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9. DIABETES WEBSITES TO EXPLORE
www.jdrf.org
Juvenile Diabetes Research Foundation website. Includes the latest news and breakthroughs in diabetes research, the activities of JDRF, and special sections devoted to children with diabetes and the newly diagnosed..

www.webmed.com
Features interviews with researchers, parents and patients and highlights areas of medical interest and importance.

www.diabetes.com

www.michigan.gov
Michigan Department of Community Health. Click on Health Care Coverage/Medicaid Programs/Children’s Special Health Care Services

www.diabetes.org

www.insulin-pumpers.org

www.childrenwithdiabetes.com


10. HEALTH INSURANCE
MIChild
A health insurance program for uninsured children. 888.988.6300

The Medicine Program
Provides prescription medication for people who do not have adequate insurance coverage or are experiencing financial hardship – no toll free number but can be reached at 573.996.7300. www.themedicineprogram.com

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11. COMPANIES THAT DONATE SUPPLIES
Medisense Meter
Donates free meters and strips. 800.527.3339

Lilly Care
Donates free insulin – works through physicians to provide medications to patients in need. 800.545.6962

Medic Alert
Donates free sterling silver bracelets or necklaces. 800.432.5378

Ciba Pharmaceuticals
Can be covered by Medicare, Medicaid or third party insurance as long as prescriptions are not covered. Eligibility is determined by the physician based on company guidelines. 800.257.3273

Door-to-Door Medical Supply, Inc.
866.589.1300 or www.doortodoormedicalsupply.com


12. RESOURCE/ASSISTANCE AGENCIES
Area Agency on Aging
Serving Livingston, Macomb, Monroe, Oakland, St. Clair & Washtenaw Counties. Offers Medical Emergency Program for Seniors (MEPS). 800.852.7795

Casa Maria Family Services
Counseling for low-income families, children’s programs, and medical/prescription programs. 313.962.4230

Crossroads
Provides 2-week supply of insulin, short-term transportation to doctor’s appointments, clothing, food, furniture. 313.831.2000

Detroit Agency on Aging
Serving Detroit & Eastern Wayne County – diabetes referral program. 313.222.5330

Calvary Center
MEPS, 2 vouchers offered for prescriptions. 313.881.3374

Community Services of Oakland
Provides prescriptions, medical devices, office visits. 248.542.5860

American Dietetic Association
Meal planning, medical therapy professionals, resource guide for people with diabetes, referral to a registered dietitian. 312.899.0040

Social Security Administration
800.772.1213

Children’s Special Health Care Services
800.359.3722 or 248.424.7900

Health Care Information by Counties:
Detroit – 313.876.4000
Macomb County – 810.469.5235
Oakland County – 248.858.1280
Wayne County – 734.727.7000

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13. LEGAL ISSUES REGARDING DIABETES
Michigan legislation that provides coverage for diabetes related programs, equipment and pharmaceuticals took effect. This legislation includes coverage for all of the following types of diabetes: gestational, insulin-dependent and non-insulin-dependent. The coverage in this legislation varies according to types of insurance. Michigan citizens can call the Office of Financial and Insurance Services toll free at 877.999.6442 for assistance with determining their coverage.

Additional information:
The legislation for insurers and health maintenance organizations can be accessed at http://www.michiganlegislature.org (SB 261, PA 425, Section 500.3406p of the Insurance Code) and the legislation for nonprofit health care corporations, including Blue Cross Blue Shield, can be accessed at http://www.michiganlegislature.org (SB 260, PA 424, Section 550.1416b in Act 350). Medicare policies also have new diabetes coverage. Medicare specific information can be accessed at http://www.medicare.gov. More information on Diabetes from the Michigan Department of Community Health can be accessed at http://www.michigan.gov/mdch.

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14. TRAVELING WITH DIABETES
The Federal Aviation Administration (FAA) has increased security measures at airports throughout the nation due to the events of September 11. Some of the precautions taken by the FAA, as well as by individual airlines, will likely affect passengers with diabetes, who must carry their medical supplies when they travel. JDRF continues to monitor the situation and provide updates whenever available.

