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  • Conquering Diabetes

    Diabetic Brothers Recognized For Longevity

    SYRACUSE, New York (AP) -- Day in and day out, brothers Robert and Gerald Cleveland have meticulously managed their blood glucose levels even though they've had diabetes for seven decades.

    On Thursday, the world's leading diabetes research center paid tribute to the Clevelands for their longevity and everyday perseverance. According to the Boston-based Joslin Diabetes Center, they are the first siblings known to have lived with Type 1 diabetes for 50 years or longer.

    Robert, 84, has lived with Type 1 diabetes for 79 years and, according to the center's Dr. Hillary Keenan, is the longest known survivor. Gerald, 88, has had diabetes for 72 years.

    "It's a minor distraction from a normal person's life. It doesn't have to interfere with any activities," said Robert, who believes he is probably in better overall health today because of his meticulously healthful habits.

    Diabetes makes people more prone to heart disease, stroke, high blood pressure, blindness, kidney disease, nervous system disease and amputations.

    "You're not handicapped with diabetes," Gerald said. "You just have a special job to do."

    A diabetic doesn't produce or properly use insulin, the hormone needed to convert food into energy. The reason continues to be a mystery, although genetics and factors such as obesity and lack of exercise appear to play roles, according to the American Diabetes Association.

    Since the Joslin Center began its 50-year medal awards in 1972, more than 2,200 Americans have been identified as living with diabetes for 50-plus years, said Dr. George King, research director at the center, which has more than 300 doctors and scientists. Eleven patients have lived 75-plus years with diabetes, he said. In 2000, the disease claimed 69,301 lives.

    Over that time, Joslin researchers have studied the group to better understand what biological and genetic factors may contribute to a long life with diabetes, Keenan said.

    Managing the disease

    Today, in the United States, there are 18.2 million diabetics, a third of whom aren't aware they have the disease. Every year, 1.3 million new cases are diagnosed in people 20 and older.

    Robert, a retired accountant, was diagnosed at age 5 in 1925 -- three years after insulin was invented. He nearly died. Seven years later, Gerald, a former Syracuse school superintendent, was diagnosed at age 16.

    Gerald said part of their secret was a caring mother who taught them to diligently manage their disease.

    Doris Guercio weighed and measured everything her sons ate. She gave them each three shots per day. She had to sterilize the needles. In a time before instant blood tests, to check her sons' sugar levels, Guercio had to take drops of urine and boil them in a test tube over an open flame, watching for changes in color.

    "Then we had two wonderful wives who would never let us give up," Gerald said.

    Today, the brothers are unwavering in their regimen.

    Gerald checks his blood sugar level about eight times a day and takes insulin before every meal and at bedtime. Robert checks his blood sugar three to five times a day, and gives himself insulin as needed before meals and at bedtime.

    "It's not an easy task to be a diabetic," Gerald said, agreeing that his illness keeps him focused on his health. "But it's certainly a worthwhile one."

    Below: Robert Cleveland, left, and his brother, Gerald

  • #2
    IM^, What timming, I just found out that my mom has been Diabetic for two years type II now she is type I, so I just put her on a new diet and teaching her how to live with this.

    As soon as I get a chance we need to have some discussion about slin as it relates to diabeties, I have some unanswered questions...
    "That damn log book" Highest quality protein at the lowest price...


    • #3
      Yes my friend certainly, anytime you need. Just ask and I will be happy to help to the best of my ability.


      • #4
        What a great article IM. I'm sending it on to my mother & my father in law since they're both diabetic. My mother lives a healthy lifestyle, but my FIL is a different story. Hoping maybe this will strike a nerve with him.

        Great info. :smooch:
        Greek women, we may be lambs in the kitchen, but we are tigers in the bedroom.

        MOD @


        • #5
          Glad you found something useful too there AI. Send them my regards along with that article as well.


          • #6
            It kinda makes you not want to bitch about weighing food and eating at certain times, huh?


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            • #7
              In-Human (and everyone else that would find this useful) - until you get some free time for us to discuss details, I took the liberty of dredging up some information from my archives that might come in handy for you in order to better help your mother out. Hopefully, this will help you both in coping in a better way with this lifelong condition. Any more questions, please just ask.

              This is taken from the National Diabetes Information ClearingHouse (NDIC).

              What Is Diabetes?
              Chapter 1 of 6

              Diabetes means that your blood glucose (often called blood sugar) is too high. Your blood always has some glucose in it because your body needs glucose for energy to keep you going. But too much glucose in the blood isn't good for your health.

              How do you get high blood glucose?

              Glucose comes from the food you eat and is also made in your liver and muscles. Your blood carries the glucose to all the cells in your body. Insulin is a chemical (a hormone) made by the pancreas. The pancreas releases insulin into the blood. Insulin helps the glucose from food get into your cells. If your body doesn't make enough insulin or if the insulin doesn't work the way it should, glucose can't get into your cells. It stays in your blood instead. Your blood glucose level then gets too high, causing pre-diabetes or diabetes.

