Could you have diabetes?

On average, every day 480 Canadians are diagnosed with diabetes, more than 20 Canadians die of diabetes-related complications, and 14 Canadians have a lower limb amputated due to diabetes. Could you have diabetes and not know it? It is important to know whether you have diabetes, because if you are aware of it, you can take steps to manage your condition and lead a healthier life. However, if left untreated, diabetes can cause very serious complications.

Different types of diabetes

There are several different types of diabetes:

• Type 1 diabetes is a condition in which the body’s immune system destroys the insulin-producing cells of the pancreas, making the affected people dependent on injecting insulin into their bodies. Type 1 diabetes usually develops in children and youths, but it can occur in adults as well.

• Type 2 diabetes occurs when the pancreas does not produce enough insulin or the body cannot properly use the insulin it produces. In some cases, type 2 diabetes can be managed with oral medication, but some people with type 2 will need to inject insulin.

• Gestational diabetes may develop during pregnancy if a woman’s blood sugar reaches too high a level. It usually disappears following delivery of the baby, but it increases the woman’s chances of developing type 2 diabetes.

What causes diabetes?

There is a lot of misinformation about diabetes floating around. For example, diabetes is not caused by eating too much sugar, and people do not give themselves diabetes. The causes of diabetes depend on the type of diabetes the person has—type 1 diabetes, type 2 diabetes, or gestational diabetes. Among the possible causes are your genes, family medical history, ethnic background, and your general health.

Symptoms

Some people with diabetes don’t experience any obvious warning signs, but those who do may have some of the following symptoms:

• cuts and bruises that are slow to heal
• lack of energy or extreme fatigue
• frequent or recurring infections
• unusual thirst
• frequent urination
• tingling or numbness in the hands or feet
• trouble achieving or maintaining an erection
• blurred vision
• weight loss or weight gain

Prediabetes

Prediabetes is a condition in which blood glucose (blood sugar) levels are higher than normal, but not high enough to be diagnosed as diabetes. Nearly six million Canadians have prediabetes. If left untreated, prediabetes can develop into type 2 diabetes. If you have prediabetes, taking steps to manage your blood glucose levels can help prevent you from developing diabetes.

Managing blood glucose

There are several measures you can take to help manage your blood glucose levels:

• Eat a healthy diet
• Be physically active
• Achieve and maintain a healthy body weight
• Monitor your blood glucose levels regularly
• Take any medication your doctor prescribes exactly according to the directions

Diagnosing diabetes

If you think you or someone you know may have diabetes, seek medical attention as soon as possible, so you can begin managing the condition and prevent complications. There are several tests used to diagnose diabetes:

• Fasting blood glucose test
• Random blood glucose test
• A1C test
• Oral glucose tolerance test

While diabetes cannot be cured, it can be managed, and people with diabetes can lead happy, fulfilling lives. Diabetes Management Clinics are also available at London Drugs for one-on-one consultations.

Read other articles in our Fall-Winter 2021 volume of our Bettercare magazine here or learn more about the Diabetes services offered at London Drugs.

Kids, Diabetes and School

Students with diabetes spend more than half of their waking hours in school during weekdays, so it is extremely important that the students, their parents or guardians, school personnel, and healthcare providers understand their roles and responsibilities in helping these students manage their diabetes and their schoolwork. They must all work together to meet the varying needs of each individual student.

Daily management

Daily diabetes management requires a balance of medication, food, and activity. A student whose blood glucose climbs too high or dips too low may be unable to perform school-related tasks. Often help from school personnel can provide the assistance that students need to manage their diabetes effectively.

Individual care plan

It all begins with the student’s individual care plan (ICP), which should be given to the school by the student’s parents or guardians. The ICP provides the school with pertinent details about the student’s daily diabetes management program and plans for dealing with emergencies.

The plan should provide the following information:

• Emergency contact information for the student’s parents or guardians and contact information for the student’s healthcare provider
• The type of diabetes the student has
• Medication/insulin dosing schedule
• Blood glucose (blood sugar) target range and frequency of testing
• Symptoms of hypoglycemia (low blood glucose) and hyperglycemia (high blood glucose) along with instructions for appropriate treatment
• Treatment options for dealing with hypoglycemia and hyperglycemia, including emergency procedures for dealing with severe hypoglycemia and hyperglycemia
• A plan for preventing hypoglycemia following periods of increased activity
• Information about the proper storage of medical supplies and equipment the student might require while in school

Nutrition

It is important that students with diabetes eat all meals and snacks on time. School personnel must make sure that the students have enough time to finish all of the food they are supposed to eat. Younger students may need supervision to ensure that they consume everything they are supposed to eat when they are supposed to eat it.

Physical activity

Being physically active is important for people with diabetes, so students should be encouraged to participate in sports and other activities that include exercise. However, planning is important to ensure that their blood glucose levels remain in the safe range. Physical activity can trigger hypoglycemia. Sometimes an extra snack can bring blood glucose levels back into the safe range, but it is important that school personnel recognize the signs of hypoglycemia and hyperglycemia so that they can take appropriate action in a timely manner.