Like us, the American Diabetes Association (ADA) is staying in close contact with the FAA. At this time, there is no official FAA policy on carrying diabetes supplies, however, the ADA received the following information verbally from a representative of the FAA’s Aviation, Security Policy & Planning Division and has posted it on their Web site. This information represents the minimum requirements for passengers, and JDRF and the FAA recommend calling the individual airline for further information, at least one day in advance of the scheduled flight.

1. Passengers may board with syringes or insulin delivery systems only if they can produce a vial of insulin with a professional, pharmaceutical pre-printed label that clearly identifies the medication. No exceptions will be made. Since the prescription label is on the outside of the box containing the vial of insulin, the FAA recommends that passengers refrain from discarding their insulin box and come prepared with their vial of insulin in its original pharmaceutically labeled box.
   
2. For passengers who have diabetes and must test their blood glucose levels but who do not require insulin, boarding with their lancets is acceptable as long as the lancets are capped, and as long as the lancets are brought on with the glucose meter that has the manufacturer's name embossed on the meter (i.e. One Touch meters say "One Touch," Accucheck meters say "Accucheck").
   
3. Glucagon is dispensed and normally kept in a pre-printed labeled plastic container or box. We advise travelers with diabetes to keep their glucagon kits intact in the original pre-printed, pharmaceutically labeled containers.
   
4. Contrary to what we were told previously, because of forgery concerns, prescriptions and letters of medical necessity will not be accepted.
   
   
5. FAA security measures apply to travel within the 50 United States only. Passengers should consult their individual air carriers for both domestic (US) and international travel regulations. Be advised that the FAA's policy and the policy of each airline are subject to change.
   

In the event that travelers with diabetes encounter problems boarding their flights, they should contact the FAA Grounds Security Commissioner at the airport for assistance. We recommend not packing diabetes supplies in checked baggage, as cargo hold temperatures vary greatly, and the passenger may need the supplies in flight.

JDRF will continue to stay abreast of FAA policy regarding these issues. For more information from the FAA, go to www.faa.gov or call 866.289.9673.

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15. SCHOOL ISSUES
When your child returns to school after being diagnosed with diabetes, it is vitally important that the school is aware of their condition and knows how to deal with it. Try to meet with the following as soon as possible: school nurse, counselor, and all teachers and coaches in contact with your child. Absent this, provide written instructions and include informational packets (available form JDRF), glucose tablets, juice boxes or other ready source of sugar, and emergency cards/contact information. Address the need for unrestricted water, snack and bathroom breaks, the need for regular blood sugar checks, the need to accompany the child to the office in the event of a low blood sugar, the symptoms of high or low blood sugar and effects of high or low blood sugar. Your child must always wear some form of Medical ID indicating that they are an insulin dependent diabetic.

On our national website (www.jdrf.org), JDRF has a variety of useful information on diabetes management in schools, including a form for that can be printed out for teachers. You can find this information in the Diabetes in School section of the JDRF website at Life With Diabetes. Also on the JDRF web site, are a number of educational brochures that can be downloaded. These brochures contain information that is useful for teachers, nurses, and administrative staff at a school attended by a child with diabetes.

Children with diabetes are covered under The Civil Rights of Students with Hidden Disabilities Under Section 504 of the Rehabilitation Act of 1973. The key to this law is that it states that school districts are required to provide a free appropriate education to students with disabilities, based on their individualized educational needs. You can read about the law at the Department of Education website – www.ed.gov. Under this Act, parents may request a meeting with school officials, at which time they should work to create a written Section 504 plan, which can include testing and insulin delivery protocol, as well as a plan for action in the event of a high or low blood sugar emergency. A sample, as well as other useful information for students, parents, teachers, and school officials, is available on the Children with Diabetes website at www.childrenwithdiabetes.com. However, if after the 504 meeting, parents still feel that the child is not being granted his or her appropriate rights, they should contact the local Department of Education Office of Civil Rights.

