Marty, u r such an !! Thank you so much for inviting me!

My BF was just diagnosed with diabetes . . his glucose level was above 450!! He has congenitive heart failure as well . . fairly young for that as he is just 50.

 [ send green star]

• My Child Has Diabetes
  What do you do when your child is diagnosed with diabetes? Mary Kate Cary shares her insight in to being the parent of a child with type 1 diabetes.
• David Mendosa's Advice for Newbies
  Follow David's tips for living with diabetes.
• How to Help a Friend
  Things to do for a friend whose child has been newly diagnosed
• Myths and Facts About Type 1 Diabetes in Children
  Mary Kate Cary recounts the tales you’ve heard again and again—and explains the real story.

Just diagnosed with diabetes and don’t know where to begin? Here are five things you should do right away to get a handle on your treatment and well being.

• Go to class. Call your doctor and ask for a referral to a diabetes education class taught by a certified diabetes educator (CDE).
• Get a meter. Buy a blood glucose meter, test strips, and lancets for testing your blood sugar levels at home
• Reassess your diet. Whether you have type 1 or type 2 diabetes, you’ll need to learn how food impacts your diabetes. Get a referral to a registered dietitian (RD) for specialized meal planning assistance.
• Seek support. Find out if your local hospital has a diabetes support group, or find a virtual group online. Hearing from others who share your concerns helps.
• Ask questions. Call your provider’s office if you need more information or have questions about your treatment. She’s there to help.

Diabetes

Like other chronic conditions, diabetes doesn't allow for any slack in treatment adherence. But according to certified diabetes educator Michelle C. Sheldon-Rubio, RN, CDE, it happens a lot. "Some patients think management leads to control [of diabetes] and control leads to cure. So then they think, 'I can go back to my old habits'," says Sheldon-Rubio, education coordinator at the Joslin Diabetes Center at University of Maryland Medicine.

That's why effectively educating patients about the disease is critical. "Part of the education process is to let people know that diabetes is a progressive disease, and it is chronic," Sheldon-Rubio tells WebMD. She sees self-monitoring as key to this education process. "By getting people to take their blood sugar before a meal and two hours after, they can see how their blood glucose levels change after they eat. They get immediate feedback," she says. "The more people monitor their blood glucose levels, the better off they are."

Many people with diabetes also don't realize the importance of routine exercise and weight control in helping keep their blood glucose under control.

There is sub-q tissue all over your body, but some places are better than others for giving insulin, because they are away from large blood vessels and nerves. The best places for injecting insulin are:

• The upper, outside part of your arm.
• The front and sides of your thighs.
• Your buttocks.
• Just above your waist on your back (this is a hard one to reach).
• Your stomach, except the area around your navel and at your waistline.

If you're really high, you might want to inject in your stomach, since insulin injected there is absorbed faster than insulin injected in arms, legs and buttocks.

RotationIt's really important to change the site where you get your injections. This is called site rotation. Site rotation helps prevent problems that can occur if you inject insulin in the same place every time. Some kids take their morning injection in the arm and their evening injection in their leg. Some do just the reverse. The important thing is to rotate where you get your injections.

Since insulin is absorbed at a different rate depending upon where it is injected, you should try to be consistent in where you inject. If you do morning shots in your arm, stick with that, but move around the arm and between arms. Consistency is an important tool to helping you maintain good control.

Diabetes Awareness: The Downside... a New Wardrobe?
Here is some commonsense thinking:

I can't understand why anyone who has diabetes wouldn't exercise and watch what they eat.

The down side is that you may have to get an entire new wardrobe since exercise and healthy eating causes weight and size reduction.

When it happens, people tell you how great you look and that motivates you even more.

Other side effects: you'll also sleep better and feel more rested than before you started walking and eating better.

I prefer walking outside, especially when the weather is nice. I even designed a walking path about 2.5 miles long around my neighborhood; part flat and part hilly.

You'll find that a walking program helps more than your body.

"For me, walking time is good thinking time. Nobody is there to interrupt my thoughts. And even when I walk on the treadmill in front of the TV, I find it helps me get ready for the day."

Exercise and healthy eating.... A powerful duo for diabetics!

Ask your doctor about diabetes and have your blood sugar checked several times a year.

For more information about diabetes, including a Diabetes Quiz and a Free booklet, visit our website at:

http://hope4diabetes.com/info

This 20 page FREE booklet will provide you with in-depth information on comprehensive diabetes care. The 7 principles, or steps, will help you to understand, manage and diagnose your potential diabetes risk.

