A person with type 1 diabetes takes insulin (see Chapter 10) to control the blood glucose. At this time, doctors and their patients cannot match the human pancreas in the way that it releases insulin just when the food is entering the bloodstream so that the glucose remains between 80 and 120 mg/dl. Therefore, the diabetic patient needs to make sure that his or her food enters as close to the expected activity of the insulin as possible.
Most people with type 1 diabetes take two different types of insulin: one that acts soon after the injection and has a brief period of activity, and a second that acts more slowly and lasts longer. The rapid-acting insulin is meant to cover the food eaten at meals, while the slower acting insulin covers the rest of the time, particularly overnight when a lot of circumstances tend to raise the blood glucose.
Fortunately, you can take a new type of insulin when you start to eat or even in the middle or at the end of a meal. (See Chapter 10 for more information on this insulin.) This insulin overcomes the problem that always previously existed — that the shot had to be taken 30 minutes before eating to give it time to be active. A person with diabetes who had a meal delayed for any reason could easily become hypoglycemic using the old preparation.
j&IBElt The person with type 1 diabetes needs to be very careful when drinking alcohol. Alcohol increases the activity of insulin and can bring the blood glucose way down if food is not taken with it. (See the section on "Counting Alcohol as Part of Your Diet," earlier in this chapter.)
Because the person with type 1 diabetes always has some injected insulin circulating whether food is available or not, this patient should not miss a meal. A midmorning snack, a midafternoon snack, and even a bedtime snack, if necessary, are particularly good ideas.
The person with type 1 diabetes needs to be willing to test the blood glucose frequently. That way, he or she can identify problems in advance. If, for example, blood glucose is low before exercise (see Chapter 9), you can take some nutrition to avoid hypoglycemia.
For much more on this subject see my new book, Type 1 Diabetes For Dummies (Wiley).
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