What happens if bloodglucose levels get out of range?
If a diabetic reaches a too low or too high bludglucose lewel he or she will not feel well. If the bloodglucose level is too low, due to too much insulin, to too little food or recent exercise, it's called hypoglyvaemia. If it's to high, due to too much food or too little insulin it's called hyperglycaemia.
 

Too low bloodglucose level,  hypoglycaemia A normal bloodglucose level for a diabetic is between ca 3,5 och 8 mmol/l. If bloodglucose level drops under 3,5 mmol/l you start to feel ill. Symptoms can differ between persons but most diabetics recognize their own symptoms. The symptoms can be headache, blured vision, irritation, nervousness, perspiration, nauseousness etc. The symptoms can be different between persons and the course of events can talk different time for differnt persons and from time to time. If the glucoselevels drops too low the diabetic becomes unconsious and if the diabetic doesn't get help from a doctor this is life threatening. How can I help a diabetic with hypoglycaemia? Hypoglycaemia is much more common than hyperglycaemia. If you find a diabetic feeling ill you should always treat it as it was hypoglycaemia if you are not absolute sure it is hyperglycaemia. This is because it's rare that a diabetic can't deal with a hyperglycaemia by him or her self and that the measurs that should be taken in case of hyperglycaemia can be directly life threatening in a hypoglycaemic situation. The reverse is not the case, it's not directly dangerous to treat a hyperglycaemic reaktion the same way you should treat hypoglycaemia. If the diabetic is consious you can help him or her to drnk or eat something sweet. Many diabetics carry some kind of sugar och dextrose with them to take if the bloodglucose level drops. Sugarcubes, sugarlemonade, milk or cola is good to take. Lightproducts is sweetened withaout sugar and is therefor not sweet enough when dealing with hypoglycaemia. They are better than nothing if they are all you've got. Always call for an ambulance if you find a person unconsious. Even if the person smells from liquer it can be a diabetic with hypoglycaemia (even diabetics sometimes drink alcohol, se below) or a person suffering from another illness.If you know that the person is diabetic or has other diseases, tell the emergency operator so they can dispatch the right help. Don't try to give an unconsious person something to eat or drink. It can get down the lungs and cause suffercation. If the person has no breath or pulse CPR can be necessary, all unconsius persons are not diabetic. When person is breathing and has got pulse, put the person in a forward position if you don't suspect other injuries like back or neck injury. Put a blanket or something like it on the patient if it is cold.

Too high bloodglucose level - hyperglycaemia If the bloodglucose level rises beyond 8-10 mmol/l glucose is first starting to fall out in the urine. You get thirsty and has to urinate frequently. Over 15 mmol/l is a risc taht the body will produce ketones and the breath will smell of acetone. The vison can get blury and headaches is not unusual. If the bloodglucose level rices more and/or the levels of ketones in the body gets to high (ketoacidoses) you can get unconsious. The signs before this happens is msot often so clear that there is plenty of time to react if you know you've got diabetes. How can you help a diabetic with hyperglycaemia? First make sure it isn't hypoglycamia your dealing with because this is a more acute condition. If your not sure, assume hypoglycaemia and call for a doctor or a nurse. If the person is consious and complains about being out of insulin help him or her to get to a doctors practice pr to a hospital. If you don't have a car take a cab or an ambulance. A walk to the hospital is also just healthy if the situation is not acute. Never try to administer insulin to a diabetic if you don't have the adequate medical training. You do not know the dosage and if it is hypglycaemia instead of hyperglycaemia you can make the situation more worsen the situation so it becomes realy serious. take the person to a hospital or a doctors practice instead. An unconsious person should always be taken to a hospital. Call for an ambulance the same way as if you suspect hypoglycaemia.

Complications
A diabetes that is hard to keep under control or has lasted for a long time might sometimes lead to complications. Since the methods of treatments are getting better and there are increasing possibilities to check your own bloddglucose levels complications are getting less usual.
 