It could help you live a longer and more active life. The booklet is Yours absolutely FREE - No Risk! Share it NOW with the people you love and want to Keep alive!.

Diabetes Awareness: I'll Wait 'til it Hurts
By the time many type 2 diabetics (and often their doctors) realize action is necessary, the disease, with its destructive high blood sugars, has been silently damaging their body for years.

Complications to the blood vessels and tissues of your eyes, feet, heart, kidneys, and other organs, are likely well underway.

You visit the doctor because you feel bad, and you wish to feel better. You react to the symptoms of perceived illness. This is understandable, but does not allow much room for prevention or early detection of diabetes.

Of course this idea, ?Don't see the doctor 'til it hurts,? comes from our ?busier-then-ever? lifestyles. But to blame, to point fingers after the damage has started is as pointless as is the leaping bungee-jumper's complaint that his equipment has just failed. It's a little late to talk about why. Some problems are better prevented.

If you have type 2 diabetes, you know most of the time you don't feel very bad. You might think that because you don't feel very bad, it isn't very serious, and you don't have to do anything about it just now. "I'll wait 'til it hurts" ...You couldn't be more wrong.

Diabetes damages your body with high blood sugars. It doesn't care whether your sugars are high from type 2, type 1, or some other cause ? if they're up, they're doing damage. Type 2 diabetics who let their sugars run ?because they don't feel bad? are doing serious damage to their eyes, kidneys, hearts, and nervous systems.

Suppose you have diabetes, and don't want the complications. Suppose you don't know you have diabetes, but you're from a high-risk group (maybe someone in your family has or had diabetes), and you want to cut the risks. Or, suppose you just want to feel better.

It's all the same ? Your early detection, education, and prevention work best.

Don't wait 'til it hurts. Ask your doctor about diabetes and have your blood sugar checked several times a year.

For more information about diabetes, including a Diabetes Quiz and a Free booklet, visit our website at:

http://hope4diabetes.com/info

This 20 page FREE booklet will provide you with in-depth information on comprehensive diabetes care. The 7 principles, or steps, will help you to understand, manage and diagnose your potential diabetes risk.

It could help you live a longer and more active life. The booklet is Yours absolutely FREE - No Risk! Share it NOW with the people you love and want to Keep alive!.

The diagnosis of diabetes mellitus, whether type 1 or type 2, can come as a devastating blow to anyone. However, today we have a great deal of knowledge about diabetes. The ways in which we can deal with these disorders have grown and improved, giving people with diabetes longer lives and better lives than ever before. If you have diabetes, or if you have a loved one who has been diagnosed with diabetes, you need to plan for more than just medicines and diets and doctor's visits. A plan for living a long, healthy life is also needed.

That plan starts with taking control of diabetes. The fundamental goal is simple: keeping blood sugar levels in the normal range. What will that gain you?1

 In the short run, you will:
 

Feel better.

Keep healthy.

Enjoy a higher energy level.

Avoid the symptoms of high blood sugar - thirstiness and fatigue, frequent urination, blurry vision, and all the other problems that high blood glucose levels cause.

 In the long run, you will: 
 

Take control of your life.

Reduce the risk of diabetes damaging your eyes, your kidneys, and your nerves.

Become wiser in the ways of your own body, and learn to appreciate how it works.

Take up habits of good health that will also lower your risks of heart disease, lung disease, and other potentially dangerous conditions.

Live a longer life, of better quality and with greater promise.

 There's much to be gained 
 

There's much to be gained, and it starts with these three steps:

Know your blood sugar numbers. Get a complete picture of your long-term blood sugar control with your healthcare provider's help by having a hemoglobin A1c test performed, and possibly an oral glucose tolerance test as well. In addition, regularly check your blood glucose levels both before and after meals with finger-stick tests using a blood glucose meter.

Reach your blood sugar goal. Make the healthy lifestyle choices you need, working with your healthcare provider to set that goal and to achieve it.

Keep your blood sugar under control. Create a plan to stick with your goals, and be prepared for setbacks, complications, depression, anxiety, frustration, and all the other obstacles you know you'll have to overcome.

Hematocrit

Hematocrit is the amount of red blood cells in the blood. Patients with higher hematocrit values will usually test lower for blood glucose than patients with normal hematocrit. Patients with lower hematocrit values will test higher. If you know that you have abnormal hematocrit values you should discuss its possible effect on glucose testing (and HbA1C testing) with your health care provider. Anemia and Sickle Cell Anemia are two conditions that affect hematocrit values.

