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Taking Charge of Your Health


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home remedies for Diabetes Diabetes is a serious disease. Following your diabetes treatment plan takes
round-the-clock commitment. Careful management of diabetes can reduce
your risk of serious — even life-threatening — complications. No matter what type of diabetes you have:
• Make a commitment to managing your diabetes. Learn all you can about diabetes. Establish a relationship with a diabetes educator,
and ask your diabetes treatment team for help when you need it. • Choose healthy foods and maintain a healthy
weight. Losing just 7 percent of your body weight
if you’re overweight can make a significant difference in your blood sugar control. A healthy diet is one with plenty of fruits,
vegetables, whole grains and legumes, with a limited amount of saturated fat. • Make physical activity part of your daily
routine. Regular exercise can help prevent prediabetes
and type 2 diabetes, and it can help those who already have diabetes to maintain better
blood sugar control. Thirty minutes of moderate exercise — such
as brisk walking — most days of the week is recommended. A combination of exercises — aerobic exercises,
such as walking or dancing on most days, combined with resistance training, such as weightlifting
or yoga twice a week — often helps control blood sugar more effectively than does either
type of exercise alone. Lifestyle for type 1 and type 2 diabetes
In addition, if you have type 1 or type 2 diabetes:
• Identify yourself. Wear a tag or bracelet that says you have
diabetes. Keep a glucagon kit nearby in case of a low
blood sugar emergency — and make sure your friends and loved ones know how to use it. • Schedule a yearly physical and regular
eye exams. Your regular diabetes checkups aren’t meant
to replace yearly physicals or routine eye exams. During the physical, your doctor will look
for any diabetes-related complications and screen for other medical problems. Your eye care specialist will check for signs
of retinal damage, cataracts and glaucoma. • Keep your vaccinations up to date. High blood sugar can weaken your immune system. Get a flu shot every year, and your doctor
may recommend the pneumonia vaccine, as well. The Centers for Disease Control and Prevention
(CDC) also currently recommends hepatitis B vaccination if you haven’t previously been
vaccinated against hepatitis B and you’re an adult ages 19 to 59 with type 1 or type
2 diabetes. The most recent CDC guidelines advise vaccination
as soon as possible after diagnosis with type 1 or type 2 diabetes. If you are age 60 or older, have diabetes,
and haven’t previously received the vaccine, talk to your doctor about whether it’s right
for you. • Pay attention to your feet. Wash your feet daily in lukewarm water. Dry them gently, especially between the toes. Moisturize with lotion, but not between the
toes. Check your feet every day for blisters, cuts,
sores, redness or swelling. Consult your doctor if you have a sore or
other foot problem that doesn’t heal promptly on its own. • Keep your blood pressure and cholesterol
under control. Eating healthy foods and exercising regularly
can go a long way toward controlling high blood pressure and cholesterol. Medication may be needed, too. • Take care of your teeth. Diabetes may leave you prone to more-serious
gum infections. Brush and floss your teeth at least twice
a day. And if you have type 1 or type 2 diabetes,
schedule regular dental exams. Consult your dentist right away if your gums
bleed or look red or swollen. • If you smoke or use other types of tobacco,
ask your doctor to help you quit. Smoking increases your risk of various diabetes
complications. Smokers who have diabetes are more likely
to die of cardiovascular disease than are nonsmokers who have diabetes, according to
the American Diabetes Association. Talk to your doctor about ways to stop smoking
or to stop using other types of tobacco. • If you drink alcohol, do so responsibly. Alcohol can cause either high or low blood
sugar, depending on how much you drink and if you eat at the same time. If you choose to drink, do so only in moderation
— one drink a day for women of all ages and men older than 65, and up to two drinks
a day for men age 65 and younger — and always with food.Remember to include the carbohydrates
from any alcohol you drink in your daily carbohydrate count. And check your blood sugar levels before going
to bed. • Take stress seriously. The hormones your body may produce in response
to prolonged stress may prevent insulin from working properly, which will raise your blood
sugar and stress you even more. Set limits for yourself and prioritize your
tasks. Learn relaxation techniques. And get plenty of sleep. Treatments for type 1 and type 2 diabetes
