blood glucose has been over 240 for longer than a day
you have moderate to large amounts of ketones in your urine
you feel sleepier than usual
you have trouble breathing
you can't think clearly
you throw up more than once
you've had diarrhea for more than 6 hours
When You're at School or Work
Take care of your diabetes when you're at school or at work:

Follow your meal plan.

Take your medicine and check your blood glucose as usual.

Tell your teachers, friends, or close co-workers about the signs of hypoglycemia. You may need their help if your blood glucose drops too low.

Keep snacks nearby and carry some with you at all times to treat hypoglycemia.

Tell your company nurse or school nurse that you have diabetes.

When You're Away From Home
Taking care of your diabetes, even on vacation, is very important.

Here are some tips:

Follow your meal plan as much as possible when you eat out. Always carry a snack with you in case you have to wait to be served.

Limit your drinking of beer, wine, or other alcoholic beverages. Ask your diabetes educator how much alcohol you can safely drink. Eat something when you drink.

If you're taking a long trip by car, check your blood glucose before driving. Stop and check your blood glucose every 2 hours. Always carry snacks like fruit, crackers, juice, or soda in the car in case your blood glucose drops too low.

Ask ahead of time for a diabetes meal if you're traveling by plane. Most airlines serve special meals for people with health needs. Carry food (like crackers or fruit) with you in case meals are late.

Carry your medicines (insulin, insulin needles, and diabetes pills) and your blood testing supplies with you. Never put them in your checked luggage.

Ask your health care team how to adjust your medicines, especially your insulin, if you're traveling across time zones.

Take comfortable, well-fitting shoes on vacation. You'll probably be walking more than usual, so you should take extra care of your feet.

If you're going to be away for a long time, ask your doctor for a written prescription for your diabetes medicine and the name of a doctor in the place you're going to visit.

Don't count on buying extra supplies when you're traveling, especially if you're going to another country. Different countries use different kinds of insulin, needles, and pills.

When You're Planning a Pregnancy
Planning ahead is very important if you want to have a baby. High blood glucose can be harmful to both a mother and her unborn baby. Even before you become pregnant, your blood glucose should be close to the normal range. Keeping blood glucose near normal before and during pregnancy helps protect both mother and baby.

Your insulin needs may change when you're pregnant. Your doctor may want you to take more insulin and check your blood glucose more often. If you take diabetes pills, you'll take insulin instead when you're pregnant.

If you plan to have a baby, do the following:

Work with your health care team to get your blood glucose as close to the normal range as possible.

See a doctor who has experience in taking care of pregnant women with diabetes.

Have your eyes and kidneys checked. Pregnancy can make eye and kidney problems worse.

Don't smoke, drink alcohol, or use harmful drugs.

Follow the meal plan you get from your dietitian or diabetes educator to make sure you and your unborn baby have a healthy diet.
If you're already pregnant, see your doctor right away. It's not too late to bring your blood glucose close to normal so that you'll stay healthy during the rest of your pregnancy.

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Diabetes and Your Kidneys
Your kidneys help clean waste products from your blood. They also work to keep the right balance of salt and fluid in your body.

Too much glucose in your blood is very hard on your kidneys. After a number of years, high blood glucose can cause the kidneys to stop working. This condition is called kidney failure. If your kidneys stop working, you'll need dialysis (using a machine or special fluids to clean your blood) or a kidney transplant.

Have a urine test, called a microalbumin test, once a year to check for signs of kidney damage. The test measures how much protein is in your urine. Some types of blood pressure medicines can help prevent kidney damage. Ask your doctor whether these medicines could help you. You can also help prevent kidney problems by doing the following:

Take your medicine if you have high blood pressure.

Ask your doctor or your dietitian whether you should eat less protein (meat, poultry, cheese, milk, fish, and eggs).

See your doctor right away if you get a bladder or kidney infection. Signs of bladder or kidney infections are cloudy or bloody urine, pain or burning when you urinate, and having to urinate often or in a hurry. Back pain, chills, and fever are also signs of kidney infection.

Keep your blood glucose and blood pressure as close to normal as possible.