Other Substances

Many other substances may interfere with your testing process. These include uric acid (a natural substance in the body that can be more concentrated in some people with diabetes), glutathione (an "anti-oxidant" also called "GSH"), and ascorbic acid (vitamin C). You should check the package insert for each meter to find what substances might affect its testing accuracy, and discuss your concerns with your health care provider.

Important Features Of Glucose Meters/Monitors

There are several features of glucose meters that you need to understand so you can use your meter and understand its results. These features are often different for different meters. You should understand the features of your own meter.

Glucose Meter Measurement Range

Most glucose meters are able to read glucose levels over a broad range of values from as low as 0 to as high as 600 mg/dL. Since the range is different among meters, interpret very high or low values carefully. Glucose readings are not linear over their entire range. If you get an extremely high or low reading from your meter, you should first confirm it with another reading. You should also consider checking your meter's calibration.

Whole Blood Glucose vs. Plasma Glucose

Glucose levels in plasma (one of the components of blood) are generally 10-15% higher than glucose measurements in whole blood (and even more after eating). This is important because home blood glucose meters measure the glucose in whole blood while most lab tests measure the glucose in plasma. There are many meters on the market now that give results as "plasma equivalent". This allows patients to easily compare their glucose measurements in a lab test and at home. Remember, this is just the way that the measurement is presented to you. All portable blood glucose meters measure the amount of glucose in whole blood. The meters that give "plasma equivalent" readings have a built in algorithm that translates the whole blood measurement to make it seem like the result that would be obtained on a plasma sample. It is important for you and your healthcare provider to know whether your meter gives its results as "whole blood equivalent" or "plasma equivalent."

Glucose Meter Cleaning

Some glucose meters need regular cleaning to be accurate. Clean your meter with soap and water, using only a dampened soft cloth to avoid damage to sensitive parts. Do not use alcohol (unless recommended in the instructions), cleansers with ammonia, glass cleaners, or abrasive cleaners. Some glucose meters do not require regular cleaning but contain electronic alerts indicating when you should clean them. Other meters can be cleaned only by the manufacturer.

Display Of High And Low Glucose Values

Part of learning how to operate a meter is understanding what the meter results mean. Be sure you know how high and low glucose concentrations are displayed on your meter.

Factors That Affect Glucose Meter Performance

The accuracy of your test results depends partly on the quality of your meter and test strips and your training. Other factors can also make a difference in the accuracy of your results.

How to Measure Blood Sugar

A glucose meter or monitor is a machine that measures how much glucose (sugar) is in the blood. Typically, a specially coated strip containing a sample of blood is inserted in the machine, which then measures the level of glucose in the blood sample and shows the result on a digital display. Some glucose meters/monitors have a memory component that can store results from multiple tests.

Monitor Blood Glucose and Maintain Glycemic Diet Control
This glucose-measuring equipment is mainly used by diabetics to monitor glucose levels which need to be kept in balance in order to reduce the risk of hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar). But a glucose meter/monitor home health test kit can help you maintain good glycemic control through diet, exercise, blood monitoring and medication.

Helpful Tips About Your Glucose Meter/Monitor

Diabetes care should be designed for each individual patient. Some patients may need to test (monitor) blood glucose more often than others do. How often you use your glucose meter should be based on the recommendation of your diabetes educator or doctor. Self-monitoring of blood glucose (SMBG) is recommended for all people with diabetes, but especially for those who take insulin (type 1 diabetics).

Learning to Use Your Glucose Meter/Monitor

Not all glucose meters work the same way. Since you need to know how to use your glucose meter and interpret its results, you should get training from a diabetes educator. The educator should watch you test your glucose to make sure you can use your meter correctly. This training is better if it is part of an overall diabetes education program.

Instructions for Using Glucose Meters/Monitors

The following are the general instructions for using a glucose meter:

Wash hands with soap and warm water and dry completely or clean the area with alcohol and dry completely.

Prick the fingertip with a lancet.

Hold the hand down and hold the finger until a small drop of blood appears; catch the blood with the test strip.

Follow the instructions for inserting the test strip and using the SMBG meter.
Record the test result.

The Food and Drug Administration (FDA) requires that glucose meters and the strips used with them have instructions for use. You should read carefully the instructions for both the meter and its test strips. Meter instructions are found in the user manual. Keep this manual to help you solve any problems that may arise. Many meters use "error codes" when there is a problem with the meter, the test strip, or the blood sample on the strip. You will need the manual to interpret these error codes and fix the problem.

