Type 1 Diabetes For Dummies

Alan L. Rubin, MD, is a physician in private practice and the author of the bestselling Diabetes For Dummies, Diabetes Cookbook For Dummies, and Thyroid For Dummies.

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