Could This Be the Key to a Better Night’s Sleep?

How well you snooze at night has a lot to do with how you spend your days—sleep quality has been linked with everything from diet and exercise to electronic screen use. Now, a new study suggests that something a little less tangible may play a role, as well: People who have a strong purpose in life tend to sleep better through the night, with fewer symptoms of sleep apnea (Sleep apnea (AP-ne-ah) is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep) and restless legs.

Published in the journal “Sleep Science and Practice”, the study suggests that cultivating a sense of purpose could be a good drug-free strategy for improving shut-eye. And while the study only included adults ages 60 and up, the authors say their findings would likely apply to younger age groups, as well.

The researchers, from Northwestern University and Rush University Medical Center, knew that sense of purpose—defined in the study as “having aspirations and goals for the future and feeing that experiences in life are meaningful”—has been linked with numerous health outcomes, including reduced risks of stroke and disability and a longer life. It’s also been shown to improve sleep when measured at a single point in time.

To study the connection over a longer period, the researchers recruited 823 participants, average age 79, and gave them a survey to assess their overall sleep quality and the likelihood they suffered from conditions such as sleep apnea (which affects breathing and oxygen levels during sleep) and restless leg syndrome (during which uncomfortable sensations and an urge to move keep people awake at night).

The participants also answered questions to determine their psychological well-being and whether they had a purpose in life. Specifically, they were asked to rate their responses to statements such as, “I feel good when I think of what I’ve done in the past and what I hope to do in the future,” and “some people wander aimlessly through life, but I am not one of them.”

Overall, those who scored higher on the purpose-in-life questionnaire were 63 percent less likely to have sleep apnea and 52 percent less likely to have restless leg syndrome than those who scored lower. They also had moderately better sleep-quality scores at the start of the study and showed increased improvement over a one-year period.

“One interpretation of our findings is that individuals with a high purpose in life tend to have better overall mental and physical health,” the authors wrote. In other words, they sleep better because they have fewer health issues keeping them up at night. Another possibility is that people with higher levels of purpose tend to engage in more healthy behaviors, such as exercise, regular doctor’s visits, and relaxing hobbies.

This finding could be especially important for older adults, the authors say, since insomnia and other sleep problems tend to increase with age. Doctors prefer to treat these issues without pharmaceuticals, when possible, and this study may suggest that having a good reason to get up every morning may help in that regard.

This study is also significant in that more than half of the participants were African-American—a group that’s often left out of scientific research, and that tends to have higher rates of sleep disturbance than their white peers. “It appears that for both African American and White American older adults, the more meaning and purpose one has in daytime activities, the better one tends to sleep at night,” the authors wrote in their paper.

Addressing sleep disorders and disturbances is vital to overall health, the authors wrote: Poor-quality shut-eye has been linked to many physical and mental health problems, including depression, heart disease, and impaired physical functioning.

The authors say the next step in this research should be to study exactly how people can find or enhance their purpose in life—perhaps through mindfulness-based therapies. If those enhancements do, in fact, improve sleep, they could be a valuable tool for improving shut-eye for people of all ages.

RELATED: The Surprising Benefit of Night Showers

Showering earlier in the evening gives your body a chance to cool off and can even trigger sleep, says Shelby Harris, director of behavioral sleep medicine at New York’s Montefiore Medical Center. Several studies have shown that warming your body by taking a bath can help induce sleep when there’s enough time to cool off afterward. While much of the research has focused on baths, a 20-minute shower would have similar effects, Harris says.

Time your shower so you’re done about an hour and a half before you want to hit the sack, Harris recommends. That way, by the time you lay down in bed, your body will be cool, dry and ready for sleep.

This article was featured on www.health.com

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Women's Health: Yeast Infections

Vaginal yeast infection facts

• Most vaginal yeast infections are caused by the organism Candida albicans.
• Yeast infections are very common and affect up to 75% of women at some point in their lifetime.
• The main symptom of a vaginal yeast infection is itching, but burning, discharge, and pain with urination or intercourse can also occur.
• Treatment involves topical or oral antifungal medications.
• It is possible for a woman to transmit a yeast infection to a male sex partner, even though yeast infection is not considered to be a true sexually-transmitted disease (STD) because it can occur in women who are not sexually active.
• Treatment of yeast infection in men, like in women, involves antifungal medications.
• Keeping the vaginal area dry and avoiding irritating chemicals can help prevent yeast infections in women. Consuming foods with probiotics also may help.

