All food that you eat turns to sugar in your body.

Carbohydrate-containing foods alter your sugar
levelsmore than any other type of food. Carbohydrates are found in starchy or sugary foods, such as
bread, rice, pasta, cereal, potatoes, peas, corn, fruit, fruit juice, milk, yogurt, cookies, candy, soda, and
other sweets.

Biguanides Biguanides (Metformin) tell the liver to decrease its production of glucose. which lowers glucose levels in the bloodstream. thereby lowering the after-meal glucose levels.Alpha-glucosidase inhibitors (such as acarbose) decrease the absorption of carbohydrates from the digestive tract. Sulfonylureas drug .

they increase the cell's sensitivity (responsiveness) to insulin. In essence. Thiazolidinediones Thiazolidinediones (such as rosiglitazone) help insulin work better at the cell site. glyburide. and tolazamide) trigger the pancreas to make more insulin. Food and insulin release .Oral sulfonylureas (like glimepiride.

Make sure you wear the right kind of shoes. . deeper or infected. The affected limb may need to be amputated if these skin ulcers do not heal or become larger. Diabetes damages the nerves. You many not notice a foot injury until you get a severe infection. It can become harder for blood to flow to your legs and feet. including trouble seeing (especially at night). and other problems. causing pain. This is very important when you already have nerve or blood vessel damage or foot problems. Possible Complications After many years. After a long time. and numbness. Improve control of your blood sugar. Because of nerve damage. Nerve damage can make it harder for men to have an erection. stroke.Insulin is a hormone secreted by the pancreas in response to increased glucose levels in the blood. Diabetes may make it harder to control your blood pressure and cholesterol. Your feet and skin can develop sores and infections. Small sores or breaks in the skin may become deeper skin sores (ulcers). Get a foot exam by your doctor at least twice a year and learn if you have nerve damage. and light sensitivity. Diabetes can also damage blood vessels. This can make you less able to feel pressure on the foot. tingling. your foot or leg may need to be amputated. diabetes can lead to serious problems:      You could have eye problems. Infection can also cause pain and itching in other parts of the body. Ask your doctor what is right for you. you could have problems digesting the food you eat. Check and care for your feet every day. You could feel weakness or have trouble going to the bathroom. Foot Care People with diabetes are more likely than those without diabetes to have foot problems. This can lead to a heart attack. You could become blind. Nerves in your body can get damaged. To prevent problems with your feet:      Stop smoking if you smoke.

Milder forms of DI can be managed by drinking enough water. The large volume of urine is diluted. having trouble thinking clearly. DI severe enough to endanger a person's health is rare. sweating. They may even stop working so that you need dialysis or akidney transplant. having dry skin. DI is a different form of illness altogether. The kidneys remove extra body fluids from the bloodstream. or pain in your feet or legs Problems with your eyesight Sores or infections on your feet Symptoms of high blood sugar (being very thirsty. or diarrhea. a person with DI may feel the need to drink large amounts and is likely to urinate frequently. on occasion. people with DI may quickly become dehydrated if they do not drink enough water. although they can have similar signs and symptoms. fast heartbeat. Children with DI may be irritable or listless and may have fever. which results from insulin deficiency or resistance leading to high blood glucose. like excessive thirst and excessive urination. needing to urinate a lot) Symptoms of low blood sugar (feeling weak or tired. vomiting. DM is far more common than DI and receives more news coverage. Because of the excretion of abnormally large volumes of dilute urine. Also call your doctor if you have:      Numbness. tingling. [Top] What is the difference between diabetes insipidus and diabetes mellitus? DI should not be confused with diabetes mellitus (DM). trembling. which can disrupt sleep and.5 liters a day. double or blurry vision. These fluids are stored in the bladder as . To make up for lost water. DI and DM are unrelated. feeling irritable. usually between 2 and 2. feeling uneasy) What is diabetes insipidus? Diabetes insipidus (DI) is a rare disease that causes frequent urination. having blurry vision. cause bedwetting. mostly water. DM has two main forms. When to Contact a Medical Professional Call 911 right away if you have:     Chest pain or pressure Fainting or unconsciousness Seizure Shortness of breath These symptoms can quickly get worse and become emergency conditions (such as convulsionsor hypoglycemic coma). feeling weak or tired. type 1 diabetes and type 2 diabetes. [Top] How is fluid in the body normally regulated? The body has a complex system for balancing the volume and composition of body fluids. also called blood sugar. even at night. Your kidneys may not work as well as they used to. High blood sugar and other problems can lead to kidney damage.

