With diabetes along the way - how to live with the disease? Diabetes and everyday life Diabetes and contraception.

Patient with diabetes in the family

The greatest help and support for a person with diabetes is his family. Family members need to try to forget petty quarrels and grievances, but also not to place the sick person in a vacuum, under a “cap”, not to create “sterile” conditions for him. This will organize, discipline him and at the same time make him feel that the whole family still needs him.

Camp, school and diabetes

When sending a child with diabetes to school, camp, travel, he must have with him:

1. A document, a note stating that the child has diabetes and receives insulin, has syringe pens, insulin and other medical equipment, has a home phone number and address, as well as coordinates of diabetes services in the region of residence and in the region, which he is going to visit.

2. Enough insulin, needles, test strips.

3. Glucometer and spare batteries for it.

4. An additional amount of food and drinks, products necessary for the relief of hypoglycemia.

Diabetes and teenagers

In puberty (teenage) period in a patient with diabetes mellitus, the need for insulin increases, so its dose increases to 1-2 units per 1 kg of body weight per day. During menstruation in girls, there is a change in the level of blood glucose, so during this period it may be necessary to adjust the dose of insulin. At the same time, very careful hygiene measures are necessary (since patients with diabetes during menstruation significantly increase the risk of developing infectious diseases if hygiene is neglected).

Diabetes and career choice

Patients with diabetes should choose a specialty ensuring compliance with a special regime of work, nutrition and the ability to inject insulin (take hypoglycemic drugs) at the right time.

Such requirements are met by specialties: pharmaceutical, medical, pedagogical, agricultural, economic, work in archives, libraries.

Absolute contraindications for working with diabetes include:

• professions associated with chemicals or other substances that can affect the skin, mucous membranes of a person;
• with irregular working hours;
• requiring increased concentration of attention: driver, electrician, pilot, others;
• work in conditions of significantly changing temperatures: in hot shops and in the cold;
• work associated with the inability to comply with the diet, rest.

Work associated with a risk to the patient and other people is contraindicated(submariners, service in the armed forces, police, fire departments, air and navy, driving passenger vehicles, managing air and rail transport).

Professions that are not recommended for people with diabetes associated with work in hot shops, when changing weather conditions, involving long business trips, staying in one static position for a long time, visual loads. Patients on insulin therapy should avoid shift work, especially at night.

Patients with diabetes who receive diet therapy and oral hypoglycemic drugs, as a rule, can engage in any type of activity. labor activity, except for work in the aviation fleet.

Diabetes and sports choice

In the thematic sections information portal about vital diabetunet.ru, devoted to physical activity, as well as the treatment of elderly patients, children and adolescents, all the rules for the use of physical exercises for persons are described in detail different ages. Patients with diabetes are not recommended to engage in heavy and team sports, wrestling, participate in competitions, take tests, standards. Swimming is very useful, but it is forbidden to swim far, it is desirable that a coach or relative is always (swimming) nearby. During swimming, severe hypoglycemia may develop (there is a danger of drowning). In any case, it is necessary to warn the physical education teacher or coach about the disease.

Diabetes and travel

Travel in the life of a diabetic patient is essential, as they bring a lot of positive emotions. But do not forget about a number of rules, following which, the trip will not cause decompensation of the disease.

During such a rest, a number of factors negatively affect a patient with diabetes: violation of the regime, change of time zones, climate, cuisine, habits, culture. Therefore, it is very important to regularly monitor glycemia, adhere to a diet and use insulin or oral antidiabetic drugs.

While traveling, the following situations may occur:

1. "Sea" or "air" sickness - motion sickness, accompanied by nausea, vomiting. Patients with diabetes may use the same drugs as other travelers. But it should be borne in mind that these drugs can cause drowsiness.

2. Change of time zone - "time shift". In this case, the best way out is to change the time interval between insulin injections by 2-3 hours. Glycemic control should be carried out every 4-6 hours until full adaptation to the time shift. With a general change in the time between injections by 6 hours within a day, there are no difficulties.

With an increase in the time between injections and with a deterioration in the results of a blood and urine test, additional administration of insulin is required (up to a maximum of 4-8 units).

3. Breakage or loss of injection equipment. Patients with diabetes should take a sufficient number of syringes, insulin, needles and self-monitoring equipment with them when traveling. It is best to store equipment for routine use and emergency supplies in separate places.

4. In temperate climates, insulin can be stored for several months at room temperature. In tropical climates, insulin should be kept in the refrigerator at 4 degrees C. (Insulin appears in the refrigerator in case of long-term storage.) Insulin should not be heavily frozen, so you should not carry the drug in the luggage compartment of the aircraft.

5. In the conditions of southern resorts, an important condition is not to overheat in the sun and not to sunbathe intensively. (This advice is useful not only for patients with diabetes, but also for healthy people.)

Diabetes and driving

Patients with diabetes mellitus who do not suffer from severe hypoglycemia with impaired consciousness, visual impairment, as a rule, it is allowed to drive a vehicle with a maximum mass of 3500 kg, the number of seats, in addition to the driver's seat, no more than 8 and a trailer with a carrying capacity of up to 750 kg (in Russia, vehicles of category "B" meet these requirements).

People with diabetes treated with diet and oral antidiabetic agents can obtain a professional driver's license, that is, the right to drive heavy vehicles and carry passengers, subject to passing a special medical examination.

Patients receiving insulin therapy are not allowed to obtain a professional driver's license, because hypoglycemia and its consequences can be dangerous.

The exception is drivers with diabetes who issued a license before 1991 and regularly undergo medical examinations.

Driver patients on insulin therapy should keep sugar in the car in case a hypoglycemic episode helps. They should not drive if they have missed a meal or after intense physical activity.