What is a vaginal yeast infection?

A vaginal yeast infection is an infection caused by yeast (a type of fungus). Vaginal yeast infection is sometimes referred to as yeast vaginitis, Candidal vaginitis, or Candidal vulvovaginitis. The scientific name for the yeast that causes vaginitis is Candida. Over 90% of vaginal yeast infections are caused by the species known as Candida albicans. Other Candida species make up the remainder of yeast infections.

Candida species can be present in healthy women in the vagina without causing any symptoms. In fact, it is estimated that 20% to 50% of women have Candida already present in the vagina. For an infection to occur, the normal balance of yeast and bacteria is disturbed, allowing overgrowth of the yeast. While yeast can be spread by sexual contact, vaginal yeast infection is not considered to be a sexually-transmitted disease because it can also occur in women who are not sexually active, due to the fact that yeast can be present in the vagina of healthy women.

Vaginal yeast infections are very common, affecting up to 75% of women at some point in life.

Signs and symptoms of a vaginal yeast infection

• a vaginal discharge that is typically thick,
• odorless, and
• whitish-gray in color.

The discharge has been described as having a cottage-cheese-like consistency.

Other symptoms of a vaginal yeast infection include:

• An intense itching of the vaginal or genital area
• Irritation and burning
• Pain during sexual intercourse
• Pain or burning during urination
• Redness, irritation, or soreness of the vagina or vulva in women; swelling of the vagina 

Vaginal yeast infections occur when new yeast is introduced into the vaginal area, or when there is an increase in the quantity of yeast already present in the vagina relative to the quantity of normal bacteria. For example, when the normal, protective bacteria are eradicated by antibiotics (taken to treat a urinary tract, respiratory, or other types of infection) or by immunosuppressive drugs, the yeast can multiply, invade tissues, and cause irritation of the lining of the vagina (vaginitis).

Vaginal yeast infections can also occur as a result of injury to the inner vagina, such as after chemotherapy. Also, women with suppressed immune systems (for example, those taking cortisone-related medications such as prednisone) develop vaginal yeast infections more frequently than women with normal immunity.

Other conditions that may predispose women to developing vaginal yeast infections include

• diabetes,
• pregnancy, and
• taking oral contraceptives.

The use of douches or perfumed vaginal hygiene sprays may also increase a woman's risk of developing a vaginal yeast infection.

A vaginal yeast infection is not considered to be a sexually transmitted disease (STD), since Candida may be present in the normal vagina, and the condition does occur in celibate women.

However, it is possible for men to develop symptoms of skin irritation of the penis from a yeast infection after sexual intercourse with an infected partner, although this is not always the case.

What may increase my risk of getting a vaginal yeast infection?

Women who have conditions that result in decreased immune function are more likely than others to develop yeast infections. These include women with cancer or receiving cancer chemotherapy, those with diabetes, and women taking steroid medications.

Pregnant women and women taking oral contraceptives are also at increased risk.

Taking antibiotics for any reason can alter the normal bacterial populations in the vagina and predispose to the overgrowth of yeast.

Taking steps to reduce moisture in the genital area can reduce the chances of developing a yeast infection. Wearing cotton underwear or underwear with a cotton crotch, wearing loose-fitting pants, and avoiding prolonged wearing of wet workout gear or bathing suits are all measures that can help control moisture, and may help reduce the chance of getting a yeast infection. 

How can vaginal yeast infections be prevented?

Because yeast can be present normally in the vagina of healthy women, not all yeast infections can be prevented. However, it is possible to take preventive measures that may reduce your risk of getting a yeast infection. These include always cleaning the genital area from front to back and changing out of wet bathing suits or damp clothes as soon as possible. Wearing loose-fitting cotton underwear can help reduce moisture and prevent yeast infections. Since chemical irritants can influence the balance of bacteria in the vagina, avoiding products with potential irritants like douches or scented tampons can also help. 

