Type I diabetes, is also called insulin-dependent diabetes. It usually starts before you’re 20, but it can also happen later. There is no cure for diabetes, but you can live an enjoyable, active life. How? By controlling your blood glucose (a type of sugar in your blood). Here are some of the basics you need to learn.
What is diabetes and how does it change the way your body gets its energy?
How can you check your blood glucose to be sure you maintain a level that’s right for you?
How can you control your blood glucose by taking insulin, eating right, and exercising regularly?
How can you take care of yourself – especially your feet and eyes, and what to do when you’re ill?
Changes That Occurs During Diabetes. What Happens When You Eat?
When you have Type I diabetes, your pancreas can’t make insulin. Without insulin, glucose can’t enter your cells.
• Food still changes into glucose.
With diabetes, your body still changes most of food the into glucose. Glucose enters your blood and travels to the cells.
• Your pancreas doesn’t make insulin
Since your pancreas don’t make insulin, there’s nothing to unlock the cells, so glucose cannot enter.
Glucose remains in your blood instead. That’s how your blood glucose gets too high.
• Your body looks for new fuel
Without glucose, your cells try to get energy from stored fat. But fats leave a waste product called ketones. Ketones build up and cause a dangerous condition called ketoacidosis.
Controlling Your Blood Glucose
Controlling your blood glucose at a level that’s right for you is done by balancing insulin, your meal plan, and exercise. When any of these three things are out of balance, your blood glucose goes out of control. Your body may react by telling you something is wrong.
Is Your Blood Glucose in Balance?
Frequent blood sugar tests are recommended to those diabetics who undergo strenuous exercises, sportsmen, athletes and / or those who are insulin-dependent and have a tendency to lapse into hypoglycaemic coma. In such cases, it is prudent to use the strip-testing method of estimation of blood sugar. Blood sugar can be tested by the patient himself with the use of Dextrostix / Glucometer system. It is an extremely simple test procedure in which, with a little training from the physician / medical worker, one can make use of this method.
Testing Your Urine for Ketones
You may need to test your urine for ketones to make sure your body isn’t trying to get energy from fats. Test your urine for ketones when—
• Your blood glucose is above 250 mg/ dl (milligrams per deciliter).
• You are ill or under stress.
• You have an upset stomach, diarrhoea (loose stool), or vomiting.
• Your blood glucose level remains higher than your normal level.
The presence of acetone in urine is an indication of hypoglycemia. When the breath of the diabetic smells like nail-polish remover, that is, of acetone, he should immediately be taken to the hospital without any delay.
Balancing Your Glucose with Insulin
Taking insulin is the first step towards keeping your blood glucose in balance. How often you take your insulin depends on the kind of insulin your doctor recommends.
There is a great bias against insulin treatment. It is so very natural as insulin has to be taken life-long, the injections are to be taken daily even twice or thrice a day, it may be inconvenient, could be painful, and there may be risk of sudden drop of blood sugar (hypoglycemia) causing emergency.
But all these apprehensions are mainly due to the lack of correct knowledge. There may be some inconveniences but when it is a life- saving treatment all other adverse points can be ignored. Today scientific advances have overcome most of these difficulties.
Storing Insulin
Never freeze insulin or let it get above 86 degree Fahrenheit. And never use it after the expiry date on the bottle.
How to Store Open Bottles?
Store the bottles that have been opened at room temperature.
Rotate your injection sites to help prevent skin problems. Use all the sites in one area.
Insulin can only be taken by injection, because being a protein, it is digested like any other food stuff if taken by mouth. Once it is injected, it is slowly absorbed in the blood and reaches different sites of action all over the body. The rate of absorption, which decides the speed of action, depends upon the type of insulin and where it is injected. Normally insulin is injected under the skin (subcutaneously), but it can also be given intra-muscularly or even intravenously. You yourself can take only subcutaneously.
New researches are going on to modify insulin in such a way that it can be taken as snuff, or skin ointment, or even by mouth. We have to wait till final satisfactory results are available.
Why Everyone Cannot be Controlled by One Injection a Day?
