Type 1 Diabetes For Dummies

Introduction 1 About This Book 1 Conventions Used in This Book 2 What You’re Not to Read 3 Foolish Assumptions 3 How This Book Is Organized 4 Part I: Defining Type 1 Diabetes 4 Part II: Considering the Consequences of Type 1 Diabetes 4 Part III: Treating Type 1 Diabetes 5 Part IV: Living with Type 1 Diabetes 5 Part V: The Part of Tens 6 Part VI: Appendixes 6 Icons Used in This Book 7 Where to Go from Here 7 Part I: Defining Type 1 Diabetes 9 Chapter 1: Dealing with Type 1 Diabetes 11 Understanding What Type 1 Diabetes Is (and Isn’t) 12 Handling the Physical and Emotional Consequences of Type 1 Diabetes 13 Treating Type 1 Diabetes Effectively 14 Undergoing regular testing 14 Eating wisely 15 Exercising for more control 15 Taking insulin 16 Using other medications and treatments 16 Deciding to transplant 16 Living Well with Type 1 Diabetes 17 Handling school, work, and other daily activities 17 Adjusting to sick days and travel 17 Getting through pregnancy and menopause 18 Aging with type 1 diabetes 18 Chapter 2: Recognizing Type 1 Diabetes 19 Understanding How Type 1 Diabetes Works 19 Distinguishing between controlled and uncontrolled glucose 21 Triggering type 1 diabetes 24 Checking Out the Statistics on Who Gets Type 1 Diabetes 25 Rates among different places and races 25 Rates in children versus adults 26 Rates in families with members who have type 1 diabetes 26 Making a Diagnosis of Type 1 Diabetes 27 Surveying the symptoms and undergoing testing 27 Gathering a group of the right doctors 28 Developing key skills after the diagnosis 29 Chapter 3: Excluding Other Types of Diabetes 31 Distinguishing Type 2 and Latent Autoimmune Diabetes from Type 1 Diabetes 31 Type 2 diabetes 32 Latent Autoimmune Diabetes in Adults (LADA) 35 Delving into Diabetes Caused by Other Diseases and Agents 36 Considering hormone-induced causes of diabetes 36 Examining diabetes caused by destructive diseases of the pancreas 40 Discovering drugs and chemicals that may cause or worsen diabetes 42 Part II: Considering the Consequences of Type 1 Diabetes 43 Chapter 4: Overcoming Short-Term Complications 45 Managing Low Blood Glucose: Hypoglycemia 46 Determining the cause 46 Recognizing the symptoms 48 Distinguishing the severity levels of hypoglycemia 49 Understanding hypoglycemic unawareness 51 Preventing and treating hypoglycemia 52 Dealing with Very High Blood Glucose: Diabetic Ketoacidosis 55 Considering some potential causes 56 Surveying the symptoms 57 Preventing and treating diabetic ketoacidosis 58 Chapter 5: Preventing Long-Term Complications 61 Focusing on Eye Disease 62 Background retinopathy 64 Proliferative retinopathy 65 Coping with Kidney Disease 66 The effects of uncontrolled diabetes on the kidneys 67 Preventing kidney disease 69 Treating kidney disease if prevention fails 70 Knowing about Nerve Disease 71 Disorders of sensation 72 Disorders of movement (mononeuropathy) 74 Disorders of automatic (autonomic) nerves 75 Macrovascular Complications: Protecting Your Heart 76 Considering Associated Diseases 78 Hyperthyroidism and hypothyroidism 78 Skin disease 80 Celiac disease 81 Chapter 6: Handling Emotional Effects 83 Coming to Terms with the Diagnosis 83 Knowing that your child is in good company 84 Encouraging positive coping skills 85 Realizing that Type 1 Diabetes Is a Family Disease 87 Getting a grip on general guidelines for parents 87 Caring for children of all ages 89 Helping siblings be understanding 92 Handling Issues of Self-Esteem 93 Busting myths about having a chronic disease 93 Clearing up fears about having special needs 94 Maintaining a High Quality of Life 95 Part III: Treating Type 1 Diabetes 97 Chapter 7: Undergoing Essential Tests and Monitoring Blood Glucose 99 Doing Key Tests at the Doctor’s Office 100 Foot problems 101 Blood pressure 102 Weight and height 103 Hemoglobin A1c 105 GlycoMark 108 Thyroid functions 109 Microalbuminuria 110 Eye problems 111 Cholesterol 111 The Basics of Testing Blood Glucose at Home 113 Deciding on the frequency of testing 114 Performing the test 115 Testing away from the finger 116 Selecting a Home Blood Glucose Meter 116 Considering a few factors when choosing a meter 117 Using a typical data management system 118 Surveying standard blood glucose meters 120 Checking out meters for continuous glucose monitoring 124 Chapter 8: Eating a Healthy Diet 127 Carbohydrates: The Energy Source with the