Parents and teachers who would like additional information or have other concerns about students with diabetes are invited to contact JDRF Public Information 800.533.CURE or info@jdrf.org

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16. JDRF BOOKSTORE
Below is a sampling of the books that can purchased from the “publications” section of JDRF’s national website (www.jdrf.org). For a complete listing of books, please click here.

Sugar Was My Best Food: Diabetes and Me
Ages: 8–13
By Carol Antoinette Peacock, Adair Gregory, and Kyle Carney Gregory;
Illustrated by Mary Jones
My name is Adair. Adair means “courageous and strong” in Irish. Two years ago, I got diabetes. This is the story of how I got sick and how I got better. Diabetes brought big changes for Adair and his family. The first year was rough, but Adair lived up to his name. Little by little, he and his family learned to manage his illness. His true story will help other kids in their struggle with diabetes and any other difficult sickness.
Item #033 Regular Price: $12.95; JDRF Member Price: $10.36

A Magic Ride in Foozbah-Land: An inside look at diabetes
Ages: 3–7
By Jean Betschart, M.N., R.N., C.D.E.
Illustrated by Jackie Urbanovic
With 4-color illustrations on every page, this book takes children on an imaginative journey through the human body. With simple rhymes, children will learn what causes diabetes, why they need to take shots, and how insulin is good for them. Comes with an audiocassette that a child can listen to alone or with parents.
Item #604 Regular price: $15.95; JDRF Member price: $12.76

Even Little Kids Get Diabetes
Ages: 2–6
By Connie White Pirner
Illustrated by Nadine Bernard Westcott
A storybook parents can read to their child about a little girl with diabetes. An ideal resource for helping a child deal with the psychological effects of diabetes.
Item #221 Regular Price: $5.95; JDRF Member Price: $4.76

Taking Diabetes to School
Ages: 6–11
By Kim Gosselin
This book allows elementary school students to teach their classmates about diabetes. Is it “catching?” Do shots hurt? Why do some kids eat snacks in school? What’s a “finger-prick?” Can you still be my friend? And much, much more.
Item #606 Regular Price: $11.95; JDRF Member Price: $9.56

In Control: A Guide for Teens with Diabetes
Ages: 12–18
By Jean Betschart, M.S.N., R.N., C.D.E., and Susan Thom, R.D., L.D., C.D.E.
This invaluable, upbeat guide dispels myths and tackles the real issues teens with diabetes face. Helps teenagers learn to take good care of their diabetes without letting it get in the way of their lives. Illustrated with fun, “off-the-wall” cartoons.
Item #229 Regular Price: $9.95; JDRF Member Price: $7.96

Everyone Likes to Eat: How Children Can Eat Most of the Foods They Enjoy and Still Take Care of Their Diabetes
Ages: 6–14
By Hugo J. Holleroth, Ed.D., and Debra Kaplan, R.D., M.S., with Anna Maria Bertorelli, M.B.A., R.D., C.D.E.
Written in conjunction with the Joslin Diabetes Center. Totally revised and updated, this guide is filled with activities, puzzles, and problem-solving exercises that show kids how to control their diabetes, yet eat at parties, holiday time, and fast food restaurants. Also covers school lunches, meal plans, and snacks. A complete list of choices and exchanges make it fast and easy. Item #603 Regular Price: $12.95; JDRF Member Price: $10.36

My Sister Rose Has Diabetes
Ages: 6–14
By Monica Driscoll Beatty; Illustrated by Kathy Parkinson
This refreshing, original book describes in their own words the impact of diabetes on ten-year old Rose and her twelve-year old, nondiabetic brother. It explains why some of the family’s routines have changed to accommodate Rose’s needs and the importance of a positive attitude.
Item #031 Regular Price: $8.95; JDRF Member Price: $7.16

It’s Time to Learn about Diabetes
Ages: 7–11
By Jean Betschart, M.S.N., R.N., C.D.E.
This workbook helps school age kids learn everything they need to know about diabetes, including how to dispel much of the fear associated with insulin shots and blood tests.
Item #228 Regular Price: $9.95; JDRF Member Price: $7.96