Reception and visiting guests

The Russian tradition is to invite guests and arrange a feast with an abundance of food. Breaking traditions is hard. But a patient with diabetes, when inviting or visiting guests (feast), should be guided by the following rules: look at the table and immediately decide for yourself what foods you can’t eat, draw a border on the table (within which you can eat a certain amount of food), don’t argue and be offended if, nevertheless, there were violations and an unauthorized product or an excess amount of food was eaten, it is important to prevent undesirable consequences (prick insulin or walk for 30-40 minutes or more or run 5 km with an easy run). Feasts, parties are not a reason to smoke for the company! You can't be afraid to say no. A person who knows how to politely say “no” is always respected in society, because, first of all, he respects himself!

Diabetes and sweets

Sweets for patients with diabetes are sold in specialized stores or pharmacies: cookies, candies, chocolates, waffles, sugary drinks, etc.

These sweets contain sweeteners, most often fructose. We should not forget that all these sweets contain carbohydrates that can increase blood glucose levels!

Therefore, it is recommended not to abuse such a dessert. Such sweets should be consumed in a reasonable amount, only for dessert, subject to normal health, the absence of acetone in the urine and a normal blood glucose level. If you want to bake a cake or make jam, you can use heat-resistant sweeteners (sorbitol, saccharin, cyclamate).

Jam, compote or pie with sweeteners contain carbohydrates. So, if there are 12 apples in a three-liter jar of compote, then 3 liters of compote is 12 bread units, and a glass of such compote contains 1 bread unit or 12 g of carbohydrates (increasing blood glucose levels by 1-2 mmol / l!).

Diabetes and vaccinations

Prophylactic vaccinations are possible with stable compensation, that is, with a normal blood sugar level, the absence of acetone in the urine, and good health.

In a state of decompensation, vaccinations are carried out only for health reasons (upon contact with a patient with an extremely dangerous infectious disease- influenza, diphtheria, with the threat of tetanus, etc.).

Diabetes and contraception

• low estrogen oral preparations;
• combined oral preparations containing low doses of estrogens and progesterone (these hormones increase the need for insulin);
• in the presence of vascular complications, the use of alternative (barrier) contraceptives (condoms) is recommended.

Diabetes and oral hygiene

Diabetes has a high risk of gum disease and cavities. Therefore, self-control and normalization of blood glucose levels are very important, as well as carrying out simple, but very useful activities:

• daily gum massage with a toothbrush;
• brushing your teeth at least 2 times a day for at least 2 minutes;
• the right choice of a toothbrush (with a working surface of not more than 1.5 cm, straight, artificial, since microorganisms often accumulate in natural bristles, change the brush at least 1 time in 3-4 weeks);
• cleansing the spaces between teeth with silk dental floss;
• the use of toothpaste with fluoride, vitamins and / or phytonutrients (strengthening gums) and mouth rinses (used 1-2 times a day, for 30-60 seconds, immediately after brushing your teeth).

Special toothpaste and mouth rinses are currently being produced for diabetic patients.

Diabetes and disability

Patients with diabetes are issued a disability. Disability registration has a number of advantages:

the opportunity to receive expensive treatment, examination, sanatorium treatment, financial support in the form of a pension, benefits for free, and also facilitates employment, especially if you can periodically be removed from the disability register.

Taking diabetes as a way of life, regular self-monitoring, proper behavior, nutrition will prevent the development of complications or slow their progression, prolong the period of working capacity and even life. Diabetes is not yet a reason for the whole world not to know about you. There are a huge number of celebrities with diabetes on the planet, including about fifty athletes, politicians, actors, and writers. And this did not prevent them from bathing in the rays of glory.

Diabetes and celebrities

It is very important for a patient with diabetes to adapt to society: the task is difficult, but doable. This is also proved by examples from the lives of famous people. It was the acceptance of diabetes and compliance with all the recommendations that helped them achieve certain heights in life.

So, famous, beautiful and ageless actress Elizabeth Taylor, Miss America 1999 - Nicole Johnson suffer from diabetes. One of the great athletes suffering from diabetes from early youth is the well-known soccer player Pele.

Of the outstanding people of art who lived with diabetes, one can name writer Ernst Hemingway. Sharon Stone, by the way, is on insulin therapy, she injects herself with insulin using an insulin pump. Among people with diabetes, Ella Fitzgerald is also a great singer. She lived for 79 years.

Paul Cezanne, a famous French impressionist painter, was also diabetic. It is believed that his "blurry" style is a consequence of a diabetic complication in his eyes.

Diabetes mellitus did not prevent Mary Tyler Moore, a TV star, leggy brunette, actress and dancer who received five Emmy awards, from achieving great success.

Dr. George Minno - the first of the patients with diabetes received Nobel Prize in the field of medicine in 1934. Scott Coleman is the first person with diabetes to swim across the English Channel in 1996.

Among the celebrities who have been diagnosed with diabetes, you can also name Elvis Presley, Thomas Edison, Sylvester Stallone, Fyodor Chaliapin, Yuri Nikulin, Nikita Khrushchev, Yuri Andropov, Mikhail Gorbachev.

To be more convincing that diabetes is not a reason to despair, here are a few stories from the lives of famous people.

Deborah Kari is a soloist with a ballet company in New York. At the age of 15, she was accepted into the ballet school. At the age of 19, as one of the most talented students, she was enrolled in a ballet troupe.

But after 3 years, when she was 21, it seemed to Deborah that the world was collapsing before her eyes - the girl fell ill with diabetes. She knew that she would never leave ballet, but how to dance professionally with this disease? However, more than 10 years have passed, and Deborah is still dancing. She has been a principal dancer with the New York Ballet for over 5 years. According to her, she “holds the disease in her hands”, namely, she checks her blood for sugar with a glucometer 6 times a day, observes strict diet selects doses of insulin.

All this allows her to withstand the enormous physical exertion at rehearsals and participate in more than 50 productions per season.

Bill Devinson 34 years old, he is the director of the world famous motorcycle company Harley Davidson. At the age of 3, he was diagnosed with insulin-dependent diabetes mellitus (type 1 diabetes). Until the age of 8, his mother gave him insulin injections. After attending diabetes school, Davidson took control of his diabetes at the age of 8.