You can get information about your glucose meter and test strips from several different sources. Your user manual should include a toll free number in case you have questions or problems. If you have a problem and can't get a response from this number, contact your healthcare provider or a local emergency room for advice. Also, the manufacturer of your glucose meter should have a website.

There is no cure for diabetes. Neither type 1 (juvenile onset or insulin-requiring) diabetes or type 2 (adult-onset) diabetes ever goes away.

In type 1 diabetes, patients sometimes experience what physicians have come to call a "honeymoon period" shortly after the disease is diagnosed. During the "honeymoon period" diabetes may appear to go away for a period of a few months to a year. The patient's insulin needs are minimal and some patients may actually find they can maintain normal or near normal blood glucose taking little or no insulin.

It would be a mistake to assume that the diabetes has gone away, however. Basically, type 1 diabetes occurs when about 90 percent of the body's insulin producing cells have been destroyed. At the time that type 1 diabetes is diagnosed, most patients still are producing some insulin. If obvious symptoms of type 1 diabetes emerge when the patient has an illness, virus or cold, for example, once the illness subsides the body's insulin needs may decrease. At this point, the number of insulin producing cells remaining may be enough — for the moment — to meet the person's insulin needs again.

But the process that has destroyed 90 percent of the insulin producing cells will ultimately destroy the remaining insulin-producing cells. And as that destruction continues, the amount of injected insulin the patient needs will increase — and ultimately the patient will be totally dependent on insulin injections.

Scientists now think that it is important for people with newly diagnosed diabetes to continue taking some insulin by injection even during the honeymoon period. Why? Because they have some scientific evidence to suggest that doing so will help preserve the few remaining insulin producing cells for a while longer.

Patients diagnosed with type 2 diabetes may discover that if they are overweight at diagnosis and then lose weight and begin regular physical activity, their blood glucose returns to normal. Does this mean diabetes has disappeared? No. The development of type 2 diabetes is a gradual process, too, in which the body becomes unable to produce enough insulin for its needs and/or the body's cells become resistant to insulin's effects. Gradually the patient goes from having "impaired glucose tolerance" — a decreased but still adequate ability to convert food into energy — to having "diabetes."

If the patient were to gain weight back or scale back on their physical activity program, high blood glucose would return. If they were to overeat at a meal, their blood glucose probably would continue to go higher than someone without diabetes. Also, the decreased insulin production and/or increased insulin resistance that led to the initial diabetes diagnosis will gradually intensify over the years and during periods of stress. In time, the patient who could maintain normal blood glucose with diet and exercise alone may discover that he or she needs to add oral diabetes medications — or perhaps even insulin injections — to keep blood glucose in a healthy range.

The good news for a type 1 and type 2 patient is that if insulin, medication, weight loss, physcal activity and changes in eating result in normal blood glucose, that means their diabetes is well controlled and their risk of developing diabetes complications is much lower.

But it doesn't mean that their diabetes has gone away.

Here is that chart  about blood glucose levels. You'll note that it give you levels for both non-diabetic and diabetic people.

For non-diabetic people
Before Breakfast (fasting) <110
Before Lunch <110
Two Hours after Meals <140
Bedtime <120
HbA1c < 6%

For People with Diabetes
Before Breakfast (fasting) 90-130
Before Lunch 90-130
Two hours after meals < 160
Bedtime 110-150
HbA1c =7%

Use of insulin or oral medications:

There are many families of medications which work in different parts of your body so it's important to ask how and where the medication you are prescribed works. You will also want to ask about any side effects. Ask your doctor to run a drug-drug interaction with the other medications you take to make sure there are no interactions that can cause you problems. If you take insulin, make sure you know the type, the half life, and how long it takes to kick in. Your health care team will tell you about timing and schedule for your medication or insulin injections. Ask someone to write it down. As you monitor your glucose, these may have to change and/or you may forget. If you take insulin, have someone teach you how to go through that process including drawing insulin, injecting and site rotation, or if you opt for a pump make sure you are thoroughly educated. Make sure you can contact someone for help if you need it. I can tell you that when I came home with my pump I had to call the manufacturer because the doctor's office had closed and I was frightened, knowing that the pump was not functioning as I thought it should. Two calls later and I was fine. As I said before, learning about new gadgets with little computers inside can be scary until you get the hang of it, and sometimes the educator, as was mine, was anxious to get home on a Friday afternoon. Sometimes we all make mistakes; we miss a pill or give ourselves the wrong amount of insulin. Ask how to correct these mistakes.

