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Diabetes Mellitus TreatmentsThe goal of diabetes management is to keep blood glucose levels as close to normal as safely possible. Since diabetes may greatly increase risk for heart disease and peripheral artery disease, measures to control blood pressure and cholesterol levels are an essential part of diabetes treatment as well. People with diabetes must take responsibility for their day-to-day care. This includes monitoring blood glucose levels, dietary management, maintaining physical activity, keeping weight and stress under control, monitoring oral medications and, if required, insulin use via injections or pump. To help patients achieve this, UCSF's Diabetes Teaching Center offers self-management educational programs that emphasize individualized diabetes care. The program enables patients to make more consistent and appropriate adjustments in their therapy and lifestyle. Dietary Management and Physical ActivityModifying eating habits and increasing physical activity are typically the first steps toward reducing blood sugar levels. At UCSF Medical Center, all patients work with their doctor and certified dietician to develop a dietary plan. Our Teaching Center conducts workshops that provide patients with information on food nutrient content, healthy cooking and exercise. Insulin TherapyPeople with type 1 diabetes require multiple insulin injections each day to maintain safe insulin levels. Insulin is often required to treat type 2 diabetes too. Using an insulin pump is an alternative to injections. The pump is about the size of a pager and is usually worn on your belt. Insulin is delivered through a small tube (catheter) that is placed under the skin (usually in the abdomen). There are four major types of insulin:
Your doctor will determine your dose and how often you need to take insulin. There is no standard insulin dose as it depends on factors such as your body weight, when you eat, how often you exercise and how much insulin your body produces. Oral MedicationsSometimes blood sugar levels remain high in people with type 2 diabetes even though they eat in a healthy manner and exercise. When this happens, medications taken in pill form may be prescribed. The medications work in several different ways. These include improve the effectiveness of the body's natural insulin, reduce blood sugar production, increase insulin production and inhibit blood sugar absorption. Oral diabetes medications are sometimes taken in combination with insulin. Learn more about our Diabetes Education Online at the UCSF Diabetes Center. UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider. Recommended reading
Gestational Diabetes: Counting Carbs Counting your carbohydrate intake due to gestational diabetes? Use these menus, each of which contains 30 grams of carbohydrates, to simplify your dieting. Seeking care at UCSF HealthOverviewWhen you have diabetes, you may have high blood sugar levels (hyperglycemia) or low blood sugar levels (hypoglycemia) from time to time. A cold, the flu, or other sudden illness can cause high blood sugar levels. You will learn to recognize the symptoms and distinguish between high and low blood sugar levels. Insulin and some types of diabetes medicines can cause low blood sugar levels. Learn how to recognize and manage high and low blood sugar levels. Then you can help avoid levels that can lead to medical emergencies, such as diabetic ketoacidosis or dehydration from high blood sugar levels or loss of consciousness from severe low blood sugar levels. Most high or low blood sugar problems can be managed at home. You just need to follow your doctor's instructions. You can help avoid blood sugar problems by following your doctor's instructions on the use of insulin or diabetes medicines, diet, and exercise. Home blood sugar testing will help you see if your blood sugar is within your target range. If you've had very low blood sugar, you may be tempted to let your sugar level run high so that you don't have another low blood sugar problem. But it's so important to keep your blood sugar in your target range. To do this, follow your treatment plan and check your blood sugar regularly. Sometimes a woman can get diabetes during pregnancy. This is called gestational diabetes. Blood sugar levels are checked regularly during the pregnancy to keep levels within a target range. Children who have diabetes need their parents' help to keep their blood sugar levels in a target range and to exercise safely. Be sure that children learn the symptoms of both high and low blood sugar. Then they can tell others when they need help. There are many support groups and diabetes education centers to help parents and children understand about blood sugar, exercise, diet, and medicines. Teens especially may have a hard time keeping their blood sugar levels in control. That's because their bodies are growing and developing. Also, they want to be with their friends and eat foods that may affect their blood sugar. Having diabetes during the teen years isn't easy. But it's an excellent age to understand the disease and its treatment. Your teen can take over some of the duties of their care. If your blood sugar level reads too high or too low but you feel fine, you may want to recheck your sugar level or recalibrate your blood glucose meter. The problem may be with either your blood sample or the machine. High blood sugar (hyperglycemia)High blood sugar occurs when the sugar (glucose) level in your blood rises above your target range. Your blood sugar can rise when you eat too many calories or miss taking your medicines (insulin or pills). It can also rise when you have an infection or illness, an injury, or surgery. Even emotional stress can cause your blood sugar to rise. High blood sugar usually happens slowly over a period of hours to days. But missing a dose of insulin can cause a quick rise in blood sugar levels. Blood sugar levels just above your target range may make you feel tired and thirsty. If your blood sugar stays higher than your target range for weeks, your body will adjust to that level. You may not have as many symptoms of high blood sugar. Unless you don't monitor your blood sugar regularly or you don't notice the symptoms of high blood sugar, you likely will have time to treat high blood sugar so that you can prevent high blood sugar emergencies. Three things can help you prevent high blood sugar problems:
Complications of high blood sugar can cause serious problems, including coma and death. Over time, high blood sugar can damage your eyes, heart, kidneys, blood vessels, and nerves. Low blood sugar (hypoglycemia)Low blood sugar occurs when the sugar (glucose) level in your blood drops below what your body needs. Your blood sugar can drop quickly if you don't eat enough food or you skip meals. It can also happen if you take too much medicine (insulin or pills), exercise more than usual, or take certain medicines that lower blood sugar. Do not drink alcohol if you have problems noticing the early signs of low blood sugar. People who lose weight or develop kidney problems may not need as much insulin or other medicines as they did before they lost the weight or had kidney problems. Their blood sugar may drop too low. Be sure to check your blood sugar often when your body goes through changes. When your blood sugar level drops below 70 milligrams per deciliter (mg/dL), you will usually have symptoms of low blood sugar. This can happen quickly, in 10 to 15 minutes.
You may have symptoms of low blood sugar if your blood sugar drops from a high level to a lower level. For example, if your blood sugar level has been higher than 300 mg/dL for a week or so and the level drops suddenly to 100 mg/dL, you may have symptoms of low blood sugar. This could happen even if your blood sugar is in the target range. But if you've had diabetes for many years, you may not have symptoms of low blood sugar until your blood sugar level is very low. If your doctor thinks you have low blood sugar levels but you aren't having symptoms, your doctor may ask you to check your blood sugar more often. You may need to check your blood sugar in the middle of the night. Or you may need to do a 3-day test using a continuous glucose monitor. Check Your SymptomsHow old are you? Less than 3 years Less than 3 years 3 years or older 3 years or older Are you male or female?
Did you pass out completely (lose consciousness)? If you are answering for someone else: Is the person unconscious now? (If you are answering this question for yourself, say no.) Are you back to your normal level of alertness? After passing out, it's normal to feel a little confused, weak, or lightheaded when you first wake up or come to. But unless something else is wrong, these symptoms should pass pretty quickly and you should soon feel about as awake and alert as you normally do. Yes Has returned to normal after loss of consciousness No Has returned to normal after loss of consciousness Did the loss of consciousness occur during the past 24 hours?
Yes Loss of consciousness in past 24 hours No Loss of consciousness in past 24 hours Do you have a plan for dealing with low blood sugar? If you haven't used your plan or don't have one, take steps to get your blood sugar back up. Yes Has plan for managing low blood sugar No Has plan for managing low blood sugar Are your symptoms: It may take up to 30 minutes after you eat a quick-sugar food before you can tell how it is affecting your blood sugar. Getting worse? Symptoms are getting worse Staying the same (not worse or better)? Symptoms are the same Getting better? Symptoms are getting better Are you concerned that you are having episodes of low blood sugar more often than in the past? Yes Increased episodes of low blood sugar No Increased episodes of low blood sugar Are the symptoms severe, moderate, or mild? Moderate Moderate dehydration Are you having trouble drinking enough to replace the fluids you've lost? Little sips of fluid usually are not enough. You need to be able to take in and keep down plenty of fluids. Yes Unable to maintain fluid intake No Able to maintain fluid intake Has there been a decrease in how alert or aware you are or how well you can think and respond? Yes Decreased level of consciousness No Decreased level of consciousness Do you have symptoms of a serious illness? Yes Symptoms of serious illness No Symptoms of serious illness Is your blood sugar high? If you are an adult, is your blood sugar >600 mg/dL? If you are younger than 18, is your blood sugar >250 mg/dL? Be sure to double-check a high blood sugar. If it's not higher than the number given for your age group but you're worried about it anyway, answer yes. Yes Blood sugar over 600 mg/dL No Blood sugar over 600 mg/dL Yes Symptoms of diabetic ketoacidosis No Symptoms of diabetic ketoacidosis Does your urine contain a moderate to large amount of ketones? Ketones are a sign that your blood sugar is getting out of control. There is a urine test for ketones that you can do at home. Yes Moderate to large amount of ketones in urine No, or you haven't tested your urine Less than moderate amount of ketones in urine (or has not tested urine) Do you have a plan for dealing with high blood sugar? Yes Has plan for managing blood sugar No Has plan for managing blood sugar Is the plan helping get your blood sugar under control? Yes Plan is helping get blood sugar under control No Plan is helping get blood sugar under control Are you concerned that you are having episodes of high blood sugar more often than in the past? Yes Increased episodes of high blood sugar No Increased episodes of high blood sugar Have you been sick with anything worse than a cold for more than 2 days? Yes Sick for more than 2 days No Sick for more than 2 days Are you concerned about how to keep your blood sugar in the target range? Yes Concerns about managing blood sugar No Concerns about managing blood sugar Many things can affect how your body responds to a symptom and what kind of care you may need. These include:
Try Home TreatmentYou have answered all the questions. Based on your answers, you may be able to take care of this problem at home.
