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Questions To Ask A Patient With Type 1 Diabetes

Type 1 Diabetes: Questions And Answers With The Experts

Type 1 Diabetes: Questions And Answers With The Experts

Type 1 Diabetes: Questions and Answers with the Experts Daily type 1 diabetes (T1D) management can be challenging for adults or children living with the disease, as well as for their parents or caregivers. We asked two diabetes experts, Desmond Schatz, M.D., and Anne Peters, M.D., to share with us the most frequently asked questions they hear in their practices. Their answers will help children and adults alike learn a little more about the disease and how to help manage it better. Both Dr. Schatz and Dr. Peters have seen many people, young and old, with T1D, and they recognize that, although the diagnosis can be scary at first, with the right help and support people with T1D can live long and healthy lives. FAQs for children with T1D and their parents Desmond Schatz, M.D., is a pediatric endocrinologist, associate chair of pediatrics, and director of the Diabetes Center at the University of Florida. Dr. Schatz has treated children with T1D for 25 years, and he directs clinical trials aimed at finding a way to prevent and reverse the disease. No one in our family has diabetes, how did our child get T1D? Dr. Schatz: Up front we can say its no ones fault that your child got diabetes. We dont know what causes T1D, although we believe that it results from a complex interaction among genes, the environment, and the immune system. In the United States, the risk of getting T1D is roughly one in 300, but when one family member is affected, the risk increases to one in 20, indicating that genes are involved. But almost 90 percent of people with T1D do not have a family history of the disease. Moreover, T1D is increasing in epidemic proportions, with a 23 percent rise in the prevalence of T1D in people under 20 years old between 2001 and 2009. Worldwide, the number of youth who Continue reading >>

8 Things You Should Never Say To Someone With Type 1 Diabetes

8 Things You Should Never Say To Someone With Type 1 Diabetes

8 things you should never say to someone with type 1 diabetes There are many misconceptions about diabetes, which means people with type 1 diabetes are often asked a lot of insensitive questions. Here are eight things you should never ask or say. When people find out that you have type 1 diabetes , they tend to ask a lot of questions. Generally, this is a good thing as it creates greater awareness. Unfortunately, both type 1 and type 2 diabetes are still poorly understood by the average person, meaning that people with diabetes tend to get asked a lot of inappropriate and insensitive questions. As someone with type 1 diabetes, Health24s Laura Newnham is no stranger to these kinds of comments and questions. Here are the eight things she is most tired of hearing: 1. Did you get diabetes from eating too much sugar? This kind of blame-game statement may not only make someone with type 1 feel like having the condition is somehow their own fault, it is also untrue. Type 1 diabetes is not caused by poor eating habits, it is actually an autoimmune condition. This means that the bodys own immune system turns on itself and attacks the pancreas, destroying the cells that produce insulin. This eventually leads to type 1 diabetes. It is not preventable and currently cannot be cured. 2.How can you have diabetes, you arent fat? Unlike type 2 diabetes, developing type 1 diabetes has nothing to do with being overweight. Prior to being diagnosed, one of the main symptoms of type 1 diabetes is unexplained weight loss, and this may actually prompt them to seek medical attention. 3. My moms aunt had diabetes and she had to have her leg amputated. This is something that no one with diabetes wants to hear. Yes, the reality is that diabetes is one of the leading causes of amputations globally Continue reading >>