              What is pre-diabetes?

              Pre-diabetes is a condition in which blood glucose levels are higher than normal but are not high enough for a diagnosis of diabetes. People with pre-diabetes are at increased risk for developing type 2 diabetes and for heart disease and stroke. The good news is if you have pre-diabetes, you can reduce your risk of getting diabetes. With modest weight loss and moderate physical activity, you can delay or prevent type 2 diabetes and even return to normal glucose levels.

              What are the signs of diabetes?

              The signs of diabetes are
              • being very thirsty
              • urinating often
              • feeling very hungry or tired
              • losing weight without trying
              • having sores that heal slowly
              • having dry, itchy skin
              • losing the feeling in your feet or having tingling in your feet
              • having blurry eyesight

              You may have had one or more of these signs before you found out you had diabetes. Or you may have had no signs at all. A blood test to check your glucose levels will show if you have pre-diabetes or diabetes.

              What kind of diabetes do you have?

              People can get diabetes at any age. There are three main kinds.

              Type 1 diabetes, formerly called juvenile diabetes or insulin-dependent diabetes, is usually first diagnosed in children, teenagers, or young adults. In this form of diabetes, the beta cells of the pancreas no longer make insulin because the body's immune system has attacked and destroyed them. Treatment for type 1 diabetes includes taking insulin shots or using an insulin pump, making wise food choices, exercising regularly, taking aspirin daily (for some), and controlling blood pressure and cholesterol.

              Type 2 diabetes, formerly called adult-onset diabetes or noninsulin-dependent diabetes, is the most common form of diabetes. People can develop type 2 diabetes at any age--even during childhood. This form of diabetes usually begins with insulin resistance, a condition in which fat, muscle, and liver cells do not use insulin properly. At first, the pancreas keeps up with the added demand by producing more insulin. In time, however, it loses the ability to secrete enough insulin in response to meals. Being overweight and inactive increases the chances of developing type 2 diabetes. Treatment includes using diabetes medicines, making wise food choices, exercising regularly, taking aspirin daily, and controlling blood pressure and cholesterol.

              Some women develop gestational diabetes during the late stages of pregnancy. Although this form of diabetes usually goes away after the baby is born, a woman who has had it is more likely to develop type 2 diabetes later in life. Gestational diabetes is caused by the hormones of pregnancy or a shortage of insulin.

              Why do you need to take care of your diabetes?

              After many years, diabetes can lead to serious problems in your eyes, kidneys, nerves, and gums and teeth. But the most serious problem caused by diabetes is heart disease. When you have diabetes, you are more than twice as likely as people without diabetes to have heart disease or a stroke.

              If you have diabetes, your risk of a heart attack is the same as someone who has already had a heart attack. Both women and men with diabetes are at risk. You may not even have the typical signs of a heart attack.

              You can reduce your risk of developing heart disease by controlling your blood pressure and blood fat levels. If you smoke, talk with your doctor about quitting. Remember that every step toward your goals helps!

              Later in this guide, we'll tell you how you can try to prevent or delay long-term problems. The best way to take care of your health is to work with your health care team to keep your blood glucose, blood pressure, and cholesterol in your target range.

              What's a desirable blood glucose level?

              Everyone's blood has some glucose in it. In people who don't have diabetes, the normal range is about 70 to 120. Blood glucose goes up after eating, but returns to the normal range 1 or 2 hours later.

              Ask your health care team when you should check your blood glucose with a meter. Talk about whether the blood glucose targets listed below are best for you. Then write in your own targets.

              Before meals - 90 to 130
              1 to 2 hours after the start of a meal - less than 180

              It may be hard to reach your target range all of the time. But the closer you get to your goal, the more you will reduce your risk of diabetes-related problems and the better you will feel. Every step helps.


              Taking Care of Your Diabetes Every Day
              Chapter 2 of 6

              Do four things every day to lower high blood glucose:
              • Follow your meal plan.
              • Get regular exercise.
              • Take your diabetes medicine.
              • Check your blood glucose.

              Experts say most people with diabetes should try to keep their blood glucose level as close as possible to the level of someone who doesn't have diabetes. The closer to normal your blood glucose is, the lower your chances are of developing damage to your eyes, kidneys, and nerves.

              Check with your doctor about the right range for you. The chart in chapter one shows target blood glucose ranges.

              Your health care team will help you learn how to reach your target blood glucose range. Your main health care providers are your doctor, nurse, diabetes educator, and dietitian.

              A diabetes educator is a health care worker who teaches people how to manage their diabetes. Your educator may be a nurse, a dietitian, or another kind of health care worker.

              A dietitian is someone who's specially trained to help people plan their meals. For more information about these health care providers and for help in finding them, see chapter six.

              The next sections of this guide will tell you more about the four main ways you take care of your diabetes: Follow your meal plan, get regular exercise, take your diabetes medicine, and check your blood glucose.

