Diabetes Mellitus Type II



righttop2014A.M. 8/4/2014400001000002014A.M. 8/4/2014left250002514600Diabetes Mellitus Type II900007300Diabetes Mellitus Type IIright300990000428625-714375What is Diabetes Mellitus?When you eat, your food is broken down into a sugar called glucose. This gives your body the energy it needs to work but to use glucose, your body needs insulin. Diabetes is a problem with your body that causes blood glucose (sugar) levels to rise higher than normal. This is also called hyperglycemia. Type 2 diabetes is the most common form of diabetes. Your body does not use insulin properly. This is called insulin resistance. What is Insulin Resistance?Insulin is a hormone produced by the pancreas that helps the body take sugar (glucose) from the food we eat so it can be used for energy. Individuals with diabetes may not produce enough insulin to meet their needs, so some sugar (glucose) is not used and sugar remains in the bloodstream, causing high blood glucose levels. Managing Your DiabetesThere is no cure for diabetes but it can be managed by balancing food, exercise, and medicine to keep blood glucose in a healthy range. 00What is Diabetes Mellitus?When you eat, your food is broken down into a sugar called glucose. This gives your body the energy it needs to work but to use glucose, your body needs insulin. Diabetes is a problem with your body that causes blood glucose (sugar) levels to rise higher than normal. This is also called hyperglycemia. Type 2 diabetes is the most common form of diabetes. Your body does not use insulin properly. This is called insulin resistance. What is Insulin Resistance?Insulin is a hormone produced by the pancreas that helps the body take sugar (glucose) from the food we eat so it can be used for energy. Individuals with diabetes may not produce enough insulin to meet their needs, so some sugar (glucose) is not used and sugar remains in the bloodstream, causing high blood glucose levels. Managing Your DiabetesThere is no cure for diabetes but it can be managed by balancing food, exercise, and medicine to keep blood glucose in a healthy range. What, How Much, and When to eat Eat a variety of foods, including vegetables, whole grains, fruits, non-fat dairy foods, healthy fats, and lean meats. Try not to eat too much food.Try not to eat too much of one type of food. Variety is the spice of life. Space your meals evenly throughout the day. Don’t skip meals. Plate MethodThe plate method is a simple and effective tool for managing diabetes. It allows you to create your own plate while still allowing you to choose the foods that you want. Try these six steps to get started:Using your dinner plate, put a line down the middle of the plate. Then on one side, cut it again so you will have three sections on your plate.Fill the largest section with non-starchy vegetables such as: spinach, carrots, lettuce, greens, cabbage, bok choygreen beans, broccoli, cauliflower, tomatoes,vegetable juice, salsa, onion, cucumber, beets, okra,mushrooms, peppers, turnipsNow in one of the small sections, put grains and starchy foods?such as: whole grain breads, such as whole wheat or ryewhole grain, high-fiber cerealcooked cereal such as oatmeal, grits, hominy or cream of wheatrice, pasta, dal, tortillascooked beans and peas, such as pinto beans or black-eyed peaspotatoes, green peas, corn, lima beans, sweet potatoes, winter squashlow-fat crackers, snack chips, pretzels and light popcornAnd then in the other small section, put your protein?such as: chicken or turkey without the skinfish such as tuna, salmon, cod or catfishother seafood such as shrimp, clams, oysters, crab or musselslean cuts of beef and pork such as sirloin or pork lointofu, eggs, low-fat cheeseAdd a serving of fruit, a serving of dairy, or both as your meal plan allows.To complete your meal, add a low calorie drink like water, unsweetened tea, or coffee.Fast food options:Restaurant Healthier PicksNutrition Facts: Wendy’sGo for a healthful yet filling salad. This half-size order of Apple Pecan Chicken Salad is served with pomegranate dressing and pecans. To drink, choose unsweetened iced tea.340 cal., 18 g total fat (4.5 g sat. fat), 60 mg chol., 700 mg sodium, 29 g carb. (4 g fiber, 22 g sugars), 19 g proMcDonald’sFor 15 grams of fast protein, choose the Filet-O-Fish