diabetes ebook: diabetes - your questions answered
DESCRIPTION
We know that managing your diabetes and understanding your diabetic products can be a challenge, and you need a reliable source for answers to questions to advance your diabetes education.TRANSCRIPT
Diabetes: Your Questions Answered
Owen Mumford
Copyright Owen Mumford 2016
Published at Smashwords
Why me?
The fact that you are reading this booklet means that
you have recently been diagnosed with diabetes. You
can rest assured that you are not alone, as diabetes is
a condition that affects over 2 million people in the UK,1
about 800,000 of whom need to inject themselves with
insulin every day.2
The key thing is not to become disheartened about your
diagnosis, because if handled properly, it should not
interfere with your lifestyle too much.
Getting into a good routine, anticipating any breaks in
this routine and generally looking after yourself will
really pay off - advice that the whole population should
follow!
So take your time to read the information given in this
booklet, and use it alongside the advice from your
Diabetes Team to start living positively with diabetes.
What is diabetes?
Your body needs sugar (glucose) to fuel your muscles
and other cells so that you have the energy to perform
everyday activities. The glucose you need comes partly
from the food you eat (bread, potatoes etc), which is
broken down to glucose in your intestines and absorbed
into your bloodstream.
Once the glucose is in your bloodstream, it can only be
taken into muscles by insulin, a hormone produced by
your pancreas. If you do not produce enough insulin (or
if the insulin you produce does not work properly), this
transfer does not happen and glucose stays in your
bloodstream.
Is diabetes the same for everyone?
No. There are two main types of diabetes:
Type 1: occurs when no insulin is produced at all
because the insulin-producing cells in the pancreas
have been destroyed. Nobody knows for sure how this
happens, but the most likely cause is the body having
an abnormal reaction to this type of cell. There is
nothing you can do to prevent type 1 diabetes. This
type of diabetes is always treated with insulin
injections.3
Type 2: develops when your body does not make
enough insulin, or the insulin that you do produce does
not work properly. It has been linked to people carrying
excess weight and is more frequently seen in people of
Asian or African origin. It usually occurs in people aged
over 40-45 years and is the most common form of
diabetes, occurring in 85 to 95% of all people with
diabetes.3
Diabetes is a lifelong condition, but learning how to
care for yourself will help you to protect your
longterm health
Want to Cure Diabetes? Click Here
How is diabetes treated?
If you have type 1 diabetes you will require insulin
therapy straight away as it is no longer being produced
by your body. There are many different types of insulin
preparations available and not everyone takes the
same type or has to inject the same number of times
each day.
You will be prescribed the insulin regimen that works
best for you.
The aim of insulin therapy is to mimic your body’s
natural response, so there is a rapid-acting type that
works like the insulin your body produces after a meal,
and a long-acting type that mirrors the low levels of
insulin your body continuously produces.
If you have type 2 diabetes, you can often control high
levels of blood glucose by improving your diet (eating
healthier options and reducing the amount of sugary
foods), and by doing more exercise to keep your weight
under control. If your blood glucose levels are still too
high, there are tablets that can help your body to either
produce more insulin or make the insulin you do
produce work more efficiently.
Some people with type 2 diabetes find that despite
having their diabetes medication adjusted, their blood
glucose levels remain too high and insulin treatment is
recommended by their doctor – if this happens to you, it
must not be seen as a ‘failure’ on your part, but as an
inevitable development in the course of your disease.
Make sure you know how you should be taking your
medication. Don’t be afraid to ask your Diabetes
Team questions, we’re here to help
What should my glucose levels be?
The amount of glucose you should have in your blood
varies depending on your type of diabetes, your age
and time of day. Your Diabetes Team will advise you
about the right level for you and how often you should
test.
How do I test my blood glucose levels?
Testing your blood glucose levels is very simple and
involves ‘pricking’ the tip of one of your fingers with a
lancet (a sharp needle-type device) to produce a small
drop of blood.
Make sure your hands are clean and choose the
nonfleshy part of your fingertip (not the index finger).
The whole process will be easier if you first massage
the area to improve circulation.
Once you have drawn a drop of blood, just put it on the
test strip and measure the amount of glucose using
your glucose meter. Always dispose of the used lancet
safely in a sharps bin or refer to your local guidelines for
the safe disposal of sharps.
Your metabolism changes throughout the day so
check your blood glucose regularly
So I need insulin – what happens now?
Injecting insulin is very quick, easy, relatively painless
and discrete these days.