Rufus Comes Home
Rufus, The Bear with Diabetes
Ages: 3–10
By Kim Gosselin
A warm and touching true story about Rufus, the Bear With Diabetes, and how a mother’s caring creation provided the love and comfort for her son, newly diagnosed with diabetes. This book, together with the Rufus plush teddy bear, can provide a unique gift of comfort and education. Kim Gosselin is a JDRF volunteer and noted author of books for kids with special needs.
Item #032 Regular Price: $12.95; JDRF Member Price: $10.36
* To purchase Rufus the Bear, call 1-800-SHOP-5050. Price: $24.95

Sarah and Puffle: A Story for Children About Diabetes
By Linnea Mulder
Illustrated by Joanne H. Friar
In this upbeat story, a stuffed animal comes to life just in time to help a young girl, who is feeling angry and sad about her condition. Puffle’s funny little rhymes are chock full of valuable advice sure to comfort all children with diabetes and to further understanding by siblings and friends. Parents will appreciate the clearly written introduction before sitting down to giggle — and learn — with their children.
Item #036 Regular Price: $8.95; JDRF Member Price: $7.16

The Best Year of My Life Book 1: Getting Diabetes
Ages 4–10
By Jed Block
While I waited for the results of my second test, I sat on my dad’s lap and wondered what I had done wrong. "Did I eat too much candy?" So goes this inspirational story, written in the voice of a newly diagnosed seven-year-old girl who also illustrated the book. It’s about setback, resilience and hope. It helps families deal with the jolts and emotional issues that accompany diabetes.
Item #034 Regular Price: $10.95; JDRF Member Price: $8.76

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17. RESEARCH UPDATES
Since diabetes research information is continually updated, we suggest you visit the research section of JDRF’s national website (www.jdrf.org) for current research articles and information. JDRF also publishes a monthly Research E-Newsletter to provide the latest information about research on type 1 diabetes and its complications.


18. JDRF METRO DETROIT AND SOUTHEAST MICHIGAN CHAPTER INFORMATION
The Metro Detroit and Southeast Michigan Chapter of the Juvenile Diabetes Research Foundation is one of the fastest growing chapters in the United States and now raises over $2 million annually for diabetes research.
Our volunteers and professional staff are focused on one mission: to raise funds for research. We do this through the combined efforts of our special events; Walk to Cure Diabetes, Golf Classic and Promise Ball, major gifts, planned giving, third party events, committees and board work.

The Chapter looks to our volunteer partners to provide their expertise, passion and working assistance in the following areas:

Administrative Support: Volunteer partners who assist the Chapter office with administrative tasks such as large mailing projects and event logistics. This assistance is on an “as need” basis and is generally supported by student and retiree groups.

Committee Members: Volunteer partners who actively participated on one or more of the Chapter’s special event or executive committees. Responsibilities include, but are not limited to, strategic planning, logistics, sponsorship, budgets and proposals.

Special Event Committees
1. Walk to Cure Diabetes
2. Promise Ball
3. Golf Classic

Executive Committees
1. Special Events
2. Major Gifts/Planned Giving
3. Strategic Planning/Finance
4. Government Relations
5. Community Outreach/Communications
6. Nominating

Board members: Volunteers generally qualify to seek nomination to serve on the Chapter Board of Directors after actively participating on one or more of the Chapter committees for at least a year.

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19. JDRF MEMBERSHIP INFORMATION
By becoming a Member of JDRF you are helping to find a cure for diabetes and its complications. We hope you'll take the time to find out more about JDRF-funded diabetes research by visiting the research portion of our National web site (www.jdrf.org).

A JDRF Membership is accompanied by a one-year subscription to Countdown Magazine and its accompanying Countdown For Kids, and various other premiums.

To register on-line to become a member, please click here or call JDRF (800) 533-CURE (2873).

20. DIABETES DICTIONARY
This dictionary consists of terms that you will hear when responding to a child with diabetes. It has been compiled so that you can become familiar with words associated with diabetes and are used by parents, doctors, nurses and other health care professionals. Individuals with diabetes will also use certain terms when describing what is going on with them when they experience symptoms. This is just a selection of the most common terms used and will be helpful as a guide and will provide valuable information for principals, school personnel, teachers, parents, volunteers, students and other individuals in a school setting.