sandwich, apple slices and unsweetened iced tea.400 cal., 18 g total fat (3.5 g sat. fat), 40 mg chol., 644 mg sodium, 42 g carb. (2 g fiber, 8 g sugars), 15 g pro.Burger KingWhopper Jr. sandwich with or without cheese -- but hold the mayonnaise. Resist the fries and balance out the meal with apple slices and diet soda.330 cal., 13 g total fat (6 g sat. fat), 45 mg chol., 640 mg sodium, 39 g carb. (2 g fiber, 13 g sugars), 16 g pro.Panera BreadOpt for a balanced meal from the You Pick Two menu. The low-cholesterol, high-fiber combination of a half Smoked Turkey Breast sandwich on Honey Wheat Loaf bread with a cup of Low-Fat Vegetarian Garden Vegetable with Pesto soup. To drink, have Acai Berry Iced Green Tea.310 cal., 7 g total fat (2 g sat. fat), 20 mg chol., 1,300 mg sodium, 47 g carb. (11 g fiber, 9 g sugars), 18 g proSubway6-inch Veggie Delite sub on Monterey Cheddar bread with lettuce, tomato, green sweet pepper, cucumber, and provolone cheese. To drink, choose a diet soda.310 cal., 10 g total fat (4.5 g sat. fat), 20 mg chol., 485 mg sodium, 42 g carb. (3 g fiber, 6 g sugars), 14 g pro.PopeyesSix-piece chicken tenders and regular green beans is a good, high-protein choice when you're on the go. Order applesauce on the side and a diet soda to drink.320 cal, 15.5 g total fat (6 g sat. fat), 45 mg chol., 780 mg sodium, 32 g carb. (5 g fiber, 9 g sugars), 13 g pro.KFCChoose grilled or baked chicken over fried, such as this protein-loaded grilled chicken breast and wing at KFC. Order sweet kernel corn and a diet soda.400 cal., 12 g total fat (3.5 g sat. fat), 185 mg chol., 980 mg sodium, 22 g carb. (2 g fiber, 3 g sugars), 53 g proChick-Fil-AChar-grilled chicken sandwich, small fruit cup, and unsweetened iced tea.340 cal., 4 g total fat (1 g sat. fat), 60 mg chol., 790 mg sodium, 49 g carb. (4 g fiber, 20 g sugars), 28 g proChipotleThree crispy tacos with chicken, lettuce, and fresh tomato salsa, complete with a diet soda.390 cal., 12.5 g total fat (3.5 g sat. fat), 115 mg chol., 870 mg sodium, 32 g carb. (3 g fiber, 4 g sugars), 33 g pro.Taco BellFresco Grilled Steak Soft Tacos with Mild Border Sauce and a diet soda.300 cal., 8 g total fat (3 g sat. fat), 30 mg chol., 1,035 mg sodium, 38 g carb. (4 g fiber, 4 g sugars), 18 g pro.StarbucksSpinach and Feta Breakfast Wrap is a relatively lean lunch option when you're in a pinch. Opt for black coffee instead of a sugary specialty drink.290 cal., 10 g total fat (3.5 g sat. fat), 20 mg chol., 830 mg sodium, 33 g carb. (6 g fiber, 4 g sugars), 19 g pro.Panda ExpressBroccoli Beef (no rice), Veggie Spring Rolls, a fortune cookie, and a diet soda.312 cal., 11 g total fat (3 g sat. fat), 10 mg chol., 1,208 mg sodium, 42 g carb. (7 g fiber, 8 g sugars), 14 g pro.Best Choices at Sandwich ShopsTo keep carbs within healthful amounts, pick half-size sandwiches or breadless options loaded with vegetables.Healthful Chicken Choices at Fast-Food RestaurantsLimit saturated fat by ordering skinless grilled chicken or a small serving of breaded chicken, such as nuggets or a half-breast piece. Round out your meal with a side dish that provides a serving of fruit or vegetables. Nutritious Fast-Food Mexican MealsSkip large burritos and fried foods to steer clear of excess calories and fat. Top servings with fresh salsa, vegetables, and beans to get some fiber.Checking Your Blood GlucoseTo check your sugar levels, you use a small machine called a blood glucose meter. These meters work by testing a small drop of your blood to measure how much glucose (sugar) is in your blood stream. Checking your blood glucose is one way you know how food and medicine is affecting your blood glucose. It is important to regularly check your glucose level as it is a way to make sure that it is not going TOO HIGH or TOO LOW. How Often to CheckThis is something that you need to talk with your doctor about how often and when to check it. In addition, you need to talk with your doctor about your target blood glucose numbers should be. Normally, blood glucose levels are checked before a meal or two hours after a meal. You should keep a manual log book (log pages included at the back of the folder). This book will stare at you in the face and it will give you patterns and clues as what changes that you need to make in your therapy. This is a self-monitoring tool