5 Questions With A Diabetes Physician Who Has Type 1

5 Questions With A Diabetes Physician Who Has Type 1

Because of his type 1 diabetes diagnosis at 5 years old, endocrinologist Scott Soleimanpour devoted his career to those with the condition. A childhood diagnosis led to a life’s work for one U-M physician. “I remember being 5 years old at a family wedding and becoming super thirsty,” says Scott Soleimanpour, M.D., assistant professor of endocrinology at the University of Michigan Health System. “I mean, imagine the worst thirst you could ever have. Like you’re out in the desert, and then multiply that times 10.” Soleimanpour didn’t know what his thirst meant at the time. But that day would significantly alter his life forever. His parents realized something was incredibly wrong, and Soleimanpour’s father, a physician, sought medical treatment for his son. After a diagnosis of type 1 diabetes, Soleimanpour spent two weeks in an intensive care unit as a medical team worked to get his sugars under control and to place him on insulin treatments. “They told me I have a lazy pancreas, and it isn’t making enough insulin,” Soleimanpour says. “It was a life-changing event that put me on the path to working with diabetes. I wanted to help people also suffering with this condition.” We sat down with Soleimanpour to learn more about being a diabetes researcher and physician affected by the disease, and how he uses his personal experiences to help others with diabetes. Soleimanpour: At the young age of my diagnosis, I saw dynamic teams of endocrine doctors, educators, nurses, etc. It also helped that my parents were always interested in the latest scientific advances. I decided to go medical school and wanted to be a pediatric diabetes doctor. I had an advisor at the time that presented me with a research opportunity and said, “Do you want to look for a c Continue reading >>

Type 1 Diabetes

Type 1 Diabetes

Print Diagnosis Diagnostic tests include: Glycated hemoglobin (A1C) test. This blood test indicates your average blood sugar level for the past two to three months. It measures the percentage of blood sugar attached to the oxygen-carrying protein in red blood cells (hemoglobin). The higher your blood sugar levels, the more hemoglobin you'll have with sugar attached. An A1C level of 6.5 percent or higher on two separate tests indicates diabetes. If the A1C test isn't available, or if you have certain conditions that can make the A1C test inaccurate — such as pregnancy or an uncommon form of hemoglobin (hemoglobin variant) — your doctor may use these tests: Random blood sugar test. A blood sample will be taken at a random time and may be confirmed by repeat testing. Blood sugar values are expressed in milligrams per deciliter (mg/dL) or millimoles per liter (mmol/L). Regardless of when you last ate, a random blood sugar level of 200 mg/dL (11.1 mmol/L) or higher suggests diabetes, especially when coupled with any of the signs and symptoms of diabetes, such as frequent urination and extreme thirst. Fasting blood sugar test. A blood sample will be taken after an overnight fast. A fasting blood sugar level less than 100 mg/dL (5.6 mmol/L) is normal. A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is considered prediabetes. If it's 126 mg/dL (7 mmol/L) or higher on two separate tests, you have diabetes. If you're diagnosed with diabetes, your doctor may also run blood tests to check for autoantibodies that are common in type 1 diabetes. These tests help your doctor distinguish between type 1 and type 2 diabetes when the diagnosis is uncertain. The presence of ketones — byproducts from the breakdown of fat — in your urine also suggests type 1 diab Continue reading >>

Questions To Ask Your Doctor

Questions To Ask Your Doctor

Your first visit to a doctor who will treat your child's diabetes should have four parts: The doctor should take a medical history (ask questions about your child's life, complications, and previous diabetes treatment plan). The doctor should give your child a complete physical examination. The doctor should run tests on your child's blood and urine to find out your child's blood glucose (blood sugar) level, glycated hemoglobin level (a measure of average blood glucose levels over the past two to three months), cholesterol and fat levels, and urine protein level. Your child's age, complications, and symptoms dictate which other laboratory tests the doctor does. Your child's health care team should work with you to make a plan for managing your child's diabetes. This checklist will help you make sure your health care team is thorough at your child's first visit. measure your child's blood pressure look in your child's eyes, ask about any problems your child may have seeing, and refer you to an eye doctor for a dilated eye exam look in your child's mouth, and ask about your child's dental health feel your child's neck to check the thyroid gland, and do tests if necessary feel your child's abdomen to check the liver and other organs ask how and when your child was diagnosed with diabetes ask for results of laboratory tests you're child has had in the past ask about your child's eating habits and weight history ask about your child's current diabetes treatment plan ask how often and how hard your child exercises ask about times your child has had ketoacidosis as well as low blood glucose reactions ask what complications your child has had and what treatments your child has received for them ask what other medical problems your child has had Putting together a diabetes care Continue reading >>

