INJECTING

Injectors

What length of needle should I use on my insulin pen?

There are several lengths of needle available today ranging from 5 mm to 12.7 mm. As a rule, they are used as follows:

• the 5 or 6 mm needle for children and thin to normal weight adults without a lifted skin fold (this means injecting straight into the skin without pinching it first);
• the 8 mm for normal weight adults with a lifted skin fold (loosely pinched);
• the 12 or 12.7 mm needle for overweight adults also with a lifted skin fold.

Ask your healthcare professional for the needle length and injection technique the most appropriate for you.

I am partially sighted. What pens or syringes are available for people like me, or for people who are blind? Are there any gadgets that would help me with my injections?

Most visually impaired people are advised to use an insulin pen rather than a syringe because you do not need to draw up insulin or check for air bubbles. The dialling mechanism usually has a distinctive clicking sound which reassures you that you have taken the correct dose. It is quite easy to use once the technique has been mastered, and offers a good choice of different types of insulin. This should be discussed with your physician or diabetes specialist nurse. There is a section Insulin pens earlier in this chapter.

Novo Nordisk produces a device called Innolet that might well suit you. It is a disposable insulin pen with a large dock-like dial and a loud clicking sound with each unit dialled. It has raised spots at every 5 units marked. It also has a ‘rocker’ that allows you to rest the device on your skin before moving the needle forward to inject. It is easier to hold as it has a large grip.

Where should I keep my supplies of insulin?

Stores of insulin should ideally be kept in a refrigerator, but not in the freezer or freezing compartment. The ideal storage temperature is between 2° and 8°C. Below 0°C insulin is destroyed, and from 30°C upwards, insulin activity progressively decreases. If you do not have a fridge, then insulin may be stored for about a month at room temperature but keep it away from sources of direct heat such as radiators and strong sunlight. Many people prefer to keep their insulin bottle and/or their insulin pen that is in current use at room temperature as it may make the injection more comfortable (cold insulin increases the pain of the injection).

Should I wipe the top of the insulin bottle or insulin cartridge with spirit before use?

It is generally accepted that it is not necessary to clean the cartridge or insulin bottle top before use.

Diabetes is a condition if our body cells do not absorb the glucose from the blood, the glucose accumulates in the blood resulted to a high blood sugar level.

The ideal blood sugar/glucose level should be in the range from 4.0mmol/L to 7.0mmol/L (72mg/dL to 126mg/dL). Reading above this range can cause health complications.

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Pancreas; a vital part of our body’s organs produces insulin naturally that is needed by our cells to absorb glucose in our blood stream for energy. The effects from the body’s failure to produce insulin naturally and a condition in which the cells fail to use insulin produced properly are most common among diabetic patients.

Diabetes is more a symptom rather than a disease; it is telling us that the immune system is confronted. The best treatment approach lies in the belief of getting back our immune system to natural state. It is important that our pancreas stay healthy through proper dietary and physical exercises and enabling it to reproduce insulin naturally again.

Now, let me share with you another foodstuff that is beneficial to Diabetics. “The Sweet Potato“. Sweet potato is edible tuberous root, found throughout the tropical climate regions. It is long and tapered and has a smooth peel whose color depends on varieties and range from red, brown, purple and white. Its flesh varies from white, yellow, orange and purple. Coincidentally, sweet potatoes look like the pancreas and actually balance the glycemic index of diabetics.

The flesh tastes sweet and despite of having the name “Sweet”, it is a favorable food for diabetics. Preliminary researches have revealed it helps to stabilize Blood Sugar and lower insulin resistance.

Nutrition facts and Health benefits of Sweet Potato:
Sweet Potato has a Starchy flesh when cooked and is rich in complex carbohydrates, dietary fiber, vitamin C, B and B6. Also, it contains great amounts of minerals like iron, calcium, magnesium, manganese and potassium.

Chronic diabetes patients need foodstuff, which is rich in complex carbohydrates in their daily diet. The complex carbohydrates behave like a store for starch in their body system which only raises the blood sugar slowly comparing to foodstuff consumed with compound (simple) sugars.

Nutritious sweet potatoes are low in calories, on comparison with starch rich cereals. It contains no saturated fats and cholesterol but they are rich source of dietary fiber, antioxidants, vitamins and minerals that are essential for body metabolism.