He is very grateful to his family and doctors who explained how to control diabetes and convinced him that it is possible to lead a full life with this disease. He himself tests new models of motorcycles, participates in motorcycle races. Bill graduated from college, where he received two diplomas in finance and management. He loves to swim and water ski. Of course, he was able to achieve all this only with the help of self-management of diabetes.

John Smith is a professional basketball player. He is a little over 40 years old. For over 10 years he has been playing in the strongest basketball league in the world - the NBA. John developed diabetes at the age of 12. This was discovered after another training session at school. But John and his family did not lose heart.

After consulting with a doctor, he continued playing basketball and reached great heights. John believes that controlling his diabetes and believing in himself are the keys to his success. The glucometer and test strips for self-monitoring are constantly with it. Measuring blood sugar while eating is a common thing for him. John is not going to leave professional sports.

Not less famous sportsman Bobby Clark fell ill with insulin-dependent diabetes (type 1 diabetes) at the age of 13. But hockey was his passion. He was fond of him, almost from the age of three and did not want to give up his favorite pastime due to illness. He never left him: he played hockey as an amateur for 19 years, was a professional hockey player for 15 years, and now, having retired, is the manager of one of the US hockey teams.

Bill Talbert - Tennis player who has won 33 U.S. national titles. He died at the age of 80 in 1999. Talbert suffered from type 1 diabetes since the age of 10. In 1992, he suffered two injuries and since then. Since then, his health has been deteriorating. Talbert was twice the only finalist in the US Championships. Lived with diabetes for exactly 70 years.

Other athletes with diabetes are known in the history of American sports, but, unlike Bobby Clark, they had non-insulin-dependent diabetes (type 2 diabetes).

One of the most notable people on this list is an American Aiden Bale.

This insulin-treated diabetic patient ran a 6,500 km marathon, crossed the North American continent, and set up the Diabetes Research Foundation with his own (very considerable, I must say) funds.

Theatrical, television and film actress Sue Getsman wrote and staged a play called "Blood Sugar". This play is autobiographical. It tells about the life of Sue, who has been living with diabetes for 31 years and has experienced many unusual events in the last 18 months.

There are over 20,000,000 diabetics in the world. This disease equally affects people of both sexes and is considered incurable. In this article, we take a closer look at the lifestyle of people with diabetes.

Diabetes mellitus is understood as a chronic endocrine pathology provoked by a malfunction of the pancreas.

The essence of the disease lies in the fact that, which is necessary for the natural saturation of cells with glucose, is violated. The types of diabetes are shown in the table.

Table 1. Main types of diabetes.

Type of diabetes	Description	Treatment
	The disease occurs in young people under 30 years of age. There is atrophy and complete destruction of pancreatic cells. Insulin synthesis is stopped. Doctors call the main cause of the development of the disease a complication after suffering viral or infectious pathologies. Type 1 disease is characterized by rapid, aggressive development. The symptoms are very pronounced.	Lifelong use of artificially synthesized insulin.
	The disease proceeds in a "sparing" rhythm. Symptoms have been relieved. The diagnosis can be made at the next blood donation. The risk group includes people who are obese.	Performing physical exercises, following the diet prescribed by the doctor.

What is the life expectancy?

The state of health of a young man suffering is aggravated against the background of complications.

Table 2. Complications of diabetes.

Complication	Description
	There is a violation of the vascular walls. This leads to a failure in the process of transporting oxygen to the tissues of the body. The risk of heart attack and stroke increases.
	Vision deteriorates sharply. Some patients develop blindness.
	Against this background, renal failure develops or.
	This occurs against the background of impaired glucose metabolism. A person complains of muscle weakness, the sensitivity of the limbs is lost. The condition can lead to paralysis.
	Wounds and cracks do not heal for a long time. Appear. This leads to the development of diabetic foot.
	The patient often suffers colds. His immune system wears out quickly.

The chart shows the % ratio of complications of type 1 diabetes.

Life expectancy for type 1 diabetes mellitus, if diagnosed at 14-15 years of age, is 26-36 years. Up to 50 years, only 10-15% of patients survive. The prognosis for people with type 2 disease is more favorable. Many patients live to old age.

Type 1 diabetics are 2.5 times more likely to die prematurely than people without any disease. Patients with type 2 diabetes live to old age 1.5 times less than healthy people.

Note! Life expectancy is affected by gender. The life of a diabetic woman is shortened by 20 years. Men on average live 12 years less.

The prognosis of life in children with diabetes worsens because parents cannot always control their nutrition.

Children of the younger preschool age die in a ketoacidotic coma. The cause of death in children aged 5-15 years is hypoglycemia. The risk of mortality in adult diabetics increases with the abuse of alcohol and tobacco products.

Features of the patient's lifestyle

The instructions for people with diabetes are as follows:

1. Pass a medical examination in a clinic that inspires confidence. All questions regarding changes in the condition should be discussed with the doctor.
2. Strictly observe the prescribed diet.
3. Observe the drinking regime.
4. Regularly pay attention to sports training.
5. Take medication prescribed by your doctor.
6. Record test measurements regularly. A sheet for recording blood glucose levels is issued by the attending physician.
7. Keep a food and exercise diary. If the situation worsens, this will help the doctor adjust the treatment regimen.
8. Keep a sleep schedule. A diabetic should sleep at least 6 hours.
9. To live an active lifestyle. If the disease is not advanced, it does not interfere with traveling and communicating with people.

Mandatory medical examination

Living with diabetes forces a person to be registered at the place of residence in a diabetes center. Dispensary observation of patients with diabetes mellitus is necessary to control treatment.

If a person is registered, he is prescribed medication and an annual examination is prescribed. The patient is not admitted to the hospital.