              Follow Your Meal Plan

              People with diabetes don't need to eat special foods. The foods on your meal plan are good for everyone in your family! Try to eat foods that are low in fat, salt, and sugar and high in fiber such as beans, fruits, vegetables, and grains. Eating right will help you

              Reach and stay at a weight that's good for your body.
              Keep your blood glucose in a desirable range.
              Prevent heart and blood vessel disease.

              Your daily meal plan should include foods from these groups: (see picture below)

              People with diabetes should have their own meal plan. Ask your doctor to give you the name of a dietitian who can work with you to develop a meal plan. Your dietitian can help you plan meals to include foods that you and your family like to eat and that are good for you too. Ask your dietitian to include foods that are heart-healthy to reduce your risk of heart disease.

              ACTION STEPS - If you use insulin
              • Follow your meal plan.
              • Don't skip meals, especially if you've already taken your insulin, because your blood glucose may go too low. (See chapter 3 for information on how to handle hypoglycemia, also called low blood sugar.)

              ACTION STEPS - If you DON'T use insulin
              • Follow your meal plan.
              • Don't skip meals, especially if you take diabetes medicine, because your blood glucose may go too low. It may be better to eat several small meals during the day instead of one or two big meals.

              Get Regular Exercise
              Exercise is good for your diabetes. Walking, swimming, dancing, riding a bicycle, playing baseball, and bowling are all good ways to exercise. You can even get exercise when you clean house or work in your garden. Exercise is especially good for people with diabetes because

              Exercise helps keep weight down.
              Exercise helps insulin work better to lower blood glucose.
              Exercise is good for your heart and lungs.
              Exercise gives you more energy.

              Before you begin exercising, talk with your doctor. Your doctor may check your heart and your feet to be sure you have no special problems. If you have high blood pressure or eye problems, some exercises like weightlifting may not be safe. Your health care team can help you find safe exercises.

              Try to exercise almost every day for a total of about 30 minutes. If you haven't exercised lately, begin slowly. Start with 5 to 10 minutes, and then add more time. Or exercise for 10 minutes, three times a day.

              If you haven't eaten for more than an hour or if your blood glucose is less than 100 to 120, have a snack before you exercise. (See chapter 3 for snack ideas.)

              When you exercise, carry glucose tablets or a carbohydrate snack with you in case you get hypoglycemia (low blood sugar). Wear or carry an identification tag or card saying that you have diabetes.

              The groups listed in chapter six have more information about diabetes and exercise.

              ACTION STEPS - If you use insulin
              • See your doctor before starting an exercise program.
              • Check your blood glucose before, during, and after exercising. Don't exercise when your blood glucose is over 240 or if you have ketones in your urine (see below).
              • Don't exercise right before you go to sleep, because it could cause hypoglycemia (low blood sugar) during the night.

              ACTION STEPS - If you don't use insulin
              • See your doctor before starting an exercise program.

              Take Your Diabetes Medicine Every Day

              Insulin and diabetes pills are the two kinds of medicines used to lower blood glucose.

              If You Use Insulin

              You need insulin if your body has stopped making insulin or if it doesn't make enough. Everyone with type 1 diabetes needs insulin, and many people with type 2 diabetes do too.

              Insulin can't be taken as a pill. You'll give yourself shots every day or use an insulin pump. Insulin pumps are small machines that connect to narrow tubing, ending with a needle just under the skin near the abdomen. Insulin is delivered through the needle.

              Keep extra insulin in your refrigerator in case you break the bottle you're using. Don't keep insulin in the freezer or in hot places like the glove compartment of your car. Also, keep it away from bright light. Too much heat, cold, and bright light can damage insulin.

              If you use a whole bottle of insulin within 30 days, you can keep that bottle at room temperature. If you don't use a whole bottle of insulin within 30 days, then store it in the refrigerator.

              If You Take Diabetes Pills

              If your body makes insulin, but the insulin doesn't lower your blood glucose, you may need diabetes pills. Some pills are taken once a day, and others are taken more often. Ask your health care team when you should take your pills.

              Be sure to tell your doctor if your pills make you feel sick or if you have any other problems. Remember, diabetes pills don't lower blood glucose all by themselves. You'll still want to follow a meal plan and exercise to help lower your blood glucose.

              Sometimes, people who take diabetes pills may need insulin shots for a while. If you get sick or have surgery, the diabetes pills may no longer work to lower your blood glucose.

              You may be able to stop taking diabetes pills if you lose weight. (Always check with your doctor before you stop taking your diabetes pills.) Losing 10 or 15 pounds can sometimes help you reach your target blood glucose level.

              If You Don't Use Insulin or Take Diabetes Pills

              Many people with type 2 diabetes don't need insulin or diabetes pills. They can take care of their diabetes by using a meal plan and exercising regularly.

              Check Your Blood Glucose as Recommended

              You'll want to know how well you're taking care of your diabetes. The best way to find out is to check your blood to see how much glucose is in it. If your blood has too much or too little glucose, you may need a change in your meal plan, exercise plan, or medicine.