Things To Ask A Diabetic Patient

Things To Ask A Diabetic Patient

By Benji Ho - November 19th, 2012 | Updated December 5th, 2012 Its important to be detailed when taking patient history to get a good picture of what is going on. For every type of patient, there are specific sets of questions that need to be asked. During our rotation, we learn to follow patients, present our patients to our attending physicians, and observe our attendings examen the patients. For every rotation, there will be times when our attendings will ask us a question about our patient to which we would realize that we had forgotten to ask that particular question during the patient interview or check for that particular sign in the physical exam. We would reply, I did not ask, and subsequently, we would then be given a lesson (to put in nice terms) about the importance of detail. Its all a part of the rotation learning experience, and after enough mistakes, eventually, doing a history and physical would become second nature to us. Ive had my fair share of incomplete histories, and because of this, I decided to personally make a list of the basic things I will ask or look for whenever I see a patient with a certain condition, like diabetes. Besides the basic interview questions (HPI, PMH, FH, SH, ROS, etc.), here is my list of other specific things to make sure to ask for in a diabetic patient: How long have you had Diabetes? Type 1 or Type 2? What is your glucose level at those times? What do you do whenever you experience hypoglycemic symptoms? Do you carry sugar pills with you? What do you do to prevent episodes from happening? What medications are you taking for Diabetes? Dose? What do you eat for breakfast/lunch/dinner? Do you eat snacks in between meals? Soda? What times do you eat breakfast/lunch/dinner? Do you eat vegetables? Drink lots of water? Educat Continue reading >>

Assessment Of The Patient With Established Diabetes

Assessment Of The Patient With Established Diabetes

Professional Reference articles are written by UK doctors and are based on research evidence, UK and European Guidelines. They are designed for health professionals to use. You may find the Pre-diabetes (Impaired Glucose Tolerance) article more useful, or one of our other health articles. See also the separate Diabetes Education and Self-management Programmes article. When, how and who? Patients with diabetes frequently attend their healthcare practitioners, either specifically for diabetes-related issues, for complications of their chronic illness, or for unrelated problems. They may see their GP, practice nurse, hospital diabetologist, diabetes specialist nurse, dietician and many others, from time to time. Each visit can be viewed as an opportunity to assess and improve the patient's understanding of their illness, and their ability to control the disease. This article provides a summary of the areas of assessment relevant to type 1 diabetes and type 2 diabetes, which will need to be adapted, depending on an individual patient's type of diabetes. Aims of assessing the patient with diabetes To educate the patient and enable them to monitor and manage their diabetes as well as possible. To assess any problems in glycaemic control and address them to improve it. To detect any complications of diabetes and treat them as appropriate. To educate and reinforce healthy lifestyle advice. To assess the patient's overall health and to treat any associated or coincidental illness, physical or mental. To provide support and advice to the patient on how to cope with living with a chronic illness and how they can best alter their lifestyle to maintain their health. A checklist for a routine, annual or opportunistic review of the patient with diabetes History There is much to cover Continue reading >>

Type 1 Diabetes: Medical History And Physical Exam - Topic Overview

Type 1 Diabetes: Medical History And Physical Exam - Topic Overview

Symptoms of type 1 diabetes usually happen quickly. If ignored, the diagnosis of type 1 diabetes may happen in an emergency room or hospital. If your doctor thinks that you might have type 1 diabetes, he or she may ask questions about your symptoms, family history of the disease, and personal medical history. Questions for the medical history may include the following: Have you had increased thirst, increased urination, and fatigue? How long have the symptoms been present? Have you had an increase in appetite? Have you lost weight lately? Is there a family history of diabetes? What other medical conditions do you have? What medicines are you are currently taking? Have you been ill recently? Has growth and development progressed normally (if the person is a child)? Your doctor will also give you a complete physical exam. You will continue having exams on a regular basis if you are diagnosed with this disease. The physical exam includes: Measuring your height and weight. Children and teens will have their height and weight compared to standards that are normal for their age groups. Checking your blood pressure. For adults, blood pressure may be checked while standing and sitting. Checking your eyes. Feeling your neck to evaluate your thyroid gland. Thyroid problems sometimes develop in people who have diabetes. Listening to your heart and lung sounds and checking the blood flow (pulses) in your arms, legs, and feet. Checking for signs of dehydration, such as loose skin, a dry mouth, or sunken eyeballs. Checking alertness, if you are very ill. Checking your feet for problems including corns, calluses, blisters, cuts, cracks, or sores. Continue reading >>