to help you in deciding how much insulin you need every time that you are due for an injection. This will help you to predict and avoid low or high blood glucose. Insulin has 3 characteristics:Onset is the length of time before insulin reaches the bloodstream and begins lowering blood glucose.Peak time is the time during which insulin is at maximum strength in terms of lowering blood glucose.Duration is how long insulin continues to lower blood glucose.The medication that your doctor has prescribed for you is NovoLog. Novolog is a fast acting mealtime insulin. The onset is within 10-15 minutes. Therefore, you should eat a meal within 5 to 10 minutes after taking it. The peak time for this drug is 60-90 minutes after taking it and the duration is approximately 4-5 hours. Rotating Your Injection SiteKnowing exactly where on your body you should give your injection(s) each day is very important. The picture to the right shows recommended sites for your insulin injections in the dark blue grid areas. Each square is a place you can give yourself an injection. Be sure not to inject insulin into a muscle or vein. You may need help from a family member to give injections in some of the sites. For your insulin to work best, don't use the exact same site each time you inject. There are different sites where you can inject throughout the day. Refer to the image above. This is called site rotation and involves following a regular pattern as you move from site to site. If you take more than one injection each day, inject the insulin in the same general area, and rotate to a different site for the next injection. Different people use different patterns, but the intent should always be to use all of the areas and the sites. When you do this, no one site will be used too often. Overusing a site can cause tissue changes that affect the amount of insulin absorbed or the rate at which it is absorbed.Insulin enters the blood more quickly from some areas than others, so your blood sugar (glucose) may be higher or lower depending on what area is used. At times, you may want to use a certain area because of how quickly or slowly insulin is taken up from that site. For example, if you plan to eat very soon after an injection, you could use a site on your stomach.Most insulin enters the blood:Fastest from the abdomen (stomach)A little slower from the armsEven more slowly from the legsMost slowly from the buttocksManifestationsCausesTreatmentPreventative MeasuresElevated Blood glucoseIncrease in urinationIncrease in appetite followed by lack of appetiteWeakness, fatigueBlurred visionHeadacheNausea and vomitingAbdominal crampsIllness, infectionCorticosteroidsToo much foodToo little or no diabetes medicationInactivityEmotional, physical stressPoor absorption of insulinGet medical careContinue diabetes medication as orderedCheck blood glucose frequently and check urine for ketones. Record resultsDrink fluids at least on an hourly basisTake prescribed dose of medication at proper timeAccurately administer insulinMaintain dietMaintain good personal hygieneAdhere to sick day rules when illCheck blood for glucose as orderedContact heath care provider regarding ketonuriaWear diabetic identificationManifestationsCausesTreatmentPreventative MeasuresBlood glucose <70 mg/dlCold, clammy skinNumbness of fingers, toes, mouthRapid heartbeatEmotional changesHeadacheNervousness, tremorsFaintness, dizzinessUnsteady walk, slurred speechHungerChanges in visionSeizures, comaAlcohol intake without foodToo little food—delayed, omitted, inadequate intakeToo much diabetic medicationToo much exercise without compensationDiabetes medication or food taken at wrong timeLoss of weight without change in medicationIngest 15-20 grams of simple carbs.Ingest another 15-20 grams of simple carbs. in 15 minutes if no relief is obtainedContact health care provider if no relief obtainedDiscuss medication dosage with health care providerTake prescribed dose of medication at proper timeAccurately administer insulinIngest all recommended foods at proper timesRecognize and know symptoms and treat them immediatelyCarry simple carbohydrateEducate family about symptoms and treatmentCheck blood glucose as orderedWear medical alert (diabetic) identification. ................
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