When most people think of diabetes, they tend to think that it has to do with eating too much sugar or being overweight.  For children diagnosed with Type 1 (or Juvenile) Diabetes, this is not the case. Type 1 Diabetes affects about 3 million Americans, and each year 15,000 more children and adults are diagnosed.  So, what exactly is Type 1 Diabetes?  This form of diabetes is an autoimmune disease, where the body stops producing insulin, and it is not caused by diet or lifestyle.
In diabetes, the pancreas doesn’t make enough insulin or the body can’t respond normally to the insulin that is made. Insulin pump – these small, computerized devices allow for a continuous flow of insulin to be released the body.
Self monitoring of blood glucose (SMBG) is very crucial for those diabetics who are on insulin or on certain oral anti-diabetic drugs which can cause hypoglycemia. It is easier for a diabetes specialist to adjust drugs or to adjust insulin dose if good SMBG record is maintained by the patient. Normally we check fasting and 2 hr post prandial blood sugar levels in lab for routine follow up. In practice I have seen several patients who had fasting and post prandial blood glucose lab tests in normal range but HbA1c levels below 7 is not achieved because they might have high blood sugars in other post meals which has got unnoticed. To achieve best blood glycemic control it is important to control blood sugar levels within normal limits during entire day and not just fasting or post breakfast levels.
In the above image of SMBG chart I have mentioned 7 point charting system where you can fill your blood glucometer readings which you take on several spots in an entire day.
This seven point SMBG charting approximately covers entire day glucose fluctuations to some extent (ofcourse  not as accurate as CGMS). I have also mentioned a comment column in the above SMBG chart where you can note down change in food or change in insulin dose or any other changes that you have made which probably caused unusual readings like for example if Hypoglycemia occurs at before lunch reading and you have skipped breakfast or had very little snack at breakfast you can mentioned that. You do not need to check daily all the 7 points, you can check any one or 2 points randomly depending upon your sugar control. Monitoring of blood glucose at home in case of diabetic pregnancy or gestational diabetes is also important where frequent monitoring and SMBG charting of glucometer readings helps a lot to patient. If you find that some of the post meal or pre meal readings are high or low, please consult your diabetologist with SMBG chart to adjust your medication or insulin dosage. Type 2 diabetes accounts for 90 to 95 percent of cases of diabetes, in which blood sugar (glucose) levels are too high, according to the Centers for Disease Control and Prevention (CDC). The good news is that type 2 diabetes can be prevented, even among people who have already been diagnosed with prediabetes, a condition where the blood glucose levels are higher than normal, but not yet in the diabetic range. The Diabetes Prevention Program (DPP), a study sponsored by the National Institutes of Health (NIH), found that prediabetic participants who made lifestyle changes were 58 percent less likely to develop the disease after three years.


The goal of the Massachusetts Department of Public Health (DPH) Diabetes Prevention and Control Program is to educate the public on how to prevent and manage diabetes, as well as improve access to high-quality diabetes care. A number of characteristics increase a person’s risk for type 2 diabetes, as well as prediabetes, a condition which 37 percent of American adults have according to the CDC’s National Diabetes Statistics Report. Have experienced gestational diabetes or have given birth to an infant weighing more than 9 pounds.
If left untreated, diabetes can cause serious health problems, including the amputation of lower limbs, heart attack and stroke, loss of vision, and kidney failure.
There are many ways to accomplish these goals, including taking advantage of some of the resources Massachusetts offers. The Massachusetts Health Promotion Clearinghouse has dozens of diabetes resources, including materials in Spanish and Portuguese, for residents.
Mass in Motion provides opportunities and support for healthier, more active living in communities across the state. The National Diabetes Education Program (NDEP) has guides to help people take small steps to change their diet and lifestyle that add up. Several YMCA branches offer YMCA’s Diabetes Prevention Program (YDPP), a group education series based on the results from the NIH DPP study that teaches the most effective lifestyle changes for preventing diabetes. Residents can locate a participating Y for more information. Although type 2 diabetes is associated with several symptoms, not every patient will experience the same — or any — signs. Prediabetic individuals typically do not experience any symptoms, but may notice dark patches of skin around their neck or armpits. Whether you drive to work every day or only get behind the wheel for weekend getaways, it can never hurt to get a refresher on the rules of the road. Once you’ve learned your rights as a tenant before you move in, it’s time to figure out what happens after you move in.
According to the United States Census Bureau (USCB), as of 2014, more than 37 percent of Massachusetts homes were occupied by renters. JANUVIA is a once-daily pill that, along with diet and exercise, helps lower blood sugar levels in adults with type 2 diabetes.
Because JANUVIA works less when blood sugar is low, it is not likely to cause hypoglycemia. JANUVIA works when your blood sugar is HIGH…and works less when your blood sugar is LOW.


Sitagliptin  (marketed as the phosphate salt under the trade name Januvia) is an oral antihyperglycemic (antidiabetic drug) of the dipeptidyl peptidase-4 (DPP-4) inhibitor class. One of the goals of treating type 2 diabetes is to lower blood sugar, but you should also be careful of it going too low.
JANUVIA is not approved to treat the serious problems that may result from high blood sugar.
High blood sugar can be lowered with diet and exercise and with certain medications, when necessary. JANUVIA is a once-daily prescription pill that, along with diet and exercise, helps lower blood sugar levels in adults with type 2 diabetes.
JANUVIA should not be used in patients with type 1 diabetes or with diabetic ketoacidosis (increased ketones in the blood or urine). The pumps have a small, flexible tube (called a catheter), which is inserted under the skin of the abdomen and taped into place. To achieve best glycemic control it is essential to know how your daily blood glucose levels are fluctuating in entire day. There is bright chance of sugar excursions in the other post meal readings which gets unnoticed. It’s important to be tested if you’re in a high-risk group for the disease, no matter how you’re feeling. For more information on diabetes care, contact DPH’s Diabetes Prevention and Control Program.
When sugar (glucose) builds up in the blood, over time it can lead to serious medical problems. If you have had pancreatitis (inflammation of the pancreas), it is not known if you have a higher chance of getting it while taking JANUVIA.



Normal blood sugar levels on waking 5am
High glucose levels problems 8th
Physical symptoms of high blood sugar levels low


Comments

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