Treatment for type 1 diabetes involves insulin injections or the use of an insulin pump,
frequent blood sugar checks, and carbohydrate counting. Treatment of type 2 diabetes primarily involves
monitoring of your blood sugar, along with diabetes medications, insulin or both. • Monitoring your blood sugar. Depending on your treatment plan, you may
check and record your blood sugar as often as several times a week to as many as four
to eight times a day. Careful monitoring is the only way to make
sure that your blood sugar level remains within your target range. People who receive insulin therapy also may
choose to monitor their blood sugar levels with a continuous glucose monitor. Although this technology doesn’t yet replace
the glucose meter, it can provide important information about trends in blood sugar levels.Even
with careful management, blood sugar levels can sometimes change unpredictably. With help from your diabetes treatment team,
you’ll learn how your blood sugar level changes in response to food, physical activity, medications,
illness, alcohol, stress — for women, fluctuations in hormone levels.In addition to daily blood
sugar monitoring, your doctor will likely recommend regular A1C testing to measure your
average blood sugar level for the past two to three months. Compared with repeated daily blood sugar tests,
A1C testing better indicates how well your diabetes treatment plan is working overall. An elevated A1C level may signal the need
for a change in your insulin regimen or meal plan. Your target A1C goal may vary depending on
your age and various other factors. However, for most people with diabetes, the
American Diabetes Association recommends an A1C of below 7 percent. Ask your doctor what your A1C target is. • Insulin. People with type 1 diabetes need insulin therapy
to survive. Many people with type 2 diabetes or gestational
diabetes also need insulin therapy.Many types of insulin are available, including rapid-acting
insulin, long-acting insulin and intermediate options. Depending on your needs, your doctor may prescribe
a mixture of insulin types to use throughout the day and night.Insulin can’t be taken orally
to lower blood sugar because stomach enzymes interfere with insulin’s action. Often insulin is injected using a fine needle
and syringe or an insulin pen — a device that looks like a large ink pen. An emerging treatment approach, not yet available,
is closed loop insulin delivery, also known as the artificial pancreas. It links a continuous glucose monitor to an
insulin pump. The device automatically delivers the correct
amount of insulin when the monitor indicates the need for it. There are a number of different versions of
the artificial pancreas, and clinical trials have had encouraging results. More research needs to be done before a fully
functional artificial pancreas can receive regulatory approval.However, the first step
toward an artificial pancreas was approved in 2013. Combining a continuous glucose monitor with
an insulin pump, this system stops insulin delivery when blood sugar levels drop too
low. Studies on the device found that it could
prevent low blood sugar levels overnight without significantly increasing morning blood sugar
levels. • Oral or other medications. Sometimes other oral or injected medications
are prescribed as well. Some diabetes medications stimulate your pancreas
to produce and release more insulin. Others inhibit the production and release
of glucose from your liver, which means you need less insulin to transport sugar into
your cells. Still others block the action of stomach or
intestinal enzymes that break down carbohydrates or make your tissues more sensitive to insulin. Metformin (Glucophage, Glumetza, others) is
generally the first medication prescribed for type 2 diabetes. • Transplantation. In some people who have type 1 diabetes, a
pancreas transplant may be an option. Islet transplants are being studied as well. With a successful pancreas transplant, you
would no longer need insulin therapy. But transplants aren’t always successful — and
these procedures pose serious risks. You need a lifetime of immune-suppressing
drugs to prevent organ rejection. These drugs can have serious side effects,
including a high risk of infection, organ injury and cancer. Because the side effects can be more dangerous
than the diabetes, transplants are usually reserved for people whose diabetes can’t be
controlled or those who also need a kidney transplant. • Bariatric surgery. Although it is not specifically considered
a treatment for type 2 diabetes, people with type 2 diabetes who also have a body mass
index higher than 35 may benefit from this type of surgery. People who’ve undergone gastric bypass have
seen significant improvements in their blood sugar levels. However, this procedure’s long-term risks
and benefits for type 2 diabetes aren’t yet known.

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