              Ask your doctor how often you should check your blood glucose. Some people check their blood glucose once a day. Others do it three or four times a day. You may check before eating, before bed, and sometimes in the middle of the night.

              Your doctor or diabetes educator will show you how to check your blood using a blood glucose meter. Your health insurance or Medicare may pay for the supplies and equipment you need.

              Take Other Tests for Your Diabetes

              Urine Tests

              You may need to check your urine if you're sick or if your blood glucose is over 240. A urine test will tell you if you have ketones in your urine. Your body makes ketones when there isn't enough insulin in your blood. Ketones can make you very sick. Call your doctor right away if you find ketones when you do a urine test. You may have a serious condition called ketoacidosis. If it isn't treated, it can cause death. Signs of ketoacidosis are vomiting, weakness, fast breathing, and a sweet smell on the breath. Ketoacidosis is more likely to develop in people with type 1 diabetes.

              You can buy strips for testing ketones at a drug store. Your doctor or diabetes educator will show you how to use them.

              The A1C Test

              Another test for blood glucose, the A1C, also called the hemoglobin A1C test, shows what your overall blood glucose was for the past 3 months. It shows how much glucose is sticking to your red blood cells. The doctor does this test to see what your blood glucose is most of the time. Have this test done at least twice a year.

              Ask your doctor what your A1C test showed. A result of under 7 usually means that your diabetes treatment is working well and your blood glucose is under control. If your A1C is 8 or above, it means that your blood glucose may be too high. You'll then have a greater chance of getting diabetes problems, like kidney damage. You may need a change in your meal plan, exercise plan, or diabetes medicine.

              A1C Results

              Target for most people with diabetes - under 7
              Time to change my diabetes care plan - 8 or above

              Talk with your doctor about what your target should be. Even if your A1C is higher than your target, remember that every step toward your goal helps reduce your risk of diabetes problems.

              Keep Daily Records

              Print and make copies of the daily diabetes record page. Then write down the results of your blood glucose checks every day. You may also want to write down what you ate, how you felt, and whether you exercised.

              By keeping daily records of your blood glucose checks, you can tell how well you're taking care of your diabetes. Show your blood glucose records to your health care team. They can use your records to see whether you need changes in your diabetes medicines or in your meal plan. If you don't know what your results mean, ask your health care team.

              Things to write down every day in your record book are:
              • results of your blood glucose checks
              • your diabetes medicines: times and amounts taken
              • if your blood glucose was very low (see chapter three)
              • if you ate more or less food than you usually do
              • if you were sick
              • if you found ketones in your urine
              • what kind of exercise you did and for how long

              ACTION STEPS - If you use insulin

              Keep a daily record of
              • Your blood glucose numbers.
              • The times of the day you took your insulin.
              • The amount and type of insulin you took.
              • Whether you had ketones in your urine.

              ACTION STEPS - If you don't use insulin

              Keep a daily record of
              • Your blood glucose numbers.
              • The times of the day you took your diabetes pills.


              • #8
                When Your Blood Glucose Is Too High or Too Low
                Chapter 3 of 6

                Sometimes, no matter how hard you try to keep your blood glucose in your target range, it's too high or too low. Blood glucose that's too high or too low can make you very sick. Here's how to handle these emergencies.

                What You Need to Know About High Blood Glucose

                If your blood glucose stays over 180, it may be too high. (Go back to the chart.) It means you don't have enough insulin in your body. High blood glucose can happen if you miss taking your diabetes medicine, eat too much, or don't get enough exercise. Sometimes, the medicines you take for other problems cause high blood glucose. Be sure to tell your doctor about other medicines you take.

                Having an infection or being sick or under stress can also make your blood glucose too high. That's why it's very important to check your blood glucose and keep taking your insulin or diabetes pills when you're sick. (For more about how to take care of yourself when you're sick, see chapter five.)

                If you're very thirsty and tired, have blurry vision, and have to go to the bathroom often, your blood glucose may be too high. Very high blood glucose may also make you feel sick to your stomach.

                If your blood glucose is high much of the time or if you have symptoms of high blood glucose, call your doctor. You may need a change in your insulin or diabetes pills, or a change in your meal plan.

                What You Need to Know About Low Blood Glucose (Hypoglycemia)

                Hypoglycemia happens if your blood glucose drops too low. It can come on fast. It's caused by taking too much diabetes medicine, missing a meal, delaying a meal, exercising more than usual, or drinking too much alcohol. Sometimes, medicines you take for other health problems can cause blood glucose to drop.

                Hypoglycemia can make you feel weak, confused, irritable, hungry, or tired. You may sweat a lot or get a headache. You may feel shaky. If your blood glucose drops lower, you could pass out or have a seizure.