Regular baths or showers are an adequate way to cleanse the vagina, and douching is not recommended and may actually increase your risk of yeast infection.

Some evidence shows that consumption of foods with probiotics (healthy bacteria that are normally found in the body) like probiotic-containing yogurt may help prevent yeast infections.

What about recurrent yeast infections?

A recurrent yeast infection occurs when a woman has four or more infections in one year that are not related to antibiotic use. Recurrent yeast infections may be related to an underlying medical condition such as impaired immunity and may require more aggressive treatment. This can include longer courses of topical treatments, oral medications, or a combination of the two.

Can a man get a yeast infection from his sexual partner?

Most experts do not consider yeast infection to be a sexually-transmitted disease, but cases of irritation and itching of the penis in men have been reported after sexual contact with a woman with a yeast infection, so it is possible for an infected woman to spread the infection to her male sex partner. Treatment of male sexual partners is not considered necessary unless the man develops symptoms.

How can you protect yourself from contracting a yeast infection from your sexual partner?

Condoms may help prevent transmission of a yeast infection from women to men, but they are not completely effective since there may be contact with areas of the body not covered by the condom.

Avoiding intercourse when a woman has symptoms of a yeast infection is the best way to prevent spreading of the infection.

SOURCES:

CDC: "Genital/Vulvovaginal Candidiasis"

<https://www.cdc.gov/fungal/diseases/candidiasis/genital/index.html>.

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20 Tips For a Healthy, Happy and Energized Weekend

If you're heading into the weekend feeling dead from your strenuous work or school week, then listen up! It's time to shake off the stress from your Monday-Friday schedule so you can celebrate health and embrace happiness.

Weekend is the perfect time for relaxation, fun, and family time!  However, oftentimes, we tend to put our healthy options behind during the weekends because we feel like having fun is more important.  We need to remember that being truly healthy is a lifestyle choice, and that even during weekends, we can all make healthier choices to ensure consistency within our healthy lifestyles. 

There are so many super-simple, positive tricks you can add into your routine; here are some great ways to be good to yourself and your body — and you'll reap the benefits of a serious mood boost, too;

1. Go into the weekend with a healthy mindset: Go into the weekend thinking you are going to stay on track, you’re more likely to actually stick with your plan that way!
2. Start your day off Right:  Start your meal with a plate full of salad, not only is it full of nutrients, but it will also curb hunger and keep you from over-eating. Use low calorie dressing for your salad like lemon and vinegar with olive oil. These alternatives are better than using mayonnaise or any other ranch style dressings.
3. Go outside: And stay outside! It's good for your eyes, prevents myopia (especially after staring at a screen all day), and will give you a healthy dose of vitamin D. Try an outdoor adventure.
4. Active Eating:  Choose a normal restaurant over a buffet to avoid over-eating. Restaurants with a pool or dance floor are great weekend destinations. A picnic spot or a resort where you can play different games like table tennis, lawn tennis or basketball are also great destinations to spend your weekend in a healthy way.
   
5. Order wisely when Eating Out:  For starters, order dishes which are grilled, baked and steamed instead of those that are fried. For a main course, choose lean meats, chicken and fish such as salmon and trout instead of lamb or beef. Order at least two side dishes of vegetables. Dishes with tomato, bitter leaves or huckleberry are great choice over those with white or cheese sauce.
6. Small Portions are Key:  Moderation is the key to keep those extra calories off. Instead of opting for bigger portions, take small portions at one time.
7. Fruits after meals: Instead of ice cream or beer take fruits.
8. Drink more water: Find a water bottle you love and keep it full all weekend long. Doing so causes a boost in metabolism, and helps with weight-loss goals, improved energy, and glowing skin.
9. Disconnect: Turn off your phone and computer when you can. It will help you relieve stress; we all know that stress = cortisol, a stress-induced hormone that slows the metabolism and increases fat retention.
   
