Having Kids With Type 1 Diabetes

Both my son's have Type 1 Diabetes and it seems more and more kids lately are developing this mystery disease. But what Is Type 1 Diabetes? According to the Junior Diabetes Research Foundation, they simply explain it this way:

"Type 1 diabetes (juvenile diabetes) can occur at any age, but most commonly is diagnosed from infancy to the late 30s. In this type of diabetes, a person's pancreas produces little or no insulin. Although the causes are not entirely known, scientists believe the body's own defense system (the immune system) attacks and destroys the insulin-producing cells in the pancreas. People with type 1 diabetes must inject insulin several times every day."

When our oldest, Russell, got sick, we had no idea what the symptoms where. Honestly, we thought he was going through a growth spurt. But is just wasn't right. He was thirsty all the time, soaked his bed every night, lethargic and eating more then normal but losing weight. I took him to the doctor and they did a simple urine test and checked his blood. At the time his brother was only 4 months old and sleeping in my arms. As soon as the tests came back, the Dr. told me I need to get him to the ER right away! I called my husband and we raced to Children's Hospital. He spent 1 night in the ICU as his blood sugar numbers where so high and out of control.

We felt guilty waiting so long to take him in, but honestly had no idea what was going on in his body. He spent 4 days total at the hospital (they did move him to a reg. room after the first day) so my husband and I could be educated on how to take care of him at home.

A few short years later, his little brother Brian was also diagnosed weeks before his 3rd birthday. He was showing the same symptoms for about a week or so and so we used his big brothers meter to check his blood sugar. Finally, while on Russell's 7th birthday, we decided to take Brian to Children's Hospital as the blood sugar meter kept saying "hi" (meaning his numbers where over 600). He spent 5 days at Children's Hospital because he also developed a viral infection.

So now we have two kids with Diabetes, two kits, two sets of insulin, meters, syringes, test strips, etc. All the tools of the trade to manage this mystery disease from home. But we do manage it. The kids have taken it on as normal as brushing their teeth.

Both my kids are on Lantus (long acting insulin) and Humalog (short acting). Every morning they each get a shot of Lantus, units are different for each child due to age and weight. The Humalog is given every time they eat food with carbohydrates that fall within a ratio of their target blood sugar. For example, at lunch, my youngest may eat food that ads up to 25 grams of carbs, so if his blood sugar is within its normal range before he eats, his shot will be 1 unit of Humalog. Same applies with his big brother, just a different dosage ratio.

How do we figure out their dosages for Lantus and Humalog? Every three months since the date of their diagnosis, we visit the Endocrine Clinic at Children's Hospital here in Seattle. Their Dr. takes a blood sample, much like their finger pokes and that will tell her their A1C levels (A1C is a test that measures a patient's blood glucose level over the previous three months that might also help predict serious health complications like heart attack and stroke).

They also download their blood glucose meters to get a readout of their average blood sugars over the last few months. With this information, she can decide where the peaks and lows are, and where the Lantus and Humalog may need adjusting. Their Dr also has a computer program on the hospital database that helps with the calculations as well as "cheat sheets" we use for each child. You see. They many times have different dosages for the Humalog for EACH meal during the day, for EACH child. A chart for Breakfast, Lunch and Dinner (if they eat a snack, for example, mid morning, I use the dosage for breakfast to treat it if necessary).

We've been very lucky with Children's Hospital, they've got the best Endocrine team there and have helped us weather many storms through both boys dealing with illness or simply not able to get their numbers under control.

This leads me to another thing we have to watch out for, ketones. Or as we like to tell our kids, we need to fight the "ketone monsters".

What are Ketones?

Ketones are due to not enough insulin being available to meet the body's needs. The 2 main causes are illness/infections (the body needs extra energy to fight off a virus or bad cold) or forgetting to take an insulin shot. There are other causes, but the primary ones we've had to deal with are the two mentioned. Another bugger, which is worse, is acidosis.

Now acidosis is the result of letting ketones get out of hand. Perhaps insulin isn't available due to an emergency situation, or the person is simply not taking care of their diabetic needs properly. See, it is not high blood sugar that causes ketones or acidosis; eating sugar does not cause acidosis. Ketones come from the breakdown of body fat. The role of insulin is to shut off fat breakdown. Now if the stress hormones are high or there simply isn't enough insulin, fat will begin to break down. And the side product of fat breakdown is ketones production. In the early stages, it can be tested with urine. But if left undetected, ketones can also build up in the blood and eventually in the body tissues. When it gets this far, it will result in acidosis (DKA).

For example, my youngest spent a week at Children's Hospital when he got the stomach flu last February. He was so sick; we couldn't get him to keep any food or liquid down. Because he wasn't eating, his blood sugar dropped low, and we couldn't give him insulin to deal with the heavy ketones because he wasn't eating. So in turn, he was on an IV drip to help rehydrate his little system as well as supply glucose for his body to work with. Even the smallest amount of long acting insulin dropped him low to the point the Glucagon wouldn't work (that is an emergency glucose administered through as a shot to help the body draw stores of sugar from the liver). But because we where able to get him in and on an IV drip, he never got as far as DKA.

Our oldest son has also developed ketones because of the flu and or a head cold. His body will have really high blood sugars (only a couple of times has he had heavy ketones and low blood sugars, luckily never needing to be admitted, but did have an ER visit). So we follow a sick day management regimen and different calculations according to how heavy his ketones are so we know how much extra insulin he needs to get his blood sugar under control. As with any illness, lots of fluids, especially water are a necessity but even more so with diabetics.

