Lesson #2

Every day is a winding road

Insulin
If you use insulin, it means that your body has stopped making or doesn't make enough insulin. Insulin cannot be taken as a pill, and must be given as an injection. Some people give themselves one shot a day, some give themselves two or more. You should never skip a shot, even if you are sick.

Your doctor will talk to you about what type of insulin to use, how much to use and when to give yourself a shot. A diabetes educator or doctor will show you how to draw up insulin in the needle and show you the best places on your body to inject yourself. Be sure to ask someone to help you with your shots if your hands are shaky or you can't see well.

Tip: It is a good idea to keep extra insulin in your refrigerator in case you break the bottle that you are using. Do not keep insulin in the freezer or in hot places like the glove compartment of your car. Also, keep it away from bright light. Extreme temperatures and bright light can damage insulin.

Diabetes pills
If your body makes insulin, but the insulin doesn't lower your blood sugar, you may have to take diabetes pills. These pills work only in people who have the ability to make some insulin of their own. There are a variety of different diabetes pills. Your doctor will help you choose which ones to use. They are safe to take, but if they make you feel bad or if you have any other adverse reactions, be sure to tell your doctor. But diabetes pills might not lower blood sugar all by themselves. If you follow a nutrition and exercise plan in addition to the pills, you will be well on your way to lowering your blood sugar.

Sometimes, if you lose weight, your blood sugar will decrease and your doctor may advise you to decrease your dosage or to stop taking the diabetes pills.

Testing your blood sugar
A key component to diabetes care is to monitor your blood sugar. If your blood has too much or too little sugar, your doctor may need to change your eating, exercise or medicine plan.

Some people test their blood once a day. Others test their blood three or four times a day. Ask your doctor how often and when you should test your blood usgar.

To test your blood, you will need a lancet and special blood testing strips. Your doctor or diabetes educator will show you how to test your blood.

Urine testing
Some people may also need to test their urine ketones when they are sick of if their blood sugar is over 240 before eating. Ketones are produced when there is not enough insulin in the blood. If there is not enough insulin, there is no way for the sugar to get into the cells, so the body starts breaking down fats for energy. Ketones are a byproduct of that process. If you find ketones, call your doctor immediately as they are a sign of ketoacidosis — a disease that can make you very sick and, if left untreated, can cause death. Some signs of ketoacidosis are vomiting, weakness, fast breathing and sweet smelling the breath.

The hemoglobin A1c test
Another test for blood sugar is the hemoglobin A1c test which shows your average blood sugar for the past three months. If most of the blood sugar tests you do for yourself show that your blood sugar is around 150, the hemoglobin A1c test will be normal. If most of your blood sugar tests are high, then the hemoglobin A1c test will be high. This test will give you a sense of how well you are controlling your diabetes.

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