Diabetes Fainting

Before the discovery of insulin in 1921, everyone with type 1 diabetes died within a few years after diagnosis. Although insulin is not considered a cure, its discovery was the first major breakthrough in the treatment of diabetes.

Today, healthy eating, physical activity, and taking insulin are the basic therapies for type 1 diabetes. The amount of insulin must be balanced with food intake and daily activities. Blood glucose should be closely monitored by frequent blood glucose control. People with diabetes also monitor levels of glucose in the blood several times a year with a laboratory test called A1C. The results of the A1C test reflects average blood glucose over a 2 - to 3-month period.

A healthy diet, physical activity and blood glucose testing are the basic management tools of type 2 diabetes. In addition, many people with type 2 diabetes require oral medication, insulin, or both to control their blood sugar.

Adults with diabetes are at high risk of cardiovascular disease (CVD). In fact, at least 65 percent of people with diabetes die from heart disease or stroke. Managing diabetes is more than keeping blood sugar under control - it is also important to manage blood pressure and cholesterol levels in healthy eating, physical activity and medication use (if necessary). In doing so, people with diabetes can reduce their risk. Aspirin, if recommended by the team of health care, and quitting smoking can also help reduce the risk.

People with diabetes must take responsibility for their care-to-day. A large part of daily care is to maintain levels of blood glucose from going too low or too high. When blood sugar drops too low - a condition known as hypoglycemia - a person can become nervous, fragile and confused. Judgement can be impaired, and if blood glucose is too low, fainting can occur.

A person may also become ill if the levels of glucose in the blood rise too high, a condition known as hyperglycemia.

People with diabetes should consult a health care provider to help them learn to manage their diabetes and who will monitor their diabetes control. Most people with diabetes receive care from primary care physicians - internists, family medicine physicians, or pediatricians. Often, having a team of providers can improve diabetes care. A team may include:

• a primary care provider as an internist, a family medicine physician or pediatrician

• an endocrinologist (a specialist in diabetes care)

• a dietician, nurse and other health care providers who are certified diabetes educators - experts in providing information on diabetes management

• a podiatrist (for foot care)

• an ophthalmologist or optometrist (for eye care)

and other health care providers, such as cardiologists and other specialists. In addition, the team for a pregnant woman with type 1, type 2 or gestational diabetes should include an obstetrician who specializes in care for women with diabetes. The team may also include a pediatrician or a neonatologist with experience taking care of babies born to women with diabetes.

The goal of diabetes management is to maintain glucose levels in blood, blood pressure and cholesterol as close to the expected range of possible conditions of safety. A major study, the Diabetes Control and Complications Trial (DCCT), sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), showed that keeping blood sugar close to normal reduces the risk of developing major complications of type 1 diabetes.

The 10-year study, completed in 1993, included 1441 people with type 1 diabetes. The study compared the effect of two methods of treatment - intensive management and standard management - on the development and progression of the eyes, kidneys, nerves and heart.