The diabetic is observed by the endocrinologist. If there is no such doctor in the district clinic, the medical examination is carried out by a general practitioner or general practitioner. The survey is preventive in nature. the main task– early detection of complications of diabetes.

Table 3. Instrumental research methods.

Method	Description	What diseases can be identified?	How many times a year to pass?
	The level of platelets, hemoglobin, leukocytes, erythrocytes is estimated.	Anemia.	2
	Total cholesterol, calcium, magnesium, sodium, triglycerides are assessed.	Fatty hepatosis, diabetic nephropathy, atherosclerosis.	2
	The concentration of erythrocytes, glucose, leukocytes, acetone, bacteria is estimated. A specialist can determine the state of the urinary system and carbohydrate metabolism.	Early stage diabetic nephropathy.	4
	The state of the immune system is assessed.	Pulmonary tuberculosis. All patients with diabetes are at risk.	2
	Identified disorders in the work of the heart.	Arrhythmias, myocardial ischemia.	2

Note! A diabetic undertakes to be checked by a neurologist and an ophthalmologist. Women must be registered with a gynecologist.

How to prolong the life of a diabetic?

How to prolong the life of people with diabetes?

People with type 1 diabetes, in addition to dieting, should do the following:

1. Constantly monitor blood sugar levels. Insulin injections should be regular.
2. Maintain normal weight.
3. Learn how to deal with stressful situations. Strong emotional upheavals can provoke an increase in the concentration of glucose in the body.
4. Take good care of your feet. This will help prevent the occurrence of trophic ulcers.

The lifestyle of diabetic patients does not involve a very strict diet.

Proteins and fats do not affect the concentration of sugar in the blood. For this reason, a diabetic can eat meat and fish in the same amount as a healthy person. If the patient has excess weight, the diet should be adjusted in the direction of reducing fat.

• low-fat varieties of cheese;
• lean meat;
• vegetable oil;
• fruit;
• low-fat milk.

If there are no problems with weight, strict calorie counting is not needed.

Nuts

Table 4. The benefits of nuts.

type of nuts	What does the product contain?	What's the use?
	Proteins, unsaturated fats, trace elements, vitamins.	Reduces the level of "bad" cholesterol.
	Vitamin A, B, unsaturated fats.	Improves the functioning of blood vessels and the heart, strengthens immune system, reduces the concentration of bad cholesterol in the blood.
	Folic acid, vitamin E.	Fights beriberi.
	Phosphorus, calcium, iron.	Improves metabolism, promotes the recovery of the skin, hair, teeth.
	Vitamin E, calcium, magnesium, phosphorus, iron.	Relieve fatigue, improve the condition of hypertension.
	Vitamin C	Helps with neurosis, improves the condition of the skin.

Products with chromium

The main effect of chromium is associated with an increase in tissue sensitivity to insulin. Also, this microelement allows you to fight obesity. Products with chromium content (mcg) are presented in the diagram.

Note! Daily rate chromium is 0.2-0.25 mg.

Diet for Type 1 Diabetes

Dietary nutrition involves the inclusion in the diet of foods with a low concentration of carbohydrates. Recommended foods for diabetics are shown in the table.

Table 5. What can you eat if you have type 1 diabetes?

Product	Short description	Daily Value (g)
	It is advisable to eat bran, rye or whole grain bread.	100
	Soups should be cooked in low-fat broth.	1 serving plate.
	You can eat chicken, turkey, diabetic sausage.	100-150
	They can be boiled and baked. Particular attention should be paid to cabbage.	200-300
	The menu should include peaches, oranges, quince.	200-300
	Preference should be given to cereals made from buckwheat and oatmeal.	150-200
	It is advisable to eat curdled milk, fermented baked milk, natural yogurt.	Up to 250 ml.
	You can eat cookies that contain a sugar substitute.	30-50.

The basic principles of nutrition in% ratio of proteins, carbohydrates and fats are presented in the diagram.

Note! It is advisable to include in the menu foods that are quickly absorbed by the intestines. Preference should be given complex carbohydrates and substances high in fiber and gluten.

Diet for Type 2 Diabetes

Approved products for diabetics are presented in the table.

Table 6. What can you eat if you have type 2 diabetes?

Product	Features of preparation and use
	Boil.
	Boil, use in salads.
	There is in its pure form, without sour cream and sugar.
	It is advisable to add some milk.
	It should be used in cooking.
	You need to drink it between meals.

All foods allowed for type 1 diabetes are also allowed.

Lifestyle in type 2 diabetes involves strict calorie control. You can eat high-calorie foods, but you need to ensure that sugar does not rise.

The daily norm of high-calorie products (g) is shown in the diagram.

Potatoes can be replaced with pasta. Water and drinks should be drunk before meals.

How to relieve hunger after dinner?

The last meal should be 4 hours before bedtime. If after dinner a person experiences excruciating hunger, he is allowed to eat any product containing a minimum amount of carbohydrates. Such foods are called "free snacks".

Table 7. How to satisfy hunger after dinner?

Product	A portion
	1 jar
	6 items.
	2 pieces.
	1 piece.
	1 piece.

You can not load the body at night. The digestive organs must finish their work, rest and recover.

Sports loads

Is diabetes a lifestyle or a disease?

If a person listens to his doctor, he can learn to perceive the disease correctly. In many ways, this is facilitated by correctly selected sports training.

Note! Physicians call sports "invisible insulin". Against the background of physical activity, the need for this element decreases.

Table 8. What sports can diabetics do?

Kind of sport	Workout time
	40-60 minutes.
	120-180 minutes.
	40-80 minutes.
	25 minutes.
	120-180 minutes.
	60-120 minutes.
	60-120 minutes.

Living with Diabetes Allows for the Use of the Following sports nutrition, not containing carbohydrates:

• whey protein;
• amino acids;
• creatine.

Gainers, protein-carbohydrate mixtures, protein bars are strictly contraindicated for diabetics.

Professional activity

Where to go to work?

The chart shows (in %) which professions young people with type 1 diabetes choose.