Biggest Impact on Blood Glucose 128 Getting a grip on the glycemic index 129 Filling up with fiber 132 Carbohydrate counting 132 Other tips for managing carbohydrate intake 134 Looking at Other Sources of Energy 135 Protein 135 Fat 136 Getting Enough Vitamins, Minerals, and Water 137 Vitamins 138 Minerals 139 Water 140 Understanding Diet Challenges at Every Age 140 Focusing on Other Food Factors 141 Using sugar substitutes 142 Considering fast food 143 Choosing a vegetarian diet 146 Handling Eating Disorders 146 Different types of disorders 147 Sources of help 149 Chapter 9: Exercising to Improve Control of Type 1 Diabetes 151 The Benefits of Exercise for People with Type 1 Diabetes 152 Taking Care Before Starting an Exercise Program 153 Talking to the doctor 153 Deciding to devote an hour each day 154 Determining how hard to exercise 154 Adjusting insulin usage and following other precautions 155 Developing (And Sticking to) an Exercise Plan 156 Encouraging exercise at all ages 156 Choosing an activity 160 Competing against others 162 A good pick for everyone: Walking 10,000 steps a day 163 Training with weights 164 Chapter 10: Understanding the Basics of Using Insulin 171 The Purpose and Types of Insulin 172 What does insulin do? 172 What are the different types of external insulin? 173 The Details of Insulin Doses 175 Calculating the bolus dose 176 Adjusting the basal dose 178 Injecting Insulin 178 Before you begin: Selecting an injection site 179 Syringes and needles 180 Taking (or giving) a shot 181 Insulin pens 184 Insulin infusers 185 Jet injectors 186 Avoiding side effects, no matter the method 187 A Major Advance: Inhaled Insulin 187 The limits on potential patients 188 Determining the dose 188 Inhaling the insulin 190 A few notes on inhaler maintenance and usage 191 Chapter 11: Delivering Insulin with a Pump 193 Keeping a Few Considerations in Mind before Using an Insulin Pump 193 Using an Insulin Pump Properly 195 Taking the right doses 195 Setting temporary doses 197 Changing the needle and insulin 198 Living comfortably with the pump 199 Switching from the pump in special cases 200 Checking Out Various Insulin Pumps 201 MiniMed Paradigm pumps 201 Accu-Chek Spirit Insulin Pump System 203 Animas pumps 203 CozMore Insulin Technology System 204 Dana Diabecare II pump 204 OmniPod Insulin Management System 205 Choosing the right pump 206 Chapter 12: Getting a Grip on Other Drugs and Treatments 207 Boosting Insulin’s Effect: Pramlintide 207 Surveying Different Treatments 209 Acupuncture 209 Biofeedback 210 Chromium 210 Cinnamon 211 Ginseng 211 Vanadium 211 Drinking Alcohol Safely 212 The maximum amount of alcohol allowed 212 The dangers of excess alcohol 213 Finding help 214 Avoiding Dangerous Drugs 215 Prescription medications 215 Tobacco 216 Illegal drugs 218 Chapter 13: Surveying Kidney, Pancreas, and Pancreatic Islet Transplants 221 Receiving a New Kidney 222 Recognizing when you need a new kidney 222 Knowing when you can’t have a kidney transplant 222 The pros and cons of a kidney transplant 223 Understanding the costs 223 Undergoing an evaluation 224 Finding a donor, living or deceased 224 The process of surgery and recovery 225 Getting a New Pancreas (Alone or with a New Kidney) 225 Recognizing when you need a new pancreas 226 Knowing when you can’t have a pancreas transplant 226 The pros and cons of a pancreas transplant 226 Looking at the costs 227 Finding a pancreas donor 227 The process of surgery and recovery 228 On the Cutting Edge: Pancreatic Islet Transplantation 229 Recognizing when you need islet transplantation 229 Knowing when you can’t have an islet transplant 230 The pros and cons of an islet transplant 230 Considering the costs 231 The donation of islets 231 The process of surgery and recovery 232 Dealing with Continuing Issues after Any Transplant 232 Following up and treating your diabetes 233 Checking for long-term complications 233 Avoiding infections 233 Being careful with conception 234 Watching out for cancer 234 Finding More Information Online 234 Part IV: Living with Type 1 Diabetes 237 Chapter 14: Adjusting to School, Work, and Other Activities 239 Dealing with Diabetes in School 240 Developing a Section 504 Plan 240 Considering an individualized education program 242 Handling diabetes in college 242 Living with Diabetes as a Working Adult 243 Understanding limits and protections 243 The real risk of hypoglycemia in