Therefore, sweet potatoes are useful diet and they are highly recommended as a healthy food supplement for Diabetics.

At Last….Diabetes Sufferer can Reveals A 100%-NATURAL Way of reversing Diabetes, to Lose Weight, Feel Healthier and Become More Energetic”

If you are looking for a natural treatment for diabetes, then here is an interesting bit of information. Chromium Polynicotinate, which first made its debut in the American Aging Association conference in 1992, is now known to possess properties that can help lower blood sugar levels. If you are wondering what the link between chromate and diabetes is, read on.

The American diet is lacking in chromium

Do you know that almost 90% of Americans do no consume enough chromium? The diet that you usually consume provides your body with just 25-33 mcg of chromium, which is about 50% of what our body needs. Research suggests that if patients suffering from Type 2 diabetes increase their chromium intake to 500-1000 mcg, then they can see a significant reduction in not just their blood sugar levels, but also in their cholesterol and triglyceride levels.

Connection between Chromium Polynicotinate and diabetes

The US Medical Department states that chromium is an essential ingredient of the Glucose Tolerance Factor (GTF) molecule that our body requires for the proper functioning of all metabolic processes. The GTF molecule is also an important component of the insulin secreted by our pancreas.

Experts suggest that if you consume enough chromium, your insulin is better equipped to process sugar and control blood sugar levels. With ample chromium in your blood stream, you have lesser chances of developing insulin resistance. In a controlled study carried out recently on 60 patients suffering from Type 2 form of this disease, it was found that a daily intake of 1000mcg of chromium boosts glucose tolerance, creates a dip in fasting glucose levels, and decreases triglyceride levels.

Chromium Polynicotinate is one of the most active parts of GTF that is responsible for linking insulin to the cell membrane. In the absence of GTF, insulin will not be of much use. Chromate supplements the biological activities of insulin, which in turn accelerates carbohydrate, protein and fat metabolism. Chromates also act as hunger suppressants and reduce carbohydrate and sugar cravings, thereby increasing the levels of glycogen in the liver.

There is another interesting angle to Chromium Polynicotinate and diabetes. Our bodies do not readily absorb chromium like other essential minerals such as iron and selenium. As you grow old, there is a decline in your body’s ability to absorb and convert this mineral to an active form. Moreover, your body loses this mineral when you are experiencing stress and anxiety or are suffering from diabetes.

This is where Chromium Polynicotinate comes into picture, as our body easily absorbs this supplement and provides it with all the benefits of this mineral. Armed with this useful information about chromate and diabetes, you can use this natural supplement to control your rising sugar levels.

Diabetes management is a way by which every individual controls diabetes to avoid its further complications. Nevertheless, for it to be effective, one needs to be up and doing. The first thing that must be established is the fact that one is really living with the disease as well as the extent of damage this ailment has done to the body. This will enable such a person to know where to start from. Therefore, one needs to consult his doctor for medical check up where various tests will be conducted. It is the outcome of the tests being conducted that will determine diabetes management required.

Diabetes management is not as easy as you might think particularly if you are the type that cannot keep your eyes off junk and processed foods. Therefore, for effective diabetes management, you must embrace healthy diet. Identified below are some other diabetes management tips you can use to prevent yourself from diabetes.

1. The first tip is that you must steer clear of unhealthy eating and lifestyle. People cannot discipline themselves any longer as far as eating habit is concerned. Unhealthy and junk foods must be avoided as much as possible. Some processed and fast foods are unhealthy and must be avoided.

2. Try as much as possible to do exercise regularly. Have and maintain a regular exercising routine that will clean the cells and assists in the circulation of blood.

3. Eat more raw vegetables, beans and fruit. This will help a lot as they contain vitamins, fiber and protective antioxidants which help to reduce the risk of heart disease and ensure healthier blood circulation.

4. Drink plenty of water and other healthy liquids often. However, sugary drinks must be avoided because they can make blood glucose to rise very quickly and be difficult to control.