Work and severity of illness

The table indicates the types of work that are contraindicated for diabetics.

Table 9. Specialty and severity of the disease.

Also, life with type 1 diabetes does not allow military service, work in infectious diseases hospitals and laboratories.

How to improve sleep?

Proper sleep helps to reduce various manifestations of diabetes. Blood sugar level drops, blood pressure returns to normal.

1. Take 1 tablet of any antihistamine. The instructions should indicate that the drug does not increase blood pressure. The safest antihistamine for diabetics is Corcidin-HBP. Its price is 150 rubles.
2. If sleep is interrupted, it is allowed to take up to 30 drops of valerian tincture. There should be 4 hours between taking this remedy and the antihistamine.
3. As a preventive measure, you can take 1 tablet of calcium or magnesium.

Eating a small amount of protein food helps to improve sleep. You can eat some white chicken or a handful of almonds.

Conclusion

Every 10 resident of Russia suffers from diabetes. This statistic is getting worse every year. The reason for this, according to doctors, is the lifestyle that the vast majority of Russians lead.

It is not the disease itself that is terrible, but its complications. The video in this article will tell you more about this, as well as other recommendations for diabetes.

WikiHow is a wiki, which means that many of our articles are written by multiple authors. When creating this article, 20 people worked on editing and improving it, including anonymously.

Number of sources used in this article: . You will find a list of them at the bottom of the page.

If you have diabetes, you are most likely interested in maintaining your health and quality of life in the long term. The disease can be successfully controlled by eating right, being physically active, and monitoring your condition for better treatment. Quality of life also means being able to be happy, socialize and enjoy life. Even with an illness affecting your the physical state, you can start every day with renewed vigor and take care of your health, and not subdue illness all your life.

Steps

1. Discuss your health status with a trusted doctor. This is an important step: firstly, you will be able to know what you should or can do, and secondly, it is easier to deal with an illness when you have support. In particular:

   • Always discuss questions and changes in condition with a specialist.
   • Notice small changes. Even small symptoms can indicate important changes, and it's best to let your doctor know as soon as possible.
   • In case of violation of the diet and medication, you should consult a doctor.

2. Follow the prescribed diet. Your healthcare provider has most likely already given you dietary advice. Proper diet is the key to good health in diabetes. When preparing recommendations for nutrition, doctors take into account individual characteristics and the state of the body.

   • If your doctor hasn't given you nutritional advice, ask him about it.
   • Ask what should be included in the diet, what should not be included and where you can buy food for diabetics.
   • Watch the composition of not only food, but also drinks - many drinks, both factory-made and home-made, contain sugar and other additives, due to the use of which you will break a carefully observed diet.
   • If you're having trouble sticking to your diet, it might be worth keeping a food diary. It will help you keep track of what psychological triggers make you crave food (for example, you tend to overeat when you are upset, or you crave sweets when you are tired), and will allow you to plan your diet and get rid of bad eating habits.
   • Read what is written on the package. It is desirable for everyone to read information about the composition and nutritional value of products, but for diabetics this is a mandatory rule.

3. Learn what foods are considered healthy for diabetes. The American Diabetes Association has developed guidelines for foods that are good for everyone, not just diabetics, so following them will help you not only control your diabetes, but be healthier overall. Here are some healthy foods recommended by this association:

   • Whole grains, legumes, pasta, and starchy vegetables (including potatoes): 6 or more servings per day. Bread, cereals, and cereals should be limited and low in sodium; products made from white flour are best avoided altogether.
   • Fruits: 2-4 servings per day.
   • Vegetables: 3-5 servings per day.
   • Meat, fish and cheese: 2-3 servings per day.
   • Milk and yogurt: 2-3 servings per day.
   • Fats, sweets and alcohol: in small amounts (depending on the doctor's recommendations).
   • Seasonings should be low in sodium (table salt) and free of sugar. Check the information on the packaging of finished products: canned, pickled, salted, dried, smoked.
   • Stay up to date with the latest dietary recommendations for diabetics as they are revised from time to time. Sign up for email newsletters and communicate with your doctor regularly to keep up to date with the latest findings in diabetes nutrition.

4. Drink at least 6-8 glasses of fluid daily. It is best to drink regular clean water, but you can also drink tea, coffee, carbonated or mineral water no additives, instant drinks with artificial sweeteners, low-calorie and other drinks for which there are no medical restrictions. In some cases, it is recommended to limit your intake of milk as it also contains natural sugars, so it is best to consult your doctor here.

   • Drinks to avoid or minimize include: sugary sports drinks (they are high in salt and sugar), sugary sodas, tonics, fruit juices, and milk (you can try almond milk, which has only 30 calories per day). 250 ml).

5. Include allowed "goodies" in your diet. Be sure to consult with your doctor about whether you can include “delicious” in your diet and what exactly you can. Although sweets and pastries with sugar are now on the black list, this does not mean that you have to completely give up sweets. You can find cookbooks and online recipes for diabetics and learn how to make amazingly delicious sweets without sugar. Also in most stores or departments diet food sweets and other sweets for diabetics are sold - try them and find what you like.

   • Snacks include a medium-sized fresh fruit, a small serving of yogurt, a few whole-grain crackers, or a handful of nuts.

6. Take your prescribed medications. If you do not regularly take drugs, you risk getting complications and endangering your health and life. Follow your doctor's instructions for proper dosage and timing.

   • Read information about drug interactions with drinks, foods, and other drugs. Talk to your doctor about what you can and cannot combine with your prescribed medications and how to combine your medications with food.
   • If you have an appointment with a new doctor, let them know you have diabetes and tell them what medications you are taking. Some drugs are incompatible, so this information is vital. Your doctor should be aware of everything you are taking, including vitamins and herbs.

7. Keep records regularly. Your doctor will give you a sheet to record your blood glucose levels. Record your measurements, even if it seems like a boring chore. Keep accurate records and bring them to your appointment every time.