So anytime my kids come down with even just a sniffel, we're on them to check for ketones and watching their blood sugars closely. We have test strips that can be dipped in urine that show a color code to how light or heavy their ketones are. Staying on top of their sick day management has prevented many trips to the ER.

What can my kids eat?

Anything! What is so nice about the insulin they're on; they're not restricted to how much food or type of food they can eat. We do, however watch how much fat (limited "fast food" and "junk food") and salt intake because it raises blood pressure as well as threatens the circulatory system. The reason fat restriction is very important because high cholesterol and diabetes are two of the four risk factors for developing heart disease. (The other two for developing heart disease is smoking and family history).

So I make a lot of my own foods for home. I've posted many of our favorite recipes at The Poor Chef website. I also input the nutrition information on a program I use at home that gives me the carb amount on home recipes per serving (FitDay.com). Another great resource for food items, especially if you're eating out (most restaurants now supply nutrition info) is a pocket book from Calorie King. I keep a copy in the car just in case, trust me, having extra resources to go to in a snap is so handy.

What about school?

Again, we are very lucky to have a great school district who supplies a full time nurse. Nurse Alice is the best. We have a system down for my oldest son Russell. I make his lunch and provide all the carb info for what is packed. She just has to add up what he's eaten and is able to use the "cheat sheets" I've provided so she knows how much insulin to give him at lunch time. We talk almost every day about his numbers so I have a complete log for when it's time to go to the doctor. It's a team effort and I can use all the help I can get. Brian isn't quite ready for school yet, but I know he'll be well taken care of when it's time.

I can't say it's been an easy road and wouldn't wish it on anyone. But if you're reading this and have a loved one with Type 1 Diabetes, I hope the information has been of some help. It's an ongoing education and we're so grateful to live in a time where medical breakthroughs are happening all the time. Who knows, maybe by the time my kids are in high school, there may be a cure for Diabetes. Until then, we'll keep managing their care, not let it get us down or hold us back from living a happy and normal life.

For more information regarding Type 1 Diabetes, please visit:

http://www.jdrf.org

"Understanding Diabetes, A Handbook for People Who Are Living with Diabetes", by H. Peter Chase, MD (aka: The Pink Panther Book)

This Article is Written by Kathleen Schmidt (c) 2009

Kathleen Schmidt:

Domestic Goddess and Work At Home Mom

877-762-1450

Diabetics - How Low is Too Low (Your Blood Sugar)

Diabetes is a dangerous condition. It is best controlled with insulin in type I diabetics. These individuals have been affected with diabetes since childhood or developed it later in life. It usually follows a hereditary pattern. Type II diabetics ,usually develop the condition later in life. Avoidable factors such as a sedentary lifestyle, bad diet, and obesity are common. Type II diabetics do not need to inject insulin, if they can control their blood sugar levels with diet and exercise and if necessary, the addition of oral medications. If this does not work, they will also need insulin for blood sugar control.

Insulin is a wonderful discovery for people afflicted with diabetes. It acts in the body, the same way the insulin from our pancreas does for controlling blood sugar levels in the blood. Without insulin, diabetics would live a shorter life due to the complications from the disease. It truly is a miracle discovery. The lifestyle of the diabetic person can return to normal, well almost. Injecting substances into our bodies is not normal, but it is necessary replacement therapy for these individuals.

Insulin and blood sugar control is a tedious process, and should be taken seriously. There are long acting 24 hour insulins, shorter acting 6-18 hour insulins, and fast acting insulins. Often, the patient is put on more than one kind for more rigorous control. Another marvelous invention is the blood glucose monitor. Previous to it's presence in the diabetic world, Glucose samples were tested with a person's urine. The readings acquired for urine were not an accurate indicator of what was going on in the body at that moment. The urine tests gave an approximate reading. And the reading at that time may have given an indication of what was going on in the body hours before. Now, with blood glucose monitors, a person can check the blood sugar level in their body at any moment, and as often as they wish.

Many times, a diabetic person will become over aggressive in their blood sugar control. They will test their blood sugar level and inject enough insulin to cover the reading. This injection is also given to control caloric intake in the hours ahead. This all well and good in a perfect world. But if it were a perfects world people would not be afflicted with diabetes.

Things happen. Let's say Dan the diabetic has been given a sliding scale to follow insulin therapy. This takes into account the present reading and the caloric intake of Dan in hours to come. Ideally, this works well. And in most cases it does. But what happens when there are variables. Dan is on his way home from work to have dinner with his beautiful family. Bang! his front tire blows out. Dan pulls of the busy road and proceeds to change the tire. It is 95 degrees outside and humid. Dan has a difficult time loosening the lug nuts, which were last tightened by an automatic fastener in the tire shop. He finally changes the tire. Dan has burned a fair amount of calories in the tire changing process. Now he if caught up in rush hour traffic. Dan is on his way to getting home 2 hours later than he had planned. The insulin level in Dan's body does not adjust to the caloric output ot the delayed schedule, as it would in a non-diabetic person. So the insulin level runs high and blood sugar low. This is not a good situation.