                If you have any of these symptoms, check your blood glucose. If the level is 70 or below, have one of the following right away:
                • 2 or 3 glucose tablets
                • 1/2 cup (4 oz.) of any fruit juice
                • a piece of fruit or a small box of raisins
                • 1/2 cup (4 oz.) of a regular (not diet) soft drink
                • 5 or 6 pieces of hard candy
                • 1 or 2 teaspoons of sugar or honey

                After 15 minutes, check your blood glucose again to make sure that it's no longer too low. Once your blood glucose is stable, if it will be at least an hour before your next meal, have a snack.

                If you take insulin or a diabetes pill that can cause hypoglycemia, always carry food for emergencies. It's a good idea also to wear a medical identification bracelet or necklace.

                If you take insulin, keep a glucagon kit at home and also at a few other places where you go often. Glucagon is given as an injection with a syringe and quickly raises blood glucose. Show your family, friends, and co-workers how to give you a glucagon injection if you pass out because of hypoglycemia.

                You can prevent hypoglycemia by eating regular meals, taking your diabetes medicine, and checking your blood glucose often. Checking will tell you whether your glucose level is going down. You can then take steps, like eating some fruit, crackers, or other snacks, to raise your blood glucose.

                ACTION STEPS - If you use insulin
                • Tell your doctor if you have hypoglycemia often, especially at the same time of the day or night several times in a row.
                • Tell your doctor if you've passed out from hypoglycemia.
                • Ask your doctor about glucagon. Glucagon is a medicine that raises blood glucose. If you pass out from hypoglycemia, someone should call 911 and give you a glucagon shot.

                ACTION STEPS - If you DON'T use insulin
                • Tell your doctor if you have hypoglycemia often, especially at the same time of the day or night several times in a row.
                • Be sure to tell your doctor about other medicines you are taking.
                • Some diabetes pills can cause hypoglycemia. Ask your doctor whether your pills can cause hypoglycemia.


                Why It's Important to Take Care of Your Diabetes
                Chapter 4 of 6

                Taking care of your diabetes every day will help keep your blood glucose in your target range and help prevent other health problems that diabetes can cause over the years. This part of the guide describes those problems. We tell you about them not to scare you, but to help you understand what you can do to keep them from happening.

                Do what you can every day to keep your blood glucose in the range that's best for you.
                Follow your meal plan every day.
                Get regular exercise every day.
                Take your diabetes medicine every day.
                Check your blood glucose as recommended.

                Diabetes and Your Heart and Blood Vessels

                The biggest problem for people with diabetes is heart and blood vessel disease. Heart and blood vessel disease can lead to heart attacks and strokes. It also causes poor blood flow (circulation) in the legs and feet.

                To check for heart and blood vessel disease, your health care team will do some tests. At least once a year, have a blood test to see how much cholesterol is in your blood. Your health care provider should take your blood pressure at every visit. He or she may also check the circulation in your legs, feet, and neck.

                The best way to prevent heart and blood vessel disease is to take good care of yourself and your diabetes.
                • Eat foods that are low in fat and salt.
                • Keep your blood glucose on track. Know your A1C. The target for most people is under 7.
                • If you smoke, quit.
                • Exercise regularly.
                • Lose weight if you need to.
                • Ask your health care team whether you should take an aspirin every day.
                • Keep your blood pressure on track. The target for most people is under 130/80. If needed, take medicine to control your blood pressure.
                • Keep your cholesterol level on track. The target for LDL cholesterol for most people is under 100. If needed, take medicine to control your blood fat levels.

                What's a desirable blood pressure level?

                Blood pressure levels tell how much your blood is pushing against the walls of your blood vessels. Your pressure is given as two numbers: The first is the pressure as your heart beats and the second is the pressure as your heart relaxes. If your blood pressure is higher than your target, talk with your health care team about changing your meal plan, adding exercise, or taking medicine.

                Blood Pressure Results

                Target for most people with diabetes - under 130/80

                What are desirable blood fat levels?

                Cholesterol, a fat found in the body, appears in different forms. If your LDL cholesterol ("bad" cholesterol) is 100 or above, you are at increased risk of heart disease and may need treatment. A high level of total cholesterol also means a greater risk of heart disease. But HDL cholesterol ("good" cholesterol) protects you from heart disease, so the higher it is, the better. It's best to keep triglyceride (another type of fat) levels under 150. All of these target numbers are important for preventing heart disease.

                Target Blood Fat Levels for People With Diabetes

                Total cholesterol - under 200
                LDL cholesterol - under 100
                HDL cholesterol - above 40 (men); above 50 (women)
                Triglycerides - under 150

                Diabetes and Your Eyes

                Have your eyes checked once a year. You could have eye problems that you haven't noticed yet. It is important to catch eye problems early when they can be treated. Treating eye problems early can help prevent blindness.

                High blood glucose can make the blood vessels in the eyes bleed. This bleeding can lead to blindness. You can help prevent eye damage by keeping your blood glucose as close to normal as possible. If your eyes are already damaged, an eye doctor may be able to save your sight with laser treatments or surgery.