Due to the availability of pen devices (which look just
like fountain pens), no-one need know that you have
diabetes - unless you want them to.
You will probably be using either:
• a prefilled/disposable pen which can be
thrown away when all of the insulin has been used.
• a refillable pen which requires insulin
cartridges – these are very easy to replace and are
thrown away when empty, retaining the pen.
The new generation of needles, like Unifine® Pentips®
are also very fine and lubricated to ensure maximum
comfort when injecting.
Before each injection, you need to check that the pen is
working by setting the dial to 2, holding the pen upright
and pressing the button. A small drop of insulin should
appear at the tip of the needle. If not, repeat the
process until, it does.
The next two pages show just how simple it is to inject.
To Cure Diabetes Click Here
WHERE do I inject my insulin?
First of all, it is important to know whereabouts on your
body you should be injecting.
The best places to inject are the abdomen (always more
than two inches away from the navel), and outer thigh.
The buttocks are also good places, as long as you can
reach them easily. Absorption rates of insulin may vary
depending on where you inject, for example your upper
thigh and buttocks have a slower absorption rate and
your abdomen has a quicker absorption rate.
To make sure you get a predictable effect, it is
advisable to use the same part of the body at the same
dose time (e.g. outer thigh in the morning, abdomen at
lunchtime). However, it is really important to remember
not to inject in exactly the same place each time (site
rotation). You can do this in two ways:
1. Switch between sides from one day to the next
(e.g. left thigh one day, right thigh the next)
2. Move injection site one inch away from previous
site at each dose.
Possible injection sites are highlighted in blue.
HOW do I inject my insulin?
There is no need to feel overwhelmed by the thought of
injecting yourself, just follow the simple steps outlined
below and it will soon become second nature to you:
1. Take the cap off your pen and insert insulin cartridge
if you are not using a prefilled/disposable pen
2. Screw on a NEW Unifine® Pentips® needle
3. Check the pen is working and set the dose
4. Inject into the layer of fat just below the surface – do
this by pinching a couple of inches of skin between
your thumb and two fingers and pulling away from
the underlying muscle
5. Insert the needle at the angle advised by your
diabetes team (usually 90°)
6. Push the button/plunger all the way down, release
skin, count to 10 and slowly remove needle/syringe.
Only use needles once and dispose of them
immediately in a sharps bin or refer to your local
guidelines for the safe disposal of sharps
What else should I know?
If your insulin is cloudy, just gently move it from side to
side and back and forth a few times, and then roll it
between the palm of your hands until it is clear, this will
ensure the insulin is mixed properly.
As mentioned before, insulin is absorbed at different
rates from different areas of the body, which is why it is
important that you remember to use the same area at
the same dose time each day. The abdomen has the
best absorption rate and so is most suitable for
shortacting insulins whilst the thighs or buttocks are
more suited for long-acting insulins.
Use a NEW insulin pen needle every time you inject.
This is a good habit to get into for a number of reasons:
• injections with new needles are easier and more
comfortable
• drug can leak out or air can get into reused needles
• reused needles can get blocked
• only new needles are guaranteed to be sterile
• blunt needles can cause lipos
If you’re worried about any part of your treatment or
feeling isolated, talk to your Diabetes Team or
contact a support group
What are lipos?
Lipos are the short name for lipohypertrophy - fatty
bumps that can form under your skin at injection sites if
you do not rotate injection sites enough.
They can be unsightly and reduce how well your insulin
works if you continue to inject there – it may interest
you to know that injecting into skin that is free of lipos
can reduce insulin requirements.4
The good news is that you can avoid lipos by using
good injection technique:
• always rotate injection sites
• always use a new needle for each injection
If you think you are developing a lipo, stop injecting into
that area immediately and talk to your nurse.
Rotate your injection site for each insulin dose What happens if my blood glucose levels are wrong?
Hyperglycaemia occurs when your blood glucose is too
high as a result of forgetting to take your diabetes
treatment, or eating too much food. It can also be the
result of infection, increased stress or decreased levels
of activity. You need to drink water and take your
medication as soon as possible
To help keep glucose levels within the normal range:
• Take your medication as directed
• Check your blood glucose regularly
• Eat a healthy diet, including complex carbohydrates,
protein and fibre and avoiding high-sugar foods
Hypoglycaemia occurs when your blood glucose is too
low because the dose of your diabetes treatment is too
high, or you are not eating enough carbohydrate after
taking your medication. Other causes include: too much
exercise, stress and hot weather. If you experience
hypoglycaemic symptoms, take a sugary snack such as
LucozadeTM, GlucoTabsTM or regular cola
Always carry sugary snacks in case you should feel
hypoglycaemic
How do I know if my blood glucose levels are wrong?