Hypoglycemia ( low blood sugar ) has adverse effects. As it starts to run low, the patient becomes hot and clammy. Some shakiness sets in. If it goes lower the symptoms get progressively worse. They can exhibit convulsive type shakes. They become disoriented and confused. Communicating becomes a problem. If no one around them, knows about their condition, thing could worsen. In the worst case scenario a patient on insulin, running low blood sugar could go into insulin induced shock. Possibly, the patient could go into a coma. And whether that patient get better or not, depend on what action is taken and how soon it is taken to change the blood sugar levels.

This is very preventable. There are products, prescription, over the counter, fruit juices, candy and more. We will just talk about some over the counter products you can purchase at your local drugstore. The diabetic person should at all times, carry with him glucose tablets, glucose gel, or glucose solutions. All of these are absorbed quickly from the gastrointestinal tract, right into the bloodstream. As soon as the patient feels any symptoms of low blood glucose, he should ingest a glucose product previously mentioned. Or if he runs into a predicament, like Dan did, then he should take it as a precautionary measure. This will prevent severe hypoglycemic reactions from occurring.

My diabetic friends, please carry one or more of the glucose products mentioned on your person. As it has been said - S**t Happens! It may not be your fault, if it happens. But you are going to be the one to suffer the consequences. It is, also, a good idea to make those you are with aware of your condition. They could turn out to be a life saver. Take your blood glucose readings. Monitor your blood glucose. Use your insulin. Eat what you were prepared to eat. And, carry those oarl glucose products with you at all times.

Written by John Markus at http://www.feelmorelife.com John had been a pharmacist for 33 years. His wife has type I diabetes. Also, his eight year old granddaughter has diabetes. He and his family have been dealing with these type of problems for a long time. Tough at times, but successfully in end. He also, has studied exercise, nutrition, and disease states for 30 plus years.

Diabetes 101 - How to Win at Life and Life Insurance

A recent article from the Hilton Head Health Institute stated, "The evidence is growing that diabetes - especially "late onset" type 2 diabetes - is becoming an epidemic. American's well-known attachment to the "couch potato" lifestyle - fatty, high calorie foods and an aversion to exercise - may be the contributing factor to the spread of the disease. On the opposite side of the coin, the healthy lifestyle is believed to contribute to diabetes prevention and management." A January 9, 2006 New York Times article declared, "that the Centers for Disease Control estimate that 21 million Americans are currently diabetic while 41 million more are suffering from pre-diabetic symptoms, and many aren't even aware of it yet. Over the past decade, the rate of diabetes has increased 80% in the US. Yet most health officials still emphasize the threat of communicable diseases, which are far less deadly than chronic conditions such as diabetes."

Any life insurance agent that has been around for very long will attest to the statements made in that article. Diabetics now make up a large percentage of our client base and the number of people diagnosed as diabetic or pre or borderline diabetic on life insurance exams has sky rocketed. While most diabetics are insurable at fair rates, it is alarming to see how many diabetics have truly stayed somewhat uneducated about their condition and do not fully comprehend or care about the fact that diabetes can have a compounding effect on other health issues and ultimately be at least the root cause of a health decline that leads to an early death. Those diabetics who do take the situation seriously, educating themselves, monitoring their diabetes and taking control of other risk factors such as hypertension and obesity, can ultimately lead a long, healthy life. Not surprising that this group is also rewarded with life insurance rates that reflect their concern with their own longevity. It should be no secret that life insurance companies reward those who have an interest in their own mortality.

Those that do not take care of themselves are usually still insurable, but will pay a premium that reflects the end of the risk pool they have chosen to swim in. Not understanding the disease, not monitoring your glucose on a regular basis, not changing your lifestyle and not being compliant with your physician's suggestions will all contribute to higher rates that you really have to pay if your concern factor was a bit higher. Good quiz for a diabetic: Do you know what your hbA1C, or A1C level is? Do you even know what it is referring to? The A1C, a test done by your physician every time you have a checkup is a measure of how well you are controlling your diabetes. Blood glucose binds to the hemoglobin through a process called glycosylation. The higher the blood sugar the more the glucose binds to the hemoglobin. A blood test can measure the amount of glycosylation that has occurred revealing the average blood glucose levels for the previous three to four months before the test.

Do you understand why this is important to you? With a healthy A1C level of say, 6.5 or less, you know that your glucose is staying in check over long periods. Do not fool yourself into believing that the glucose reading you took before breakfast this morning is indicative of where your glucose is all the time. For instance, let us say you take your glucose at an optimal time, before breakfast, and the reading is 110. Then let us assume that your A1C is 7.5. That would indicate that your average glucose over the last 3 months is around 165. So, if the average is 165 and the low end is 110, that means that there are many times when your glucose is well over 200, not a healthy level. What are the complications of type 2 diabetes? What really worries life insurance underwriters? This list came from the American Diabetes Association website. www.diabetes.org:

Heart Disease and Stroke

People with diabetes have extra reason to be mindful of heart and blood vessel disease. Diabetes carries an increased risk for heart attack, stroke, and complications related to poor circulation.

Kidney Disease

Diabetes can damage the kidneys, which not only can cause them to fail, but can also make them lose their ability to filter out waste products.

Eye Complications

 

Diabetes can cause eye problems and may lead to blindness. People with diabetes do have a higher risk of blindness than people without diabetes. Early detection and treatment of eye problems can save your sight.

