Type 1 diabetes is a lifelong condition. Its symptoms increase or decrease depending on your response to the insulin and your new diet and on how well you are able to control your blood sugar level. Taking good care of yourself to avoid complications is especially important with diabetes. Possible diabetic complications include heart disease, stroke, blindness, kidney failure, and nerve damage, especially to your feet and legs. Carefully controlling your blood sugar will delay or prevent these complications. Also make sure you get yearly tests to check your kidneys. For example:

• If you have had type 1 diabetes for at least 5 years, the urine protein test should be done every year to check for microalbumin, a type of protein.
• A blood test to check creatinine should be done at least once a year.

Guidelines for eating:

• Choose foods with lean protein, complex carbohydrates, and lots of fiber. Choose foods low in saturated fats. Read labels.
• Distribute your total calories evenly throughout the day.
• Time your meals to balance peak insulin effects and scheduled activities. Try to always have your meals and snacks at the same time each day.
• When you increase your activity, check your blood sugars more often. You may need to eat more or decrease the insulin you are taking. This will help prevent low blood sugar.
• Learn how to make proper food choices when you eat out.
• Ask for diabetic meals when you travel (for example, in hotels and on planes). Order your meals ahead of time.

Guidelines for managing calories:

• Avoid compulsive eating.
• Drink water or other noncaloric drinks when you feel an urge to eat between meals.
• Limit the amount of alcohol you drink. It can cause low blood sugar as well as worsen nervous system problems caused by diabetes.
• Buy only the types of food allowed by your diet plan.
• Eat on a regular schedule.
• Eat slowly and chew food thoroughly.

Guidelines for managing insulin:

• Follow your healthcare provider's instructions for giving yourself insulin.
• Ask your healthcare provider about the symptoms and causes of low blood sugar and what to do when you have low blood sugar.
• Know when and how to test your blood.
• Follow your healthcare provider's instructions for adjusting your insulin dosage according to the results of blood tests.
• Carry some form of sugar at all times, so you can treat low blood sugar quickly.
• Carry a protein snack, such as cheese and crackers, to make sure you eat as often as you should.
• Make sure your family members know what to do if your sugar is too high or too low.

Guidelines for seeing your healthcare provider:

• Follow your healthcare provider's recommendations for frequent follow-up visits until your diabetes is under good control.
• When your diabetes is under control, see your healthcare provider every 3 to 6 months unless your provider needs to see you more often.
• Eyes are affected by diabetes. You should have your eyes checked within 5 years of diagnosis if you are under 30 and right away if you are over 30. You will then need eye checkups at least every year. Women with diabetes who become pregnant should have their eyes checked each trimester because diabetic eye problems can worsen quickly during pregnancy. Excellent blood sugar control can reduce the risk of worsening diabetic eye disease.

Other guidelines for managing diabetes:

• Learn how to do proper skin and foot care every day. Wear comfortable, well-fitting shoes to help prevent foot injury. Break in new shoes gradually.
• Exercise regularly according to your healthcare provider's advice. Exercise helps the insulin do its job better. It also helps you to maintain a normal blood pressure and a healthy heart. Wear well-fitting, supportive, and well-cushioned shoes when you exercise.
• Ask your provider if you need to check your urine for ketones. Ketones are chemicals that show that your sugar is too high. Your provider will tell you when and how to check for ketones, if you need to. It is usually necessary only if you are starting to come down with an illness or if your sugars have been running too high.
• Carry an ID (such as a card or bracelet) that says you have diabetes, in case of an emergency.

Learn about diabetes and its complications so you can make the correct decisions to control your blood sugar levels. There is a lot to learn. Talk to your doctor about how you can learn all you need to know. You can also check with the local American Diabetes Association chapter, hospital, or health department about diabetes educators and dietitians who can help you or about classes in your area. It's good for your family to also learn about diabetes.

You can get diabetic cookbooks and more information about diabetes from:
The American Diabetes Association
Phone: 800-DIABETES (800-342-2383)
Web site: http://www.diabetes.org .

Type 1 diabetes cannot be prevented. However, many of the problems associated with the disease can be avoided or reduced if you:

• Follow the guidelines your healthcare provider gives you.
• Maintain a normal blood sugar level.
• Learn how to inject insulin correctly, including where to inject it.
• Learn how to test your blood sugar.
• Know when to adjust your medicine.
• Do not smoke. Smoking speeds up the damage to the heart and blood vessels.
• Have other medical problems treated, especially high blood pressure and high cholesterol.
• Keep your appointments with your provider.
• Call your provider if you have any questions.