Feet High bloodsugar can, if not treated, lead to problems with the circulation of the blood i feet and legs. The doctor should check the feeling in feet and legs regulary to detect bad circulation. If feeling is reduced in the feet there is an enlarged risc that injuries, cuts and wounds on the feet goes on undetected. The reduced bloodcirculation also makes it harder for wounds to heal. In worst case this can lead to so severe infections that amputation is the only option. By checking your feet regulary, by letting the doctor check the feeling and by letting a footspecialist check your feet if needed this can be avoided.

Kidneys If the kidneys have to filter out too much glucose from the blood they eventually get overstrained and can cease to work. Then dialysis and maybe a transplant can be necesary. This can be avoided by keeping the bloodglucose level down. The kidneys function is usually check regulary with a simple bloodtest.

Eyes High bloodglucoselevels might lead to bleedings on the retina retina that can lead to impaired vision or blindness. The eyes should therefore be checked regulary by a doctor specialiced in diseases in the eye. The doctor or a nurse can also take photographs of the retina. If the bleedings is found in time they can be treated with laser.

The risc of complications can be reduced considerably with a well controled bloodglocuse level. This can be easier said then don though. Most diabetes doctors understand that the glucose levels can go up and down even if you do your best. But I have met general practioners and eye doctors that don't have the same understanding. I have been lucky not to have any serious complication ins spite of my 30 years with diabetes.

Diet
What should you eat when you are diabetic? Most (all?) diabetes care centers have a food specialist that can give you advice. The diet is always important but the patient who takes insulininjection has little more freedom than those who just take tablets or are treated with just diet an exercise. I've noticed under my years with diabetes that whats "forbidden" one year can be recomended the next. Whats clear is that the sweeter a product is, the higher bloodglucose peaks it givs. Many high peaks gives fluctuating bloddglucose levels that are hard to control. Dark bread, maybe with sourdough, and other food that is rich with fibers gives a more stable bloodglucose pattern. You should be careful with pure sugar, sweet(ened) food and drink, pastery and white bread. Remeber that food don't have to be sweetened to be sweet. many diabetics eats a lot of food that is sweetened with artifical sweetener like sorbitol or nutrasweet (aspartam). Even if this might not be harmful for your diabetes it can be harmful to your stomach or other parts of your body. My advise is to try to as natuaral food as possible. But: Remember to live! You've got diabetes, diabetes hasn't got you!

Control
When I got diabetes bloodglucose was only tested when you met your doctor. Then you also left to urine samples collect during 24 hours. You also could check for glucose in the urine with a strongly corrosive tablet. Whit a stick you could also check for ketones.

Today you can use one stick to easaly check for both glucose in the urine and ketones. You can also easaly check the bloodglucose at home. In sweden you can buy a bloodglucose analysor for about $15-$70. The rest of the test material is free in sweden. Check with your doctor or insurance comapany because regulary tested bloodglucose gives you the posibilty to alter your insulin doses after your current needs and can give your doctor or nurse better grounds for their advise. This can save you from complications.

Glycated hemoglobin test is a blood test that measurs the bloodglucose level for a longer period of time (about 6 weeks). This test gives a good picture of your control over your diabets.

Diabetes and alcohol
The negative aspects of alcohol is true even for diabetics. It can hurt your liver, braincells and other organs. In addition alcohol lowers your bloodglucose level. This can be dangerous because the liver that usually stands by to produce glucose to oppose the drop in glucose level is occupied burning alcohol. The drop in glucose levels can be faster and reach a lower level of hypoglycaemia than normal that can be lifethreatening. It can be hard to detarmine between alchol intoxication and hypoglycaemia which makes it even more dangerous. If you become unconsious and smell of alcohol can make people, even the police, believe your just drunk so you don't get the medical attentio  you need. If you want to take the risc and drink alcohol anyway think of this:

• Tell yor friends you are diabetic so they know what to do. Carry an id-card or neclace that tells your a diabetic.
• Don't drink so much that you don't know what your doing. It's only you who know how you feel. (A good tip for everyone)
• Avoid pure alchol. You should rather take sweet drinks, red whine, cider or beer. If you drink white whine you may have to eat some thing (sweet) with it.
• Check your bloodglucose before you go to bed. It should rather be too high then too low.
• Adjust your insulindosage.
• Talk to your doctor!