Type 1 Diabetes Mellitusclinical Presentation

Type 1 Diabetes Mellitusclinical Presentation

Type 1 Diabetes MellitusClinical Presentation Author: Romesh Khardori, MD, PhD, FACP; Chief Editor: George T Griffing, MD more... The most common symptoms of type 1 diabetes mellitus (DM) are polyuria, polydipsia, and polyphagia, along with lassitude, nausea, and blurred vision, all of which result from the hyperglycemia itself. Polyuria is caused by osmotic diuresis secondary to hyperglycemia. Severe nocturnal enuresis secondary to polyuria can be an indication of onset of diabetes in young children. Thirst is a response to the hyperosmolar state and dehydration. Fatigue and weakness may be caused by muscle wasting from the catabolic state of insulin deficiency, hypovolemia, and hypokalemia. Muscle cramps are caused by electrolyte imbalance. Blurred vision results from the effect of the hyperosmolar state on the lens and vitreous humor. Glucose and its metabolites cause osmotic swelling of the lens, altering its normal focal length. Symptoms at the time of the first clinical presentation can usually be traced back several days to several weeks. However, beta-cell destruction may have started months, or even years, before the onset of clinical symptoms. The onset of symptomatic disease may be sudden. It is not unusual for patients with type 1 DM to present with diabetic ketoacidosis (DKA), which may occur de novo or secondary to the stress of illness or surgery. An explosive onset of symptoms in a young lean patient with ketoacidosis always has been considered diagnostic of type 1 DM. Over time, patients with new-onset type 1 DM will lose weight, despite normal or increased appetite, because of depletion of water and a catabolic state with reduced glycogen, proteins, and triglycerides. Weight loss may not occur if treatment is initiated promptly after the onset of the Continue reading >>

Common Questions About Type 1 Diabetes

Common Questions About Type 1 Diabetes

Answers to your questions from Joslin Diabetes Center, the world leader in diabetes treatment and research. What is type 1 diabetes? In type 1 diabetes (formerly called 'juvenile-onset' or 'insulin-dependent'), the pancreas completely stops producing any insulin, a hormone that enables the body to use glucose (sugar) found in foods for energy. Instead of the body converting glucose into energy, it backs up in the blood stream and causes a variety of symptoms, including fatigue. Type 1 diabetes is different from type 2 diabetes because it is treatable only with insulin, delivered either via multiple syringe injections subcutaneously (under the skin) or through an insulin pump. Many of the symptoms of type 1 diabetes, however, are also those of type 2. Your doctor will perform a test to determine your pancreatic function and confirm a diagnosis. What causes type 1 diabetes? The cause of type 1 diabetes is still unknown, although many have speculated that it is a combination of genetic predisposition and environmental factors such as viruses that serve as the catalyst for the disease’s onset. Who gets type 1 diabetes? You can have type 1 diabetes at any point that your pancreas completely ceases to produce insulin to regulate glucose levels, although most people diagnosed with type 1 diabetes are usually children or young adults. How is type 1 diabetes treated? Unlike some people with type 2 diabetes who use insulin when diabetes pills have not been effective at regulating their glucose levels, people with type 1 can never use pills. The goal of insulin therapy is to mimic the way the pancreas would produce and distribute its own insulin, if it were able to produce it. One of the key factors in Joslin’s treatment of diabetes is tight blood glucose control, so be certai Continue reading >>