Normally insulin is secreted in small quantities continuously to provide a basal constant level, and there is a spurt of release when we eat (according to the amount of food). Such a precise stimulation of insulin release cannot be achieved with an injection of insulin. Therefore, majority of patients need two or even three injections a day, specially for a mixture of short and long acting insulin, the proportion and exact dosage has to be worked out by your doctor. You can do minor adjustment of dosage (add or reduce 2 units at a time) once you understand how to do it.
One injection a day of long acting insulin either produces a very high insulin level during some hours and an ineffective level at others. If the requirement is less than 25 Units per day, one injection a day could be tried.
Even when you are taking insulin it does not mean you can eat whatever you want and whenever you want. In fact, still strict adjustment of diet both in terms of quality, quantity of food and its timings, is required to achieve a smooth blood sugar level without wide fluctuations. Eat a little extra, before you expect hypoglycemia and reduce the quantity if your blood sugar level shoots up. lush-ad of changing the dose of insulin more frequently, adjust the food accordingly.
Taking Insulin
Today with availability of disposable syringes and very fine needles, it has become so very simple and painless to have insulin injections, that even a small child does not resent it. It is the initial apprehension and resistance that makes the injection so difficult. Doctors have always succeeded to initiate the very first injection even by a child and then there are no further problems. Select the best available syringe, particularly with fixed needles of 28 or 29 x 1/2 size, and it is almost safe to use the same syringe several times, of course, for the same patient, provided you don’t wipe off the needle with cotton swab, or spirit.
A new device called NOVOPEN can be used for self-injection. It is loaded with special cartridges of insulin, and with required adjustment, a pre-fixed dose of insulin is delivered with push of the button. It is simple, convenient to carry and eliminates the problems of filling insulin and measuring the dose. It is slightly costlier.
Nowadays INSULIN PUMPS are also available, these are like automatic syringes, it injects insulin at a constant rate which can be adjusted according to the need. It runs on battery and being the size of a pocket transister, the patient can move around with it without much difficulty.
Of course, it requires a little training and frequent self-monitoring of blood glucose to use these pumps. At present, it is being used in hospitals under direct supervision of experts in cases where an ideal control is very much needed or when proper control becomes difficult even with multiple doses of insulin.
While on Insulin, You Need More Frequent Monitoring
You know insulin is a very effective drug to reduce the blood sugar level, hence it requires an equally efficiency method of monitoring the blood sugar level. We assess the blood sugar level either by measuring the glucose in the blood or indirectly through measuring glucose in urine. Urine method is not so accurate, but useful as it is cheap, requires no pricking, and can be done by patients themselves. Dose of insulin or intake of food should be so adjusted that there is no chance of hypoglycemia, and blood sugar does not exceed the normal range.
Learn the correct procedure of filling the syringe and injecting it yourself. Use the appropriate syringe (U 40 syringe for Insulin 40 U / ml) for different strength of insulin. If in doubt, discuss with your medical team. Learn to make minor adjustment in doses of insulin according to day-to-day situations.
Always Carry the Card
“I am a Diabetic
Name :
Address :
Tel No. :
It helps you in emergency. Risk of Hypoglycemia
Sudden drop of blood glucose level is quite frequent with insulin treatment, particularly if the patients are not very careful about their diet, exercise or dosage of insulin and its timings. You know insulin is a powerful drug, if you are not careful, the blood sugar level may suddenly drop and you have the nasty feeling of weakness, hunger, palpitation, trembling, sweating and loss of consciousness even. Since there are so many variable situations in real life, it does happen to almost every patient sometimes or the other, more so with those patients who are not so careful. It is good to have this experience under supervision, so that one can recognize it in emergency. Better controlled, well experienced and alert patients hardly have any hypoglycemia. Be prepared with its remedy, always, all the time specially when you are going out. A few biscuits, a sugar cube or toffee in time can save a major panic. In doubt, take sugar and wait a while, if it was hypoglycemia you will improve immediately.
To avoid hypoglycemia, don’t avoid insulin.