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