10. Try New Social Gatherings: Weekends should not be about food but rather they should be about spending fun time with your loved ones. A movie/ TV-series marathon with friends along with healthy food options like fruits & salads, a game of basketball or football, a trip to the beach or an early morning trek are just as amazing options to spend you weekend in a healthy way.  A house party with home cooked food or a cook-off at your place with friends are also great away of making those Sundays exciting.
11. Get ZZZ's: Speaking of which, catch up on sleep while you can! It aids in weight loss, energy levels, mood, and overall health.
12. Diffuse and unwind with soothing essential oils like lavender and eucalyptus.
13. Move a little more: Try a low-key workout to keep your body moving.
14. Make some tea: A cup of green tea has ample amounts of magnesium, B vitamins, and L-theanine — the anti-stress trifecta!
15. Get organized: Use your downtime to prep healthy meals for the rest of the week, clean up clutter, and eliminate any stressors.
16. Try a new workout: Science shows that new exercises aren't just great for your body, but that they're good for your brain, too!
17. Meditate often: Set aside time to meditate and clear your mind from your hectic week.
18. Set a new goal, and start planning it: Have you been thinking about a half marathon? Maybe a backpacking trip? Pick a date, an event, and a training plan and get started.
    
19. Listen to happy music and go for a run. Music is known to reduce stress!
20. Start Fresh on Monday:  After the amazing weekend, it is very important to get back to regular eating patterns and diet from Monday. To make up for the extra calories consumed during your weekend, consume a high protein, low carbohydrate diet dinner, low fat cheese, egg white preparations, for two days after that amazing weekend.

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Health Tips on Lowering Risk of a Heart Attack or Stroke

Sometimes, small changes to your lifestyle can really cut your odds of having a heart attack or stroke. Try this step-by-step approach.

1. Exercise a Little Each Day

Moderate physical activity lowers your chances of a heart attack. Shoot for 30 minutes of exercise that gets your heart pumping at least 5 days a week. Brisk walking or swimming are some good choices. On the other 2 days, do strength training, like lifting weights.

If you've got a tight schedule, break your exercise routine into small chunks. Try a 15-minute walk in the morning and another before lunch.

2. Set a Reasonable Goal for Weight Loss

If you're overweight or obese, you don't have to get thin to reduce your risk for a heart attack or stroke. If you lose 5% to 10% of your weight, you'll improve your cholesterol numbers and lower your blood pressure and blood sugar levels.

3. Take Your Heart Medicine

It sounds like a no-brainer, but don't skip your meds. Many people don't take their medications the way their doctor told them to. Figure out what keeps you from taking your medicine -- it could be side effects, cost, or forgetfulness -- and ask your doctor for help.

4. Eat Well

If you stick to a healthy diet, you could lower your odds of getting heart disease.

Fill your plate with different kinds of:

• Fruits
• Veggies
• Whole grains
• Fish
• Lean meats

Stay away from processed or prepared foods that often are high in salt and added sugar. They’re also filled with preservatives.

5. Drink Some Alcohol, but Not Too Much

If you drink, any type of alcohol helps your heart, but use caution. Too much raises your risk of high blood pressure, heart attack, and stroke.

To get the benefit without the risk, stop at one drink a day if you're a woman and two if you're a man.

6. Eat a Little Chocolate

Go for dark chocolate, and make sure the ingredients are at least 70% cacao. It's filled with nutrients that help protect your ticker.

Keep your portions small so you don't gain weight and work your heart harder.

7. Don't Smoke

Smoking dramatically raises your risk of heart attacks and strokes. Talk to your doctor about how to quit. You'll also be doing your friends and family a favor, since secondhand smoke can also lead to heart disease.

8. Pay Attention to Your Symptoms

Don't just hope they'll go away. See your doctor if you feel anything unusual, like shortness of breath, changes in your heart rhythm, or extreme tiredness. Also, watch for pain in your jaw or back, nausea or vomiting, sweating, or flu-like symptoms.

References

• American Heart Association: "Lifestyle Changes," "Smoking: Do You Really Know the Risks?" "Professional Dental Cleanings May Reduce Risk of Heart Attack, Stroke," "Recommendations for Heart Health."
• Buitrago-Lopez A. BMJ, August 2011.
• CDC: "Losing Weight," "Physical Activity for Everyone."
• "Exercise and Your Heart," "Diet."
• Naderi, S. American Journal of Medicine, 2012. 

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Mental Health 1: Headaches That Require Emergency Attention

What is a Headache?

