Diabetes Blog

Coping with Your Diabetic Child

Posted by john in Diabetes Care

As you learn to help your child regulate his or her body chemistry for a healthier life, remember to do what your physician and health care team advise. Friends and relatives will offer well meaning advice and suggestions that may be based on something they read or heard and mayor mar not be applicable to your child’s condition. Control of your child’s diabetes will depend on proper diet, emotional stability, well regulated insulin injections, exercise, and regular glucose testing. Families that have adjusted well to caring for a diabetic child do not make the child’s diabetes a central concern to the family and do not need to change the entire family’s lifestyle. If you set reasonable goals for diet, testing, exercise, and self-care, your child will adapt to the situation with flexibility and good humor, and so will others in the family. The best assistance you can give your child or adolescent with diabetes is to keep calm and not express constant concern over every detail of the management of the diabetes. Your matter-of­ fact attitude will rub off on your child. If you accept the additional activities of daily living related to diabetic care as part of the family routine, so will your child. Your child should come to view diabetic care as an un-complicating and uncomplicated aspect of life. If your child takes injections, he William to view the minor discomfort as part of his regular day, just as he accepts daily hygiene routines, occasional skinned knees, falls from his bicycle, and other cuts and bruises. If you express too much sympathy for occasional discomfort, your child may begin to feel sorry for himself and thus have a harder time taking the injections and caring for himself.

Children with diabetes should not be permitted to use their disease as a frequent excuse for avoiding special lessons, taking the school bus, or other situations. Of course, occasional head. aches or sick spells may occur just as they do in non diabetic children. However, you should encourage the diabetic child to learn to view illness as something to overcome, not something to hide behind. If you, as the parent, are not overprotective and encourage carrying on routine activities despite some occasional under par feelings, your child will develop a mature outlook toward living with diabetes.

Encourage your child to follow his or her physician’s recommendations to take the daily injections of insulin at the same time each day, using the correct dosage. A common cause of poor diabetic control is changing the time of day for the injection and taking an incorrect dose of the injection. Frequent and unnecessary changes may cause blood sugar to become too low and then go too high.

Additionally your doctor may recommend that you do not adjust the amount of insulin on days when your child expects more activity than usual. Instead, you can give the child additional food before he or she engages in heavy sports activities. Also, the child may keep some extra food handy in case of an insulin reaction (low blood sugar) during a game or strenuous activity.

Overall, your role in coping with your diabetic child will be supportive but should not be overindulgent, Encourage self-care and participation in routine activities. However, two medical emergencies may require quick action on your part: hypoglycemia (low blood sugar) and ketoacidosis (diabetic coma). There may be times when you suspect that either of these reactions is taking place. If you suspect low blood sugar, use a self-monitoring blood glucose test, if you can. Or use a urine test for acetone, a sign of possible ketoacidosis. Ketones do not always indicate ketoacidosis, as it may result from emotional stress, diet, exercise, and especially low blood sugar. Your health care team will give you specific instructions to follow if these conditions occur.

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Diabetes Foot Care

Posted by john in Diabetes Care

You feel as good as your feet feel. To keep your feet feeling good, your health care team will recommend many of the following routines for you.

• After daily bathing, dry your feet well. Excessive moisture can set the scene for fungus infections, blisters, and other irritations.
• When choosing shoes and socks, be sure they fit well and do not cause pressure effects such as corns and calluses or constriction by elastic.
• Keep your toe nails trimmed straight across and not too short. Avoid cutting into the corners, which could injure the soft tissue and permit infection to develop. To prevent ingrown toenails you might want to round the corners gently.
• If you do develop corns and calluses, careful use of pressure relieving pads may help. If you want to reduce corns and
  calluses, discuss this with your health care team. They may recommend use of a pumice stone. If corns and call uses cause persistent pain, redness, or swelling, you will want to seek professional advice from competent specialists recommended by your medical advisors.
• If excessive dryness or cracking of the skin on your feet is a problem for you, moisturizing bath oil or skin lubricants may be helpful. In cold climates, wear adequate protective outer footwear. Boots should be warm, waterproof, and fitted carefully to prevent constriction, excessive rubbing, and frostbite.

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Glucose Tolerance Tests

Posted by john in Diabetes News

The basic glucose tolerance test may be ordered by your physician as part of a complete physical examination or specifically because diabetes is suspected. It involves taking a small specimen of blood from a vein in your arm. Over approximately a several hour period, multiple separate readings of your blood glucose level are taken. These measurements, when plotted on a graph, graphically portray how your body handles glucose. The test is especially valuable because it can confirm the presence of a condition known as impaired glucose tolerance. While people who have impaired glucose tolerance do have elevated blood glucose levels after meals, impaired glucose tolerance is not necessarily diabetes, and their fasting blood sugar is normal. However, people who have this condition may be more likely than others to develop active diabetes.

If your physician orders a glucose tolerance test, it will be scheduled in the morning after you have had three days of good food intake so that your body can handle sugar optimally. You will be asked not to eat breakfast that morning so that your first blood sample will reflect your fasting glucose level. Next you will be given a beverage or test meal containing glucose to drink or eat. On some occasions glucose is administered intravenously. At various hourly intervals after you have taken the glucose, blood samples will be taken and the glucose level of your blood will be measured.

This test is usually not used by physicians during periods of long dietary restriction, illness, or disability or without the three ­day good food intake preparation. If you do not have diabetes or impaired glucose tolerance, the resulting readings, plotted on a graph, will show a normal pattern. If you do have diabetes, the graph will show that your blood glucose level rose and kept rising and did not even begin to drop by the end of the test. If you have impaired glucose tolerance, the graph will look much like the non-diabetics graph, but it will indicate higher blood sugar concentrations with normal fasting or end-of-test levels. The levels will fall between the range of the non-diabetic and the diabetic on the graph. The term impaired glucose tolerance refers to the condition in which the fasting plasma glucose level is between normal and diabetic levels. This term is used instead of the term borderline, chemical or latent diabetes.