If you smoke, quit.
 Mike is a migrant farm worker with type 2 diabetes and high blood pressure. Mike, 47, is married, and he and his wife have three children. The family is often on the move, depending on where the work is. Mike has his blood pressure and kidneys checked at clinics in migrant worker camps. Some of the clinics also offer diabetes classes. Whenever they can, Mike and his wife attend these classes. They especially like the cooking classes because they learn how to prepare low-cost, healthy meals for the whole family.
Diabetes and Your Nerves
Over time, high blood glucose can harm the nerves in your body. Nerve damage can cause you to lose the feeling in your feet or to have painful, burning feet. It can also cause pain in your legs, arms, or hands or cause problems with eating, going to the bathroom, or having sex.

Nerve damage can happen slowly. You may not even realize you have nerve problems. Your doctor should check your nerves at least once a year. Part of this exam should include tests to check your sense of feeling and the pulses in your feet.

Tell the doctor about any problems with your feet, legs, hands, or arms. Also, tell the doctor if you have trouble digesting food, going to the bathroom, or having sex, or if you feel dizzy sometimes.

Nerve damage to the feet can lead to amputations. You may not feel pain from injuries or sore spots on your feet. If you have poor circulation because of blood vessel problems in your legs, the sores on your feet can't heal and might become infected. If the infection isn't treated, it could lead to amputation.

Ask your doctor whether you already have nerve damage in your feet. If you do, it is especially important to take good care of your feet. To help prevent complications from nerve damage, check your feet every day (see Foot care tips below).

Here are some ways to take care of your nerves:

Keep your blood glucose and blood pressure as close to normal as possible.

Limit the amount of alcohol you drink.

Check your feet every day.

If you smoke, quit.
Foot Care Tips
You can do a lot to prevent problems with your feet. Keeping your blood glucose in your target range and taking care of your feet can help protect them.

Check your bare feet every day. Look for cuts, sores, bumps, or red spots. Use a mirror or ask a family member for help if you have trouble seeing the bottoms of your feet.

Wash your feet in warm—not hot—water every day, but don't soak them. Use mild soap. Dry your feet with a soft towel, and dry carefully between your toes.

After washing your feet, cover them with lotion before putting your shoes and socks on. Don't put lotion or cream between your toes.

File your toenails straight across with an emery board. Don't leave sharp edges that could cut the next toe.

Don't try to cut calluses or corns off with a razor blade or knife, and don't use wart removers on your feet. If you have warts or painful corns or calluses, see a podiatrist, a doctor who treats foot problems.

Wear thick, soft socks. Don't wear mended stockings or stockings with holes or seams that might rub against your feet.

Check your shoes before you put them on to be sure they have no sharp edges or objects in them.

Wear shoes that fit well and let your toes move. Break new shoes in slowly. Don't wear flip-flops, shoes with pointed toes, or plastic shoes. Never go barefoot.

Wear socks if your feet get cold at night. Don't use heating pads or hot water bottles on your feet.

Have your doctor check your feet at every visit. Take your shoes and socks off when you go into the examining room. This will remind the doctor to check your feet.

See a podiatrist for help if you can't take care of your feet yourself.

Diabetes and Your Gums and Teeth
Diabetes can lead to infections in your gums and the bones that hold your teeth in place. Like all infections, gum infections can cause blood glucose to rise. Without treatment, teeth may become loose and fall out.

Help prevent damage to your gums and teeth by doing the following:

See your dentist twice a year. Tell your dentist that you have diabetes.
Brush and floss your teeth at least twice a day.
If you smoke, quit.

Why It's Important to Take Care of Your Diabetes
Chapter 4 of 6

Taking care of your diabetes every day will help keep your blood glucose in your target range and help prevent other health problems that diabetes can cause over the years. This part of the guide describes those problems. We tell you about them not to scare you, but to help you understand what you can do to keep them from happening.

Do what you can every day to keep your blood glucose in the range that's best for you.

 
Follow your meal plan every day.  Be physically active every day. 

 
Take your diabetes medicine every day.  Check your blood glucose as recommended. 