Headache is defined as a pain arising from the head or upper neck of the body. The pain originates from the tissues and structures that surround the skull or the brain because the brain itself has no nerves that give rise to the sensation of pain (pain fibers). The thin layer of tissue (periosteum) that surrounds bones, muscles that encase the skull, sinuses, eyes, and ears, as well as thin tissues that cover the surface of the brain and spinal cord (meninges), arteries, veins, and nerves, all can become inflamed or irritated and cause headache. The pain may be a dull ache, sharp, throbbing, constant, intermittent, mild, or intense.

Headaches can occur as a result of many conditions whether serious or not. There are a number of different classification systems for headaches. Causes of headaches may include fatigue, sleep deprivation, stress, the effects of medications, the effects of recreational drugs, viral infections, loud noises, common colds, head injury, rapid ingestion of a very cold food or beverage, and dental or sinus issues.

Is it just a headache?

Although a bad migraine might make you wish for the end of everything, headaches are not usually life threatening. However, a severe headache can signal something much more serious, requiring emergency attention such as stroke, aneurysm, and meningitis. These are not terribly common, but it's worth watching for a headache that feels markedly different from normal—even if normal is agonizing. Here are three signs to watch for;

Neck pain and fever

A stiff neck and fever could be a sign of meningitis; an inflammation of the membranes surrounding the central nervous system, which can quickly become critical.

Nausea

Severe nausea or vomiting and any neuro-deficit (such as difficulty speaking or walking), which could be signs of a hemorrhagic stroke

The worst headache ever

"The thing we're taught to look for is someone claiming to have 'the worst headache of their life,'" says an MD, an ER specialist. "It may mean that they have an aneurysm in the brain that has begun to leak a little blood, but could turn into a catastrophic full bleed. And that can be life threatening."

See a doctor

If you go to the emergency room, expect the doctors to perform a CT scan, which can reveal a bigger problem. Those with migraine headaches often have a treatment plan that will allow treatment at home. Prescription medications are available to abort or stop the headache. Other medications are available to treat the nausea and vomiting. Most patients with migraine headaches get much relief after resting in a dark room and falling asleep.

Curated from: 

Health.com

MedicineNet

Wikipedia

REFERENCES:

• Schurks, M. Current Pain Headache Report, April 2008; vol 12: pp 115-21.
• Mukamal, K. Neurology. March 10, 2009; vol 72(10): pp 922–927.
• American Headache Society: "Headache Hygiene - What Is It?" 
• NHS: "10 surprising headache triggers."
• Wikipedia: "Headaches"

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Managing Type 1 Diabetes

What Is Type 1 Diabetes ?

Type 1 diabetes is a chronic condition that usually starts in childhood, but can occur in adults (30 to 40-year-olds). In type 1 diabetes, the pancreas produces very little insulin. Insulin helps cells in the body convert sugar into energy. When the pancreas cannot make enough insulin, sugar starts to build up in the blood, causing life-threatening complications. Individuals with type 1 diabetes must take some form of insulin for the rest of their lives.

What Are The Symptoms?

Unusual Thirst Symptoms

Unusual thirst is a very common symptom of type 1 diabetes. This condition causes the kidneys to remove excess sugar in the blood by getting rid of more water. The water is removed through urination, causing dehydration and dehydration causes you to drink more water.

Weight Loss Symptoms

Patient with type 1 diabetes develop unintentional weight loss and an increase in appetite because blood sugar levels remain high and the body metabolizes fat for energy. Disrupted glucose metabolism also causes patient to feel a lack of energy and drowsy for extended periods Excess urination also cause weight loss because many calories are leaving the body in urine.

Skin Problems Symptoms

The disruption in glucose metabolism in patient with type 1 diabetes causes skin changes. Type 1 diabetics are at a higher risk for bacterial infections and fungal infections. Poor blood circulation in the skin may also occur. Patient with type 1 diabetes are often infected with fungal infections caused by the yeast Candida albicans. Common fungal infections include athlete's foot, vaginal yeast infection in women, jock itch, ringworm, and diaper rashes in babies. Diaper rash caused by the yeast Candida albicans can spread to other areas of the body such as the stomach and legs.