   • It is also helpful to keep a food and exercise diary. The more information you can give your doctor about your lifestyle, the easier it will be for them to give you advice on disease control.

8. Check your blood sugar levels (see below for adults). According to the recommendations of the American Diabetes Association, in type 2 diabetes, one should strive to ensure that blood sugar levels fall into the safe range:

   • before meals (on an empty stomach) - from 70 to 130 mg / dl (from 3.9 to 7.3 mmol / l);
   • after meals (after 1-2 hours) - less than 180 mg / dl (10 mmol / l);
   • at bedtime, 90 to 150 mg/dL (5 to 8.3 mmol/L).

9. Watch for signs of complications. Forewarned is forearmed: if you are aware of a possible danger, you are more likely to notice its early symptoms and be able to take action in a timely manner. Possible complications that can develop with diabetes include:

   • Cardiovascular disease and stroke. Diabetics should pay special attention to the health of the heart and the cardiovascular system. Diabetes increases the risk of heart attack, stroke, and complications related to poor circulation.
   • Kidney diseases. Diabetes can lead to kidney failure and cause the kidneys to lose their filtering ability.
   • Visual impairment. Diabetes can cause visual impairment, sometimes even total blindness. The risk of blindness in diabetics is higher than in people without the disease. Early diagnosis and treatment will save your vision.
   • Oral health problems. Diabetes increases the risk of gum disease, so regular dental checkups are recommended.
   • Diabetic neuropathy and nerve damage. One of the most common complications of diabetes is diabetic neuropathy. Neuropathy is the destruction of the nerves in the body that connect the spinal cord to muscles, skin, blood vessels, and other organs.
   • Diabetic foot. Diabetics often suffer from various foot pathologies, which are caused by nerve damage or impaired blood supply to the extremities.
   • Skin diseases. Approximately one third of diabetics at one stage or another experience skin diseases caused or complicated by diabetes. In fact, such problems are often the first symptom of diabetes. Fortunately, most skin conditions can be prevented or treated if detected early enough.
   • diabetic gastroparesis. Gastroparesis is a decrease in the activity of the muscular apparatus of the stomach, which occurs in type 1 and type 2 diabetes.
   • Depression. It's okay to be sad from time to time. However, some people constantly feel depressed, and life seems meaningless to them. If this feeling persists for two or more weeks, this is a sign of serious depression.

10. Seek support from people who care about you and know about your condition. Tell your friends and family about your illness and how it affects your life. If a person knows about what is happening, he will support you. It's likely that friends and family will want to help you with your exercise, food choices, and doctor visits. In addition to the circle of best friends, you can get close to other diabetics. Find out if there are diabetes support groups in your city, or join one online. You can make new friends there, but more importantly, you will feel supported and see how other people are coping and living life to the fullest with diabetes.

    • Consider membership in a larger diabetic organization. In addition to personal support, such communities usually distribute useful information about diets and advances in medicine.
11. If you need help getting a good night's sleep, try the following remedies. (1) Take 1 tablet of an antihistamine that causes drowsiness but does not increase blood pressure. Do not take antihistamine syrups containing sugar. (2) Take valerian - this is an effective sedative to help you fall asleep and also alleviate aches and pains of various kinds. If you wake up too early, drink water and you can repeat both of these remedies if at least 4 hours have passed since the first dose. (3) Take calcium with magnesium, vitamin D3, B vitamins, omega-3 and omega-3-6-9 fatty acids - all of these supplements help the body relax, and also have many other benefits. (4) Eat a small portion of protein food - this also improves sleep. It can be lean turkey or chicken. Also eat almonds (eat more fiber!), walnuts, pecans, sunflower or pumpkin seeds, pistachios, red peanuts with skins (these seeds and nuts also contain healthy oils!).

• Always follow your doctor's recommendations. Diabetes is serious illness that can cause serious consequences without proper treatment.
• Sometimes there may be an unexpected reaction to an increase in insulin levels when injected. Warn loved ones of this possibility, and let them know which foods you almost don't need (e.g. sugar/soda/milk/orange juice). Instruct family members to ask you about your blood sugar if your behavior seems strange or appears to be intoxicated. They may offer you some sweets to tie up excess insulin.
• Sometimes the opposite happens - you overeat a little after the insulin shot, and then you need a little more insulin to normalize your blood sugar levels. Also explain this to your loved ones.

If you have been diagnosed with type 2 diabetes, then you should know that diabetes is not only a disease, it's a way of life! Patients with diabetes mellitus can significantly improve the course of the disease if healthy lifestyle life, which includes proper nutrition, rational physical activity and smoking cessation. These interventions are of great benefit and can greatly reduce the need for drug therapy.

The main meaning of the rules of nutrition in diabetes mellitus - help your body cope with a metabolic disorder due to illness. Type 2 Diabetes Treatment (especially in overweight people) begin with the normalization of the stereotype (character) of nutrition.

• Nutritionin type 2 diabetes, it should be frequent (three main and two intermediate meals, the interval between them should be at least 2-3 hours) with small meals.
• should be correlated with physical exercises and daily activity, taking hypoglycemic drugs.
• Main and intermediate meals should be at the same time.
• caloriesThe selected diet should help achieve the ideal weight (low-calorie diet).
• Limit alcohol consumption , so they are a source of additional calories (especially in overweight people) and can provoke hypoglycemic conditions (leading to an excessive decrease in blood glucose levels).
• Meals should be regular (daily at a certain time).
• Food compositionshould be balanced (consumption of fats and easily digestible carbohydrates: sugar, jam, honey, chocolate, sweets, cakes to a minimum).
• Limit food calories with excess weight by eliminating fats of animal origin from the diet.
• The diet is enriched high-fiber foods: fresh vegetables and fruits (daily ≥400 grams per day, except for melons, pears, grapes, bananas and dried fruits), bran, as well as dishes from cereals and cereals: potatoes, pasta, wholemeal bread.
• The use of special diabetic products when compensating for diabetes is optional.