5. In your diabetes management, avoid too many salt and salty foods.

6. Always supplement with balanced diet and herbal remedies.

7. Avoid eating too much meal at a sitting. Take small quantity at regular intervals.

8. Take high fiber diet high fiber diet is good for children with juvenile diabetes otherwise called type 1 diabetes. Taking 60 grains of fiber daily will ensure stable blood sugar among children.

9. Cut back on saturated fat. Too much of this can raise cholesterol levels and the risk of heart disease and stroke.

Diabetes management is necessary to avoid further damage and after effect of diabetes. However, this will be effective if you can maintain healthy eating habits. Also, for it to work, you must be self disciplined to take your mind and eyes off junk and processed foods. Nevertheless, follow the above tips strict for efficient and successful management.

What is a diabetic coma?

It is a medical emergency and an acute life-threatening event that occurs in people with Diabetes Mellitus.

What causes a diabetic coma to occur?

1. diabetes that is undiagnosed
2. failure to take insulin as prescribed
3. treatment that is not adequate
4. infection
5. surgery
6. trauma
7. stress

What happens with a diabetic coma?

There is not adequate insulin to metabolize glucose so fats are used for energy. When these fats are broken down it causes ketone waste to build up causing metabolic acidosis. The body attempts to react to counteract the state of acidosis. What happens is that the alkali reserve is depleted causing water, potassium and sodium chloride to be lost. The respiratory rate increases, in a process called kussmaul breathing, as the body attempts to blow off excess carbon dioxide that will eventually cause hypoxia. Urinary excretion is also increased leading to dehydration.

What are the warning signs and symptoms of a diabetic coma?

1. headache that is dull
2. fatigue
3. thirst
4. nausea/vomiting
5. epigastric pain
6. facial flushing
7. lips are parched
8. eyes sunken
9. increased body temp to begin with then decreased
10. drop in systolic blood pressure
11. circulatory collapse

The treatment for a diabetic coma includes the immediate administration of short-acting insulin and replacing electrolytes and fluids to counteract the acidosis and dehydration.

There are five types of diabetic coma a person with diabetes must be aware of

1. Diabetic Ketoacidosis (DKA; Diabetic Coma)

Diabetic Ketoacidosis occurs when there is a severe increase in blood sugar associated with poorly controlled diabetes. As a result there is an increase in the metabolism of fat and protein for energy sources. When fats are metabolized this results in the production of fatty acids that are converted into ketone bodies. An increase in the number of circulating ketone bodies leads to acidosis. This occurs mainly with type 1 diabetics. The onset can be rapid or over several days. This can be caused from stress, surgery, infection, or lack of insulin control.

With DKA (diabetic ketoacidosis) there is severe hyperglycemia 300 to 1500 mg/dl. DKA is often caused due to infection, emotional stress, fever, increased food intake, pregnancy or inadequate insulin dose. Hyperkalemia (increased potassium), metabolic acidosis, weakness, thirst, urine ketones and sugar are increased, nausea, vomiting, diarrhea, fruity breath, kussmaul respirations, abdominal pain, level of consciousness decreases, confusion increasing to coma, skin will be warm dry and flushed. Kussmaul respirations are very deep respirations that occur as the body attempts to blow off carbon dioxide.

Heart rate will be increased. Urine output is increased. Due to the dehydration there will be an increased body temp, polyuria, polydispia, weight loss, dry skin, sunken eyes. Large amounts of ketones will be in urine and serum Ph will be below 7.25 (acidotic). Hematocrit will be high due to dehydration. BUN and creatinine will be elevated due to dehydration. DKA occurs in all age groups with primarily type 1 diabetes but can occur with severe distress with type 2 diabetics. If left untreated DKA leads to coma and death.

2. HHNC – Hyperosmolar Hyperglycemia Non Ketotic Coma

This is a condition where there is enough insulin produced to prevent the breakdown of fat but severe hyperglycemia occurs. HHNC can be caused by infection, diarrhea, vomiting, failure to comply with dietary and medication regimen, stress, prolonged exposure to drugs that induce hyperglycemia such as steroids or poor fluid intake. In the absence of the acidotic state there is a severe dehydration and electrolyte imbalance. With HHNC hyperglycemia ranges from 700 to 2000 mg/100dL. This is seen mostly with geriatric type 2 diabetics. Because the body is able to maintain a very low level of insulin production this keeps the fat from being broken down resulting in ketone bodies and acidosis.