Diabetes and Your Heart and Blood Vessels
The biggest problem for people with diabetes is heart and blood vessel disease. Heart and blood vessel disease can lead to heart attacks and strokes. It also causes poor blood flow (circulation) in the legs and feet.

To check for heart and blood vessel disease, your health care team will do some tests. At least once a year, have a blood test to see how much cholesterol is in your blood. Your health care provider should take your blood pressure at every visit. Your provider may also check the circulation in your legs, feet, and neck.

The best way to prevent heart and blood vessel disease is to take good care of yourself and your diabetes.

Eat foods that are low in fat and salt.

Keep your blood glucose on track. Know your A1C. The target for most people is under 7.

If you smoke, quit.

Be physically active.

Lose weight if you need to.

Ask your health care team whether you should take an aspirin every day.

Keep your blood pressure on track. The target for most people is under 130/80. If needed, take medicine to control your blood pressure.

Keep your cholesterol level on track. The target for LDL cholesterol for most people is under 100. If needed, take medicine to control your blood fat levels.
What's a desirable blood pressure level?
Blood pressure levels tell how hard your blood is pushing against the walls of your blood vessels. Your pressure is given as two numbers: The first is the pressure as your heart beats and the second is the pressure as your heart relaxes. If your blood pressure is higher than your target, talk with your health care team about changing your meal plan, exercising, or taking medicine.

Blood Pressure Results
Target for most people with diabetes under 130/80
My last result ____________
My target ____________

printer-friendly version of Blood Pressure Results form

What are desirable blood fat levels?
Cholesterol, a fat found in the body, appears in different forms. If your LDL cholesterol ("bad" cholesterol) is 100 or above, you are at increased risk of heart disease and may need treatment. A high level of total cholesterol also means a greater risk of heart disease. But HDL cholesterol ("good" cholesterol) protects you from heart disease, so the higher it is, the better. It's best to keep triglyceride (another type of fat) levels under 150. All of these target numbers are important for preventing heart disease.

Target Blood Fat Levels for People With Diabetes
Total cholesterol under 200 My last result_____ My target_____
LDL cholesterol under 100 My last result_____ My target_____
HDL cholesterol above 40 (men) My last result_____ My target_____
 above 50 (women) My last result_____ My target_____
Triglycerides under 150 My last result_____ My target_____
Diabetes and Your Eyes
Have your eyes checked once a year. You could have eye problems that you haven't noticed yet. It is important to catch eye problems early when they can be treated. Treating eye problems early can help prevent blindness.

High blood glucose can make the blood vessels in the eyes bleed. This bleeding can lead to blindness. You can help prevent eye damage by keeping your blood glucose as close to normal as possible. If your eyes are already damaged, an eye doctor may be able to save your sight with laser treatments or surgery.

The best way to prevent eye disease is to have a yearly eye exam. In this exam, the eye doctor puts drops in your eyes to make your pupils get bigger (dilate). When the pupils are big, the doctor can see into the back of the eye. This is called a dilated eye exam, and it doesn't hurt. If you've never had this kind of eye exam before, you should have one now, even if you haven't had any trouble with your eyes. Be sure to tell your eye doctor that you have diabetes.

Here are some tips for taking care of your eyes:

For people with type 1 diabetes: Have your eyes examined when you have had diabetes for 5 years and every year after that first exam. (Children should have an eye exam in their early teens.)

For people with type 2 diabetes: Have an eye exam every year.

For women planning to have a baby: Have an eye exam before becoming pregnant.

If you smoke, quit.

Keep your blood glucose and blood pressure as close to normal as possible.
Tell your eye doctor right away if you have any problems like blurry vision or seeing dark spots, flashing lights, or rings around lights.

.

When Your Blood Glucose Is Too High or Too Low
Chapter 3 of 6

Sometimes, no matter how hard you try to keep your blood glucose in your target range, it's too high or too low. Blood glucose that's too high or too low can make you very sick. Here's how to handle these emergencies.