Diabetic Neuropathy and Nerve Damage

One of the most common complications of diabetes is diabetic neuropathy. Neuropathy means damage to the nerves that run throughout the body, connecting the spinal cord to muscles, skin, blood vessels, and other organs.

Foot Complications

People with diabetes can develop many different foot problems. Foot problems most often happen when there is nerve damage in the feet or when blood flow is poor. Learn how to protect your feet by following some basic guidelines.

Skin Complications

As many as one-third of people with diabetes will have a skin disorder caused or affected by diabetes at some time in their lives. In fact, such problems are sometimes the first sign that a person has diabetes. Luckily, most skin conditions can be prevented or easily treated if caught early.

Gastroparesis and Diabetes

Gastroparesis is a disorder that affects people with both type 1 and type 2 diabetes.

Depression

Feeling down once in a while is normal. But some people feel a sadness that just won't go away. Life seems hopeless. Feeling this way most of the day for two weeks or more is a sign of serious depression.

Ultimately there is good news for type 2 diabetics working to acquire life insurance. With improvements in treatment and all of the available diabetic education, you can control your condition and to a great extent control your ability to get affordable life insurance. Type 1 diabetes Type 1 diabetes, often called juvenile diabetes, is different from type 2 diabetes but often has many of the same complications. While type 2 diabetes is occurs when a person has too little natural insulin or his or her body is not able to use the insulin `effectively, type 1 diabetes is the absence of insulin altogether. From www.ehealthmd.com we get this take on the cause of type 1 diabetes. "Diabetes is an autoimmune disease. That means the body's defense system attacks some of the body's own cells. In type 1 diabetes, the cells in the pancreas that make insulin are destroyed, and therefore they are no longer capable of making insulin.

We don't know exactly why this happens, but we do know that some people are born with a tendency to develop diabetes. Then something "triggers" the onset of the disease. It may be a virus that triggers the onset, or it may be something in the environment. There is nothing a person can do to prevent this from happening."

That having been said, a person with type 1 diabetes is left with two options. They can control their diabetes by persistently monitoring their glucose levels and being very committed and dogmatic about administering insulin as prescribed. There is an often-misunderstood relationship between diet and diabetes. The Mayo Clinic's website at www.mayoclinic.com suggests the following: "Contrary to popular perception, there is no diabetes diet. Furthermore, having diabetes doesn't mean you have to eat only bland, boring foods. Instead, it means you'll eat more fruits, vegetables and whole grains - foods that are high in nutrition and low in fat and calories - and fewer animal products and sweets. Actually, it's the same eating plan everyone should follow." So, a healthy diet and persistent monitoring and treatment are the key.

The other option I suggested would be the option of not taking your diabetes seriously. A type 1 diabetic who only occasionally checks their glucose, is not horribly committed to a healthy lifestyle, and may not take insulin as prescribed, but more when they think they need it, is a person who is looking for a long-term health problem. The long-term affects of mismanaged type 1 diabetes are at best damaging and at worst deadly. It should be no wonder that life insurance underwriters pay special attention to the type of compliance you keep with your doctor and dietician and the type of control you have achieved and maintained with your glucose levels.Again, you will not impress a life insurance underwriter, or for that matter, a life insurance agent who is knowledgeable about diabetes by telling them your most recent glucose reading was 98. That may be control, but it might also be a well-timed glucose check. The real story comes from your regular lab work and the test that reveals all secrets, the hbA1C. This test will take both your 98 and 230 into account; the reading you did not want to discuss or possibly did not even take because you knew it was bad timing for a good reading.

Your doctor and the life insurance underwriter are preaching from the same book, and the sermon is CONTROL! CONTROL! CONTROL!The Mayo Clinic sums up the repercussions of not following that advice. "Long term complications include - Heart and blood vessel (cardiovascular) disease - Nerve damage (neuropathy) - Kidney damage (nephropathy) - Eye damage (diabetic retinopathy) - Osteoporosis and several skin conditions." "Short term complications such as low blood sugar (hypoglycemia), high blood sugar (hyperglycemia) and a high level of ketones in your urine (diabetic ketoacidosis), require immediate care. If left untreated, these conditions can cause seizures and loss of consciousness (coma)." In summation it seems clear that whether type 1 or type 2 diabetes, the conditions are something that simply has to be taken seriously or the results can be disastrous and deadly. This fact is not lost on the people who decide what rate you are going to pay for life insurance. Diabetes does not preclude getting life insurance at competitive and good rates. Poorly controlled diabetes, for abundantly obvious reasons, may very well make life insurance expensive and even unattainable.

Diabetes And Feet: Why A Podiatrist Is A Vital Part Of A Diabetic's Care

Diabetes is a serious disease that affects millions of Americans, and that number is going to astronomically grow as the baby boomer generation ages further. Complications associated with diabetes can be devastating, and can lead to organ failure and even death. Foot-related complications in particular are very common in diabetes, and unfortunately cause the majority of leg amputations performed by surgeons. Comprehensive care by a podiatrist can identify foot problems early before they lead to leg loss, and in many cases can prevent those problems in the first place. This article will discuss the ways a podiatrist can protect diabetic feet, and ultimately save a diabetic's limb and life.