What does happen is osmotic diuresis because of the hyperglycemia causing the patient to become dehydrated quickly. HHNC will present with skin that is warm and flushed, lethargy, decreased LOC ( Level of Consciousness), weakness, thirst, increased body temp due dehydration, hematocrit will be high due to dehydration, increased heart rate, hypertension ( increased blood pressure), hyperglycemia, increased urine output, and glycosuria. BUN (Blood, Urea, Nitrogen) and creatinine levels will be increased. HHNC occurs often in elderly people that are undiagnosed type 2 diabetics. Elderly are also at a greater risk for dehydration due to their altered thirst perception.

As the patient becomes acidotic potassium moves out of the cell leaving the cell depleted of potassium, serum potassium remains normal due to the excessive excretion. With the hyperglycemia/hyperosmolar state osmotic diuresis is the result causing the serum potassium to be excreted. With dehydration the serum potassium becomes concentrated and does not show the loss of cellular potassium. When the acidosis and osmolarity are corrected and insulin is given the potassium will shift back into the cells causing hypokalemia (decreased potassium) to occur.

3. Exogenously induced hypoglycemia (insulin coma)

This occurs when the blood glucose level falls below 60 mg/dl. This can be a side effect of insulin therapy or hypoglycemic medications taken by mouth. It can occur when a meal is skipped, diabetic patient takes too much insulin, vomits a meal, or is over exercising. The signs and symptoms that are seen are a result of the sympathetic nervous system being stimulated or due to the reduced supply of glucose to the brain. What will be felt by the patient is muscle weakness, diplopia, feeling faint, tingling and numbness of the fingers lips and tongue. What will we be able to see? Diaphoresis, shaking, increased heat rate, and confusion. The patient should be given glucose orally if alert. Glucagon may be given intravenously to stimulate glycogenolysis. Patient maybe given 50% dextrose via IV if necessary.

4. Endogenously induced Hypoglycemia (Reactive Hypoglycemia)

Blood glucose falls below 60 mg/dl. This is caused by an overproduction of insulin or an insulin-like substance. This maybe caused by a tumor with the ability to produce insulin, or an autoimmune disease. This can be brought on by the under production of glucose due the hormonal deficiency including ACTH, glucagon and catecholamine’s. This can be the result of liver disease or brought on by drugs such as alcohol, propranolol and salicylate’s.

Depending on the cause the patient may need surgery to remove the insulin producing tumor, diazoxide therapy to suppress insulin production or hormone replacement to correct deficiencies. Patient should discontinue drugs that cause hypoglycemia. If possible correction of liver disease will also mitigate this condition. Patients should eat a low carbohydrate diet with high protein and avoid simple sugars and fasting.

5. Reactive (functional) Hypoglycemia

Reactive Hypoglycemia is due to rapid gastric emptying and often occurs after gastric surgery. This rapid gastric emptying stimulates the production of excessive amounts of insulin resulting in a low blood sugar. The patient will feel anxious, irritable, weak, fatigued. You will be able to observe hypoglycemia, pallor, and diaphoresis. Rapidly absorbed sugars should be avoided. Frequent meals are helpful. Patients who experience reactive hypoglycemia should increase protein, complex carbohydrates and fiber due to their ability to slow gastric emptying and slow glucose absorption.

A diabetic coma is a life threatening condition that needs to be dealt with quickly. Knowing the signs and symptoms is the first step to preventing this deadly occurrence.

If you are a teenager who has Type 2 diabetes, you are not alone. More and more people in your age group are being diagnosed with Type 2 diabetes, and most of them struggle with their diabetes treatment. Learning to live with diabetes can be somewhat challenging. But what about handling your diabetes while you attend school? It can be especially difficult unless you have a plan in place.

The first greatest challenge has to do with the actual food. School is grueling enough, but when you throw in studying, and traveling to and from school, it consumes time very quickly. That’s when convenience overpowers logic. When this occurs, food choices go down in quality.

