Diabetes Ebook: Diabetes - Your Questions Answered

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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.

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Diabetes: Your Questions Answered Owen Mumford Copyright Owen Mumford 2016 Published at Smashwords

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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 UK1 about 800000 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.

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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

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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

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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

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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

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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.

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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

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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.

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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

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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

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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

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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

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• 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.

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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.

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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:

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• 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

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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

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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

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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.

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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: infodiabetes.org.ukWebsite: http://www.diabetes.org.uk/

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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

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• 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 2007772:231-6.

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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

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