Diabetes is a disease in which glucose, the body's main source of 'fuel', is not properly absorbed into the body's tissues and remains stuck in the bloodstream. Glucose is a type of 'sugar' derived from the body's digestion of carbohydrates (grains, breads, pastas, sugary food, fruits, starches, and dairy) The body needs a hormone called insulin, which is produced in the pancreas, to coax the glucose into body tissue to fuel it. Some diabetics are born with or develop at a young age an inability to produce insulin, resulting in type 1 diabetes. The majority of diabetics develop their disease as they become much older, and the ability of insulin to coax glucose into tissue wanes due to a sort of resistance to or an ineffectiveness of the action of insulin. This is called type 2 diabetes. Diabetes can also develop from high dose steroid use, during pregnancy (where it is temporary), or after pancreas disease or certain infections. The high concentration of glucose in the blood that remains out of the body tissue in diabetes can cause damage to parts all over the body. Organs and tissue that slowly are damaged by high concentrations of glucose stuck in the blood include the heart, the kidneys, blood vessels, the brain, the nerve tissue, skin, and the immune and injury repair cells. The higher the concentration of glucose in the blood, and the longer this glucose is present in the blood in an elevated state, the more damage will occur. Death can occur with severe levels of glucose in the blood stream, although this is not the case in most diabetics. Most diabetics who do not control their blood glucose well develop tissue damage over a long period of time, and serious disease, organ failure, and the potential for leg loss does eventually arrive, although not right away.

Foot disease in diabetes is common, and one of the more devastating and taxing complications associated directly and indirectly with high blood sugar. Foot disease takes the form of decreased sensation, poor circulation, a higher likelihood of developing skin wounds and infections, and a decreased ability to heal those skin wounds and infections. Key to this entire spectrum of foot complications is the presence of poor sensation. Most diabetics have less feeling in their feet than non-diabetics, due to the indirect action increased glucose has on nerve tissue. This decreased sensation can be a significant numbness, or it can be a mere subtle numbness that makes sharp objects seem smooth, or erases the irritation of a tight shoe. Advanced cases can actually have phantom pains of burning or tingling in addition to the numbness. With decreased sensation comes a much greater risk for skin wounds, mostly due to the inability to feel pain from thick calluses, sharp objects on the ground, and poorly fitting shoes. When a wound has formed as a result of skin dying under the strain of a thick corn or callus, from a needle or splinter driven into the foot, or from a tight shoe rubbing a friction burn on the skin, the diabetic foot has great difficulty starting and completing the healing process. Untreated skin wounds will break down further, and the wound can extend to deeper tissue, including muscle and bone. Bacteria will enter the body through these wounds, and can potentially cause an infection that can spread beyond the foot itself. A diabetic's body has a particularly difficult time defending itself from bacteria due to the way high glucose affects the very cells that eat bacteria, and diabetics tend to get infected by multiple species of bacteria as well. Combine all this with decreased circulation (and therefore decreased distribution of nutrients and chemicals to preserve foot tissue and help it thrive), and one has all the components in place for a potential amputation. Amputations are performed when bacteria spreads along the body and threatens death, when wounds and foot tissue will not heal as a result of gangrene from advancing tissue death and infection, and when poor circulation will not allow the tissue to thrive ever again. The statistics following a leg amputation are grim: about half of diabetics who undergo one amputation will require an amputation of the other foot or leg, and about that same number in five years will be dead from the heart strain endured when one's body has to expend energy to use a prosthetic limb.

A podiatrist can ensure that all the above complications are significantly limited, and in some cases prevented all together. Podiatrists are physicians who specialize solely in the care of foot and ankle disease, through medicine and surgery. The attend a four year podiatric medical school following college, and enter into a two or three year of hospital-based residency program after that to hone their advanced reconstructive surgical skills, and to study advanced medical. Podiatrists are generally considered the experts on all things involving the foot and ankle, and their unique understanding amongst other medical specialties of how the foot functions in relationship to the leg and ground (biomechanics) allows them to target therapy towards controlling or changing that function in addition to treating tissue disease. A great majority of the problems that lead to diabetic amputations start off as problems related to the structure of the foot and how it relates to the ground and to the shoe worn above. Controlling or repairing these structural problems will often result in prevention of wounds, which in turn will prevent infection, gangrene, and amputation.

To start with, a podiatrist will provide a diabetic patient with a complete foot exam that takes into account circulation, sensation, bone deformities, and skin issues, and pressures generated by walking and standing. From this initial assessment, a protection and treatment course can be created specific to the individual needs of the diabetic for maintenance, protection, and active treatment of problems that do develop. Commonly performed maintenance services include regular examinations several times a year to identify developing problems, care of toe nails to prevent a diabetic with poor sensation from accidentally cutting themselves when attempting to trim their nails, regular thinning of calluses to prevent wounds from developing, and repetitive education on diabetic foot problems to ensure proper habits are followed. Preventative services include using special deep shoes with protective inserts in diabetics at-risk for developing wounds from regular shoes, assessment of potential circulation problems with prompt referral to vascular specialists if needed, and possible surgery to reduce the potential of wounds to develop over areas of bony prominences. Active treatment of foot problems performed by a podiatrist involves the care and healing of wounds, the treatment of diabetic infections, and surgery to address serious foot injury, deep infections, gangrene, and other urgent problems. Because of a podiatrist's unique understanding of the way the foot structure affects disease and injury, all treatment will be centered around the principles of how the foot realistically functions in conjunction with the leg and the ground. This becomes invaluable in the struggle to prevent diabetic wounds and infections, while allowing one to remain mobile and active at the same time.