The key here is proper planning: there are tasks you must do to take care of yourself that other kids who don’t have diabetes don’t have to worry about. It’s important to take care of your diabetes in school, as well as anywhere else you happen to be. It starts with a good, wholesome breakfast with just the right amounts of protein and fiber to get the sugar burning process started off right. This is not a time for quick junk food or sugar-laced breakfast foods. These two choices are not only going to cause a crash later on in the morning, but it will happen at an inopportune time, in a location when it is either difficult or impossible to adequately address.

If you know a particular day is going to be overly hectic, it is better to plan in advance for it. You might have to do a few extra meals in advance, but if they end up not being used they can still be refrigerated for later.

Planning also includes having adequate snacks on hand. Even something simple and quick will fend off the advances Type 2 diabetes can provoke and stave them off until they can be effectively managed at lunch. Make sure the snacks can be taken anywhere – in case your schedule changes.

The right lunch is equally as important as the right breakfast, since it will be responsible for getting you through the second half of the day. Breakfast starts your metabolism off for the first half so remember that when you make those early selections.

Lunchtime means that your body has been in operation for quite a while, so maintaining that level of energy without tapping into vital reserves is necessary. Another snack may be necessary, as long as it is eaten when needed and in moderation. Junk food should not be included in this category.

Regardless of how diligent you are, it is important your teachers are aware of your condition in case something happens. You should also familiarize yourself with the school’s medical services and where they are located. Most of the time schools are supportive and helpful. Obviously, not everyone in the school needs to know you have Type 2 diabetes, but at the very least the school nurse should know. How much and what to tell others depends a lot on whether you take medication or insulin, and how prone you are to low blood sugar levels. Letting your close friends in on your condition, and making sure they are aware of how to respond is highly recommended.

The diabetes diet is essential for taking and keeping diabetes under control. It revolves around eating a healthy well balanced diet that can keep the desired equilibrium of an individual’s blood sugar levels as well as help him manage his weight. Through keeping blood glucose within allowed limits the complications of the illness will be avoided and the diabetic may eventually live healthy even without the consumption of medicinal drugs and other treatment. Losing unwanted weight is also a very effective technique to control the disease because the less unneeded body fat the more effectively the body will be able to make use of the available insulin. Given below are some useful planning guidelines for a diabetes diet.

1. Calorie distribution in your diabetes diet should be composed of 50 to 60 percent carbohydrates, at most 30% from fat, and 12 to 20 percent from protein.

2. Meals should be consumed more often in smaller quantities instead of the regular three meals in large quantities. This will help better distribute nutrients to the body and help avoid sudden spikes in blood sugar levels.

3. Adjustments to the diet directed at weight loss should be applied little by little. Sudden changes in the diet can lead to perilous outcomes. Getting the opinion of a doctor or dietitian when making changes is also advised.

4. Simple carbohydrates should be replaced by complex carbohydrates in order to control blood cholesterol levels and reduce the risk of heart attacks that has already been amplified by the diabetes. Complex carbohydrates take longer to break down and absorb while simple carbohydrates are readily absorbable by the body. Unsaturated fats and monounsaturated fats should always replace saturated fats whenever possible.

5. Fiber rich foods aid in digestion and in lowering blood sugar levels. Fiber however should be consumed in larger quantities before these benefits can be realized. Fiber should be integrated into a diabetes diet very carefully. Common fiber rich foods are fruits, vegetables, peas, beans, and whole-grain breads and cereals.

6. A diabetes diet should always aim for three specific goals which are stabilizing blood sugar levels, maintaining a desired body weight, and reducing the risks of heart attacks through reduced cholesterol intake.

7. Creating a meal plan for diabetes can be very complex and difficult for the average person. Seeking the aid of a dietitian can be of great help. A dietitian is a nutritional expert that can help you create dishes and meal plans that will provide you with your recommended dietary allowance.

Having diabetes means your body cannot produce enough insulin (Type 1 Diabetes) or can produce enough insulin but cannot effectively make use of it (Type 2 Diabetes). Since insulin is responsible for the regulation of the amount of sugar in the blood, a diabetic has very high chances of developing very high blood glucose levels. Eating healthy is the best way to manage diabetes and the best way to eat healthy is through the use of a diabetic diet. The meal program and schedule will allow you to keep your blood sugar stable and within safe limits. Such is essential towards avoiding the complications of the condition. Devising such plan can be very complicated and consultation with a dietitian is often adviced. The best diabetic diet for one person may not be the best for another because of many considerations that need to be taken into account.