Questions For Your Doctor

Questions For Your Doctor

Ensuring Good Care You’ve just been diagnosed with diabetes and you want to take proper care of yourself. After all, you know that if you control your blood glucose levels, you’ll feel better and lessen your chances of developing complications. But there are two problems. The first is that you don’t know enough about diabetes to ask the right questions. And the second? There’s a chance your doctor doesn’t know a lot about diabetes, either. On the other hand, it’s possible that your doctor didn’t explain much when you were diagnosed because he knew that all you would hear that day was the word “diabetes,” and wanted to give you some time to let the diagnosis sink in. Short of completing a fellowship in endocrinology, how can you tell if your doctor knows enough about diabetes to give you the proper care? It’s simple: Interview your current or potential doctor. Although taking care of your diabetes day-to-day will be primarily a do-it-yourself project, you’ll need the proper knowledge and tools before you can manage the condition, and that calls for a team of experts to guide you along the road to maintaining good health. Dr. Rhoda Cobin suggests beginning the interview with your doctor or prospective doctor with the open-ended question, “What’s going on in my body?” Cobin, who is a past president of the American College of Endocrinologists, Clinical Professor of Medicine at the Mount Sinai School of Medicine in New York City, and practices endocrinology in Ridgewood, New Jersey, says that that is the most important question you can ask. That one question, Cobin says, can open up a dialogue between you and the doctor. It’s a chance for the doctor to tell you about diabetes: how it begins, how it can affect the rest of your body, what needs to Continue reading >>

20 Questions To Ask A New Endocrinologist

20 Questions To Ask A New Endocrinologist

Here are some questions you might want to ask a doctor during this initial visit: 1. What is your experience with Type 1 diabetes? 2. What do you expect my A1C score to be? 5. Do you do the A1C test in your office? 6. How many times a day do you expect me to test my blood sugar? 7. What is your protocol on treating a bout of hypoglycemia? 8. What is your protocol on treating blood sugar levels that are 300 mg/dL or higher? 9. When do you have your patients test for ketones? 11. Do you have a certified diabetes educator who is experienced in working with people with Type 1 diabetes? 12. Do you have a dietician who is experienced in working with people with Type 1 diabetes? 13. Who takes insulin adjustment calls, and what are their hours? 14. Who do I call in the middle of the night? 16. Are you familiar with all the insulin pumps on the market? 18. Do you download pumps and meters at every visit? 19. Do you have many patients on continuous glucose monitors? 20. Who in your office works with prior authorizations in case I have an issue with supplies? Your options for doctors may be limited by geography. If you are in a rural area, there may only be one endocrinologist in the area, or there may be none. If thats the case, you will have to make the best of the situation and develop a good relationship with that physician. However, if you do have a choice, this set of questions will help you find the best medical provider possible for your needs. If you would like to buy The Savvy Diabetic A Survival Guide, you can do so at thesavvydiabetic.com/buythebook . This excerpt has been edited for length and clarity. Thanks for reading this Insulin Nation article. Want more Type 1 news? Subscribe here . Have Type 2 diabetes or know someone who does? Try Type 2 Nation , our sister p Continue reading >>

Patient Information About Type 1 Diabetes

Patient Information About Type 1 Diabetes

Patient Information about Type 1 Diabetes Patient Information about Type 1 Diabetes Type 1 diabetes, sometimes called insulin-dependent diabetes or juvenile diabetes, usually develops before the age of 30. Diabetes type 1 is a serious, chronic autoimmune disease in which the pancreas no longer produces enough insulin. This type of diabetes mellitus often requires several insulin injections each day to prevent high blood sugar (glucose) levels and cannot be controlled through diet, nutrition, and exercise. Type 1 diabetes usually develops suddenly and causes severe symptoms. Symptoms of diabetes include excessive thirst and urination, weight loss, nausea and vomiting, fatigue, rapid breathing, abdominal pain, and confusion. Breath that smells fruity is a common sign of diabetes. Diabetes can cause serious complications, including organ damage, so it is very important for people with diabetes type 1 to monitor and manage their blood sugar levels carefully. Here are some questions to ask your or your child's doctor or certified diabetes educator (C.D.E.) about type 1 diabetes. Print this page, note the questions you would like answered, and take it with you to your next appointment. The more knowledge you have about diabetes, the easier it will be to make important decisions about managing diabetes. Questions to Ask Your Doctor about Type 1 Diabetes Why do you suspect that I or my child has type 1 diabetes? What other conditions might be causing these symptoms? How is type 1 diabetes usually diagnosed? What kind of diagnostic tests will be performed? What are the risks, benefits, and possible complications associated with these tests? How long after these tests will I be able to return to my normal activities? Does diabetes treatment require lifestyle changes? Will certai Continue reading >>