The words are listed in alphabetical order. Resources for this listing include but are not limited to: National Diabetes Information Clearinghouse, National Institute of Diabetes and Digestive and Kidney Diseases National Institutes of Health, Juvenile Diabetes Research Foundation, and the American Diabetes Foundation. This information was compiled by Grenae D. Dudley, Ph.D., mother of a child with diabetes and Kenneth E. White, step-father of a child with diabetes.

Acetone (as´ - _ - t_n)
A chemical formed in the blood when the body uses fat instead of glucose (sugar) for energy. If acetone forms, it usually means that the cells do not have enough insulin, or cannot use the insulin that is in the blood, to use glucose for energy. Acetone passes through the body into the urine. Someone with a lot of acetone in the body can have breath that smells fruity and is called “acetone breath.”

Acidosis (as - i´ - d_´- s_s)
Too much acid in the body. For a person with diabetes, this can lead to diabetic ketoacidosis.

Antiseptic (an´ - t_ _ s_p´ - t_k)
An agent that kills bacteria. Alcohol is a common antiseptic. Before injecting insulin, many people use alcohol to clean their skin to avoid infection.

Aspartame (_s´ - p_r - t_m)
A man-made sweetener that people use in place of sugar because it has very few calories.

Autoimmune Disease (_t´- _ - _ - my_n´)
Disorder of the body’s immune system in which the immune system mistakenly attacks and destroys body tissue that it believes to be foreign. Insulin-dependent diabetes is an autoimmune disease because the immune system attacks and destroys the insulin-producing beta cells of the pancreas.

Beta Cell (b_´ - tah s_l)
A type of cell in the pancreas. Beta cells make and release insulin, a hormone that controls the level of glucose (sugar) in the blood.

Blood Glucose (bl_d gl_´ - k_s)
The main sugar that the body makes from the three elements of food-proteins, fats, and carbohydrates-but mostly from carbohydrates. Glucose is the major source of energy for living cells and is carried to each cell through the bloodstream. However, the cells cannot use glucose without the help of insulin.

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Blood Glucose Meter (bl_d gl_´ - k_s m_´ - t_r )
A machine that helps test how much glucose (sugar) is in the blood. A specially coated strip containing a fresh sample of blood is inserted in a machine, which then calculates the correct level of glucose in the blood sample and shows the result in a digital display. Some meters have a memory that can store results from multiple tests.

Blood Glucose Monitoring (bl_d gl_´ - k_s mon´ - i - tôr´ - ing)
A way of testing how much glucose (sugar) is in the blood. A drop of blood, usually taken from the fingertip, is placed on the end of a specially coated strip, called a testing strip. The strip has a chemical on it that makes it change color according to how much glucose is in the blood. A person can tell if the level of glucose is low, high or normal in one of two ways. The first is by comparing the color on the end of the strip to a color chart that is printed on the side of the test strip container. The second is by inserting the strip into a small machine, called a meter, which “reads” the strip and shows the level of blood glucose in a digital window display.

Blood testing is more accurate than urine testing in monitoring blood glucose levels because it shows what the current level of glucose is, rather than what the level was an hour or so previously.

Blood Sampling Device
A small instrument for pricking the skin with a fine needle to obtain a sample of blood to test for glucose (sugar). Also see: Blood glucose monitoring.

Blood Sugar
See: Blood glucos

Brittle Diabetes (br_t´ - tul)
Antiquated term; not a distinct form of diabetes. A term used when a person’s blood glucose (sugar) level often swings quickly from high to low and from low to high. Also called labile and unstable diabetes.

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Calorie (kal´ - _ - r_ )
Energy that comes from food. Some foods have more calories than others. Fats have many calories. Most vegetables have few. People with diabetes are advised to follow meal plans with suggested amounts of calories for each meal and /or snack. Also See: Meal plan: exchange lists.

