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A New Way to Control Type 1 Diabetes

A New Way to Control Type 1 Diabetes
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Oct. 3, 2002 -- An education-based approach to managing type 1 diabetes may allow patients to eat whatever they want, whenever they want, and better control their blood sugar levels.

The downside? The approach requires more frequent doctor visits, and patients must give themselves insulin shots and test their blood sugar levels more often -- an average of five times a day. Still, most patients taking part in a British study evaluating the program found the inconvenience to be worth it because it allowed them dietary freedom.

While acknowledging the approach is not for everyone, the British researchers say all diabetics should be offered the intensive training needed to implement it so they can chose for themselves.

"The thing that really knocked us out was that so many of the patients reported that their quality of life improved," lead author Simon Heller tells WebMD. "We had people tell us that for the first time in 20 years they were able to manage their disease properly."

Most insulin-dependent diabetics eliminate certain foods, take two to four insulin shots during the day, and time their meals carefully to keep blood glucose levels under control.

In this study, Heller and colleagues from three British diabetes clinics evaluated a diabetes management approach requiring patients to take a five-day training course on how to maintain normal glucose levels throughout the day by adjusting insulin injections to the foods they eat.

The findings appear in the Oct. 5 issue of the British Medical Journal.

Patients following the program took medium- or long-acting insulin injections before bed and first thing in the morning, and then took short-acting insulin shots each time they ate. The amount of insulin injected was determined by the foods eaten.

After six months, patients who took the five-day course had significantly better blood sugar control than those who did not. General well-being and treatment satisfaction also improved, but low blood sugar episodes, weight, and lipid profiles were unchanged.

American Diabetes Association spokesperson Matt Petersen tells WebMD that the findings confirm what has long been known -- that better educated patients can better control their disease. Petersen is the association's director of diabetes information resources.

"It is not exactly news that counseling patients on the best match of insulin administration to meals is worthwhile," he says. "But this shows that patients who know what they are doing can actually improve glucose control and follow a less restrictive eating schedule that may better suit their lifestyle."

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If the level is below 70 or you are experiencing symptoms such as shaking, sweating or difficulty thinking, you will need to raise the number immediately. A quick solution is to eat a few pieces of hard candy or 1 tablespoon of sugar or honey. Recheck your numbers again in 15 minutes to see if the number has gone up. If not, repeat the steps above or call your doctor.

People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.

Congratulations on taking steps to manage your health.

However, it's important to continue to track your numbers so that you can make lifestyle changes if needed. If you are pregnant always consult with your physician.

Your level is high if this reading was taken before eating. Aim for 70-130 before meals and less than 180 two hours after meals.

Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.

One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.

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