When ADH reaches the kidneys. and the rate of excretion is governed by the production of antidiuretic hormone (ADH). and water can build up now that the kidneys are making less urine and are less responsive to changes in body fluids. Damage to the pituitary gland can be caused by different diseases as well as by head injuries. The hypothalamus makes antidiuretic hormone (ADH). a synthetic hormone called desmopressin can be taken by an injection. To treat the ADH deficiency that results from any kind of damage to the hypothalamus or pituitary. While taking desmopressin. DI occurs when this precise system for regulating the kidneys' handling of fluids is disrupted. Sometimes the cause of nephrogenic DI is never discovered. If the fluid regulation system is working properly. or a pill. results from damage to the pituitary gland. a small gland located in the brain. the rate of fluid intake is governed by thirst. ADH is stored in the nearby pituitary gland and released into the bloodstream when necessary. kidney failure. the kidneys make less urine to conserve fluid when water intake is decreased or water is lost. HCTZ is sometimes combined with another drug called . Nephrogenic DI Nephrogenic DI results when the kidneys are unable to respond to ADH. sickle cell disease. a person should drink fluids only when thirsty and not at other times. This hormone is made in the hypothalamus. or genetic disorders. also called vasopressin. for example—and by chronic disorders including polycystic kidney disease. through sweating or diarrhea. The drug prevents water excretion. central DI. neurosurgery. The kidneys' ability to respond to ADH can be impaired by drugs—like lithium. To keep the volume and composition of body fluids balanced. which directs the kidneys to make less urine. Instead. a nasal spray.urine. which disrupts the normal storage and release of ADH. partial blockage of the ureters. a person with nephrogenic DI may be given hydrochlorothiazide (HCTZ) or indomethacin. and inherited genetic disorders. The kidneys also make less urine at night when the body's metabolic processes are slower. it directs them to concentrate the urine by reabsorbing some of the filtered water to the bloodstream and therefore make less urine. Desmopressin will not work for this form of DI. for example. [Top] What are the types of diabetes insipidus? Central DI The most common form of serious DI.

[Top] Points to Remember  Diabetes insipidus (DI) is a rare disease that causes frequent urination and excessive thirst. Therefore. an abnormality in the thirst mechanism causes gestational DI. however. a condition that lowers the concentration of sodium in the blood and can seriously damage the brain. urine output. But testing should make the diagnosis clear. Diagnosis is based on a series of tests. and desmopressin should not be used. including urinalysis and a fluid deprivation test. A physician evaluates the concentration of urine by measuring how many particles are in a kilogram of water or by comparing the weight of the urine with an equal volume of distilled water. a magnetic resonance imaging (MRI) of the brain may be necessary as well. The urine of a person with DI will be less concentrated. This fluid overload can lead to water intoxication. a health care provider may suspect that a patient with DI has DM. The combination of HCTZ and amiloride is sold under the brand name Moduretic. In rare cases.amiloride. which is located in the hypothalamus. Again.  DI is not related to diabetes mellitus (DM). Scientists have not yet found an effective treatment for dipsogenic DI. The placenta is the system of blood vessels and other tissue that develops with the fetus. This defect results in an abnormal increase in thirst and fluid intake that suppresses ADH secretion and increases urine output. The placenta allows exchange of nutrients and waste products between mother and fetus. Dipsogenic DI Dipsogenic DI is caused by a defect in or damage to the thirst mechanism. . and urine composition when fluids are withheld. Desmopressin or other drugs should not be used to treat dipsogenic DI because they may decrease urine output but not thirst and fluid intake. [Top] How is diabetes insipidus diagnosed? Because DM is more common and because DM and DI have similar symptoms. A fluid deprivation test helps determine whether DI is caused by one of the following:  excessive intake of fluid  a defect in ADH production  a defect in the kidneys' response to ADH This test measures changes in body weight. with this combination of drugs. Urinalysis is the physical and chemical examination of urine. the salt and waste concentrations are low and the amount of water excreted is high. Sometimes measuring blood levels of ADH during this test is also necessary. A doctor must determine which type of DI is involved before proper treatment can begin. one should drink fluids only when thirsty and not at other times. Most cases of gestational DI can be treated with desmopressin. Gestational DI Gestational DI occurs only during pregnancy and results when an enzyme made by the placenta destroys ADH in the mother. In some patients.