Carbohydrate (kar´ - b_ - h_ - dr_t)
One of the three main classes of foods and a source of energy. Carbohydrates are mainly sugars and starches that the body breaks down into glucose (a simple sugar that the body can use to feed its cells). The body also uses carbohydrates to make a substance called glycogen that is stored in the liver and muscles for future use. If the body does not have enough insulin or cannot use the insulin it has, then the body will not be able to use carbohydrates for energy the way it should. This condition is called diabetes. Also see: Fats; protein.

Chronic (kr_n´ - _k)
Present over a long period of time. Diabetes is an example of a chronic disease.

Coma (k_´ - m_h)
A sleep-like state; not conscious. May be due to a high or low level of glucose (sugar) in the blood. Also See: Diabetic coma.

Comatose (k_´ - m_h - t_s)
In a coma; not conscious.

Complications of Diabetes (k_m - pl_ - k_´ - sh_ns)
Harmful effects that may happen when a person has diabetes. Some effects, such as hypoglycemia, can happen any time. Others develop when a person has had diabetes for a long time. These include damage to the retina of the eye (retinopathy), the blood vessels (angiopathy), the nervous system (neuropathy), and the kidneys (nephropathy). Studies show that keeping blood glucose levels as close to the normal, non-diabetic range as possible may help prevent, slow, or delay harmful effects to the eyes, kidneys, and nerves.

Controlled Disease
Taking care of oneself so that a disease has less of an effect on the body. People with diabetes can “control” the disease by staying on their diets, by exercising, by taking their medicine if it is needed, and by monitoring their blood glucose. This care will help keep the glucose (sugar) level in the blood from becoming either too high or too low.

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Dehydration (d_´ - h_ - dr_´ - sh_n)
Great loss of body water. A very high level of glucose (sugar) in the blood stream cause loss of a great deal of water and the person becomes very thirsty.

Dextrose (d_ks´ - tr_s)
A simple sugar found in the blood. It is the body’s main source of energy. Also called glucose. Also see: Blood glucose.

Diabetes Mellitus (d_´ - ah - b_´ - t_z m_l´ - i -t_s)
A disease that occurs when the body is not able to use sugar as it should. The body needs sugar for growth and energy for daily activities. It gets sugar when it changes food into glucose (form of sugar). A hormone called insulin is needed for the glucose to be taken up and used by the body. Diabetes occurs when the body cannot make use of the glucose in the blood for energy because either the pancreas is not able to make enough insulin or the insulin that is available is not effective. The beta cells in areas of the pancreas called the islets of Langerhans usually make insulin. For more details information and facts on type 1 diabetes and type 2 diabetes, please visit www.jdrf.org.

Diabetic Coma (k_´ - m_h)
A severe emergency in which a person is not conscious because the blood glucose (sugar) is too low, the person has hypoglycemia; if the level is too low, the person has hypoglycemia; if the level to too high, the person has hyperglycemia and may develop ketoacidosis. Also see: Hyperglycemia; hypoglycemia; diabetic ketoacidosis.

Diabetic Ketoacidosis (DKA) (k_´- t_ - as´ - _ - d_´ - s_s)
Severe, out of control diabetes (high blood sugar) that needs emergency treatment. DKA happens when blood sugar levels get too high. This may happen because of illness, taking too little insulin, or getting too little exercise. The body starts using stored fat for energy, and ketone bodies (acids) build up in the blood.

Ketoacidosis starts slowly and builds up. The signs include nausea and vomiting, which can lead to loss of water from the body, stomach pain, and deep and rapid breathing. Other signs are a flushed face, dry skin and mouth, a fruity breath order, a rapid and weak pulse, and low blood pressure. If the person is not given fluids and insulin right away, ketoacidosis can lead to coma and even death.

Diet Plan
See: Meal Plan

Dietitian (d_ - _ - tish´ - _n)
An expert in nutrition who helps people with special health needs plan the kind and amounts of foods to eat. A registered dietitian (R.D.) has special qualifications. The health care team for diabetes should include a dietitian, preferably an R.D.

DKA
See: Diabetic ketoacidosis

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Emergency Medical Identification
Cards, bracelets, or necklaces with a written message used by people with diabetes or other medical problems to alert others in case of a medical emergency such as coma.