 [report anonymous abuse]

Newly diagnosed?

What is type 1 diabetes? This is the type of diabetes that used to be called juvenile diabetes or insulin dependent diabetes. It results from our body's inability to make insulin-the hormone that allows glucose in and out of cells to fuel them. Glucose is the end product of the metabolism of the food that we eat. It gives us energy and allows us to function normally throughout the day. Before you were diagnosed with diabetes, you will remember how tired you were and how much weight you lost. This is a result of that loss of insulin in the body so the body no longer functions normally. You will also note that when you begin to take insulin, you will become less dehydrated and will begin to regain that excessive weight loss. The tell tale symptoms of diabetes will fade away, like impaired sight, fatigue, poor healing etc.

What is type 2 diabetes? I  know some of you know all of this, but remember when you were just diagnosed? Type 2 diabetes used to be called non-insulin dependent diabetes. Of course, we all know that many type 2 diabetic patients take insulin, so this is probably not a good medical way to describe it. Type 2 diabetes is a result of insulin resistance (condition in which the body fails to make enough or properly use insulin it makes), combined with relative insulin deficiency. Often type 2 diabetes can be controlled through losing weight, improved nutrition, and exercise alone, but many people may need oral medications and/or insulin to control their diabetes

Meal Planning:

The first thing people think of when you say diabetes is that you will have to give up anything with sugar in it for the rest of your life. The concept of carbohydrate metabolism and therefore carbohydrate counting has evolved over the past years, so this is no longer the case. What you do need to do as soon as you are diagnosed is to meet with a dietitian or diabetes educator who specializes in meal planning. The "whys" of this are simple. If you need to lose weight, this is the person who will know how. If you need to gain weight, this is the person to see, and if you want to maintain weight, the answer is the same. Every person's meal plan should be different depending on their ethnic backgrounds, work conditions, other medical conditions etc. You may be taught how to count carbohydrate grams or use diabetic exchanges, all of which are just weights of food which your insulin or medication will need to cover. Your meal plan will include the number of meals you eat per day (some people do better on many small meals, others eat regular meals and snacks as needed), how many calories you need to eat, how to include special foods for special days, how to dine out, guidelines for low cholesterol and lower fat intake, how you actually add some sugar to your recipes, how to include that glass of wine with meals, and finally how to become a savvy food shopper and read labels for your health. If you want to see some examples of Meal Plans, look at our welcome page in the yellow box on the right.

Self monitoring of blood glucose levels: Why is it important to prick your finger or arm and test your blood? We all know that having a high blood glucose level over time can lead to serious complications throughout our bodies. People with diabetes suffer high rates of cardiovascular disease, kidney disease, neuropathy, digestive disease, skin and teeth disease, muscular problems, diabetic retinopathy and more. If you haven't heard about the DCCT (Diabetes Control and Complication Trial) and the British UKPDS (UK Prospective Diabetes Study), you certainly will as you talk about diabetes and read about it in books, medical journals and on the net. Both studies have ended the argument about the benefits of lowering glucose levels in diabetes. The goal today is decisively glucose control.

What do you need to know about blood glucose control? When you sit down with your physician or diabetes educator, ask just what goals you need to set for yourself and how they can help you help yourself. At the end of this section, we'll list the medical goals that are common out there, so you can take them to your medical appointment. Anytime you have a new diagnosis, you may feel confused about the everyday stuff. Monitoring your blood glucose level has become an easy prospect compared to 20 years ago. My first glucometer was the size of a novel, and each time I had to recalibrate it for the first few months I had to ask my druggist to help. Today, I can carry my meter in a pocket when I exercise or travel. My first meter took 2 minutes to register; today there are ones that take just a few seconds. Like any new skill, it will take a few times to master the programming, etc., but here you are using a computer so a meter will be child's play. You will need to have a schedule for taking your blood sugar levels. This schedule will help you and your health care team to understand how your levels vary according to certain foods, stress, exercise, etc. and then to modify your medications or activities. Storage of medications and insulin as well as monitoring supplies always comes up in questions. If you take insulin you will need to know what your insulin should look like and how to store it safely. Finally, the team should help educate you on interpreting blood glucose levels and then making decisions on how to treat them. This includes how to treat both high and low blood levels, and will depend on what medication, if any, that you are taking or the type of insulin you use. One last proviso and that is to keep the manual that comes with your meter. You'll be surprised how long those batteries last and how soon we all forget how to program another gadget around the house.