Because food provides us with the nutrients we need to keep us alive, healthy and productive, it is a key element in managing diabetes. Against the backdrop of compliance quality food composition and its regular intake (4-5 times a day) after 1-4 weeks, the condition usually improves.

has a very great importance to maintain proper blood sugar levels and reduce the risk of diabetes complications. Regularly maintained physical activity is very effective method treatment of diabetes.

Therapeutic exercise improves:

• physical and mental condition;

· normalizes metabolism and blood pressure;

• promotes weight loss;
• trains the cardiovascular system;
• improves lipid metabolism (cholesterol, etc.);
• lowers blood sugar levels;
• increases the sensitivity of cells to insulin.

Before you start regular physical activity, you need to be examined by a doctor. A thorough examination and assessment of your health condition will help develop the ideal exercise program for you.

The type of physical exercises is chosen depending on the state of health and sports training. It is better to start with exercises that give pleasure (for example, 10 minutes of walking). When doing any exercise, breathe deeply and try to do the exercises in a way that involves the whole body, for example, when walking, move your upper body and arms. With the permission of the attending physician, you can start aerobic exercise - continuous rhythmic exercises that lead to an increase in heart rate up to 70-80% of your maximum rate in at least 15-20 minutes. Doctors will help determine the optimal heart rate for you, taking into account your age and physical fitness. physical activity decrease gradually until the heart rate returns to normal.

Helpful Hints:

· each time before exercise it is necessary to measure the level of sugar in the blood; Before exercise you need to "snack" if: the blood sugar level is 3.5-8.0 mmol / l and you have injected insulin. If the blood sugar level is above 15 mmol / l, it is not recommended to exercise;

· always carry an identification medical certificate (for example, a diabetes patient card, a special medallion or bracelet);

· always start with slow exercises; do not strive to do too many exercises at a fast pace, even if you feel that you are capable of it; increase the load slowly, as far as physical fitness allows;

· record progress: record your achievements in a diabetes diary;

· proceed to exercise 1-2 hours after eating to balance food intake and physical activity;

· if possible, practice every day at the same time; for those days when the regular schedule is violated, it is necessary to draw up a special plan for eating and medicine;

· always carry foods containing easily digestible carbohydrates, such as sugar, juice, sweets;

· wear comfortable socks made from natural fibers (such as cotton) and comfortable, well-fitting shoes that allow the skin to breathe and support the foot well.

Smokingis one of the leading causes of death in the population. It has been proven that smoking significantly aggravates the severity of diabetes mellitus. Smoking in diabetes much faster leads to changes in large peripheral blood vessels, including the legs, usually ending in amputation of the lower extremities. The risk of strokes and heart attacks in smokers increases. At the same time, damage to small blood vessels is accelerated, which entails the rapid development of changes in the kidneys (nephropathy), contributing to secondary arterial hypertension, the eyes (retinopathy), leading to blindness, and the nervous system (neuropathy), causing a violation of sensitivity and constant pain.

Studies show that in smokers, to achieve the desired effect, the dose of some drugs must be increased by 2-4 times. This means that the risk of side effects may increase by the same amount (and I must say that smokers already have side effects of drugs that are 30% more common than non-smokers).

It is necessary to use all the currently available arsenal of means for smoking cessation - psychotherapeutic effects, herbal medicine, nicotine replacement therapy, drugs. Quitting smoking is helped by increasing physical activity, changing stress-related work to a more relaxed one, and any other activities, for each person, to reduce the withdrawal syndrome when quitting smoking.

When you stop smoking the chances of a diabetic patient for a normal long life increase.

Thanks to high motivation and training in diabetes management, you can expand your capabilities, compensate for the disease, prevent terrible complications, and gain a full life.

About ten times a day I take a sample for sugar with a special device. You prick your finger on your own - and the device gives you the result, the needles are very small and thin, so it doesn’t hurt. Based on the data obtained, you calculate the required dose of insulin. Once or twice a day, you need to make an injection of a “long” (prolonged) action that mimics the production of pancreatic insulin. Before each meal - an injection of "short", which helps to absorb carbohydrates at a particular meal. After that, you must definitely eat, otherwise the sugar will drop to zero, and this threatens with a coma. Plus jokes during snacks, as well as additional doses if the device showed that sugar is above normal. It turns out about ten injections. They usually inject under the skin with tiny insulin syringes-pens: in the stomach, thigh, shoulder, where you can reach. It's easy to learn.

There used to be two types of insulin sold. Cheap, "pork" (low quality), obtained from the pancreas of animals. It has a bad effect on the body, gradually destroys the pancreas, liver, and other organs, leads to visual impairment. This, of course, is very scary. The disease already harms the body, and if you don’t have the opportunity to inject another insulin, wild panic, fear, and tears roll over. Thank God, this did not happen to me - we immediately began to buy in bulk and use high-quality insulin, which is synthetically obtained in laboratories. It is completely equivalent to human, it does not contain any substances that can cause harm.

Before eating, it is necessary to count the carbohydrate content in each dish and determine the amount of insulin. At first I went with a cheat sheet, but after eight years of illness I learned to calculate the dose almost automatically, like a calculator. It greatly develops mathematical abilities.

Then, at the age of sixteen, only my relatives and a couple of my closest friends knew about my diagnosis. I was terribly embarrassed by the injections, I was afraid that they would think something wrong about me: drug addicts use such syringes. Therefore, she always hid, gave injections in the toilet, encrypted herself, was very afraid of prying eyes. It is doubly difficult for a teenager with diabetes: in the company, friends did not understand why I refuse chips, crackers, and alcohol. They persuaded me, I gave in, and then I felt bad. I realized very quickly: first of all, I myself must bear responsibility for my life.