Other Dangerous Signs and Symptoms

Patient with untreated type 1 diabetes can experience serious symptoms such as blurry vision, numbness or tingling in the extremities (especially the feet), loss of consciousness, fatigue, fruity breath, dry mouth, and diabetic coma. In contrast to high sugars in the blood, occasionally patient with type 1 diabetes can get low blood sugars (hypoglycemia) when their blood glucose level falls suddenly.

In patient with type 1 diabetes, loss of consciousness, diabetic coma, and in some cases hypoglycemia, are medical emergencies. Some people who are undiagnosed may have no warning signs, yet still can develop diabetic coma or hypoglycemia

Ketoacidosis Symptoms

The problem with type 1 diabetes is that the person's cells are deprived of the sugar they need for energy. Without the insulin produced by the pancreas, sugar has difficulty entering the body's cells. Consequently, the body cells start burning fat for energy, which causes ketones to build up in the blood. These acids can change the person's blood pH level and can trigger a life-threatening coma. This is termed diabetic ketoacidosis. Diabetic ketoacidosis is a medical emergency that needs to be treated quickly, usually in a hospital setting. Symptoms of diabetic ketoacidosis include the following:

• Flushed, hot, dry skin
• Blurred vision
• Feeling thirsty and excess urination
• Drowsiness
• Rapid, deep breathing
• Fruity breath odor
• Loss of appetite, belly pain, and vomiting
• Confusion

What is the Difference between Type 1 and Type 2 Diabetes?

Type 1 diabetes usually starts in childhood or young adulthood, whereas type 2 diabetes usually starts in adulthood. In patient with type 1 diabetes, the body's immune system attacks and destroys pancreatic cells (Beta cells) that produce insulin. In patient with type 2 diabetes, the pancreas is not attacked and usually produces insulin. However, patient with type 2 diabetes, for numerous reasons, cannot use the available insulin effectively.

Patient with type 2 diabetes can have the same symptoms as patient with type 1 diabetes, but patient with type 1 diabetes usually have symptoms occur more rapidly. Type 1 diabetes cannot be prevented, but type 2 diabetes can be prevented or delayed with a healthy lifestyle.

What Causes Type 1 Diabetes?

When the body’s immune system destroys beta cells in part of the pancreas, type 1 diabetes develops. Beta cells in the pancreas produce insulin. Researchers are not sure why a person's immune system attacks its own insulin producing cells. However, researchers and clinicians suspect that genetic susceptibility and environmental factors raise the risk for developing type 1 diabetes.

Scientists have identified genes and gene regions that raise the risk of developing type 1 diabetes, but they are not the only factors that cause the disease. Researchers suggest that environmental triggers such as a viral infection or perhaps dietary or pregnancy-related factors may also play a role in developing type 1 diabetes

Who Gets Type 1 Diabetes?

Although type 1 diabetes can develop at any age, about two-thirds of new cases are diagnosed in individuals under the age of 19. Researchers have noted two peak times for development of type 1 diabetes; the first is in early childhood and the second occurs at puberty. Type 1 diabetes affects males and females equally, and is more common in Caucasians than in other ethnic groups. A family history of type 1 diabetes also increases one’s risk for developing type 1 diabetes.

Diagnosis and Treatment

Simple blood tests can indicate the presence of abnormal sugar levels in the blood. If a person has any symptoms of diabetes, a fasting blood sugar test or even a random blood sugar test is usually the first step in diagnosis. A hemoglobin A1c test can reveal average blood sugar levels for the past 2 to 3 months. In most cases these tests are repeated on at least two separate days. Other tests used are the glucose tolerance test or testing for specific antibodies in the blood.