On this page:

What You Need to Know About High Blood Glucose
If your blood glucose stays over 180, it may be too high. (Go back to the chart.) It means you don't have enough insulin in your body. High blood glucose can happen if you miss taking your diabetes medicine, eat too much, or don't get enough exercise. Sometimes, the medicines you take for other problems cause high blood glucose. Be sure to tell your doctor about other medicines you take.

Having an infection or being sick or under stress can also make your blood glucose too high. That's why it's very important to check your blood glucose and keep taking your insulin or diabetes pills when you're sick. (For more about how to take care of yourself when you're sick, see chapter five.)

If you're very thirsty and tired, have blurry vision, and have to go to the bathroom often, your blood glucose may be too high. Very high blood glucose may also make you feel sick to your stomach.

If your blood glucose is high much of the time or if you have symptoms of high blood glucose, call your doctor. You may need a change in your insulin or diabetes pills, or a change in your meal plan.

What You Need to Know About Low Blood Glucose (Hypoglycemia)
Hypoglycemia happens if your blood glucose drops too low. It can come on fast. It's caused by taking too much diabetes medicine, missing a meal, delaying a meal, exercising more than usual, or drinking alcoholic beverages. Sometimes, medicines you take for other health problems can cause blood glucose to drop.

Hypoglycemia can make you feel weak, confused, irritable, hungry, or tired. You may sweat a lot or get a headache. You may feel shaky. If your blood glucose drops lower, you could pass out or have a seizure.

If you have any of these symptoms, check your blood glucose. If the level is 70 or below, have one of the following right away:

2 or 3 glucose tablets
1/2 cup (4 ounces) of any fruit juice
a piece of fruit or a small box of raisins
1 cup (8 ounces) of milk
1/2 cup (4 ounces) of a regular (not diet) soft drink
5 or 6 pieces of hard candy
1 or 2 teaspoons of sugar or honey
After 15 minutes, check your blood glucose again to make sure your level is 70 or above. Repeat these steps as needed. Once your blood glucose is stable, if it will be at least an hour before your next meal, have a snack.

If you take insulin or a diabetes pill that can cause hypoglycemia, always carry food for emergencies. It's a good idea also to wear a medical identification bracelet or necklace.

If you take insulin, keep a glucagon kit at home and also at a few other places where you go often. Glucagon is given as an injection with a syringe and quickly raises blood glucose. Show your family, friends, and co-workers how to give you a glucagon injection if you pass out because of hypoglycemia.

You can prevent hypoglycemia by eating regular meals, taking your diabetes medicine, and checking your blood glucose often. Checking will tell you whether your glucose level is going down. You can then take steps, like drinking fruit juice, to raise your blood glucose.

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Im starting to feel tired its 8pm eastern time here so I will work on the next 4 chapters tomorrow. Hope everyone has a good night.   Hugs and Love Anjee

Many people with type 2 diabetes don't need insulin or diabetes pills. They can take care of their diabetes by using a meal plan and exercising regularly

Talk with your doctor about what your target should be. Even if your A1C is higher than your target, remember that every step toward your goal helps reduce your risk of diabetes problems.

Print and make copies of the daily diabetes record page. Then write down the results of your blood glucose checks every day. You may also want to write down what you ate, how you felt, and whether you exercised.

By keeping daily records of your blood glucose checks, you can tell how well you're taking care of your diabetes. Show your blood glucose records to your health care team. They can use your records to see whether you need changes in your diabetes medicines or in your meal plan. If you don't know what your results mean, ask your health care team.

Things to write down every day in your record book are

• results of your blood glucose checks
• your diabetes medicines: times and amounts taken
• if your blood glucose was very low (see chapter three)
• if you ate more or less food than you usually do
• if you were sick
• if you found ketones in your urine
• what kind of physical activity you did and for how long

ACTION STEPS

If you DON'T use insulin

• Follow your meal plan.
  
  
• Don't skip meals, especially if you take diabetes medicine, because your blood glucose may go too low. It may be better to eat several small meals during the day instead of one or two big meals

When you exercise, carry glucose tablets or a carbohydrate snack with you in case you get hypoglycemia (low blood sugar). Wear or carry an identification tag or card saying that you have diabetes.