To Cure Diabetes Naturally Click
Here
Recognising a hypoglycaemic episode
These are known as hypos for short and can produce
the following effects:
• anxiety/nervousness
• excessive sweating
• faintness/dizziness
• headache
• rapid heart rate
• paleness
• ingling lips or fingertips
• blurred vision
• confusion/lack of concentration
• feeling irritable
• extreme hunger
• problems waking up/sleepiness
• shakiness/trembling
• slurred speech
Recognising a hyperglycaemic episode
These are known as hypers for short and can produce
the following effects:
• excessive thirst
• frequent urination
• feeling weak/tired
• stomach pains
• feeling ‘achy’
• high levels of glucose in your urine
• blurred vision
• itchy skin
• feeling/being sick
• shortness of breath
Hopefully you will not experience hypos or hypers, but if
you do, you will soon get to recognise the signs and
symptoms and so will be able to deal with them quickly
and effectively.
Carry an Insulin user’s identity card (from
Diabetes UK) which explains what should be done if
you become unwell when out
Will I have to alter my lifestyle?
Not drastically. The main differences that diabetes may
make to your lifestyle are getting used to your treatment
regime and remembering to take your medication when
you need to, checking your blood glucose levels
regularly (if on insulin or recommended by your
Diabetes Team) and being aware of your food choices
and exercise routine.
Having diabetes does not mean that you have to stop
driving if it is well-controlled and your doctor agrees, but
you must contact your insurance company. You must
also inform the Driving and Vehicle Licensing Agency (
DVLA) if you are treated with insulin or tablets.
Always be aware of the possibility of hypoglycaemic
episodes and any deterioration in your eyesight and
inform the DVLA and your insurance company of any
complications - failure to do so could invalidate your
insurance.
Having diabetes shouldn’t prevent you from continuing
to enjoy travelling and holidays it may just require a bit
of planning. Always take your medication in your hand
luggage, get a doctor’s note to explain your medication
and don’t forget to take any additional items that you
will need, such as cool wallets and sharps bins
(available from the Medical Shop, see next page for
details).
If you are ill, continue to take your medication and
adjust the dose in response to your glucose test
results, and check your glucose levels often (at least
four times a day and four times at night) and drink
plenty of sugar-free drinks. Contact your doctor or
Diabetes Team if:
• blood glucose levels are continuously high
• you are vomiting
• you are unsure what to do
• if you are feeling unwell and your blood glucose
levels stay high, it is important to test for ketones in
your urine, and if present you need to contact your
healthcare professional immediately
Where can I find out more?
The following organisations can provide further
information and support to help you manage your
condition:
Diabetes UK
Tel: 020 7424 1000Email:
http://www.diabetes.org.uk/
Diabetes Support
Website: http://www.diabetessupport.co.uk/
Patient UK
Website: http://www.patient.co.uk/doctor/diabetes-
dietand-exercise.htm
Medical Shop
Website: http://www.medicalshop.co.uk
Involve your friends and family, so they know what
to do if you experience a hypoglycaemic episode
Important things to remember
• Always take your medication as prescribed
• Check your blood glucose regularly
• Eat healthily (not too many sugary foods)
• Drink plenty of water
• Try to exercise
• Be careful about your alcohol intake
• Rotate injection sites each time
• Use a new needle for each injection
• If you are feeling worried or isolated, talk to friends,
family or your Diabetes Team
• Think positive - be confident about your ability to
manage your diabetes
Owen Mumford Ltd would like to thank the Diabetes
Teams at
Buckinghamshire, Central & Eastern Cheshire and Lanarkshire for their advice in producing this
booklet.
References:
1. Diabetes UK. Diabetes in the UK: Key statistics on
diabetes. September 2009; 2. Available at:
http://www.netdoctor.co.uk/health_advice/facts/diabetes
insulin.htm;
3 . Available at: http://www.diabetes.org.uk 4.
Vardar B, Kizilci S. Diabetes Res Clin Pract
2007;77(2):231-6.
This leaflet contains general information about medical
conditions and treatments. The information is not
advice, and should not be treated as such.
You must not rely on the information in this leaflet as an
alternative to medical advice from your doctor or other
professional healthcare provider. If you have any
specific questions about any medical matter you should
consult your doctor or other professional healthcare
provider