Endocrinologist (_n´ - d_ – kr_ - n_l´ - _ - jist)
A doctor who treats people who have problems with their endocrine glands. Diabetes is an endocrine disorder. See: Endocrine glands.

Exchange Lists
A grouping of foods by type to help people on special diets stay on the diet. Each group lists food in serving sizes. A person can exchange, trade, or substitute a food serving in one group for another food serving in the same group. The lists put foods in six groups: (1) starch/bread, (2) meat, (3) vegetables, (4) fruit, (5) milk, and (6) fats. Within a food group, each serving has about the same amount of carbohydrate, protein, fat and calories.

Fats
One of the three main classes of foods and a source of energy in the body. Fats help the body use some vitamins and keep the skin healthy. They also serve as energy stores for the body. In food, there are two types of fats: saturated and unsaturated.

Saturated fats are solid at room temperature and come chiefly from animal food products. Some examples are butter, lard, meat fat, solid shortening, palm oil, and coconut oil. These fats tend to raise the level of cholesterol, a fat-like substance in the blood.

Unsaturated fats, which include monounsaturated fats and polyunsaturated fats, are liquid at room temperature and come from plant oils such as olive, peanut, corn, cottonseed, sunflower, safflower, and soybean. These fats tend to lower the level of cholesterol in the blood. See: Carbohydrate; protein.

Food Exchange
See: Exchange lists

Foot Care
Taking special steps to avoid foot problems such as sores, cuts, bunions, and calluses. Good care includes daily examination of the feet, toes and toenails and choosing shoes and socks or stockings that fit well. People with diabetes have to take special care of their feet because nerve damage and reduced blood flow sometimes mean they will have less feeling in their feet than normal. They may not notice cuts and other problems as soon as they should.

Fructose (fr_k´ - t_s)
A type of sugar found in many fruits and vegetables and in honey. Fructose is used to sweeten some diet foods. It is considered a nutritive sweetener because it has calories.

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Gestational Diabetes Mellitus (GDM) (j_s - t_´ - sh_n - _l)
A type of diabetes mellitus that can occur when a women is pregnant. In the second half of the pregnancy, the woman may have glucose (sugar) in the blood at a higher than normal level. However, when the pregnancy ends, the blood glucose levels return to normal in about 95% of all cases.

Glucagon (gl_´ - k_ - g_n)
A hormone that raises the level of glucose (sugar) in the blood. The alpha cells of the pancreas (in areas called the islets of Langerhans) make glucagons when the body needs to put more sugar into the blood.
An injectable form of glucagon, which can be bought in a drug store, is sometimes used to treat insulin shock. The glucagon is injected and quickly raises blood glucose levels.

Glucose (gl_´ - k_s)
A simple sugar found in the blood. It is the body’s main source of energy, also known as dextrose. See: Blood glucose.

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Home Blood Glucose Monitoring
A way a person can test how much glucose (sugar) is in the blood. Also called self- monitoring of blood glucose. See: Blood glucose monitoring.

Human Insulin (hy_´ - m_n _n´ - s_ - l_n)
Man made insulins that are similar to insulin produced by your own body. Human insulin has been available since October 1982.

Hyperglycemia (h_´ - p_r – gl_ - s_´ - m_ - ah)
Too high a level of glucose (sugar) in the blood; a sign that diabetes is out of control. Many things can cause hyperglycemia. It occurs when the body does not have enough insulin or cannot use the insulin it does have to turn glucose into energy. Signs of hyperglycemia are a great thirst, a dry mouth, and a need to urinate often. For people with insulin-dependent diabetes, hyperglycemia may lead to diabetic ketoacidosis.

Hypoglycemia (h_´ - p_ – gl_ - s_´ - m_ - ah)
Too low a level of glucose (sugar) in the blood. This occurs when a person with diabetes has injected too much insulin, eaten too little food, or has exercised without extra food. A person with hypoglycemia may feel nervous, shaky, weak, or sweaty, and have a headache, blurred vision, and hunger. Taking small amounts of sugar, sweet juice, or food with sugar will usually help the person feel better within 10-15 minutes. See: Insulin shock.