If a glucose tolerance test reveals that you have impaired glucose tolerance, your doctor may recommend that you have further tests. Also, because people with impaired glucose tolerance are, more likely to develop diabetes, and because at this stage diabetes is preventable, your doctor may advise you to lose weight, cut your intake of simple sugars, exercise more, and avoid cardiovascular risk factors, including high blood pressure, smoking, and high cholesterol levels.

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Carbohydrates: Simple and Complex

Posted by john in Diabetes Care

There are two types of carbohydrates: simple and complex. Simple carbohydrates are composed of relatively few building blocks (for example, glucose molecules) and are therefore broken down quickly and easily. Table sugar, honey, candy, jams and jellies, cakes and pastries are all examples of sources of simple carbohydrates. Usually a person’s body releases enough insulin to clear the sugar from these simple carbohydrates out of the blood and move it into the cells, where it can be used for energy. In a diabetic, however, either there is not enough insulin to get the job done or the insulin is ineffective. The simple carbohydrates break down and flood into the bloodstream. That is why your physician will recommend that you limit simple carbohydrates if you have diabetes.

Complex carbohydrates present another story. These are much larger than the simple carbohydrates because they contain many building blocks Complex carbohydrates are broken down slowly in the intestinal tract, and, as a result, even. with decreased insulin, bleed sugar rises much mere slowly after you have eaten these feeds. Starch found in pasta, bread, cereals, and vegetables are examples of complex carbohydrates. Because these carbohydrates are broken down into their individual glucose units mere slowly than simple carbohydrates, they do net affect the diabetic in the same way. Recently many doctors have recommended that carbohydrates,especially the complex types, scheduled make up 50 percent or mere of the diabetic’s total daily calories. In the past the percentage of carbohydrates in the diabetic’s diet was considerably lower, the difference being made up by a higher percentage of fat in the diet. New there is evidence that diets lower in total fat but with a greater proportion of polyunsaturated fat are helpful in even ting some forms of vascular disease. These facts, together with the knowledge that carbohydrates are net the risk or danger they were once thought to be have greatly changed diets for people who have diabetes.

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Glycosylated Hemoglobin - Diabetes Test

Posted by john in Diabetes Information

Another blood test your physician may perform to learn more about the glucose concentration in your blood involves glycosylated hemoglobin. Glycosylated hemoglobin is created when glucose is attached to hemoglobin cells (red blood cells). The concentration of these glycosylated hemoglobin molecules is a good barometer of average glucose content, as it is higher in diabetics than in non-diabetics. It is also very high in patients who poorly control their diabetes. Glucose attaches to the hemoglobin slowly, depending on the concentration of glucose in the blood. Since the life span of a red blood cells is about four months, a high concentration of glycosylated hemoglobin in your blood indicates that the condition has been building over a period of time. A measurement of glycosylated hemoglobin is like peering back in time. Because this test indicates what happened previously, rather than what is taking place now, it does help your doctor in terms of establishing or making adjustments in your treatment. Also, the test at present is expensive. However, for long-term monitoring of diabetic control, glycosylated hemoglobin tests are useful, and your physician may make use of them in treating you.

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Causes of Juvenile Diabetes

Posted by john in Diabetes Information

Your child will probably ask many questions about diabetes, Just as you will. Why your child? The causes of diabetes in young children and adolescents are not known. Heredity plays a role, but heredity alone is not enough to cause diabetes. According to the American Diabetes Association, recent research indicates that certain viruses may combine with an inherited susceptibility and playa role in the development of diabetes. Of the 5 million Indians who have diabetes, many cases began in childhood Or adolescence. A child’s diabetes is not the result of anything the parents do or do not do.

If your child is old enough, he or she will be able to understand that diabetes is a condition in which the body doesn’t utilize food appropriately because of the lack of insulin, the hormone produced in the pancreas. The lack of insulin causes sugar (in the form of glucose) to build up in the blood and urine. It isn’t distributed throughout the body to produce energy as it should.

You may have noticed that your child was weak, was constantly thirsty and hungry, and urinated frequently. Many cases of diabetes in children under age 15 appear suddenly. Unlike non insulin-dependent diabetes, which is often related to obesity in adults, diabetes in children has little to do with weight. While losing weight may contribute to your diabetic child’s comfort and self esteem, the weight loss alone probably will not be enough to stabilize the blood sugar level. If your child’s case is like many of the juvenile onset type, it is very likely to be insulin dependent and will require daily insulin injections.

Your child may be admitted to a hospital after the diagnosis is made so that additional tests can be performed and the optimal level of insulin can be prescribed and monitored for a few days. Your learning process and the child’s learning process will begin at that time. You will both learn how to function at home within the family structure and, if the child is old enough, how to feel secure with self care.

The health care team’s educational approach and care plan for your young child with diabetes will be geared to encourage independence. Your physician will strive to preserve your child’s previous lifestyle as much as possible and center the diet and insulin needs around it. For example, if your child is sports minded, athletic activities will not have to be curtailed if the child has fairly good control of the disease. With an older child the health care team’s goal will be to enable the child to assume responsibility for injections and insulin measurement, diet, and self monitoring without being totally dependent on you or the doctor.

The health care team will work with you to help you combat any tendencies toward over protectiveness and possible guilt concerning your child’s disease. You will learn to cope with your child’s adaptation to regulation and new sense of discipline necessary” to control the disease properly. Health care professionals will be available to provide advice, instructional materials, and emotional support for you.

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