known as point-of-care (POC) tests.  Most forms of gestational DI can be treated with desmopressin. which prevents water excretion.  The A1C test is based on the attachment of glucose to hemoglobin. are not standardized for diagnosing diabetes.4 percent Points to Remember  The A1C test is a blood test that provides information about a person’s average levels of blood glucose. The .  A doctor must determine which type of DI is involved before proper treatment can begin. Thus. over the past 3 months. indomethacin.5 percent or above Prediabetes 5. The following table provides the percentages that indicate diagnoses of normal.7 percent Diabetes 6. also called blood sugar.  In 2009. Central DI is caused by damage to the pituitary gland and is treated with a synthetic hormone called desmopressin. experts are hoping its convenience will allow more people to get tested—thus. and prediabetes according to A1C levels.  Nephrogenic DI is caused by drugs or kidney disease and is treated with hydrochlorothiazide (HCTZ).  Because the A1C test does not require fasting and blood can be drawn for the test at any time of day. diabetes. the A1C test was not recommended for diagnosis of type 2 diabetes and prediabetes because the many different types of A1C tests could give varied results. the protein in red blood cells that carries oxygen. decreasing the number of people with undiagnosed diabetes.  Scientists have not yet discovered an effective treatment for dipsogenic DI. an international expert committee recommended the A1C test be used as one of the tests available to help diagnose type 2 diabetes and prediabetes. or a combination of HCTZ and amiloride.  Blood samples analyzed in a health care provider’s office. the A1C test reflects the average of a person’s blood glucose levels over the past 3 months. which is caused by a defect in the thirst mechanism. A1C Diagnosis* A1C Level Normal below 5.7 to 6.  In the past.

 Estimated average glucose (eAG) is calculated from the A1C to help people with diabetes relate their A1C to daily glucose monitoring levels. Some people with type 2 diabetes need diabetes pills or insulin shots to help their bodies use glucose for energy.  The standard blood glucose tests used for diagnosing type 2 diabetes and prediabetes—the fasting plasma glucose (FPG) test and the OGTT—are still recommended. People should discuss their A1C target with their health care provider. After that. are not standardized for use in diagnosing diabetes. It must be injected into the fat under your skin for it to get into your blood. People with type 2 diabetes make insulin. and how long they last. The beta cells have been destroyed and they need insulin shots to use glucose from meals. Insulin cannot be taken as a pill because it would be broken down during digestion just like the protein in food. when they peak. .  The A1C test may be used at the first visit to the health care provider during pregnancy to see if women with risk factors had undiagnosed diabetes before becoming pregnant. but their bodies don't respond well to it. In some rare cases insulin can lead to an allergic reaction at the injection site. but animal insulin can still be imported for personal use.  The American Diabetes Association recommends that people with diabetes who are meeting treatment goals and have stable blood glucose levels have the A1C test twice a year. With each meal. beta cells release insulin to help the body use or store the blood glucose it gets from food.  People will have different A1C targets depending on their diabetes history and their general health. beta cells make the hormone insulin. the pancreas no longer makes insulin.  The A1C test can be unreliable for diagnosing or monitoring diabetes in people with certain conditions that are known to interfere with the results. Blood samples analyzed in a health care provider’s office. the most common is U-100.accuracy has been improved by the National Glycohemoglobin Standardization Program (NGSP). The random plasma glucose test may be used for diagnosing diabetes when symptoms of diabetes are present.  All insulin available in the United States is manufactured in a laboratory. known as point-of-care (POC) tests. In people with type 1 diabetes. which developed standards for the A1C tests. the oral glucose tolerance test (OGTT) is used to test for diabetes that develops during pregnancy—known as gestational diabetes.  Insulin is available in different strengths. Talk to your doctor if you believe you may be experiencing a reaction. Inside the pancreas. Insulin Basics  There are different types of insulin depending on how quickly they work.