The essential goal of a podiatrist in caring for a diabetic patient is to prevent wounds, infections, and the amputations that result. This philosophy is called limb salvage, and it is accomplished through the above listed methods. Because of the severity of foot disease as a complication of diabetes, a podiatrist is an integral part of a diabetic's care, and sometimes can even be the physician that diagnoses diabetes in the first place if foot disease appears as an early symptom of undiagnosed diabetes. For these reasons, all diabetics should be assessed by a podiatrist for potential problems, and those at-risk for foot wounds and infections should have regular foot examinations and preventative treatment. As a final note, online resources by podiatrists discussing diabetic foot issues abound, including a regular blog by this author ( thediabeticfoot.blogspot.com ). While these resources do not replace a diabetic foot exam, they do help educate diabetics on how best to care for their feet, and what to do if problems develop. This can lead to better knowledge and understanding of foot issues when diabetics begin to see a podiatrist regularly, and can help prevent early foot complications from developing.]

Dr. Kilberg provides compassionate and complete foot and ankle care to adults and children in the Indianapolis area. He is board certified by the American Board of Podiatric Surgery. He enjoys providing comprehensive foot health information to the online community. Visit the website of this Indianapolis foot doctor for more information.

10 Things I Wish I Knew When I First Got Diabetes

1)    You can adjust your insulin to your diet rather than adjusting your diet to your insulin.

Most diabetics follow a fairly structured diet and insulin regimen when it comes to managing their diabetes. This offers them the best opportunity to consistently keep their blood glucose levels within an acceptable range.

I, as I do with many things in life, decided to head down a different path. I manage my diabetes with a sliding scale of insulin that I adjust to the number of carbohydrates consumed on a per meal basis. Yes this does mean that I take a shot of insulin every time I eat but it also means I can eat a full plate of pasta one night and 16 ounce steak the next. Or I can eat lunch at noon on Monday and three on Tuesday.

The flexibility this offers far outweighs the slight pain of taking one or two extra shots of insulin per day. In my case it also leads to better overall control of my blood sugar.

2)    You can order 3 months worth of prescriptions at a time which saves a ton of money.

After leaving the hospital and or being diagnosed with diabetes you head home with a pocket full of prescriptions and an assumption that your local pharmacy is your best option as it was for pain relievers after your last root canal. This is not the case with many if not all of your diabetes prescriptions.

Personally I take two types of insulin, Humalog as a short acting insulin and Lantus as a long acting insulin. At Walgreens using my current insurance provider it cost $12 per prescription for approximately one month worth of Humalog and 3 months worth of Lantus.

About a year later I realized that same insurance company, and every insurance company I have had since, offered a mail order prescription service where you could get a much larger prescription supply for the same cost or less than what you paid at your local pharmacy. Additional benefits to this method include prescriptions being mailed directly to your home or work, Doctors being able to write a years worth of prescriptions at one time, and the ability to order refills online.

In my case I received a three month supply of Humalog and six month supply of Lantus at $8 dollars per prescription. Not a huge savings but every little bit helps, especially in this economy.

3) There are a ton of options when it comes to choosing a glucose monitor, test strips, and needles.

Along with the pocket full of prescriptions you will likely also have a fairly lengthy supply list to purchase as well. If you are anything like me you will head out and purchase whatever brands and products you were exposed to at the hospital. This usually occurs for one of two reasons. One you are under the impression that whatever the hospital was using has to be the best option for you, or two, you are as unaware as I was to the large number of choices out there for diabetes management products.

The following are just a few of the products I would investigate and try out multiple options on before settling on a long term product. There are huge savings to be found depending on brand and where you purchase your supplies.

Blood Glucose Monitor and Test strips - Test strips can vary from $1 per test strip to $.30 per test strip depending on brand and quantity ordered.

Lancets - Lancets are offered in many different lengths and gauges. You can go a long way in limiting your discomfort by choosing the correct lancet.

Syringes and/or pen needles - Similar to lancets needles are offered in a wide variety of lengths and thicknesses. I personally go with the thinnest and shortest needle available. 3/16th of an inch in length and 31 gauge for thickness.

Alcohol swabs - Pretty cheap anywhere you shop but you might as well get the best deal available.

4)    Choose your Dr. and any other members of your health care team wisely.

Choosing your health care team is one of the most important decisions you will make after being diagnosed with diabetes. You want a team consisting of not just competent professionals but also of people you feel 100% comfortable with. There are many sensitive issues you will discuss all of which require total honesty between you and your doctor.

Did you cheat on your diet? Do you smoke? How often do you consume alcohol? How often do you exercise? To receive the best health care possible you need to be upfront and honest about these and many other questions. If you pick the right team you will be able to provide them with the information to create a diabetes management program that gives you the best chance to life a long complication free life.

5)    If managed properly being diabetic can actually improve your health.

This is one of those, get out what you put in, situations but I honestly believe being diabetic for the past 13 years has actually improved my overall health. Because of diabetes I exercise more, eat better, and drink less. I do know a few diabetics out there who neglect their diabetes but for me I decided to head down a different path.

It has been my experience with most diabetics that we are significantly more knowledgeable about nutrition and our bodies than your average individual. Some of this is by choice and some of it is out of self preservation.

In order to adequately care for your diabetes, you will need to learn the nutritional information of foods you eat, limit your intake of sugar and carbohydrates, maintain a regular exercise schedule, and have regular blood tests and eye exams. All of which will hopefully lead you down a long diabetes complication free life.