High Blood Pressure Risks

Type 1 diabetes damages arteries and makes them susceptible to hardening (atherosclerosis), which can lead to high blood pressure and other heart and circulation problems. Unfortunately, undiagnosed or prolonged high blood sugar levels can result in damage to organ systems in the body over time. Patient with type 1 diabetes have a high risk of vision problems, heart disease, stroke, kidney failure, gum disease, tooth loss, and nerve damage (especially in the hands and feet). Other organs may also be damaged

Monitoring Blood Sugar Levels Treatment

For patient with diabetes, complications that can damage organs can be prevented or reduced by regulating their blood sugar level. This is done by pricking the finger and putting a drop of blood on a test strip. The strip is then placed in a monitor that reads the glucose level. Close monitoring of glucose levels allows the individual to regulate their blood sugar by either medication if the sugar is high, or taking in sugar if the level is low. If a person with diabetes is able to keep blood sugar levels in or near the normal range, they will decrease the likelihood of developing complications and have more energy and fewer problems related to diabetes

Measuring Blood Glucose (Sugar) Levels

There is a test called the hemoglobin A1c blood test that is used to help determine how well a person is managing their blood glucose levels. This test is taken at the doctor's office and measures how well the blood sugar has been controlled over a 2 to 3 month span. If the results show poor blood sugar control (high A1c levels), it suggests that the person's insulin therapy, dietary habits, and/or physical activity be modified to lower blood sugar levels into a more normal range.

Continuous Glucose Monitoring (CGM) Treatment

Another device that measures glucose is termed a continuous glucose monitoring system (CGM). This system consists of a tiny sensor under the skin to check blood sugar levels. It send the information to a cell phone sized device that records an average glucose value every five minutes for about 72 hours. CGM is now accepted for long term use in some patients with models that turn off insulin infusion when sugars start to drop.

Insulin Shots Treatment

Every person with type 1 diabetes needs to take insulin to help their body process sugar in the blood. Most people with type 1 diabetes take insulin in the injectable form and require several shots per day. There are different types of insulin available.

• Rapid-acting insulin starts to work within a few minutes and lasts for a couple of hours.
• Regular or short-acting insulin takes about 30 minutes to work and lasts 3-6 hours.
• Intermediate-acting insulin takes 2-4 hours to work and lasts up to 18 hours.
• Long-acting insulin can work for an entire day.

You and your doctor can adjust your insulin shots based on results of blood sugar testing. As previously stated, the goal is to keep glucose levels in the blood within normal range as often as possible.

Insulin can be injected using a needle and syringe, a cartridge system, or a pre-filled pen system. Inhaled insulin, insulin pumps, and a quick-acting insulin device can also be used. If injecting insulin into your body the best place is the abdomen, but the arms, thighs, and buttocks are also effective.

What Does Insulin Do?

Insulin is a hormone from the pancreas that allows sugar to enter the cells. Insulin also lowers the amount of sugar in the bloodstream. Without insulin, sugar is unable to enter the cells. This means that cells that make up muscles and other tissues will not be able to receive their main source of energy. Patient with type 1 diabetes will have a buildup of sugar in the bloodstream, causing life-threatening conditions.

Insulin Side Effects

• Low blood sugar
• Headache
• Flu-like symptoms
• Weight gain when you first start using insulin
• Lumps, scars, or rash at injection site

Insulin Shock

Although insulin is a wonderful drug that helps people with diabetes, it needs to be used carefully. If a person takes too much insulin it is possible the blood sugar level will lower into dangerous levels. This situation is termed an insulin reaction (low blood sugar due to excessive insulin).

Too much insulin can result in symptoms that may be mild, moderate, or severe, depending on how low and how long the low blood sugar levels exist in a person's blood. Some signs and symptoms of low blood sugar include fatigue, excessive yawning, mild confusion, decreased coordination, sweating, muscle twitching, and pale skin. As these symptoms get progressively worse, seizures, loss of consciousness, and even death may occur.

People with diabetes, especially type 1 diabetes, are advised to carry about 15 grams of a quick-acting carbohydrate at all times. Quick-acting carbohydrates are foods or drinks containing glucose that is rapidly absorbed into the body and the blood. Examples include a half-cup of fruit juice or a non-diet soda, five Life Savers (small hard candies), two tablespoons of raisins, one cup of milk, or three glucose tablets. These carbohydrates may resolve mild to moderate insulin reactions. For severe reactions, a drug called glucagon should be injected under the skin by a family member or friend familiar with treating severe insulin reactions and the person should be seen by a medical health care professional.