Stopping eating in public completely, so as not to demonstrate all these rituals with syringes, was also not the best option. When I'm hungry, my sugar goes down, I feel pounding, my hands shake, I get nervous, I stop controlling myself, I scream. At first, relatives did not understand, they were offended. Now they urgently run for an apple or a candy. As soon as the sugar returns to normal, I calm down. In most cases, even without a special device, I can calculate the level of sugar in my blood, just by feeling.

Safety

Not everyone immediately understands how serious this disease is. And for a long time I could not realize that my life depends on one injection made on time. The doctors, thanks to them, were able to intimidate me qualitatively. When sugar drops below a certain level, within fifteen minutes coma and death occur. Exceeding the norm leads to the same consequences. When I first met my future husband, he persuaded: “Yes, it's okay, eat another piece, then you will introduce a double dose.” Now she is watching me like a mom: she selects bananas (they have a huge amount of carbohydrates!), counts the amount of insulin that she injected per day. It happened several times: I forgot how many injections I gave, and he had to stay up at night and constantly measure my sugar, make sure that it didn’t fall below the norm and I didn’t pass out right in my sleep.

Patients with type 1 diabetes often have periods when they almost lose control of themselves: they want to pounce on the refrigerator and eat it along with all the contents. As my doctor says, "if it's really bad, chew cabbage." And I chew. I also do a lot of sports, snowboarding in winter and cycling in summer. Exercise lowers blood glucose levels - muscles use it as a source of energy. This helps to keep the sugar normal, less insulin is required. It’s hard for me to understand those who fit on the sofa because they are terminally ill and “nothing can be done about it.”

I broke only once - during pregnancy. When I came to the usual antenatal clinic, I was driven to hysterics. The doctor immediately told me what a terrible freak I was giving birth to, that an abortion should be done as soon as possible. Since then, I went there only with my husband and only after drinking sedatives. My "interesting" position required a particularly strict diet. I was very hungry all the time, strictly kept the first two trimesters, but in the last I could not stand it. A hormonal surge, fear for a child who wanted to chew, because the doctors continued to scare me with the consequences and console me with the opportunity to donate what I give birth to in an orphanage, plus sugar surges. In general, she ate without ceasing, she could not help herself. She cried in horror, but ate anyway.

As a result, my son and I had wild edema. The children of diabetic mothers are already born large, and I fed my son up to more than five kilograms, he was fifty-seven centimeters tall. After giving birth, he did not cry, scoring only four points out of ten on the Apgar scale. He had pulmonary edema, and he spent about a month in a special box. Now he is four and a half years old, and, thank God, he is an absolutely healthy and cheerful boy. But I remember that state of fear, it seems, for the rest of my life.

Broke during pregnancy. Cried in horror, but ate

water pump

I bought a pump two years ago. This is a device that partly replaces the pancreas, it looks like a pager, is attached under clothing and automatically injects insulin. With a pump, you do not need to give injections all the time, carry syringes with you. The constant fear is gone that if I forget or miss some trifle, I will immediately die.

My pump cost one hundred and eighty thousand rubles, my husband and I saved up for it for several years, our parents also helped. With her, life is much easier and more enjoyable, although even simple maintenance is very expensive. The set of catheter and reservoir with insulin needs to be changed every three days, but I save money: I change the catheter once a week, and I fill the reservoir twice. Inside there are drops from the previous dose of insulin, which eventually deteriorates itself and spoils the new dose. Those with allergies or sensitive skin have to change catheters more often, but I was lucky. If you do not save, then the components cost fifteen thousand rubles a month, I fit into six.

Recently, the attending physician wrote down my data, said that the Ministry of Health collects information about patients who have a pump. They say there is a chance that we will be given components for free. No one, of course, especially believes in this, but we still hope for a miracle. After all, my doctor alone has about two hundred patients with pumps, and many spend a significant portion of their income on pump care.

In theory, the pump itself determines the level of sugar in the blood. But in practice, the device can be very wrong. This happened in the first week of its use: I believed the testimony, set the right amount of insulin. And pretty soon I felt that the sugar began to fall catastrophically, the dose turned out to be much more than necessary. I grabbed and drank one pack of juice, measured the sugar - it fell even more. I ate chocolate. The sugar was dropping and I was getting worse. Fortunately, my husband was at home, and at the moment when I passed out, he gave me an injection of glucagon, saved me.

For all eight years, this was the only case when such emergency measures had to be taken. I carry my diabetic card with me at all times. It contains the contacts of my relatives and the doctor, tells what to do if I suddenly become ill in a public place.

I always have a full party kit in my bag - cookies, apples, juice, candy - as well as a syringe with the same glucagon. Some still wear special bracelets - they are easier to notice than a card, but I think I'm already prepared enough for any surprises.

My story can hardly be called dramatic. Probably because she never perceived her illness as something really terrible. Yes, in order to live, an ordinary person needs to breathe, eat, drink and sleep. I need all the same, plus insulin. Not such a big difference when you think about it. No one has yet felt unhappy and disabled because he will die if he does not eat, say, meat for three days. I know exactly what I have to do in order to live and feel good, and I clearly follow the instructions.

In fact, I am a perfectionist and an excellent student. I got used to control everything, this skill helped me a lot. I read a lot of literature on diabetes and realized that now I have to live differently. But I do know exactly how. And it's soothing.

Diabetes

• Type 1 diabetes Endocrine disease with absolute insulin deficiency. Can develop at any age, but is most common children, adolescents and adults under the age of thirty.
• Symptoms: thirst, increased urine output, weight loss, excessive or no appetite, weakness and feeling unwell.
• If left untreated, type 1 diabetes progresses rapidly and leads to coma, which ends in the death of the patient.
• According to statistics, in Russia 3 million patients with type 1 diabetes. Their life expectancy is 50-60 years, and has recently increased to 70 years.
• A patient who follows all the recommendations and who manages to avoid complications (thrombosis, cardiovascular pathologies) has every chance to live a full life, like any healthy person.

Alina Farkash
Photo: Alexey Bashmakov