6)    Diabetes as a pre-existing condition pretty much eliminates any chance of being accepted into a private insurance plan.

Hopefully this is something that changes with one of the many health care reform bills being discussed in Washington but since there is no guarantee change will happen I will discuss this topic anyway.

If you are diabetic and have insurance through your employer, the insurance company is required to admit you to their coverage under what is usually called "Guarantee Issue Insurance". What this means is if a health insurance plan is described as "guaranteed issue," it means that applicants cannot be turned down for coverage based on their health status. Most job-based group health plans offer coverage on a guaranteed issue basis.

That being said, if you decide to leave your employer's insurance coverage and seek an individual health insurance plan you are in for an uphill battle. I was considering leaving my current job a few years back and looked into private insurance. At the time I was 24 with no diabetes complications or other health risks, and a non-smoker. I applied to 10 different individual health insurance plans and was rejected by every single one on the basis of my pre-existing condition.

At this point, at least where I live in Illinois, any diabetic attempting to secure a individual health insurance police with in all likelihood be denied. As I mentioned this will potentially be changed with the upcoming health care legislation that the Obama Administration is trying to have passed this year.

Most, if not all, of the legislation being proposed included provisions that all applicants must be granted insurance regardless of any pre-existing condition they may have.

Here's hoping....

7)    Not all carbohydrates are digested the same way.

This is one topic I would cover more with your doctor or dietitian as they will be able to guide you much better than I. What I can say is different types of carbohydrates are absorbed into the body in different ways and over different periods of time. With that certain foods will have a bigger impact on your blood sugar even though the total carbohydrate count may be the same.

8)    Diabetes increases your risks for.......

This topic is not meant to scare you but rather should be considered a word of caution that diabetes should be taken seriously. Even a person with well maintained diabetes is at greater risk for health complications as you can see from the facts below.

•    Diabetes is the leading cause of new cases of blindness among adults ages 20 to 74.
•    People with diabetes are 40 percent more likely to develop glaucoma.
•    People with diabetes are 60 percent more likely to develop cataracts.
•    Adults w/ diabetes have heart disease death rates about 2 to 4 times higher than adults w/o diabetes.
•    Diabetes is the leading cause of kidney failure, accounting for approximately 44 percent of new cases.
•    More than 60 percent of non-traumatic lower-limb amputations occur in people with diabetes.
•    Periodontal, or gum, disease is more common in people with diabetes. Among young adults, those with diabetes have about twice the risk of those without diabetes.

9)    Candy or fruit snacks work just as well as glucose pills.

This one is pretty much self-explanatory but if you are in a pinch and suffering from hypoglycemia (low blood sugar) eating or drinking anything with sugar or carbohydrates will usually correct the problem. The trick it to only have a few skittles, life savers, or fruit snacks to raise your blood sugar to the appropriate level and not eat too much and end up with hyperglycemia.

I usually have a small bag of skittles or fruit snacks stashed away wherever I am. Good places to keep them include your desk at work, purse, gym bag, car, and your backpack or briefcase.

10)    There are no carbohydrates in certain types of Alcoholic beverages.

When I first started drinking I was under the impression there was no way I could both enjoy myself as every college student should, and maintain my diabetes at the same time. After discussions with my doctor I was informed I could do both fairly easily by making smart choices when I did decide to drink. Keeping in mind that my Dr. stressed on many occasions that alcohol and diabetes should be combined only in moderation we came up with a list of drinks that were to some degree diabetes friendly. For more information please consult your Dr. or diabetes educator.

If you found the above article useful, take a look at others at http://www.newdiabetic.net

Diabetic Diet Samples

Diabetes has entered your life with a bang. Perhaps you know others who are diabetics, perhaps not. Perhaps you have friends or family members who are diabetic. Perhaps you were secretly expecting diabetes to strike, perhaps it came as a surprise. You are now faced with some important choices - first and foremost, your diet.

Any diabetic must think and plan his or her meals. This planning becomes second nature in time and will not always be as overwhelming as it may seem when you are newly diagnosed. Since the majority of diabetics suffer from Type II diabetes, or adult onset diabetes, you have likely had poor eating habits for some time now. You will now need to take some time to educate yourself and to actually sit down and write out your menu.

One of the first people that your diagnosing physician will direct you to will be a registered dietician. Your dietician will help you in planning your meals and will likely provide you with recipes for healthy eating. You will go over your own individual diet needs. Each diabetic is different. You may need to lose weight in addition to managing you diabetes. You may need to gain weight in addition to managing you diabetes. Your lifestyle will have a bearing on what your diabetic needs are. Diabetics with active lifestyles have different caloric needs than those who lead relatively sedentary lives. Your dietician will consider all of these factors and then will assist you in developing a diabetic diet sample from which you will determine the meal plan that is right for you.

With the wealth of information that is now available via the internet, diabetics have many resources right at their fingertips. Diabetics are no longer limited to the information that they are given. Diabetics are encouraged to find as much information as they can about their condition. Education is the key to living a healthy diabetic lifestyle. Many reputable diabetes organizations have internet web sites and most of them provide surfers with a diabetic diet sample. Many of these web sites have forums on which you can network with other diabetics that can offer more diabetic diet samples. Diabetics today have more information available to them than diabetics did just a decade or two ago.