                The best way to prevent eye disease is to have a yearly eye exam. In this exam, the eye doctor puts drops in your eyes to make your pupils get bigger (dilate). When the pupils are big, the doctor can see into the back of the eye. This is called a dilated eye exam, and it doesn't hurt. If you've never had this kind of eye exam before, you should have one now, even if you haven't had any trouble with your eyes. Be sure to tell your eye doctor that you have diabetes.

                Here are some tips for taking care of your eyes:
                • For people with type 1 diabetes: Have your eyes examined when you have had diabetes for 5 years and every year after that first exam. (Children should have an eye exam in their early teens.)
                • For people with type 2 diabetes: Have an eye exam every year.
                • For women planning to have a baby: Have an eye exam before becoming pregnant.
                • If you smoke, quit.
                • Keep your blood glucose and blood pressure as close to normal as possible.

                Tell your eye doctor right away if you have any problems like blurry vision or seeing dark spots, flashing lights, or rings around lights.

                Diabetes and Your Kidneys

                Your kidneys help clean waste products from your blood. They also work to keep the right balance of salt and fluid in your body.

                Too much glucose in your blood is very hard on your kidneys. After a number of years, high blood glucose can cause the kidneys to stop working. This condition is called kidney failure. If your kidneys stop working, you'll need dialysis (using a machine or special fluids to clean your blood) or a kidney transplant.

                Have a urine test once a year for signs of kidney damage. The test measures how much protein is in your urine. A blood pressure medicine (called an ACE inhibitor) can help prevent kidney damage. Ask your doctor whether this medicine could help you. Other ways to help prevent kidney problems are to
                • Take your medicine if you have high blood pressure.
                • Ask your doctor or your dietitian whether you should eat less meat, cheese, milk, and fish or fewer eggs.
                • See your doctor right away if you get a bladder or kidney infection. Signs of bladder or kidney infections are cloudy or bloody urine, pain or burning when you urinate, and having to urinate often or in a hurry. Back pain, chills, and fever are also signs of kidney infection.
                • Keep your blood glucose and blood pressure as close to normal as possible.
                • If you smoke, quit.

                Diabetes and Your Nerves

                Over time, high blood glucose can harm the nerves in your body. Nerve damage can cause you to lose the feeling in your feet or to have painful, burning feet. It can also cause pain in your legs, arms, or hands or cause problems with eating, going to the bathroom, or having sex.

                Nerve damage can happen slowly. You may not even realize you have nerve problems. Your doctor should check your nerves at least once a year. Part of this exam should include tests to check your sense of feeling and the pulse in your feet.

                Tell the doctor about any problems with your feet, legs, hands, or arms. Also, tell the doctor if you have trouble eating, going to the bathroom, or having sex, or if you feel dizzy sometimes.

                Nerve damage to the feet can lead to amputations. You may not feel pain from injuries or sore spots on your feet. If you have poor circulation because of blood vessel problems in your legs, the sores on your feet can't heal and might become infected. If the infection isn't treated, it could lead to amputation.

                Ask your doctor whether you already have nerve damage in your feet. If you do, it is especially important to take good care of your feet. To help prevent complications from nerve damage, check your feet every day (see Foot care tips below).

                Here are some ways to take care of your nerves:
                • Keep your blood glucose and blood pressure as close to normal as possible.
                • Limit the amount of alcohol you drink.
                • Check your feet every day.
                • If you smoke, quit.

                Foot Care Tips

                You can do a lot to prevent problems with your feet. Keeping your blood glucose in your target range and taking care of your feet can help protect them.
                • Check your bare feet every day. Look for cuts, sores, bumps, or red spots. Use a mirror or ask a family member for help if you have trouble seeing the bottoms of your feet.
                • Wash your feet in warm--not hot--water every day, but don't soak them. Use mild soap. Dry your feet with a soft towel, and dry carefully between your toes.
                • After washing your feet, cover them with lotion before putting your shoes and socks on. Don't put lotion or cream between your toes.
                • File your toenails straight across with an emery board. Don't leave sharp edges that could cut the next toe.
                • Don't try to cut calluses or corns off with a razor blade or knife, and don't use wart removers on your feet. If you have warts or painful corns or calluses, see a podiatrist, a doctor who treats foot problems.
                • Wear thick, soft socks. Don't wear mended stockings or stockings with holes or seams that might rub against your feet.
                • Check your shoes before you put them on to be sure they have no sharp edges or objects in them.
                • Wear shoes that fit well and let your toes move. Break new shoes in slowly. Don't wear flip-flops, shoes with pointed toes, or plastic shoes. Never go barefoot.
                • Wear socks if your feet get cold at night. Don't use heating pads or hot water bottles on your feet.
                • Have your doctor check your feet at every visit. Take your shoes and socks off when you go into the examining room. This will remind the doctor to check your feet.
                • See a podiatrist for help if you can't take care of your feet yourself.

