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General measures

The home nurse, the doctor, the social worker (in case there are any special allowances that can be claimed to assist in any extra expense involved in the appropriate diet) and the health visitor will all be available to help the families of diabetics or diabetic patients themselves. After a period of time, however, and for most it will take three to six months, patients becomes accustomed to controlling their disorder and leading a normal life despite it. The need to go on urine testing four times a day becomes less necessary as the diabetes is controlled and most patients end up perhaps only doing it daily (the early morning test is most useful guide) or even only when they are in some doubt about their health.

It is important for others to know a patient is diabetic, though there is never any need to make a fuss about it. The use of the 'Medic-Alert' (or 'SOS Talisman') bracelet or discreet medallion has a lot to recommend it if an accident ever occurs that renders the patient unconscious (see Useful Addresses'). A card can be carried in the wallet that gives the diagnosis type and dosage of insulin or tablet, the details of the home doctor, etc. With children, schoolteachers must know about their diabetes and as well as where to contact the relatives, be told 'when in doubt give sugar or a bar of chocolate',for the school playground can be the commonest cause of 'hypo' reactions in the diabetic youngster.

Regular meals are the most important aspect of diabetic control for all. There can be no 'skipping' breakfast, working through lunch, missing tea and snatching an evening snack before hurrying to a disco, a meeting or the WI, or down to the pub. The insulin injected is working regardless of the blood-sugar level in the body and it will continue to do so whether the patient eats or not. That is what the diabetics life is like not like the normal person's, where the pancreas increases or decreases its Output according to the needs of the body. Once the insulin is injected, therefore, its effects have to be balanced by a regular input of food for it to deal with. Thus if the person is on a twice-daily soluble-insulin routine, they will be hungriest of all about two to three hours after taking it. Breakfast and the mid-morning coffee break with a biscuit or two are most important. After the evening dose the later evening meal must betaken and, particularly if the urine test before bed is sugar free, a bedtime snack must be taken,too. Similarly, with the longer acting insulin and the once-a-day injection,the peak effect is eight hours or so after injection so the lunch must be substantial, the mid-afternoon tea-break supplemented by a sweet biscuit or two and the evening's high tea nutritiously adequate with an extra slice of bread or two (or portion of chips,potatoes,etc.) if the day's physical demands have been tiring.

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