Recently Diagnosed – Type 1 Diabetes Patient Where Do I Begin?

Recently Diagnosed – Type 1 Diabetes Patient Where Do I Begin?

If you have recently been diagnosed with Type 1 diabetes, you may feel like you have a tall mountain to climb. There is so much to learn and you may feel confused, scared, and unsure of your future. Not to worry! You just have to know where to begin and make a plan for yourself. As a home health nurse, I visited many new diabetics in their homes. They were often diagnosed in the hospital and discharged with very little teaching. How do I use these syringes? What can I eat? What is my blood sugar supposed to be? These were a few of the questions I would be asked at that first meeting. It would take a few visits to get them squared away, but when I left them they were ready to climb that mountain! You may be wondering which way to go first. The steps below will help you move forward after diagnosis and find the help and support you need: Breathe and Accept You’ve just heard the words, Type 1 Diabetes. It’s frightening and confusing. Your entire life just changed in the blink of an eye and you have so much going through your head. Now is the time to just sit and breathe in quiet contemplation. Type 1 diabetes isn’t a sentence, it’s a journey. A journey that begins with acceptance and the will to succeed. A journey that can be done. Just like with any other journey, you have to come up with a plan. You will need to map things out. For now, just breathe. Everything will be fine once you get used to the new routine. Ask Questions This is the tricky part. When you’re still in shock, it is hard to even know what questions to ask. However, this diagnosis doesn’t go away until you are ready to face it. It’s already there and needs immediate and lifelong treatment. We have you covered. Here is a list of common questions that are very important to ask your doctor on t Continue reading >>

Q & A: Your Questions On Diabetes

Q & A: Your Questions On Diabetes

Two new treatments for diabetes have led to great excitement among those who might benefit. Inhalable insulin, which should be available this month, could mean less pain for diabetics who inject the hormone daily. And the drug exenatide, which helps promote insulin production, can lead to weight loss for some. Dr. Martin Abrahamson, medical director of the Joslin Diabetes Center in Boston, answers questions from the NPR audience, submitted after our story on the two treatments. Can people with Type 1 diabetes (formerly called juvenile or insulin-dependent diabetes) benefit from exenatide, the new injected drug that uses a natural hormone to stimulate insulin release? submitted by several listeners Type 1 diabetes is caused by destruction of the cells of the pancreas that make insulin the beta cells. It is what we call an autoimmune disease: the immune system thinks the beta cells are foreign cells and destroys them. For exenatide to work, some beta cells must be functioning. Thus, exenatide would not work in people with Type 1 diabetes and is not approved for their use. I've been an insulin-dependent diabetic for 31 years with good control and no complications. Could I benefit from inhalable insulin? J.S. Orlando, Fla. Inhaled insulin is approved for use in patients with either type 1 or type 2 diabetes. You may be a candidate, provided you do not smoke, have not smoked for 6 months and do not have any active lung disease. Could inhalable insulin lead to weight loss? submitted by several listeners No. Insulin therapy, whether injected or inhaled, usually leads to some weight gain. Are there any negative side effects to inhalable insulin? What about lung problems? Nancy Williams, Cincinnati, Ohio At this stage, we know of no long-term negative pulmonary side effects of Continue reading >>

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