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Implantable Insulin Pump (_m – plant´ - _ - b_l)
A small pump placed inside of the body that delivers insulin in response to commands from a hand held device called a programmer.

Injection (_n - j_k´ - sh_n)
Putting liquid into the body with a needle and syringe. Person with diabetes injects insulin by putting the needle into the tissue under the skin (called subcutaneous). Other ways of giving medicine or nourishment by injection are to put the needle into a vein (intravenous) or into a muscle (intramuscular).

Injection Sites
Places on the body where people can inject insulin most easily. These are:

1. The outer area of the upper arm
   
2. Just above and below the waist, except the area right around the navel (a 2-inch circle)
   
3. The front of the thigh, midway to the outer side, 4 inches below the top of the thigh to 4 inches above the knee.
   These areas can vary with the size of the person.
   

Injection Site Rotation
Changing the places on the body where a person injects insulin. Changing the injection site keeps lumps or small dents from forming in the skin. These lumps or dents are call lipodystrophies. However, people should try to use the same body area for injections that are given at the same time each day- for example, always using stomach for the morning injection or an arm for the evening injection. Using the same body area for these routine injections lessens the possibility of changes in the timing and action of insulin.

Insulin (_n´ - s_ - l_n)
A hormone hat helps the body use glucose (sugar) for energy. The beta cells of the pancreas (in areas called the islets of Langerhans) make the insulin. When the body cannot make enough insulin on its own, a person with diabetes must inject insulin made from other sources, i.e., beef, pork, human insulin (recombinant DNA origin), or human insulin (pork-derived, semisynthetic).

Insulin-Dependent Diabetes Mellitus (IDDM)
A chronic condition in which the pancreas makes little or no insulin because the beta cells have been destroyed. The body is then not able to use the glucose (blood sugar) for energy. IDDM usually comes on abruptly, although the damage to the beta cells may begin much earlier. The signs of IDDM are a great thirst, hunger, a need to urinate often, and a loss of weight. To treat the disease, the person must inject insulin, follow a diet plan, exercise daily and test blood glucose several times a day. IDDM usually occurs in children and adults who are under the age of 30. This type of diabetes used to be known as “juvenile diabetes, “juvenile-onset diabetes” and “ketosis-prone diabetes.” It is also called Type 1 diabetes mellitus.

Insulin-Induced Atrophy (at´ - r_ - f_)
Small dents that form on the skin when a person keeps injecting a needle in the same spot. They are harmless.

Insulin Induced Hypertrophy (h_´ p_r – tr_ - f_)
Small lumps that form under the skin when a person keeps injecting a needle in the same spot.

Insulin Pen
An insulin injection device the size of a pen that includes a needle and holds a vial of insulin. It can be used instead of syringes for giving insulin injections.

Insulin Pump
A device that delivers a continuous supply of insulin into the body. The insulin flows from the pump through a plastic tube that is connected to a needle inserted into the body and taped in place. Insulin is delivered at two rates: a low, steady rate (called the basal rate) for continuous day-long coverage, and extra boosts of insulin (called bolus doses) to cover meals or when extra insulin is needed. The pump runs on batteries and can be worn clipped to a belt or carried in a pocket. It is used by people with insulin-dependent diabetes.

Insulin Reaction (r_ - _k´ - sh_n)
Too low a level of glucose (sugar) in the blood; also called hypoglycemia. This occurs when a person with diabetes has injected too much insulin, eaten too little food, or exercised without extra food. The person may feel hungry, nauseated, weak, nervous, shaky, confused, and sweaty. Taking small amounts of sugar, sweet juice, or food with sugar will usually help the person feel better within 10- 15 minutes. See: Hypoglycemia; insulin shock.

Insulin Shock (sh_k)
A severe condition that occurs when the level of blood glucose (sugar) drops quickly. The signs are shaking, sweating, dizziness, double vision, convulsions, and collapse. Insulin shock may occur when an insulin reaction is not treated quickly enough. See: Hypoglycemia; insulin reaction.

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