Symptoms of serious illness may include:
Symptoms of serious illness in a baby may include the following:
You can get dehydrated when you lose a lot of fluids because of problems like vomiting or fever. Symptoms of dehydration can range from mild to severe. For example:
Severe dehydration means:
Moderate dehydration means:
Mild dehydration means:
Severe dehydration means:
Moderate dehydration means:
Mild dehydration means:
Early symptoms of low blood sugar may include:
If blood sugar continues to drop, you may start to have more severe symptoms. You can test for ketones at home using special tablets or test strips. Ketones are substances made by the body when it burns fat instead of sugar. They are a sign that your blood sugar is out of control. To do the urine test:
Some home blood sugar meters can also measure blood ketones. You use the same finger-prick method that you use to measure blood sugar. Symptoms of infection may include:
Symptoms of diabetic ketoacidosis may include:
Here is what you can do to treat low blood sugar. If at any point during these steps you think you are getting worse, seek care immediately.
Seek Care TodayBased on your answers, you may need care soon. The problem probably will not get better without medical care.
Call 911 NowBased on your answers, you need emergency care. Call 911 or other emergency services now. Sometimes people don't want to call 911. They may think that their symptoms aren't serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital. Seek Care NowBased on your answers, you may need care right away. The problem is likely to get worse without medical care.
Make an AppointmentBased on your answers, the problem may not improve without medical care.
Self-CareManage blood sugar levelsOne of the most important skills to learn is how to manage your blood sugar level. This is true whether you have type 1 diabetes, type 2 diabetes, or gestational diabetes. Follow your doctor's instructions on the use of insulin or diabetes medicines, diet, and exercise. They will help you avoid blood sugar problems. You'll learn to recognize the symptoms and know if they're from high or low blood sugar levels. Then you can take the right steps to bring your blood sugar back to your target levels. People who keep their blood sugar levels under control with diet, exercise, or oral diabetes medicines are less likely to have problems with high or low blood sugar levels. Do not drink alcohol if you have problems noticing the early signs of low blood sugar. Treat high blood sugarIf you have symptoms of high blood sugar, check your blood sugar. Your goal is to get your level back to your target range. Here are ways you can treat high blood sugar.
If your symptoms or blood sugar levels are getting worse or have not improved after taking these steps, seek medical care right away. Treat low blood sugarYou can treat low blood sugar by eating or drinking something that has 15 grams of carbohydrate. These should be quick-sugar foods. Check your blood sugar level again 15 minutes after having a quick-sugar food to make sure your level is getting back to your target range. Children usually need less than 15 grams of carbohydrate. Check with your doctor or diabetes educator for the amount that is right for your child. Here are examples of quick-sugar foods that have 15 grams of carbohydrate:
If you have problems with severe low blood sugar, someone else may have to give you glucagon. This is a hormone that raises blood sugar levels quickly. When to call for help during self-careCall a doctor if any of the following occur during self-care at home:
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WatchPreparing For Your AppointmentCreditsCurrent as of: April 13, 2022 Author: Healthwise Staff When the nurse describes a patients perceived ability to successfully complete a task which term should the nurse use?11. A nurse is describing a patient's perceived ability to successfully complete a task. Which term should the nurse use to describe this attribute? Self-efficacy, a concept included in social learning theory, refers to a person's perceived ability to successfully complete a task.
Which nursing action is most appropriate for assessing a client's learning needs?Which nursing action is most appropriate for assessing a patient's learning needs? Assess the patient's health literacy.
Which domain of learning occurs when a patient is developing values attitudes and beliefs toward improving health?The affective domain involves expressing feelings and accepting attitudes, opinions, and values. The nurse should focus on these two domains while teaching the patient about behavioral modifications. The psychomotor domain involves the use of mental and muscular activity.
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