Insulin Pump Treatment

Although many people administer insulin through several shots per day, some people may be able to utilize an insulin pump. This pump delivers insulin around-the-clock by pushing insulin through a thin tube inserted into the person's skin. The insulin pump can be programmed to deliver exact amounts of insulin in a continuous dose as well as deliver extra doses certain times, typically when eating. People with diabetes are encouraged to discuss the advantages and disadvantages of this insulin delivery system with their doctor.

Pancreatic Islet Cell Transplant

Some people with diabetes fail insulin therapy and may have reactions to the insulin that is injected. These people may be candidates for a procedure that some clinicians consider experimental. The procedure is a transfer of healthy insulin-producing cells from a donor into the pancreas of the patient with type 1 diabetes. Although there are benefits to this procedure, there are also drawbacks including medications with serious side effects that must be used to prevent rejection of the donor cells, and the probability that the transplanted cells may only function for a few years.

Artificial Pancreas

Researchers are attempting to develop an artificial pancreas. This device is a combination of an insulin pump and continuous glucose monitoring system controlled by a computer program. The goal for the system is to release insulin in response to blood sugar levels and to reduce the release of insulin if blood sugar levels drop. The goal is to have a device that mimics the function of a normal pancreas. Some early trials of experimental devices suggest this device may be available in the future.

Type 1 Diabetes and Life Scenarios

Exercise

People with type 1 diabetes benefit from exercise, but they need to take precautions to prevent sudden drops in blood glucose levels. Diabetics should check their blood sugars before exercising and may require eating a snack before or during exercise. They may need to adjust their insulin dosage before exercising to ensure they stay within normal ranges of blood glucose. People with type 1 diabetes may also need to check their urine for ketones – ketones suggest that your blood sugar is too high. Strenuous activity needs to be avoided if ketones are detected or if your blood sugar level is either high or low before exercise.

Diet

People with type 1 diabetes, like everyone else, need to eat a well-balanced diet. This will help their insulin therapy and reduce the chance of diabetic complications. There is no “diabetes diet”. Even a person with type 1 diabetes can eat sweets as long as it is part of a well-balanced diet. That is not to say they can eat anything all the time, but they need to consider how sweets can fit into their well-balanced diet. Type 1 diabetics should also consider the fact that carbohydrates raise blood sugar levels faster than any other food. Food low in carbs, but high in calcium, potassium, fiber, magnesium, and other vitamins are excellent food choices for diabetics. Consider the following guidelines when planning your meals:

• Eat less unhealthy fat
• Get enough fiber
• Keep track of carbohydrate consumption
• Keep track of carbohydrates in sugar-free foods

Healthcare workers such as dietitians can help people with diabetes plan a well-balanced and varied diet.

Pregnancy

Women with type 1 diabetes need to let their doctors know if they plan to become pregnant. Poor control of their blood sugars may cause complications such as birth defects. Planning ahead, even before conception, to control blood sugar levels can lower the risk of miscarriage and birth defects. During pregnancy, it is important to test blood glucose often and keep your A1c below 7%. Good blood sugar control can reduce other complications during pregnancy such as high blood pressure or retinal damage in the mother.

Preeclampsia is a condition that 18%-30% of pregnant women with diabetes develop. Preeclampsia develops after the 20-week mark and is characterized by high blood pressure and proteins in the urine. It is important to treat preeclampsia, if untreated it may harm the baby and put the mother at risk for stroke and seizures. Once the baby is born and if the mother is breastfeeding, it is important for her to check her glucose levels frequently.

Juvenile Diabetes

Diagnosis of diabetes in children is a life-changing situation because it affects the whole family. Parents must help children monitor blood sugar and plan family meals that are appropriate for the child with diabetes and other family members. Insulin dosages must be monitored and blood sugar levels need to be checked by the child’s caregivers.

Diabetes in children is a 24-hour-a-day problem that needs to be considered when a child is attending school and participating in extracurricular activities. Parents and their children need to make arrangements to follow through with insulin treatments even while the child is at school. These arrangements need to be planned in advance, as not every state or school may participate in the child’s care the same way.

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REFERENCES:

• Diabetes.org: "Skin Complications"
• DiabetesForecast.org: "A Guide to Pregnancy With Diabetes"
• Hormone.org: "What Does Insulin Do"
• Medscape: "Type 1 Diabetes Mellitus"
• MedicineNet