Monday, February, 13, 2012

Type 1 diabetes

Table of Contents

At bedtime:

  • Less than 180 mg/dL for adults
  • 110 - 200 mg/dL for children under age 6
  • 100 - 180 mg/dL for children 6 - 12 years old
  • 90 - 150 mg/dL for children 13 - 19 years old

FOOT CARE

Diabetes causes damage to the blood vessels and nerves. This can reduce your ability to feel injury to or pressure on the foot. You may not notice a foot injury until severe infection develops. Diabetes can also damage blood vessels. Small sores or breaks in the skin may progress to deeper skin ulcers. Amputation of the affected limb may be needed when these skin ulcers do not improve or become larger or deeper.

To prevent problems with your feet, you should:

  • Stop smoking if you smoke.
  • Improve control of your blood sugar.
  • Get a foot exam by your health care provider at least twice a year and learn whether you have nerve damage.
  • Check and care for your feet EVERY DAY, especially if you already have known nerve or blood vessel damage or current foot problems.
  • Make sure you are wearing the right kind of shoes.

See: Diabetes foot care.

TREATING LOW BLOOD SUGAR

Hypoglycemia can develop quickly in people with diabetes. Symptoms typically appear when the blood sugar level falls below 70 mg/dL. If you have symptoms:

  • Do a blood sugar check.
  • If the level is low or you have symptoms of hypoglycemia, eat something with sugar: 4 ounces of fruit juice, 3 - 4 Lifesavers candies, or 4 ounces of regular soda. Overtreating a mild low blood sugar reaction can lead to problems with high blood sugar and difficult blood sugar control overall.
  • Symptoms should go away within 15 minutes. If the symptoms don't go away, repeat the sugar-containing food as above, and test the sugar level again. When your blood sugar is in a safer range (over 70 mg/dL), you may need to eat a snack with carbohydrates and protein, such as cheese and crackers or a glass of milk.

Ask your doctor if you need a glucagon injection kit to raise blood sugar quickly in an emergency.

MEDICATIONS TO PREVENT COMPLICATIONS

Your doctor may prescribe medications to reduce your chances of developing eye disease, kidney disease, and other conditions that are more common in people with diabetes.

An ACE inhibitor (or ARB) is often recommended as the first choice for those with high blood pressure and those with signs of kidney disease. ACE inhibitors include:

  • Benazepril (Lotensin)
  • Captopril (Capoten)
  • Enalapril (Vasotec)
  • Guinapril (Accupril)
  • Lisinopril (Prinivil, Zestril)
  • Perindopril (Aceon)
  • Ramipril (Altace)

Statin drugs are usually the first choice to treat an abnormal cholesterol level. Aim for an LDL cholesterol level of less than 100 mg/dL (less than 70 mg/dL in high-risk patients).

Aspirin to prevent heart disease is most often recommended for people with diabetes who:

  • Are older than 40
  • Have a personal or family history of heart problems
  • Have high blood pressure or high cholesterol
  • Smoke

Review Date: 05/10/2010
Reviewed By: Ari S. Eckman, MD, Division of Endocrinology and Metabolism, Johns Hopkins School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)