Diabetes Mellitus, Type 1 Author: Maureen D. Passaro, MD; Robert E. Ratner, MD
Editorial changes - 2009-10-30
Author information and module status
Prevention
Screening
Diagnosis
Consultation for Diagnosis
Hospitalization
Non-drug Therapy
Drug Therapy
Patient Education
Consultation for Management
Follow-up
Tables
Figures
References
Glossary
What's New
Patient Information
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Quality Measures Quality Measures
Patient Education
  • When initiating therapy, teach patients necessary survival skills.
  • Refer patients to a skilled diabetes educator.
  • Instruct patients about self-monitoring of capillary blood glucose.

When initiating therapy, teach patients necessary survival skills. C

  • Instruct patients with newly diagnosed diabetes about:
    • Insulin administration
    • Signs, symptoms, and treatment of hypoglycemia
    • Blood glucose monitoring
    • Need for consistent food intake
    • When to call a doctor
    • Sick day rules
  • See figure Initial Assessment for Diabetes Form.
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Refer patients to a skilled diabetes educator. AB

  • Assess educational needs as patients' medical and psychosocial circumstances change.
  • Refer patients to a diabetes education program, if available, to assess their knowledge of diabetes and for instruction on diabetes self-management.
  • Include the following in diabetes education:
    • Self-monitoring
    • Meal planning
    • Carbohydrate counting
    • Insulin action and adjustment
    • Injection site rotation
    • Foot care
    • Acute and chronic complications of diabetes
    • Effects of exercise
    • Sick day rules for adjusting insulin doses
    • Reinforcement of survival skills
  • See figure Insulin Adjustment When Testing Blood Sugar Before and After Meals.
  • See figure Sick Day Guidelines and Insulin Adjustment
  • See a diagram of injection sites at www.lillydiabetes.com.
  • See the Non-drug Therapy section of the module Diabetes Mellitus, Type 2.
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Instruct patients about self-monitoring of capillary blood glucose. B

  • Use self-monitoring of blood glucose to facilitate adjustment of insulin doses, to meet target goals for glycemic control, and to avoid hypoglycemia.
  • Do not measure urine glucose.
  • Recommend monitoring blood sugars while fasting and before each meal or more frequently if necessary.
  • Test urine ketones during times of illness to make appropriate adjustments in insulin therapy.
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FAQs
Abd Tahrani, MD, editorial consultant, has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Maureen D. Passaro, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Robert E. Ratner, MD, is a consultant for Amylin Pharmaceuticals, AstraZeneca, GlaxoSmithKline, Lifescan, Inc., NovoNordisk, Sanofi-Aventis, Takeda, owns stocks in Merck, Johnson & Johnson, Abbott, received grants from Amylin, AstraZeneca, Bayhill Therapeutics, Boehringer Ingelheim, Conjuchem, Inc., Eil Lilly, GlaxoSmithKline, Merck, NovoNordisk, Pfizer, Sanofi-Aventis, Takeda.
Steven E. Weinberger, MD, FACP, Acting Editor, PIER, has stock holdings in Glaxosmithkline and Abbott.

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