the workplace 244 Taking action if you suspect discrimination related to diabetes 245 Working together: Helping employers integrate employees with diabetes 245 Driving Safely with Type 1 Diabetes 247 Tackling Insurance Issues 248 Health insurance 248 Life insurance 250 Chapter 15: Managing Illness and Travel 251 Dealing with Sick Days 251 Monitoring the blood glucose 252 Measuring blood ketones 253 Modifying the diet 254 Taking medications 255 Traveling with Type 1 Diabetes 256 Carrying the necessities 256 Adjusting insulin intake in a different time zone 257 Eating sensibly 258 Ensuring a smooth journey 259 Chapter 16: Going through Pregnancy and Menopause 261 Understanding Normal Female Sexual Development 262 Starting before birth 262 Continuing at puberty and adolescence 262 Controlling Type 1 Diabetes before Conception 263 Handling blood glucose during your menstrual periods 263 Dealing with sexual dysfunction 264 Getting a few tests if you’re thinking of getting pregnant 264 The risks of conceiving before you have control of T1DM 265 Using contraception until you’re under control 268 Ensuring a Safe Pregnancy and Delivery 269 Using insulin during and after pregnancy 270 Managing your diet 271 Adding exercise 272 Monitoring your baby 272 Dealing with Type 1 Diabetes during Menopause 272 Sticking to good habits 273 Considering hormone replacement therapy 274 Chapter 17: Controlling Type 1 Diabetes in the Elderly 277 Making a Diagnosis 278 Surveying symptoms 279 Conditions connected to the onset of type 1 diabetes 280 Confirming the diagnosis with testing 280 Recognizing the Challenges of Managing Type 1 Diabetes in the Elderly 281 Realizing how the elderly differ from other patients 281 Determining an elderly patient’s ability to treat his own type 1 diabetes 282 Effectively Treating Type 1 Diabetes in the Elderly 283 Medications 284 Nutrition 285 Exercise 286 Checking Out Resources for the Elderly with Type 1 Diabetes 287 Government help 287 Drug company resources 288 Part V: The Part of Tens 291 Chapter 18: Ten Ways to Involve Kids in Their Own Diabetes Care 293 Set Some Goals for Care with Your Child 294 Show Your Child How to Test His Blood Glucose 294 Shop for Food Together 295 Plant a Garden Together 296 Have Your Child Help with the Cooking 296 Exercise as a Family 297 Show Your Child How to Administer Insulin 297 Plan a Trip Together 298 Have Your Child Do Household Chores 298 Encourage Your Child to Play Video Games (Really!) 299 Chapter 19: Ten Commandments for Good Diabetes Management 301 An Affirmative Attitude 302 Total Testing 302 Extraordinary Eye Care 303 Foolproof Foot Care 303 Mega-Monitoring 304 Dedicated Dieting 305 Emphatic Exercising 306 Mindful Medicating 306 Planning for Potential Problems 307 Lifelong Learning 308 Chapter 20: Ten Myths about Type 1 Diabetes 309 No Symptoms of Type 1 Diabetes Appear before Damage Has Occurred 310 Type 1 Diabetes and Type 2 Diabetes Are the Same 310 You Can’t Eat Sugar with Type 1 Diabetes 311 You Have to Eat Special Foods When You Have Type 1 Diabetes 312 If You Take Insulin, You Must Have Type 1 Diabetes 312 Insulin Causes Atherosclerosis 313 Insulin Cures Type 1 Diabetes 313 You’re More Prone to Illness When You Have Type 1 Diabetes 314 Women with Type 1 Diabetes Shouldn’t Get Pregnant 314 Doctors Are Hiding the Cure for Type 1 Diabetes So They Can Make More Money 315 Chapter 21: Ten of the Latest Discoveries in Type 1 Diabetes 317 The Development of the GAD Vaccine 318 The Possible Prevention of Type 1 Diabetes with Oral Insulin 319 The Possible Prevention of Type 1 Diabetes with Intranasal Insulin 319 The Study of Continuous Glucose Monitoring 320 Contact Lenses That Indicate Your Glucose Level 320 A Drug to Fight Diabetic Neuropathy 321 Drugs to Block the Immunity That Kills Beta Cells 321 The Regeneration of Beta Cells with a Protein 322 The Infusion of Stem Cells 322 The Use of Cord Blood to Regenerate Beta Cells 323 Part VI: Appendixes 325 Appendix A: Glossary 327 Appendix B: Resources for the Latest Information 335 My Web Site 335 General Web Sites 336 Government Web Sites 337 Companies That Make Diabetes Products 338 Glucose meters 338 Lancing devices 339 Insulin 339 Insulin syringes 339 Insulin jet injection devices 339 Insulin pumps 340 Recipes for People with Diabetes 340 Web Sites for Diabetes Complications 341 Vision 341 Kidneys 342 Diabetic neuropathy 342 Heart disease 342 Index 343