                Diabetes and Your Gums and Teeth

                Diabetes can lead to infections in your gums and the bones that hold your teeth in place. Like all infections, gum infections can cause blood glucose to rise. Without treatment, teeth may become loose and fall out.

                To help prevent damage to your gums and teeth:
                • See your dentist twice a year. Tell your dentist that you have diabetes.
                • Brush and floss your teeth at least twice a day.
                • If you smoke, quit.
                • Keep your blood glucose as close to normal as possible.
                • Keeping your blood glucose in your target range, brushing and flossing your teeth every day, and having regular dental checkups are the best ways to prevent gum and teeth problems when you have diabetes.


                Taking Care of Your Diabetes at Special Times
                Chapter 5 of 6

                Diabetes is part of your life. It's very important to take care of it when you're sick, when you're at school or work, when you travel, or when you're pregnant or thinking about having a baby. Here are some tips to help you take care of your diabetes at these times.

                When You're Sick

                Take good care of yourself when you have a cold, the flu, an infection, or other illness. Being sick can raise your blood glucose. When you're sick:
                • Check your blood glucose every 4 hours. Write down the results.
                • Keep taking your insulin and your diabetes pills. Even if you can't keep food down, you still need your diabetes medicine. Ask your doctor or diabetes educator whether to change the amount of insulin or pills you take.
                • Drink at least a cup (8 ounces) of water or other calorie-free, caffeine-free liquid every hour while you're awake.
                • If you can't eat your usual food, try drinking juice or eating crackers, popsicles, or soup.
                • If you can't eat at all, drink clear liquids such as ginger ale. Eat or drink something with sugar in it if you have trouble keeping food down.

                Test your urine for ketones if :

                your blood glucose is over 240
                you can't keep food or liquids down

                Call your health care provider right away if :

                your blood glucose has been over 240 for longer than a day
                you have moderate to large amounts of ketones in your urine
                you feel sleepier than usual
                you have trouble breathing
                you can't think clearly
                you throw up more than once
                you've had diarrhea for more than 6 hours

                ACTION STEPS - If you use insulin

                Take your insulin, even if you've been throwing up. Ask your doctor about how to adjust your insulin dose, based on your blood glucose test results.

                ACTION STEPS - If you don't use insulin

                Take your diabetes pills, even if you've been throwing up.

                When You're at School or Work

                Take care of your diabetes when you're at school or at work:
                • Follow your meal plan.
                • Take your medicine and check your blood glucose as usual.
                • Tell your teachers, friends, or close co-workers about the signs of hypoglycemia. You may need their help if your blood glucose drops too low.
                • Keep snacks nearby and carry some with you at all times to treat hypoglycemia.
                • Tell your company nurse or school nurse that you have diabetes.

                When You're Away From Home

                Taking care of your diabetes, even on vacation, is very important.

                Here are some tips:
                • Follow your meal plan as much as possible when you eat out. Always carry a snack with you in case you have to wait to be served.
                • Limit your drinking of beer, wine, or other alcoholic beverages. Ask your diabetes educator how much alcohol you can safely drink. Eat something when you drink.
                • If you're taking a long trip by car, check your blood glucose before driving. Stop and check your blood glucose every 2 hours. Always carry snacks like fruit, crackers, juice, or soda in the car in case your blood glucose drops too low.
                • Ask ahead of time for a diabetes meal if you're traveling by plane. Most airlines serve special meals for people with health needs. Carry food (like crackers or fruit) with you in case meals are late.
                • Carry your medicines (insulin, insulin needles, and diabetes pills) and your blood testing supplies with you. Never put them in the suitcase you don't carry with you on the plane or train.
                • Ask your health care team how to adjust your medicines, especially your insulin, if you're traveling across time zones.
                • Take comfortable, well-fitting shoes on vacation. You'll probably be walking more than usual, so you should take extra care of your feet.
                • If you're going to be away for a long time, ask your doctor for a written prescription for your diabetes medicine and the name of a doctor in the place you're going to visit.
                • Don't count on buying extra supplies when you're traveling, especially if you're going to another country. Different countries use different kinds of insulin, needles, and pills.

                ACTION STEPS - If you use insulin

                When you travel,
                • Buy special insulated bags to carry your insulin and to keep it from freezing or getting too hot.
                • Take extra needles, insulin, and blood glucose test strips in case of loss or breakage.
                • If you're going to another country, ask your doctor for a letter saying that you have diabetes and need insulin shots. If asked, show the letter to the customs people.

                When You're Planning a Pregnancy

                Planning ahead is very important if you want to have a baby. High blood glucose can be harmful to both a mother and her unborn baby. Even before you become pregnant, your blood glucose should be close to the normal range. Keeping blood glucose near normal before and during pregnancy helps protect both mother and baby.

                Your insulin needs may change when you're pregnant. Your doctor may want you to take more insulin and check your blood glucose more often. If you take diabetes pills, your doctor will switch you to insulin when you're pregnant.