All diets for diabetes however have the following targets:

*Avoid sugar-rich foods
*Consume meals in small sizes but eat more often
*Keep track of carbohydrate intake
*Consume a wide variety of whole grains and leafy vegetables
*Reduce fat intake/
*Limit the drinking of alcohol
*Mitigate salt intake

A diabetic diet is best formulated and implemented with the assistance and guidance of a dietitian. A dietitian is a professional specializing in food and nutrition. One can be of great help and creating dishes that are tailor fit to your needs and circumstances. A dietitian can craft healthy meals that can provide you with your recommended dietary allowance without sacrificing taste. One can also help you make smoother the adaptation process which can be very painstaking especially if you have been diagnosed of diabetes just recently and it is your first time to try to transition towards healthy eating. Having someone you know you can rely on whenever you are in doubt about what you want to eat will help provide you with peace of mind and confidence that you can succeed on getting your condition under control. This is the reason why doctors normally include seeing a dietitian as one of the first tips they tell people who have just been tested positive of diabetes.
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A dietitian can assure you that the diabetic diet you are following really matches your condition. The feeling of assurance this knowledge provides can be just what you need to be able to live a normal life with less worries.

Researchers are trying their best to find a sure cure for the juvenile diabetes by finding the core reason of this disease. They are trying to invent some vaccine that can be given to newborn babies that can help to prevent this all consuming disease. Also they are in the process of making a drug that can be given in case you find early signs of this disease in your child.

But nowadays this disease is usually treated with some kinds of exercises and a juvenile dietary plan accompanied by insulin therapy. To control your child’s blood sugars always choose the healthy food over the high sugar content ones.

Blurred vision, abdominal pain, frequent urination, extreme hunger, weight loss, nausea, vomiting, and fatigue are the signs of this disease. When your blood sugar level, after fasting, comes out to be more than 120 mg/dL, the diagnosis is usually made.

To control your blood sugar you must do regular exercises. But be careful about children, as they should be limited to a certain level of exercise after Type 1 Diabetes is diagnosed. This is required because if children overdo the exercise then the blood sugar level can drop significantly. Anxiety, sweating, intense hunger, weakness, and trembling are the symptoms of low blood sugar or hypoglycemia. Even we don’t have a definite cure for the juvenile diabetes, you can administer your insulin with the help of a remote which can be of tremendous help. This type of Insulin pump is implanted inside the body then is signaled by this remote. Researchers are trying to find some method to deliver the insulin through the skin.

Although there is no cure for this kind of Type I diabetes, you can prevent some of its effects by taking necessary precautions when you observe any its signs. To stay healthy physically and mentally, try to avoid stress and anxiety. The stress and depression are also signs of juvenile diabetes so in case you are suffering from them you must see your doctor.

Usually people ignores the signs and do not take them seriously. Everyone take time to adjust with them. Whenever you observe any signs follow these strategies that can help you and your child to cope with the juvenile diabetes.

Encourage your Child to be a Team Captain

You should boost your child to be the captain of the juvenile diabetes team. Your child can be more healthy and happy if he or she involves more in her juvenile diabetes care.

Learn about Juvenile diabetes

There is a local American Juvenile diabetes Association, a juvenile diabetes educator, and many books that can give you proper guidance about the signs of diabetes. Learning more about it will help you to deal properly with this disease.

Share with Family and Friends

You should motivate your child to talk more about the juvenile diabetes with family and friends. Only encourage your child to talk but never force them.

Talk to Others with Juvenile diabetes

It can be beneficial for your child to participate in some group of children suffering from juvenile diabetes.

Stress Relievers

Most of the people become tensed when they come across the signs of diabetes. In order to reduce your stress you can follow these simple ways.

Exercise– exercise helps in relaxing your tensed muscles as well as you may feel happy.
Writing– you can overcome your frustration by writing.
Relaxation exercises– try some yoga, deep breathing or do the exercise of one muscle at a time.
Distraction– try to distract your mind from this issue by going out with friends, watch movies, etc.
Meditation– you can even try to do some meditation.