The groups listed in chapter six have more information about diabetes and exercise.

Insulin and diabetes pills are the two kinds of medicines used to lower blood glucose.

You need insulin if your body has stopped making insulin or if it doesn't make enough. Everyone with type 1 diabetes needs insulin, and many people with type 2 diabetes do too.

Insulin can't be taken as a pill. You'll give yourself shots every day or use an insulin pump. An insulin pump is a small machine that connects to narrow tubing, ending with a needle just under the skin near the abdomen. Insulin is delivered through the needle.

Keep extra insulin in your refrigerator in case you break the bottle you're using. Don't keep insulin in the freezer or in hot places like the glove compartment of your car. Also, keep it away from bright light. Too much heat, cold, or bright light can damage insulin.

If you use a whole bottle of insulin within a month, you can keep that bottle at room temperature. If you don't use a whole bottle of insulin within one month, then store it in the refrigerator.

If your body makes insulin, but the insulin doesn't lower your blood glucose, you may need diabetes pills. Some pills are taken once a day, and others are taken more often. Ask your health care team when you should take your pills.

Be sure to tell your doctor if your pills make you feel sick or if you have any other problems. Remember, diabetes pills don't lower blood glucose all by themselves. You'll still want to follow a meal plan and be active to help lower your blood glucose.

Sometimes, people who take diabetes pills may need insulin shots for a while. If you get sick or have surgery, the diabetes pills may no longer work to lower your blood glucose.

You may be able to stop taking diabetes pills if you lose weight. (Always check with your doctor before you stop taking your diabetes pills.) Losing 10 or 15 pounds can sometimes help you reach your target blood glucose level.

Taking Care of Your Diabetes Every Day
Chapter 2 of 6

Do four things every day to lower high blood glucose:

Follow your meal plan.

Be physically active.

Take your diabetes medicine.

Check your blood glucose.

Experts say most people with diabetes should try to keep their blood glucose level as close as possible to the level of someone who doesn't have diabetes. The closer to normal your blood glucose is, the lower your chances are of developing damage to your eyes, kidneys, and nerves.

Check with your doctor about the right range for you

Your health care team will help you learn how to reach your target blood glucose range. Your main health care providers are your doctor, nurse, diabetes educator, and dietitian
A diabetes educator is a health care worker who teaches people how to manage their diabetes. Your educator may be a nurse, a dietitian, or another kind of health care worker.

A dietitian is someone who's specially trained to help people plan their meals. For more information about these health care providers and for help in finding them, see chapter six.

The next sections of this guide will tell you more about the four main ways you take care of your diabetes: Follow your meal plan, by physically active, take your diabetes medicine, and check your blood glucose.

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Chapter 1 of 6

Diabetes means that your blood glucose (often called blood sugar) is too high. Your blood always has some glucose in it because your body needs glucose for energy to keep you going. But too much glucose in the blood isn't good for your health.

How do you get high blood glucose?
Glucose comes from the food you eat and is also made in your liver and muscles. Your blood carries the glucose to all the cells in your body. Insulin is a chemical (a hormone) made by the pancreas. The pancreas releases insulin into the blood. Insulin helps the glucose from food get into your cells. If your body doesn't make enough insulin or if the insulin doesn't work the way it should, glucose can't get into your cells. It stays in your blood instead. Your blood glucose level then gets too high, causing pre-diabetes or diabetes

What is pre-diabetes?
Pre-diabetes is a condition in which blood glucose levels are higher than normal but are not high enough for a diagnosis of diabetes. People with pre-diabetes are at increased risk for developing type 2 diabetes and for heart disease and stroke. The good news is if you have pre-diabetes, you can reduce your risk of getting diabetes. With modest weight loss and moderate physical activity, you can delay or prevent type 2 diabetes and even return to normal glucose levels.

What are the signs of diabetes?
The signs of diabetes are

being very thirsty
urinating often
feeling very hungry or tired
losing weight without trying
having sores that heal slowly
having dry, itchy skin
losing the feeling in your feet or having tingling in your feet
having blurry eyesight
You may have had one or more of these signs before you found out you had diabetes. Or you may have had no signs at all. A blood test to check your glucose levels will show if you have pre-diabetes or diabetes.

