TYPE 1 DIABETES MELLITUS, SELF-CARE, ADULT

TYPE 1 DIABETES MELLITUS, SELF-CARE, ADULT

Caring for yourself after you have been diagnosed with type 1 diabetes (type 1 diabetes mellitus) means keeping your blood sugar (glucose) under control with a balance of:

  • Insulin.
  • Nutrition.
  • Exercise.
  • Lifestyle changes.
  • Other medicines, if necessary.
  • Support from your team of health care providers and others.

The following information explains what you need to know to manage your diabetes at home.

  • Check your blood glucose every day, as often as told by your health care provider.
  • Contact your health care provider if your blood glucose is above your target for 2 tests in a row.
  • Have your A1c (haemoglobin A1c) level checked at least two times a year, or as often as told by your health care provider.

Your health care provider will set individualized treatment goals for you. Generally, the goal of treatment is to maintain the following blood glucose levels:

  • Before meals (pre-prandial): 80–130 mg/dL (4.4–7.2 mmol/L).
  • After meals (postprandial): below 180 mg/dL (10 mmol/L).
  • A1c level: less than 7%.

What is hyperglycaemia?

Hyperglycaemia, also called high blood glucose, occurs when blood glucose is too high. Make sure you know the early signs of hyperglycaemia, such as:

  • Increased thirst.
  • Hunger.
  • Feeling very tired.
  • Needing to urinate more often than usual.
  • Blurry vision.

What is hypoglycaemia?

Hypoglycaemia, also called low blood glucose, occurs with a blood glucose level at or below 70 mg/dL (3.9 mmol/L). The risk for hypoglycaemia increases during or after exercise, during sleep, during illness, and when skipping meals or not eating for a long time (fasting).

It is important to know the symptoms of hypoglycaemia and treat it right away. Always have a 15-gram rapid-acting carbohydrate snack with you to treat low blood glucose. Family members and close friends should also know the symptoms and should understand how to treat hypoglycaemia, in case you are not able to treat yourself.

What are the symptoms of hypoglycaemia?

Hypoglycaemia symptoms can include:

  • Hunger.
  • Anxiety.
  • Sweating and feeling clammy.
  • Confusion.
  • Dizziness or feeling light-headed.
  • Sleepiness.
  • Nausea.
  • Increased heart rate.
  • Headache.
  • Blurry vision.
  • Seizure.
  • Nightmares.
  • Tingling or numbness around the mouth, lips, or tongue.
  • A change in speech.
  • Decreased ability to concentrate.
  • A change in coordination.
  • Restless sleep.
  • Tremors or shakes.
  • Fainting.
  • Irritability.

How do I treat hypoglycaemia?

If you are alert and able to swallow safely, follow the 15:15 rule:

  • Take 15 grams of a rapid-acting carbohydrate. Rapid-acting options include:
    • 1 tube of glucose gel.
    • 3 glucose pills.
    • 6–8 pieces of hard candy.
    • 4 oz (120 mL) of fruit juice.
    • 4 oz (120 mL) of regular (not diet) soda.
  • Check your blood glucose 15 minutes after you take the carbohydrate.
  • If the repeat blood glucose level is still at or below 70 mg/dL (3.9 mmol/L), take 15 grams of a carbohydrate again.
  • If your blood glucose level does not increase above 70 mg/dL (3.9 mmol/L) after 3 tries, seek emergency medical care.
  • After your blood glucose returns to normal, eat a meal or a snack within 1 hour.

How do I treat severe hypoglycaemia?

Severe hypoglycaemia is when your blood glucose level is at or below 54 mg/dL (3 mmol/L).Severe hypoglycaemia is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.). Do not drive yourself to the hospital.

If you have severe hypoglycaemia and you cannot eat or drink, you may need an injection of glucagon. A family member or close friend should learn how to check your blood glucose and how to give you a glucagon injection. Ask your health care provider if you need to have an emergency glucagon injection kit available.

Severe hypoglycaemia may need to be treated in a hospital. The treatment may include getting glucose through an IV tube. You may also need treatment for the cause of your hypoglycaemia.

Having diabetes can put you at risk for other long-term (chronic) conditions, such as heart disease and kidney disease. Along with insulin, your health care provider may prescribe medicines to help prevent complications from diabetes. These medicines may include:

  • Aspirin.
  • Medicine to lower cholesterol.
  • Medicine to control blood pressure.

Take your diabetes medicines as told

  • Take your insulin and other diabetes medicines every day as told.
  • Do not run out of insulin or other diabetes medicines that you take. Plan ahead so you always have these available.
  • Adjust your insulin dosage based on how physically active you are and what foods you eat. Your health care provider will tell you how to adjust your dosage.

Make healthy food choices

The things that you eat and drink affect your blood glucose and your insulin dosage. Making good choices helps to control your diabetes and prevent other health problems. A healthy meal plan includes eating lean proteins, complex carbohydrates, fresh fruits and vegetables, low-fat dairy products, and healthy fats.

Make an appointment to see a diet and nutrition specialist (registered dietitian) to help you create an eating plan that is right for you. Make sure that you:

  • Follow instructions from your health care provider about eating or drinking restrictions.
  • Drink enough fluid to keep your urine clear or pale yellow.
  • Eat healthy snacks between nutritious meals.
  • Track the carbohydrates that you eat. Do this by reading food labels and learning the standard serving sizes of foods.
  • Follow your sick day plan whenever you cannot eat or drink as usual. Make this plan in advance with your health care provider.

Stay active

Exercise regularly, as told by your health care provider. This may include:

  • Stretching and doing strength exercises, such as yoga or weightlifting, at least 2 times a week.
  • Doing at least 150 minutes of moderate-intensity or vigorous-intensity exercise each week. This could be brisk walking, biking, or water aerobics.
    • Spread out your activity over at least 3 days of the week.
    • Do not go more than 2 days in a row without doing some kind of physical activity.

When you start a new exercise or activity, work with your health care provider to adjust your insulin or food intake as needed.

Make healthy lifestyle choices

  • Do not use any tobacco products, such as cigarettes, chewing tobacco, and e-cigarettes. If you need help quitting, ask your health care provider.
  • If your health care provider says that alcohol is safe for you, limit alcohol intake to no more than 1 drink per day for nonpregnant women and 2 drinks per day for men. One drink equals 12 oz of beer, 5 oz of wine, or 1½ oz of hard liquor.
  • Learn to manage stress. If you need help with this, ask your health care provider.

Care for your body

  • Keep your immunizations up to date. In addition to getting vaccinations as told by your health care provider, it is recommended that you get vaccinated against the following illnesses:
    • The flu (influenza). Get a flu shot every year.
    • Pneumonia.
    • Hepatitis B.
  • Schedule an eye exam within 3–5 years after your diagnosis, and then one time every year after that.
  • Check your skin and feet every day for cuts, bruises, redness, blisters, or sores. Schedule a foot exam with your health care provider 3–5 years after your diagnosis, and then every year after the first exam.
  • Brush your teeth and gums two times a day, and floss at least one time a day. Visit your dentist at least once every 6 months.
  • Maintain a healthy weight.

General instructions

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Share your diabetes management plan with people in your workplace, school, and household.
  • Check your urine for ketones when you are ill and as told by your health care provider.
  • Ask your health care provider:
    • Do I need to meet with a diabetes educator?
    • Where can I find a support group for people with diabetes?
  • Carry a medical alert card or wear medical alert jewellery.
  • Keep all follow-up visits as told by your health care provider. This is important.

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