                If you plan to have a baby:
                • Work with your health care team to get your blood glucose as close to the normal range as possible.
                • See a doctor who has experience in taking care of pregnant women with diabetes.
                • Have your eyes and kidneys checked. Pregnancy can make eye and kidney problems worse.
                • Don't smoke, drink alcohol, or use harmful drugs.
                • Follow the meal plan you get from your dietitian or diabetes educator to make sure you and your unborn baby have a healthy diet.

                If you're already pregnant, see your doctor right away. It's not too late to bring your blood glucose close to normal so that you'll stay healthy during the rest of your pregnancy.


                Where to Get More Help With Your Diabetes
                Chapter 6 of 6

                People Who Can Help You

                Your doctor. He or she may be your doctor at the clinic where you go for health care, your family doctor, or someone who has special training in caring for people with diabetes. A doctor with that kind of special training is called an endocrinologist or diabetologist.

                You'll talk with your doctor about what kind of medicine you need and how much you should take. You'll also agree on a target blood glucose range and blood pressure and cholesterol targets. Your doctor will do tests to be sure that your blood glucose, blood pressure, and cholesterol are staying on track and that you're staying healthy. Ask your doctor if you should take aspirin every day to help prevent heart disease.

                Your diabetes educator. A diabetes educator may be a nurse, a dietitian, or another kind of health care worker. Diabetes educators teach you about meal planning, diabetes medicines, exercise, how to check your blood glucose, and how to fit diabetes care into your everyday life.

                Don't be shy about asking your doctor or diabetes educator about the information in this guide. Ask questions if you don't understand something. After all, it's your health!

                Your family and friends. Keeping your blood glucose at your target level is a daily job. You may need help or support from your family or friends. You may want to bring a family member or close friend with you when you visit your doctor or diabetes educator. Taking good care of your diabetes can sometimes be a family affair!

                A counselor or mental health worker. You might feel sad about having diabetes or get tired of taking care of yourself. Or you might be having problems because of work, school, or family. If diabetes makes you feel sad or angry or if you have other problems that make you feel bad, you can talk to a counselor or mental health worker. Your doctor or diabetes educator can help you find a counselor if you need one.

                Organizations That Can Help You

                How to find a diabetes educator

                To find a diabetes educator near you, call the American Association of Diabetes Educators toll-free at 1-800-832-6874, or look on the Internet at and click on "Find a Diabetes Educator."

                How to find a dietitian

                To find a dietitian near you, call the American Dietetic Association toll-free at 1-800-366-1655, or look on the Internet at and click on "Find a Dietitian."

                How to find programs about diabetes

                To find programs about diabetes or for additional information, contact

                American Diabetes Association
                1701 North Beauregard Street
                Alexandria, VA 22311
                Phone: 1-800-342-2383

                Juvenile Diabetes Research Foundation International
                120 Wall Street, 19th Floor
                New York, NY 10005
                Phone: 1-800-533-2873

                Both these organizations have magazines and other information for people with diabetes.

                They also have local groups in many places where you can meet other people who have diabetes.

                How to get more information about diabetes

                To get more information about taking care of diabetes, contact

                National Diabetes Education Program
                1 Diabetes Way
                Bethesda, MD 20892-3600
                Phone: 1-800-438-5383
                Fax: (301) 907-8906


                • #9
                  Whew golly!!! That took a while to write down. Hehehe. OK, hope that serves as a good starting base for people dealing with diabetes anywhere in their life or within their immediate circle. As I said, any questions, please just ask.


                  • #10
                    Originally posted by Skip
                    It kinda makes you not want to bitch about weighing food and eating at certain times, huh?

                    Oooh OUCH!! RIght under the belt Skipper. NASTY!!


                    • #11
                      IM^, Incredible, thank you for all that, when I get back from the gym I will go over this and absorb it...
                      "That damn log book"

             Highest quality protein at the lowest price...


                      • #12
                        Most welcome my friend, I'm delighted to help.


                        • #13
                          IM, Thanks so much , great post . I just passed this info on to a friend of mine. She is an identical twin, she is diabetic but her sister is not. They work out at the gym at the same time that I do. Its wild because when they work out its like watching a trick mirror !
                          Stay Hard and Get Huge !

                          Whatever you can do or dream you can do, begin it. Boldness has genius , power and magic in it. Begin it now. - Goethe


                          • #14
                            I found an interesting article while web surfing tonite....I just posted it in the health forum. From the looks of this article there may be a correlation b/n diabetes and the consumption of milk. I am curious as to some of the responses to this. Feel free to post either in this thread or the thread in the health forum....

                            [email protected]

                            " We know that to err is human, but the HIV/AIDS hypothesis is one hell of a mistake"
                            Dr. Kary Mullis, Nobel Prize Winner in Chemistry for inventing the Polymerase Chain Reaction

                            "The fact is that you can not start off with bad science and end up with good medicine"


                            • #15
                              Man, SS, DON'T put me off milk too. That's all I need now, another food source off my rapidly dwindling list. Darn it!!