What kind of diabetes do you have?
People can get diabetes at any age. There are three main kinds. Type 1 diabetes, formerly called juvenile diabetes or insulin-dependent diabetes, is usually first diagnosed in children, teenagers, or young adults. In this form of diabetes, the beta cells of the pancreas no longer make insulin because the body's immune system has attacked and destroyed them. Treatment for type 1 diabetes includes taking insulin shots or using an insulin pump, making wise food choices, being physically active, taking aspirin daily (for some), and controlling blood pressure and cholesterol.

Type 2 diabetes, formerly called adult-onset diabetes or noninsulin-dependent diabetes, is the most common form of diabetes. People can develop type 2 diabetes at any age—even during childhood. This form of diabetes usually begins with insulin resistance, a condition in which fat, muscle, and liver cells do not use insulin properly. At first, the pancreas keeps up with the added demand by producing more insulin. In time, however, it loses the ability to secrete enough insulin in response to meals. Being overweight and inactive increases the chances of developing type 2 diabetes. Treatment includes using diabetes medicines, making wise food choices, being physically active, taking aspirin daily, and controlling blood pressure and cholesterol.

Some women develop gestational diabetes during the late stages of pregnancy. Although this form of diabetes usually goes away after the baby is born, a woman who has had it is more likely to develop type 2 diabetes later in life. Gestational diabetes is caused by the hormones of pregnancy or a shortage of insulin.

Why do you need to take care of your diabetes?
After many years, diabetes can lead to serious problems in your eyes, kidneys, nerves, and gums and teeth. But the most serious problem caused by diabetes is heart disease. When you have diabetes, you are more than twice as likely as people without diabetes to have heart disease or a stroke.

If you have diabetes, your risk of a heart attack is the same as someone who has already had a heart attack. Both women and men with diabetes are at risk. You may not even have the typical signs of a heart attack.

You can reduce your risk of developing heart disease by controlling your blood pressure and blood fat levels. If you smoke, talk with your doctor about quitting. Remember that every step toward your goals helps!

Later in this guide, we'll tell you how you can try to prevent or delay long-term problems. The best way to take care of your health is to work with your health care team to keep your blood glucose, blood pressure, and cholesterol in your target range.

What's a desirable blood glucose level?
Everyone's blood has some glucose in it. In people who don't have diabetes, the normal range is about 70 to 120. Blood glucose goes up after eating, but returns to the normal range 1 or 2 hours later.

Ask your health care team when you should check your blood glucose with a meter. Talk about whether the blood glucose targets listed below are best for you. Then write in your own targets.

Blood Glucose Targets for Most People
When Target levels My target levels
Before meals
 90 to 130
 _____________
 
1 to 2 hours after the start of a meal
 less than 180
 _____________
 
It may be hard to reach your target range all of the time. But the closer you get to your goal, the more you will reduce your risk of diabetes-related problems and the better you will feel. Every step helps.

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Typical Diabetes Facts

There are three types of diabetes

Type I - generally occurs when the pancreas no longer produces any or very little insulin. The body needs insulin to break down sugars for energy. Statistics show that approximately 10% of diabetics have type I diabetes.

Type II - generally occurs when the pancreas does not produce enough insulin or when the body does not use insulin effectively. Statistics show that approximately 90% of diabetics have type II diabetes.

Gestational - is considered a temporary condition that occurs during pregnancy. It affects 2% to 5% of all pregnancies. Gestational diabetes increases the risk of developing diabetes for both mother and child.

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All About Diabetes

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Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. The cause of diabetes continues to be a mystery, although both genetics and environmental factors such as obesity and lack of exercise appear to play roles.

There are 18.2 million people in the United States, or 6.3% of the population, who have diabetes. While an estimated 13 million have been diagnosed with diabetes, unfortunately, 5.2 million people (or nearly one-third) are unaware that they have the disease.