Warning signs of hypoglycemia (less than 4 mmol/L):
• Confused, unable to concentrate
• Drowsy
• Feeling shaky
• Headachy
• Hungry
• Increased heart rate
• Light-headed
• Nauseated
• Nervous, irritable, anxious
• Numbness or tingling on the lips or tongue
• Sweaty
• Weak

Warning signs of severe hypoglycemia (less than 2.8 mmol/L):
• Confused and disoriented
• Having a seizure
• Loss of consciousness

Warning sign of hyperglycemia:
• Being tired
• Feeling thirsty
• Urinating more often than usual

Medications & insulin

The medication management schedule outlined in the student’s ICP should be followed very carefully. Some students may require supervision with medication or insulin administration, and parents/guardians must provide permission for school personnel to administer medications or insulin, and the school personnel must be provided with proper training. While some students with diabetes may have type 2, which can often be managed with oral medications, most students with diabetes have type 1, which means they require insulin. Insulin is delivered in three ways: by syringe, by insulin pen, and by insulin pump.

Syringe:
Insulin is stored in a vial and drawn into a syringe that is used to inject the insulin under the skin into an arm, thigh, buttocks, or stomach.

Insulin pen:
The pen contains a cartridge of insulin and a dial that permits the user to select the proper dose. A pin on the tip of the pen is used to inject the insulin.

Insulin pump:
This device administers insulin continuously through a small tube under the skin. The user can direct the pump to deliver an extra dose when more insulin is needed.

Insulin must be stored properly in order to be effective. Unopened vials or cartridges should be refrigerated until ready to be used. It is important to make sure the insulin does not freeze. Once opened, most vials and cartridges can be left at room temperature for up to 30 days. Insulin that has passed its expiry date should not be used.

Special accommodations

Special accommodations may need to be made for students with diabetes. For example:
• They must be given time and a place to test their blood glucose levels and to take their medications or insulin in accordance with their ICPs.
• They should be allowed to keep a water bottle with them.
• They should be allowed to take bathroom breaks as often as necessary.
• They should be allowed to snack when necessary to maintain a safe blood glucose level.
• They should be allowed to participate in school parties, field trips, and other events, but plans must be made in advance to accommodate any special needs.
• Accommodations should be made for taking tests. Both hypoglycemia and hyperglycemia can affect the ability to concentrate. It may be necessary to allow the student to measure his or her blood glucose prior to taking the test and to allow extra time to complete the test. In some cases, the test may need to be rescheduled for a student whose blood glucose is too low or too high.

Communication is key

Every child with diabetes is different, and needs vary. To provide the support each child needs to thrive requires good communication between parents/guardians, school personnel, and the child’s healthcare team. When everyone works together for the benefit of children with diabetes, these students can achieve academic success. Diabetes Management Clinics are also available at London Drugs for one-on-one consultations.

Read other articles in our latest issue of our Living with Diabetes magazine here or learn more about the Diabetes services offered at London Drugs.

Newly Diagnosed: Meeting the Challenge

You’ve just received the diagnosis: you have diabetes. This can be an overwhelming experience. You may feel shocked, stressed, or even depressed. You may have difficulty coming to terms with the fact that diabetes is a serious condition. Coping with a new diagnosis takes time, but with the right support you can do it. The good news is that there are many resources available to assist you in understanding the changes that you will have to make in your life.

Take control

You might be tempted to ignore the diagnosis and continue living your life as you have been, but taking control of your diabetes right away will deliver big benefits in the long run, helping you live a healthier life and preventing or delaying the development of complications. Taking an active role in managing your diabetes will help put you in control and make you feel better—both emotionally and physically. This means following your meal plan, being physically active, monitoring your blood glucose (blood sugar) levels daily, and being diligent about taking your medicines or injecting your insulin on schedule. Recording and monitoring your blood glucose readings will help you identify patterns that will enable you to see which factors are affecting your blood sugar levels and what lifestyle changes you may need to make.

Accept what you are feeling

The first step in learning to cope with the diagnosis is accepting that your emotions are likely to swing back and forth between feeling confident that you can manage your condition and struggling to cope with what might seem to be an endless list of new things to learn and do. That’s natural. You aren’t the only one to feel these things. Be kind to yourself and don’t expect perfection right away. There is always a learning curve; things take time. You can’t fix everything overnight. Don’t try to hide your diabetes from the people around you. Share your experiences with trusted family members, friends, and coworkers. They can be a resource for helping you cope when you are feeling sad, and they can help watch for signs that your diabetes may not be well managed. Starting a mood journal or diary may also help. This will provide a safe place to share your hopes and fears. By recording your emotions you may discover links between what you are doing physically and what you are experiencing emotionally. This can help you identify things in your life that you may want to change. As time goes on and you begin to adjust to the changes you are making in your life, you will start to become more comfortable and will begin to feel confident in your ability to manage your diabetes. Your negative feelings may return from time to time, because it is difficult to be positive all of the time. If your down moods don’t last too long, it’s probably nothing to be concerned about; however, if they start to take over your emotions, ask your healthcare provider if a professional counselor would be helpful.

Looking for help

It is important to learn everything you can about diabetes. The more you know, the better able you will be to manage the condition in a healthy manner. If you are looking for information on programs and services to help people newly diagnosed with diabetes, Diabetes Canada can help. Contact information for regional offices across Canada is available at https://www.diabetes.ca/contact-us/regional-offices. Your healthcare team is there to help you. Don’t overlook this important resource. Doctors, certified diabetes educators, dietitians, and pharmacists all have a role to play in helping you live a healthy life.

If you have any questions about managing your diabetes or about where to go for additional help, your London Drugs pharmacists are always happy to help.