A well-planned diabetic diet sample will take the reader through at least one day of planned meals. Using what will likely be the diabetic food pyramid, the diabetic diet sample should include food exchanges and how to use them. Using an example, the diabetic diet sample will build meals based on a number of exchanges to clarify the method that a diabetic will use to create his or her own meals. A diabetic diet sample may also include recipes that are based on food exchanges. Cooking a stew, for example, may include exchanges from several different food groups. You may use meat exchanges, vegetable exchanges, and fat exchanges to create a stew or casserole. Meals based on a combination of exchanges may seem difficult at first but will soon become second nature. Keeping your diabetic diet samples and your diabetic recipes close at hand will give you the tools you will need for a successful diabetic diet.

Arm yourself with as many diabetic diet samples as you can access. The more samples you have the more food choices you will have to begin with. Until you become familiar with the process of creating meals from you allotment of food exchanges, let these diabetic diet samples will be your guide. Don't' worry at first about creating your own meals. Once you are comfortable with planning your own recipes and meals, you will find that you can share your own diabetic diet samples with other newly diagnosed diabetics.

Rebecca J. Stigall is a full-time freelance writer, author, and editor with a background in psychology, education, and sales. She has written extensively in the areas of self-help, relationships, psychology, health, business, finance, real estate, fitness, academics, and much more! Rebecca is a highly sought after ghostwriter with clients worldwide, and offers her services through her website at http://www.forewordcommunications.com/

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A Natural Way of Reversing Type 2 Diabetes is Needed Now More Than Ever

Diabetes is a growing health problem in the United States and has risen about six-fold since 1950, now affecting approximately 20.8 million Americans. About one-third of those 20.8 million do not know that they have the disease. Reversing type 2 diabetes is a possibility for millions of people with the illness. A natural diabetes treatment can be used using healthy organic foods in the right combination.

Diabetes has become an epidemic that affects one out of every 12 adult New Yorkers, for example. It is a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. Diabetes is a disorder of metabolism-the way the body uses digested food for growth and energy. Most of the food people eat is broken down into glucose, the form of sugar in the blood. A natural diabetes treatment reduces the blood sugar level through proper eating habits.

Diabetes disrupts the normal balance between insulin and glucose. After a meal, carbohydrates usually are broken down into glucose and other simple sugars. You need to keep track closely of your consumption of key foods. There is software to do that. One program is called Diabetes Pilot. It organizes the information you need, whether you're at home or on the go. The mobile versions of Diabetes Pilot works as a team with Diabetes Pilot Desktop - information you enter in one can be transferred to with the other.

Diabetes Pilot records glucose measurements, insulin and other medicine, meals, exercise, blood pressure, test results, and other notes. It tracks the carbohydrate, calories, fat, protein, fiber, sodium, cholesterol and other nutrients in the foods that you eat. Diabetes Pilot has an integrated food database with information on thousands of foods, including hundreds of fast foods. It helps you see trends in your blood sugars, medications, diet, and other areas with various reports and graphs. It lets you categorize records by time of day or any other system that you'd like, further helping you to find important patterns. It also allows you to transfer your data in various ways for further analysis and communication with your health care team.

Type 2 diabetes can damage blood vessels and nerves and decrease the body's ability to fight infection. You may not notice a foot injury until an infection develops. Diabetes is running rampant in our country. Diabetes can also occur in animals. Most commonly occurs in middle age to older dogs and cats, but occasionally occurs in young animals. When diabetes occurs in young animals, it is often genetic and may occur in related animals. Treatment is based on the severity of the disease. Cats with ketoacidosis require prompt intensive care, which usually includes fluid therapy and short-acting insulin injections.

Diabetes is closely associated with severe coronary heart disease and increased risk of heart attack. Diabetes mellitus is characterized by constant high levels of blood glucose (sugar). The human body has to maintain the blood glucose level at a very narrow range, which is done with insulin and glucagon. To reversing diabetes type 2 brings glucose levels back into normal ranges.

Diabetes Health cited a study that confirms daily doses of 2,000 mg of absorbic acid improved both fasting blood glucose and HbA1c readings in patients with type 2 diabetes. Diabetes may cause nerve damage in your hands, legs and feet, or eyes. In some cases, diabetes can cause blindness or lead to amputation. Diabetes is a disability when it substantially limits one or more of a person's major life activities. Major life activities are basic activities that an average person can perform with little or no difficulty, such as eating or caring for oneself.

Diabetes is a chronic medical condition, meaning that although it can be controlled, it lasts a lifetime. To reverse type 2 diabetes through diet and exercise can be accomplished. Diabetes can cause many short term, long term, acute and chronic complications. By losing weight and following the appropriate diet, type 2 diabetes can be controlled and even reversed leading to a healthy happy lifestyle. A natural diabetes treatment that works.

Diabetes is a global problem with devastating human, social and economic impact. Today more than 250 million people worldwide are living with diabetes. Reversing diabetes naturally through diet and exercise can alleviate suffering in many cases. Diabetes symptoms may include increased thirst and urination, blurred vision, and fatigue. Being able to live without those symptoms is a significant benefit to a person afflicted with the illness.

I have been interested in the possibilities of reversing type 2 diabetes naturally and have learned so much from professional sources. I can apply the techniques I have learned into real life situations. I found an amazing resource that you can can use to reverse your type 2 diabetes here at Natural Diabetes Treatment [http://reversing-diabetes.com].