In order to determine whether or not a patient has pre-diabetes or diabetes, health care providers conduct a Fasting Plasma Glucose Test (FPG) or an Oral Glucose Tolerance Test (OGTT). Either test can be used to diagnose pre-diabetes or diabetes. The American Diabetes Association recommends the FPG because it is easier, faster, and less expensive to perform.

With the FPG test, a fasting blood glucose level between 100 and 125 mg/dl signals pre-diabetes. A person with a fasting blood glucose level of 126 mg/dl or higher has diabetes.

In the OGTT test, a person's blood glucose level is measured after a fast and two hours after drinking a glucose-rich beverage. If the two-hour blood glucose level is between 140 and 199 mg/dl, the person tested has pre-diabetes. If the two-hour blood glucose level is at 200 mg/dl or higher, the person tested has diabetes.

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Type 1 Diabetes

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Type 1 diabetes is usually diagnosed in children and young adults, and was previously known as juvenile diabetes. In type 1 diabetes, the body does not produce insulin. Insulin is necessary for the body to be able to use sugar. Sugar is the basic fuel for the cells in the body, and insulin takes the sugar from the blood into the cells.

Finding out you have diabetes is scary. But don't panic. Type 1 diabetes is serious, but people with diabetes can live long, healthy, happy lives.

Conditions & Treatment
Arm yourself with information about conditions associated with type 1 diabetes, and how to prevent them. Conditions associated with type 1 diabetes include hyperglycemia, hypoglycemia, ketoacidosis and celiac disease. You will also find helpful information about insulin, choosing blood glucose meters, various diagnostic tests including the A1c test, managing and checking your blood glucose, kidney and islet transplantations, and tips on what to expect from your health care provider.

Complications
Having type 1 diabetes increases your risk for many serious complications. Some complications of type 1 diabetes include: heart disease (cardiovascular disease), blindness (retinopathy), nerve damage (neuropathy), and kidney damage (nephropathy). Learn more about these complications and how to cope with them.

Diabetes Learning Center for the Newly Diagnosed
You've just been diagnosed with diabetes. Chances are you have a million questions running through your head. To help you answer those questions, and take the first steps toward better diabetes care, visit the Diabetes Learning Center -- an area for people who are newly diagnosed with diabetes, or those needing basic information.

Your Body's Well Being
Make it a priority to take good care of your body. The time you spend now on eye care, foot care and skin care, as well as your heart health and oral health, could delay or prevent the onset of dangerous type 1 diabetes complications later in life. Plus, some of the best things you can do for your body are to stop smoking, and reduce the amount of alcohol you drink.

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What is Diabetes?
The two types of diabetes, insulin-dependent and noninsulin-dependent, are different disorders. While the causes, short-term effects, and treatments for the two types differ, both can cause the same long-term health problems. Both types also affect the body's ability to use digested food for energy. Diabetes doesn't interfere with digestion, but it does prevent the body from using an important product of digestion, glucose (commonly known as sugar), for energy.

After a meal the digestive system breaks some food down into glucose. The blood carries the glucose or sugar throughout the body, causing blood glucose levels to rise. In response to this rise the hormone insulin is released into the bloodstream to signal the body tissues to metabolize or burn the glucose for fuel, causing blood glucose levels to return to normal. A gland called the pancreas, found just behind the stomach, makes insulin. Glucose the body doesn't use right away goes to the liver, muscle or fat for storage.

In someone with diabetes, this process doesn't work correctly. In people with insulin-dependent diabetes, the pancreas doesn't produce insulin. This condition usually begins in childhood and is also known as type I (formerly called juvenile-onset) diabetes. People with this kind of diabetes must have daily insulin injections to survive.

In people with noninsulin-dependent diabetes the pancreas usually produces some insulin, but the body's tissues don't respond very well to the insulin signal and, therefore, don't metabolize the glucose properly, a condition called insulin resistance. Insulin resistance is an important factor in noninsulin-dependent diabetes.

Points to Remember

* Diabetes interferes with the body's use of food for energy.

* While noninsulin-dependent diabetes are different disorders, they can cause the same complications.