peaks 4 to 12 hours later. Insulin Strength All insulins come dissolved or suspended in liquids.  Peaktime is the time during which insulin is at maximum strength in terms of lowering blood glucose. Types: Insulin detemir (Levemir) and insulin glargine (Lantus) Premixed insulin can be helpful for people who have trouble drawing up insulin out of two bottles and reading the correct directions and dosages. . which has 40 units of insulin per milliliter of fluid. begins to work about 15 minutes after injection. and insulin aspart (NovoLog)  Regular or Short-acting insulin usually reaches the bloodstream within 30 minutes after injection.Types of Insulin  Rapid-acting insulin. which means it has 100 units of insulin per milliliter of fluid. It is also useful for those who have poor eyesight or dexterity and is convenient for people whose diabetes has been stabilized on this combination. peaks in about 1 hour. The standard and most commonly used strength in the United States today is U-100.  Duration is how long insulin continues to lower blood glucose. If you're traveling outside of the U.. U-40. though U500 insulin is available for patients who are extremely insulin resistant. Types: Humulin R. Types: NPH (Humulin N. Types: Insulin glulisine (Apidra). Novolin N)  Long-acting insulin reaches the bloodstream several hours after injection and tends to lower glucose levels fairly evenly over a 24-hour period. and continues to work for 2 to 4 hours. Novolin R  Intermediate-acting insulin generally reaches the bloodstream about 2 to 4 hours after injection. and is effective for about 12 to 18 hours. has generally been phased out around the world. be certain to match your insulin strength with the correct size syringe.S. but it is possible that it could still be found in some places (and U-40 insulin is still used in veterinary care). and is effective for approximately 3 to 6 hours. peaks anywhere from 2 to 3 hours after injection. Characteristics of Insulin Insulin has 3 characteristics:  Onset is the length of time before insulin reaches the bloodstream and begins lowering blood glucose. insulin lispro (Humalog).

but move around the same area. Injecting insulin in the same general area (for example. or different foods affect your blood glucose level. and activity. Ask your health care provider if you aren't sure where to inject your insulin. Both of these problems are unsightly and make the insulin action less reliable. You can also use this information to make decisions about your insulin dose. Site Rotation  The place on your body where you inject insulin affects your blood glucose level.  Timing  . For example. food.Fine-Tuning Your Blood Glucose Many factors affect your blood glucose levels. giving your before-breakfast insulin injection in the abdomen and your before-supper insulin injection in the leg each day give more similar blood glucose results. Insulin enters the blood at different speeds when injected at different sites. your abdomen) will give you the best results from your insulin. Each mealtime injection of insulin should be given in the same general area for best results. including the following:       What you eat How much and when you exercise Where you inject your insulin When you take your insulin injections Illness Stress    Self Monitoring Checking your blood glucose and looking over results can help you understand how exercise. hard lumps or extra fatty deposits may develop. Insulin shots work fastest when given in the abdomen. Don't inject the insulin in exactly the same place each time. an exciting event. If you inject insulin near the same place each time. You can use it to predict and avoid low or high blood glucose levels. This is because the insulin will reach the blood with about the same speed with each insulin shot. Insulin arrives in the blood a little more slowly from the upper arms and even more slowly from the thighs and buttocks.

for several nights and discuss the results with your health care provider. One relates to hormones that are released in the early part of sleep (called the Dawn Phenomenon). why did your blood glucose level go up? There are two common reasons for high before-breakfast blood glucose levels. Studies have shown that three or four injections of insulin a day give the best blood glucose control and can prevent or delay the eye. Sometimes diabetes pills stop working.org/living-with-diabetes/treatment-andcare/medication/insulin/insulin-routines.html#sthash. set your alarm to self-monitor around 2 or 3 a. Too much insulin or not enough?  High morning blood glucose levels before breakfast can be a puzzle.hadTUuPd. The other is from taking too little insulin in the evening. kidney. and people with type 2 diabetes will start with two injections per day of two different types of insulin. and nerve damage caused by diabetes.m.  Insulin shots are most effective when you take them so that insulin goes to work when glucose from your food starts to enter your blood.  Type 2  Most people with type 2 diabetes may need one injection per day without any diabetes pills. If you haven't eaten.diabetes.See more at: http://www.dpuf . To see which one is the cause.  Type 1  People diagnosed with type 1 diabetes usually start with two injections of insulin per day of two different types of insulin and generally progress to three or four injections per day of insulin of different types. regular insulin works best if you take it 30 minutes before you eat.  . The types of insulin used depend on their blood glucose levels. They may progress to three or four injections of insulin per day. Some may need a single injection of insulin in the evening (at supper or bedtime) along with diabetes pills. For example.