Diabetes For Dummies

From Diabetes For Dummies, 3rd Edition by Alan L. Rubin, MD

Diabetes, which is excessive glucose in your blood, leads to serious health problems if left untreated. Follow the American Diabetes Association guidelines to get tested for diabetes at the earliest possible time. Adopt some basic rules for living with diabetes and continuing your diabetic care to better control the disease. If you're prescribed oral medications for diabetes, do your homework on dosage amounts and side effects.

Ten Rules for Diabetes Control

Diabetes doesn't have to rule your life. Be proactive! Follow these guidelines for controlling your diabetes, and your problems should be few and far between:

Major monitoring
Devout dieting
Tenacious testing
Enthusiastic exercising
Lifelong learning
Meticulous medicating
Appropriate attitude
Preventive planning
Fastidious foot care
Essential eye care

Standards for Continuing Your Diabetes Care

Managing diabetes requires regular doctor visits that include standard monitoring of various diabetic factors. Following are guidelines for your diabetes care — like when to see your doctor, what should happen at each visit, when to have lab tests done, and how often to self-monitor blood glucose.

Consistent diabetes management is key; if test results show any change from your history, then you and your doctor can address them before any problem worsens.

Frequency of visits:

Daily if starting insulin
Weekly for oral drugs
Monthly if not stable
Quarterly if stable

History at each visit:

Frequency of hypoglycemia
Results of blood glucose self-monitoring
Changes in treatment
Symptoms of complications
Psychosocial issues
New medications

Physical at each visit:

Blood pressure
Weight
Foot exam if neuropathy is present

Physical at least annually:

Dilated eye exam by eye doctor
Filament test for foot sensation

Lab tests:

Hemoglobin A1c every three months
Fasting lipid profile yearly
Microalbumin measurement yearly if urine protein negative

Frequency of blood glucose self-monitoring:

Before meals and bedtime for person with type 1 diabetes
Before breakfast and supper for person with type 2 diabetes
Once daily for person with stable diabetes
Before and one hour after meals for pregnant woman with type 1 diabetes or gestational diabetes

Oral Drugs for Diabetes

Insulin shots aren't the only drug treatment for diabetes. If your doctor prescribes oral drugs for your diabetes, use this chart to look up the medication names and dosage amounts. Then educate yourself on diabetes medications, their possible side effects, and drug interactions.

Class	Brand Name	Generic Name	Average Dose	Range
Sulfonylureas	Orinase	tolbutamide	1,500 mg	500-3,000 mg
	Tolinase	tolazamide	250 mg	100-1,000 mg
	Diabinase	chlorpropamide	250 mg	100-500 mg
	Dymelor	acetohexamide	500 mg	250-1,500 mg
	Glucotrol	glipazide	10 mg	2.5-40 mg
	DiaBeta, Glynase	glyburide	7.5 mg	1.25-20 mg
	Amaryl	glimepiride	4 mg	1-8 mg
Meglitinides	Prandin	repaglinide	1 mg	0.5-4 mg
	Starlix	nateglinide	180 mg	180-360 mg
Biguanides	Glucophage	metformin	1,000 mg	500-2,000 mg
Thiazolidinediones	Actos	pioglitazone	30 mg	15-45 mg
Alpha-glucosidase inhibitors	Precose Glyset	Acarbose miglitol	100 mg 50 mg	50-250 mg 25-75 mg
DPP-4 Inhibitors	Januvia	sitagliptin	100 mg	25-100 mg

Screening Guidelines for Diabetes

The American Diabetes Association created guidelines to screen for diabetes at the earliest possible appropriate time. Take a look at these guidelines to find out when to get tested for diabetes:

People with symptoms of thirst, frequent urination, and weight loss are tested immediately.
People over age 45 should be tested every three years if normal.
People should be tested at a younger age and more often if:

They are obese.

Their parent or siblings have diabetes.

They are from a high-risk group, such as African American, Hispanic, Asian, or Native American.

They have delivered a baby over nine pounds or had gestational diabetes.

They have high blood pressure.

They have low HDL cholesterol or high triglycerides.