Type 2 diabetes

If you continue to have poor blood glucose control despite lifestyle changes and taking medicines by mouth, your doctor will prescribe insulin. Insulin may also be prescribed if you have had a bad reaction toother medicines. Insulin must be injected under the skin using a syringe and cannot be taken by mouth.

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Insulin preparations differ in how fast they start to work and how long they work. Your healthcare provider will determine the appropriate type of insulin to use and will tellyouwhat time of day to use it.

More than one type may be mixed together in an injection to achieve the best control of blood glucose. Usuallyinjections are needed one to four times a day. Your doctor or diabetes educator will show youhow to give yourself an injection.

FOOT CARE

People with diabetes are prone to foot problems.Diabetes can cause damage to nerves, which means you may not feel an injury to the foot until a large sore or infection develops. Diabetes can also damage blood vessels, which makes it harder for the bodyto fight infection.

To prevent injury to the feet, a person with diabetes should adopt a daily routine of checking and caring for the feet as follows:

Check your feet every day, and report sores or changes and signs of infection.
Wash feet every day with lukewarm water and mild soap, and dry them thoroughly.
Soften dry skin with lotion or petroleum jelly.
Protect feet with comfortable, well-fitting shoes.
Exercise daily to promote good circulation.
See a podiatrist for foot problems, or to have corns or calluses removed.
Remove shoes and socks during a visit to the health care provider to remind them to examine your feet.
Stopsmoking because it worsens blood flow to the feet.

CONTINUING CARE

A person with type 2 diabetes should have a visit with a diabetes care provider every3 months. A complete examination includes:

Glycosylated hemoglobin (HbA1c) is a 3-month average of your blood glucose level. This test measures how much glucose has been sticking to red blood cells and other cells. A high HbA1c is an indicator of risk for long-term complications. Currently, the ADA recommends an HbA1c of less than 7% to protect oneself from complications.
Blood pressure check
Foot and skin examination
Ophthalmoscopy examination
Neurological examination

The following evaluations should be done at least once a year: