Diabetes Research

A member here had suggested on a previous thread of mine that an illness a friend of mine might want to consider for her character is diabetes. I was wondering though if anyone here might have any personal stories of theirs they wold like to share as well as a few questions such as:

1) The character she is considering is either 17-19 at the time but she is possibly thinking he would be under the age of 10 when he is diagnosed, what type of diabetes would he possibly be diagnosed as having?

2) How would the following conditions affect his diagnoses: a) Sleep [The appropriate number of hours this character would need to sleep & how would lack of sleep or too much sleep affect this] b) Stress such as being removed from the home with one parent & being told by said parent they may not contact their other parent. [For this it would be him being moved from his mother's care to live with his father. His mother has Paranoid Schizophrenia whether he is aware at the young age is undetermined as of yet] C) A lack of a proper diet.

3) How would medication be given during the 80s, 90's, & today as far as insulin? What is the proper way to refill this medication? Doctor's visits?

4) What is an example of a proper diet for someone with diabetes? What is the proper amount of sugar intake? What are some sugarfree foods? What if he were to cheat a bit with his diet? What would you consider just a little too much & what would be the amount that would require additional medication or hospitalization?

5) What would he have done for him in a hospital? How does diabetes affect colds, flues,or infections? What would diabetes affect in surgeries? What are some signs that he is beginning to get sick before being diagnosed? How would he be diagnosed? What are some signs he is staking a bad turn with this illness?

6) How would this affect a character who also is lactose intolorent?

I'm no expert; I just have loved ones with diabetes and some scientific background in studying it (but not anything remotely near a degree). And aaaalll of my experiences, both personal and research, have been about type 1.

1) Juvenile/Type-1. Pretty much for sure; type-2 is much more common when older (and common, period) and I have never heard of a kid getting it. Type 1 is mostly genetic as far as anybody can tell (vs type 2, which has behavioral risk factors), and tends to show up around that age (but does appear later in some people).

2) Blood sugar issues can cause sleep issues, and stress can make controlling blood sugar harder (my boyfriend has type 1 and trust me, these factors all together can be hellish). A bad diet could make it really hard, although if he has type 1 he'll use insulin regardless, so I guess if he was very good about administering the right amount at the right time for the food (probably he'd have to have an insulin pump, vs. injections), he might be OK? A bad diet makes everybody feel worse, though, so.

3) Used to be, insulin had to be administered by regular injections multiple times a day (so no, not by doctors). Before scientists figured out how to mass-produce insulin (and I don't know the date, but I think it was pre-80s), it was also even more expensive and hard to get than it is now. If you have to use injections, you also have to be pretty careful about food types and times, because you need to coordinate the insulin with the carbs. These days (and again, I don't know how old the technology is), people can instead use insulin pumps, which are basically just a vial of insulin + tubing + a site (needle semi-permanently puncturing skin). As I've seen it used, the machine gives a regular low dose of insulin (immediate-acting; there are also slow-acting types for injection), and then the person can also tell it when to give larger doses (for meals). But some people still prefer injections.

4) I'm sure doctors will disagree with me, but with proper insulin administration, it's pretty much the same as a non-diabetic's diet (again, this is all for type 1. Type 2 actually can be managed with just diet, for some people, and in that case there is a different diet). Yes, it's easier to say drink sugarfree soda than soda with sugar, and it's easier to be healthy as a general rule for anyone, but nothing terrible is going to happen if you have the insulin there to deal with the sugar. Generally, worst-case I've seen is that he, say, forgets to give himself insulin at a meal, feels ill, realizes he has high blood sugar, gives himself insulin, and is OK (but does tend to sleep/feel bad for a good number of hours).

5) THAT SAID. My boyfriend has gone to the hospital for diabetes issues (although only once did he have to; a few other times he's been sick for other reasons and doctors who don't know what to do with a diabetic send him to the hospital to be on the safe side -- illnesses like colds can make it WAY harder to manage blood sugar, so when he gets sick he also does tend to get high more often). The one time he did go for high blood sugar, his pump had broken without being noticeable. So he was without insulin for... probably 12 or 18 hours. High blood sugar, left untreated, makes one nauseous and generally awful-feeling. After he threw up for several hours, his roommate decided that something was clearly wrong (my BF had given himself insulin, but didn't realize it wasn't working) and got him to the hospital. An hour or so in the ER + a night in the ICU + a day in whatever the regular thing is called, and his blood sugar finally went back to normal. So. Can be bad. Usually not that bad, because again, no insulin at all. But infection/illness is what the doctors thought, until they figured out what was wrong with the pump.

6) Dunno, but the person I'm getting most of this from finds all cheese violently disgusting, so doesn't consume much lactose at all. Doesn't seem to do much.

If you have more questions, do ask. And I may well be misstating/misunderstanding some parts, so please do correct me if I got something wrong.

Oh lord. Okay let's do this. I am a diabetic, have been for two years and I'll answer your questions as well as I can. I'll tell you right now, you're probably going to get a lot of diffrent answers because no two diabetics are exactly the same.


1) At 10 or Under it would be Juvenile/Type 1 diabetes. Although, just a side note, if the character were hypothetically diagnosed at 17-19, they would almost always be thrown into Type 2 status without any proper tests being done.

2) High blood sugar makes you tired. So this kid would probably be sleeping a lot more than normal leading up to his diagnosis. If he has thyroid problems on top of it (very common) then that would also be a factor.

Stress raises blood sugar. Heat raises blood sugar. Looking at food funny raises blood sugar. Prediagnosis, none of this will matter because without insulin the kid's sugar will be through the roof no matter what. It's almost gauranteed that he won't be eating a 'diabetic' diet beforehand, so that will have to be adjusted later. Prediagnosis he will be drinking a TON of water and eating all the food that will fit in his mouth (probably to the point where he makes himself sick). Believe it or not, hunger is a symptom of high blood sugar. Despite the extra eating and drinking, weight loss will probably happen.

Now, with all those family problems, unless someone is keeping a very close watch they may not actually notice he's sick. A lot of people tend to rationalize illness as much as they can until it's too obvious to ignore.


3) I do not know about the 80's or 90's. Today they'll have the choice of insulin syringes, pens, or a pump. Just to keep it simple anyway. Their doctor can write a prescription for insulin, or if they have the right type of health insurance it can be arranged for a supply of insulin to be delivered every three months or so. Typically I see my doctor every three months minimum to check my progress and get a new prescription. For a Type 1 getting insulin is kind of a no-brainer. Now if you're a Type 2, that's where it gets obnoxious. Most Type 2's absolutely need insulin, but can't get it because of horrible stereotypes. So doctors will flat out refuse to give it, or their insurance will deny coverage.

4) See you're going to get a lot of different responses for this. I completely disagree with the above poster. I have yet to meet a Type 1 diabetic who eats a normal diet and hasn't suffered some complication somewhere down the road/gained a TON of weight. Obviously I don't know everyone, but it just seems like a bad idea to eat cake and soda then just take extra insulin to compensate. This is just my personal opinion. I tend to follow a more strict diet when I can and I find it works best for me. Also, no, not all Type 2 cases can be controlled with diet. Only very few can just eat right and everything will be roses and peaches. But that's a story for another time.

I personally favor a semi-low carb diet. Carbohydrates are where the real trouble lies. In the end sugar is just another carb and can be counted as such. Now, I myself don't follow a super strict diet. I eat normally...to a point. Nine times out of ten I will turn down dessert or have a smaller portion just because taking that extra insulin makes me sick and causes cravings for more carbs (hence, why people gain weight on insulin). Sugar free foods may not have much sugar, but most of them have a LOT of carbs and are just barely better than the real thing. Not to mention some people cannot handle the sugar alcohols, which can do a number on your stomach if you abuse them. Like everything they must be eaten in moderation. I still love my diet soda and I have had many weird arguments with my grandpa who insists splenda will give you cancer whereas I practically abuse the stuff.

Unless this kid is refusing to take his insulin for long periods of time, it's not too likely he'll end up hospitalized for high blood sugar. Some people can last longer than others without insulin. Typically though, I always say I'd rather be high than low. He's much more likely to be hospitalized after a bad bout of hypoglycemia. This can happen from an insulin miscalculation. Like he accidently took too much or took it too early and didn't get a chance to eat.

5) Depending on why he's there, they'd try to bring his sugar up or down obviously. I've never gone to the hospital for a low. For super high sugars, they'd give you some insulin first off and then do a liquid IV drip to keep you hydrated.

Colds/Flus/Infections ruin everything. I swear to god. I cannot control my sugar when I'm sick, and it doesn't seem to matter how much insulin I take. It takes longer for me to recover and the illness seems much worse than how it was before I was diagnosed. His doctor is probably going to insist he get a flu shot, because diabetics have a harder time fighting infections and if they're not careful things can get real bad, real fast.

I think I answered some prediagnosis questions up there already. Oops. xD But some additional info. Around his age he's probably going to start getting rebellious. Hurr hurr, I can eat this or that or I don't need my insulin! The early college years tend to be hard on diabetics, because diabetes is an illness that requires discipline and, well. Lol. Teenagers tend to think they're too young to experience complications when, no, they're really not. Luckily some complications are reversible, but it can be a nasty wake up call. I recommend you look up some stories because mileage may vary as to how this disease smacks you upside the head. You really never know what will happen if you're not careful. Heck, you never know what might happen if you ARE careful. There's no real right or wrong way to treat diabetes so long as sugars are controlled to the best of their ability. Watch, you're very likely to get a few responses that seem to completely contradict with mine. If all diabetics were the same, we'd probably have a cure by now.

6) It wouldn't? Milk has a ton of carbs in it anyway and more often that not he probably shouldn't be drinking it. As far as things like cheese go, well, that's on him. xD Come to think of it, I don't know if lactose intolrance is worsened by uncontrolled sugars. It would be worth looking up I think.

This is a ton of information from you both & I will not only take the time to read this but to also respond to each of your points but at the moment i have no internet so it may take me a few days to reply.

I wanted too know if anyone may know the effect of drugs on a diabetic? Behavior changes, medication reactions and potential health problems that may result from drug usage eve if the drug was legal such as specific pain medications [If anyone may be able to post the names of certain medications with both negative and postistive reactions that would be wonderful]

What about the potential health risks of illegal drugs such as Heroine, Cocaine, & Dilaudid [Drug store Heroine]

Winter, you mentioned a little bit about the differences between high & low blood sugars, but I was wondering if you or maybe someone else as well, might be able to go further into details about the symptoms you might have heard, read, or experiences, that would distinguish the differences between the two. For example, said character might be at the hospital, what would lead the doctor to diagnose it as a case of low blood sugar factor wise, what would reasons would he have versus what might lead a doctor to determine that it might be high blood sugar? If he were not to be near a doctor but at his age would recognize the symptoms for both cases, what might he do to correct both & what symptoms would he have for either that he would know and recognize? As a child he might not be sure and a d doctor might explain the symptoms where as at the more present teenage years, he would probably have a better understanding having lived this way for the past few years. [Will someone please go into as much detail as they might on hypoglycemia? Hyperglycemia?]

Myself & my friend were curious about something we had read & I was hoping someone could correct might be wrong or let me know if this is accurate? It was research on how to specially check for diabetes & I read something about a test titled a random Plasma Glucose test & that it measured blood sugar in Milligrams per deciliter? & that a normal blood sugar level was about 100/mg/dl of blood? It mentioned something also called Ketoacidoisis if anyone might be able to explain that complication/illness? Ketones? Also it mentioned an Oral Glucose Tolerance test if someone might explain more, something about fasting for eight or so hours and then measuring the blood before drinking a sugary substance, then testing the blood again an hour later before again after two hours. That anything below 140 as a result was normal but over 200 might signify diabetes? If this true? Might someone explain more in further detail?

What are the procedures for using insulin by injection? Would he use a vial of insulin & if so how small would it be & how easy would the glass break? How much might he need for small doses & larder meals? Will he might have a bag that would hold the medicine and syringes? What temperatures should insulin be stored & what might happen should he store it a the wrong temperature or perhaps leave it somewhere overnight? What might the insulin appear as if the medicine was expired or ruined from the wrong temperatures & what might be the complications he if were to use it not realizing the differences or figuring he might not be able to receive a new one for a while. [He’s pretty clever but not the brightest on practical things]

If he were to reuse the syringes because he might not be able to afford much, would he be able to use it only once? Twice? What might happen as a side effect from overuse of a syringe? Where is insulin given, to which part of the body specially as in the injection site? Which areas can be used & would he change injection sites as in rotate the areas? If he were to use a pump how is that inserted & what might be the best age for this & for example would that hinder things such as a job that requires a hight level of outdoors, walking or bending to pick things up would he have a discussion with a doctor first if he chose to try this after using injections for a few years & would he be able to reverse this & go back to injections? Would he have some adjustment issues with using a pump after injections for so long & what about changing time zones as his job requires constant plane rides to different areas back & forth within a few days span? Would he have bruises or such if he used a syringe wrong? What if he use a pump, how is it inserted, where is it inserted, is it bulky, is it thin, would it be obvious a person might be wearing one as in would someone be able to tell under a thin shirt?

How might he hide his illness from his friend/co-workers s who he might want to know right away? Such as when they go to dinners together or if he were to get sick from different blood sugar levels would people assume it were a cold? & what if he were too sick to the point of hospitalization, would symptoms might there be? Such as if he were to get much smaller meals or eat too much to try & remain to him normal such as his friends & co-workers or if he could not eat & might feel odd to not have something as they might? Would he have small snacks on him & if so what, if he feels a bit faint to control blood sugar levels? What if he were younger & his blood sugar seemed too low, would someone who might know try & balance it out first without insulin, such as maybe trying to get him to drink a regular soda or eat something in a bit higher sugar than he may be used to? How might he achieve a right balance? What if he feels his blood sugar is too height so he decides, being younger, to skip a meal to attempt to balance it himself, what might happen if he were too low because of this & perhaps had to do running for school, or other work? For school? Would he feel clammy? Faint? Nauseous? Concentration problems before hand if he were too low or too high?

Also read about testing blood sugar yourself & again correct me if this is wrong which is why I also ask for more detail or personal stories, I read you use a device which is where you load a lancet into a spring device that resembles a pen. A person presses it to the tip of a finger, if someone can say if there is a specific one let me know, & press a button. You press a test of blood on a test strip & slide it into the machine. Is the machine meter machine? That before meals the reading should be before 100 & 120 after meals? Is this correct?

With insulin must it be taken with food as opposed to not? Is there such a thing as a practice kit to teach a person or the family about administrating insulin themselves or for someone to learn in case he might be too weak? How would a practice kit work or what might it contain? Also I read about something called Glucose rolls which I think is sugar in a sort of candy type form /chewing tablet form to help balance lower levels? Os this right & if so what might they look like?

Wills someone please list a few things that would have too much carbs in it & how would that affect blood sugar & diabetes?

Will he be able to receive a medical alert bracelet since he is young just for if something happens & he might be too sick & someone might either recognize the symbol or wording & may help or if someone sees him too sick & with the syringes unable to do it and someone who tries to help may get confused that they were sick of a drug overdose rather than sick from a medical condition if he is a bit older and does not have a bracelet or recognize it and refuses to help out of misunderstanding? What is your opinions on a bracelet & if so what would one appear as? What if someone sees his bracelet in school & assumes he has a catching bad illness after seeing it or assumes that he is much worse off than he is? How might he react to people then and later in life for this?

What are the complications that can arise health wise for severe blood loss for example as the blood level drops more rapidly such as being injured, for this story the main character as a college teen gets severely injured and there is a lot of blood loss, how would his illness affect it and how much worse would it be? How does diabetes affect accidents & illnesses, he has to have surgery as a result of this? If blood sugar drops rapidly low or too low could it cause seizures? Would they vomit? How sick could this character potentially get as a result?

Also what if a person with Diabetes wanted to get drunk how would their blood sugar be affected with they do not care at the moment about the amount of alcohol they consume? What if they were doing drugs and had diabetes? How would this interfere with their help and Insulin? For example, this character was or is at the moment addicted to Dilaudid which is titled Drug Store Heroine if this may be easier to understand? They may have also had a problem with cocaine if I am helping to make this more clear and if anyone can tell how drugs and alcohol affect Insulin an Diabetes as a whole?

I love being thorough with research & at the moment have limited access to a computer so I want to get as much questions as I can down until a few days when I can make time again. Anyone please can answer, please be through if you can. : ( I have no internet so it may be days to a week/ a week and a half before I can respond or ask. Besides,a s a writer should we not be thorough as best we can ;) Especially as I have no prior knowledge for this.

Hi. I’m new here and this is actually my very first post! I think I might be able to help you a little bit, however, most of my rather limited knowledge is about type 2 diabetes (I have friends and family with it), so some of this might not be accurate for type 1. I don’t know anything at all about ketones, insulin pumps, or how certain drugs impact diabetes, so I just ignored those parts, sorry. I hope someone who is more knowledgeable than I am will correct me if I’m totally wrong about anything here.

Q: For example, said character might be at the hospital, what would lead the doctor to diagnose it as a case of low blood sugar factor wise, what would reasons would he have versus what might lead a doctor to determine that it might be high blood sugar?

A: If the character goes to the hospital, the doctor will take a blood sample and see what his sugar is. This only takes a few seconds, and even if the doctor knows that the character’s blood sugar is high or low based on symptoms, he/she would still test to make sure and see what the exact level is.

Q: If he were not to be near a doctor but at his age would recognize the symptoms for both cases, what might he do to correct both & what symptoms would he have for either that he would know and recognize?

A. By the time he’s 17-19, he definitely should be able to recognize the symptoms. Everyone is a bit different, but low blood sugar can cause tiredness, a cold sweat, rapid heartbeat, and feeling weak or dizzy/shaky. It will eventually lead to seizures or a coma if it isn’t treated. High blood sugar can cause a desire to eat (which is odd if you think about it), a grumpy feeling, thirst, blurry vision, confusion, upset stomach, and tiredness. It is possible to confuse the symptoms from time to time, so your character should check his blood sugar before doing anything to correct it. When his sugar is high, he should generally avoid eating until the level has gone down (I’m not sure if that also goes for type 1), and drink lots of water. Light exercise (such as a walk, nothing intense) can also help if his sugar is only a little bit elevated, but can be bad if his sugar is really high (like over 250 or 300) and should be avoided in that case. His doctor might tell him to call if his sugar goes above a certain level or to go to the hospital if it is really high. When his sugar is low, he needs to eat some glucose tablets (or candy, or drink a regular soda, etc.) to get it back up. He should test his sugar 15 minutes after eating and have more if his sugar still isn’t where it needs to be. If his sugar won’t come up, he should definitely go straight to the ER.

Q: Random Plasma Glucose test & that it measured blood sugar in Milligrams per deciliter? & that a normal blood sugar level was about 100/mg/dl of blood? Also it mentioned an Oral Glucose Tolerance test if someone might explain more, something about fasting for eight or so hours and then measuring the blood before drinking a sugary substance, then testing the blood again an hour later before again after two hours. That anything below 140 as a result was normal but over 200 might signify diabetes? If this true? Might someone explain more in further detail?

A: Fasting plasma glucose test is probably the most common test to diagnose diabetes. A person doesn’t eat for at least 8 hours and then goes in and has blood drawn. Below 100 is normal, 100-125 is prediabetes, over 125 is diabetes. If the test shows diabetes, most doctors will do a repeat test to confirm the diagnosis. The random plasma glucose test is similar, except there is no fasting involved. It isn’t as accurate, but over 200 means the person likely has diabetes and should have a different test to confirm. The oral glucose tolerance test is basically like you described, though some doctors only draw blood twice—once before drinking the stuff and then two hours later. Below 140 is normal, 140-199 is prediabetes, and over 200 is diabetes. Again, the test is likely to be repeated to confirm the diagnosis.

Q: What are the procedures for using insulin by injection? Would he use a vial of insulin & if so how small would it be & how easy would the glass break? How much might he need for small doses & larder meals? Will he might have a bag that would hold the medicine and syringes? What temperatures should insulin be stored & what might happen should he store it a the wrong temperature or perhaps leave it somewhere overnight? What might the insulin appear as if the medicine was expired or ruined from the wrong temperatures & what might be the complications he if were to use it not realizing the differences or figuring he might not be able to receive a new one for a while.

A: I think insulin is most often administered using an insulin pen now rather than vials, but I’m sure some people still use them. I think the vials are pretty small and I imagine the glass would be easy enough to break if dropped (don't know for sure). How much insulin he needs depends on his exact situation and the type(s) of insulin he is taking in addition to the food he’s eating. I don’t know enough about this to give a better answer. Yes, he could have a bag to keep all of his medications in if he wants to. I’m not sure about temperatures and insulin. A friend of mine says her pens have to stay in the fridge until she opens one, but once it is open it no longer has to be refrigerated (I’m not sure why). In her case, leaving it “somewhere” overnight would not be a problem, unless someone tampered with it or something like that. I think it gets cloudy looking if it has gone bad. It might not work as well if used anyway, but I’m not sure if anything bad would happen or not.

Q: If he were to reuse the syringes because he might not be able to afford much, would he be able to use it only once? Twice? What might happen as a side effect from overuse of a syringe? Where is insulin given, to which part of the body specially as in the injection site? Which areas can be used & would he change injection sites as in rotate the areas? Would he have bruises or such if he used a syringe wrong?

A: He could reuse the syringes/needles multiple times (more than just once or twice), but it wouldn’t be a very good idea. Side effects could include infection, especially if he doesn’t clean it with alcohol or something first, but it’s more likely just to hurt more the more he reuses it (the duller the needle, the more it hurts). Rather than reusing syringes/needles (unless he’s in a one-off situation, like getting ready to eat at a restaurant and he thinks he has needles but when he looks in his bag he can’t find a new one), he might try talking to a pharmacist or something. Pen needles can be bought OTC (in the US anyway) and he could possibly get some free samples to last him until he can afford to buy more. Insulin can be given in several spots, but I think stomach, upper arm, and top of the thigh are the most common. He would definitely rotate rather than stick himself in the exact same spot each time, he should generally move over a bit (an inch or two) from where he did his last injection. He could have bruises even if he uses the syringe correctly.

Q: How might he hide his illness from his friend/co-workers s who he might want to know right away? Such as when they go to dinners together or if he were to get sick from different blood sugar levels would people assume it were a cold? & what if he were too sick to the point of hospitalization, would symptoms might there be? Such as if he were to get much smaller meals or eat too much to try & remain to him normal such as his friends & co-workers or if he could not eat & might feel odd to not have something as they might? Would he have small snacks on him & if so what, if he feels a bit faint to control blood sugar levels? What if he were younger & his blood sugar seemed too low, would someone who might know try & balance it out first without insulin, such as maybe trying to get him to drink a regular soda or eat something in a bit higher sugar than he may be used to? How might he achieve a right balance?

A: It wouldn’t be too hard to hide if he didn’t want his coworkers to know, but it probably would be best for them to know just in case, especially if he tends to have a hard time regulating his blood sugar levels and tends to drop low (which seems to be the case for this character based on your questions). Maybe he could just tell his boss and a few people that he gets along with rather than making a big announcement. I’m not sure what the next few parts of your question are asking, so sorry if I miss the point, but I don’t think eating at work would be that big of a deal. He’d eat lunch like everyone else and have a few snacks if he needs to, like everyone else. He might avoid treats other people bring in if they’re bad for him, but most people wouldn’t really care or notice what he eats or doesn’t eat (and he could just shrug them off if they do say something). Yes, he should keep some glucose tablets or snacks around just in case. If his blood sugar was low and someone noticed, they should definitely NOT give him insulin, which would make things worse. If they don’t know about his diabetes but notice him seeming a bit off, they might ask him if he is okay or if he needs anything. If they do know, they should encourage him to test his sugar and offer him something like you mentioned above if it is low. If he is acting very strange or isn’t responsive, they should call an ambulance for him. Chances are he’d notice before someone else in his office would though.

Q: What if he feels his blood sugar is too height so he decides, being younger, to skip a meal to attempt to balance it himself, what might happen if he were too low because of this & perhaps had to do running for school, or other work? For school? Would he feel clammy? Faint? Nauseous? Concentration problems before hand if he were too low or too high?

A: Again, blood sugar levels should be tested and not just assumed to be high or low based off of what the person is feeling (and he should know this). But, if something like this happened (and it does), he’d probably need to grab some glucose tablets or a snack to help bring his sugar back up. He might not want to leave and go to work or school until after he has stabilized his levels if he was very low. Yes, he could feel any of the things you mentioned.

Q: Also read about testing blood sugar yourself & again correct me if this is wrong which is why I also ask for more detail or personal stories, I read you use a device which is where you load a lancet into a spring device that resembles a pen. A person presses it to the tip of a finger, if someone can say if there is a specific one let me know, & press a button. You press a test of blood on a test strip & slide it into the machine. Is the machine meter machine? That before meals the reading should be before 100 & 120 after meals? Is this correct?

A: You can test on any finger; some newer ones let you use other test sites too, such as the arms. The test strip goes in the machine (meter) before you put blood on it. It only takes a few seconds to get a reading. Yes, before meals blood sugar should be less than 100 for most people, and two hours after meals should be below 120 for most people. Sometimes endocrinologists suggest different ranges for different people, like 80-140 two hours after eating. It kind of depends on the doctor and patient in question, but those you’ve listed are good general ranges.

Q: With insulin must it be taken with food as opposed to not? Is there such a thing as a practice kit to teach a person or the family about administrating insulin themselves or for someone to learn in case he might be too weak? How would a practice kit work or what might it contain? Also I read about something called Glucose rolls which I think is sugar in a sort of candy type form /chewing tablet form to help balance lower levels? Os this right & if so what might they look like?

A: There are different types of insulin. I’m pretty sure fast-acting insulins are always taken with food, but long lasting are usually not. I don’t know if there’s a practice kit or anything like that. The doctor would probably just show the patient and his parents in his office, or have them visit a diabetes educator. Yes, glucose rolls (also called glucose tablets asI’ve been referring to them throughout my other answers) are sugar candy-type things. They are basically pure sugar with some flavoring and are used when blood sugar is too low (never when it’s high). They come in bottles or tubes, are chalky, and resemble large Smarties (candy). They come in many flavors and colors. I think there’s also a gel form.

Q: Wills someone please list a few things that would have too much carbs in it & how would that affect blood sugar & diabetes?

A: This one I can’t give an exact answer on. Pretty much any food can be eaten in small amounts or on occasion without causing trouble. If someone eats food with a lot of simple carbs (like cake, chips, or other junk food, or even pasta and bread) it can cause their blood sugar to go high, especially if they don’t adjust their insulin accordingly.

Q: Will he be able to receive a medical alert bracelet since he is young just for if something happens & he might be too sick & someone might either recognize the symbol or wording & may help or if someone sees him too sick & with the syringes unable to do it and someone who tries to help may get confused that they were sick of a drug overdose rather than sick from a medical condition if he is a bit older and does not have a bracelet or recognize it and refuses to help out of misunderstanding? What is your opinions on a bracelet & if so what would one appear as? What if someone sees his bracelet in school & assumes he has a catching bad illness after seeing it or assumes that he is much worse off than he is? How might he react to people then and later in life for this?

A: He could have a medical alert bracelet if he wants to. If someone finds him too sick to tell them what’s wrong, they should call an ambulance for him. I don’t think most people would assume he was doing drugs if they saw him. If he’s passed out or not responsive, it is likely that his sugar is too low and he would not be getting his insulin and stuff out, which would eliminate the don't-help-the-druggie worry. However, to answer your question, if he didn’t have a medical bracelet on and passersby thought he was having a drug overdose problem, I imagine someone would call an ambulance for him anyway. Most people are decent and would want a stranger to get help even if they think he is doing something bad.

His parents might make him wear a medical bracelet when he’s younger. If he’s embarrassed by it at school he could sneak and take it off when he gets there (which his parents might get mad about if they find out) or wear long sleeves so the other kids won’t see it. His diabetes should be on his record at school, so his teachers would know and they would stop any kids who pick on him about it. Most of the time kids don’t get too overworked about these things if a teacher talks to them about it a little bit, which may (or may not) be embarrassing for your character, but will fade with time. Also keep in mind that most kids would have heard of diabetes by the time they’re 10 and most wouldn’t think it is something that they can catch. He might have to deal with people who think he is worse off than he is or try to baby him, but he would probably get used to people like that after a while and tell them to leave him alone about it.

Q: What are the complications that can arise health wise for severe blood loss for example as the blood level drops more rapidly such as being injured, for this story the main character as a college teen gets severely injured and there is a lot of blood loss, how would his illness affect it and how much worse would it be? How does diabetes affect accidents & illnesses, he has to have surgery as a result of this? If blood sugar drops rapidly low or too low could it cause seizures? Would they vomit? How sick could this character potentially get as a result?

A: I don’t think severe blood loss would affect his blood sugar that way, but I don’t know for sure. He would probably have to have blood given to him, depending on how much he lost. Because of the diabetes, he might take longer to heal (depends) than others would after the accident/surgery. If he’s in a hospital, they’d probably be able to monitor and manage his blood sugar pretty well. He might be more likely to have high blood sugar rather than low due to stress. Again, I don’t know for sure on this one.

I hope this has helped you at least a little bit. There's no such thing as too much research! Good luck.

a doctor who specializes in diabetic care is an endocrinologist.

the diet recommended by endocrinilogists is the diet recommended by cardiologists.

Low blood sugar AKA hypoglycemia, severe case:

Hypoglycemia is a hangover without the alcohol. You wake up with a nasty sensation like someone hammered a steel bar through your skull behind the eye sockets. When you get up the steel bar stays still and your head passes through it. When you turn your head the steel bar spins like a boat propeller.

Sitting up and swinging your legs off the bed takes 45 seconds to a minute. then you sit for two minutes and recover.

The walk to the bathroom, 10 feet, is a controlled stumble. stepping over the edge into the tub is a major challenge. After that, it's 25 feet to the kitchen.

the only thing you can stand to chew and swallow is two eggs. They come right back up. after that, you can eat a bowl of mixed vegetables and keep that down.

you lose about 40 IQ points. if asked a question, you can barely mumble an answer. the rest of the day is shot. best to go back to bed and rest a couple of hours. you won't be much good to anybody in the condition you're in.

I can go 18 hours max without a meal. after that, strap me to a hand truck; I'm out of it.

I want to thank everyone who has answered. Another Quill, I love how you separated the questions from the answers, it is really appreciated & I really hope to hear from you again as well as what you have provided has helped a lot. Also, another quill, I took your idea of separating things, I loved how you did Q then A. Hehe. Also, welcome to the site! It's my first year here and I am so glad that your first post was here, it was so helpful & resourceful.

Q] I was going through a few smaller things for research & found at least two different types of Insulin Therapy and wanted to know a few things about them. Starting with, what’s correct & if there is any mistakes I should know about. I don’t have access to a regular computer so the more background information & research the better, & even if some of this is correct, doesn’t mean I wouldn’t appreciate more details added. If anyone has any personal stories they would share that would be nice as well. Want to make these characters seem the most believable that is possible.

Conventional Therapy -
A person with Diabetes receives one to three fixed doses of Insulin at the same time each day.
Since they receive the same amount, their diet is usually fixed to be abut the same amount of food per meal. Usually around the same time of the day.
With this therapy a person should maintain a similar level of activities & so forth.
This is supposed to balance out the amount of Insulin doses.

Flexibly Therapy -
Gives a person with Diabetes more flexibility over meal times, & level of activities.
However, may lead to Hypoglycemic attacks if the person is not careful enough.
Assuming this may mean that a person may also be effected by blood sugar levels rising too high or falling too low.
Requires at least three more Insulin shots per day.

I was wondering if any of the above is correct for either Therapy. Also I wanted to know the following such as:

Q] Which Therapy would be best for a person who first learns they have Diabetes? Specifically a child below ten years of age?

Q] Would it be possible for a person with Diabetes to switch between the two Therapy’s as they grow older? Would their be complications possible & would they have to speak with a doctor on the possibility of switching? As a person grows up they pretty much move from regular school time & going home to being a teenager & young adult with varying work times & college & stress of their everyday life?

Q] What sort of adjustments must first be made when establishing a Therapy? Would a young kid speak to a doctor regularly? Would he & his parents first speak to a Nutrition & Diet specialist to help him first adjust? What sort of adjustments must he face as the years progress if he were to switch to another Therapy form?

Q] How would activities such as running or playing sports such as Softball & such effect blood sugar level when he is younger if he’s not used to taking his Insulin doses?

Some of this research I’ve gotten from reading a few different things so please let me know if anything is wrong & what, again, is correct? Also, again, please add some more details even if everything turns out to be right because just because I read this doesn’t mean I really know if just from what was said. But having somebody go over the info & adding more will make everything seem more understanding. Also, again, please if you can add a person story or something if you can.

Morning Doses consist of a mixture of Basal Insulin [Intermediate Insulin correct?] & Bolus Insulin which may be either rapid or short acting?
Both Rapid & Short acting Insulin have varying acting times such as between 5-15 minutes before short acting begins to work and between 30 - 45 minutes before the short acting begins to work.
This will mean that you are able to have a meal sometime close by if you were to use the rapid acting but you may not be eating for a bit if you chose the short acting? Is this right? & you would take the Insulin before the meal & not eat until after the medicine begins to work? Am I right? & if so how would you know it has begun to work? What if he were to assume it has worked and it hasn’t?
The Immediate Insulin is cloudy where as the Short or Rapid acting is clear? Is this correct? This insulin is mixed first from drawing up from the clear & then from the cloudy. Using the same syringe right?
For the morning dose, you should have alcohol wipes, Syringe, Intermediate Insulin & either short or Rapid depending on the meal time. What about throughout the day? If this is the case, would you still use the Intermediate Insulin or just the Rapid or Short acting?
A Fresh bottle of Insulin lasts about 30 days when first opened? So it would be best to write the date opened on first right.
One of the examples they use that I read was 15 units [What are the unites exactly measured in?] for the Intermediate Insulin & 42 units for short acting for example. Would this be a good calculation to use for somebody/? At about a child’s age or a teenager? I know it depends on weight, number of injections, calories of meals, but is there a sort of math example I might be able to follow or a sort of online calculator.

I know air bubbles should not be in Syringes but I read this about using Insulin. Is this acceptable to use?

When drawing Insulin from a vial, you should inject air into the vial first?
The amount of air should reflect the amount of the prescribed dose?
First you pull the sterility cap off of the syringe (Possible orange in color etc)
Inject air into the cloudy Intermediate Insulin first.
For the example I stated I read earlier the stopper should be up to 15 units for the air in the vial.
Lay the vial flat on a surface & clean a bit with alcohol wipes.
Place the needle tip slowly into the bottle. Slowly press the plunger to now avoid air bubbles.
Since both vials have had air injected before, hold the clear Insulin vial upside down & draw clear Insulin for example to 42 units. Again slowly.
Air bubbles can mess up the Insulin taking the place in certain spots of the medicine so it will not be as effective. How would this effect him if he has not noticed? Will he have symptoms for short times he does not notice or if he does this regularly without notice?
If you get bubbles you should redraw the Insulin more slowly. This is for the clear Short or Rapid acting Insulin only as pushing Insulin back in the Intermediate cloudy one will contaminate the vial.
Some injection sites can include Abdomen, Thigh, the back of your arm, or buttocks. Would the Abdomen & thigh be easier if he wanted to hide his Diabetes?
I read the Abdomen has the most Muscle & usually is the easiest to use.
You clean the site with a Wipe then push the plunger & inject for up to 5 seconds to prevent the Insulin from leaking.

Is any of this correct & again will someone please add details of how it feels or personal stories they would like to share of what taking the medication is like or what effects might be experienced at first.

Q] Is it true that a person with Diabetes would have poor circulation in their feet? Is this at any age or only within a certain age range for people such as can someone young have this or is it more of a symptom of someone older?

Q] How would a person know they have poor circulation in their feet? What are the symptoms‘? Numbing? Pins & Needles feeling? How would you be able to tell if you have this?

Q] Could poor circulation in the feet lead to more infections if you may not be able to detect an open wound or cut as easily? Would you be less likely to feel the cut unless you flat out see the blood or can a scrape become infected easier if it can not be cleaned?

Q] If an infection does occur in the feet & has to be treated with antibiotics to prevent Amputation so the infection does not spread [Is it true this could happen if it’s not treated long term], what antibiotics is best to be given?

Q] Can Amputation happen in the long run of infection? At any age of not having proper self-caring?

Q] In keeping with maintaining proper blood sugar levels if proper foot care also essential to living with Diabetes & if so what sort of care is involved?

Q] Is there more of a proper way to wash the feet for cuts & scrapes as well as to check for them. I also read there was a more careful way for little things such as cutting the toe nails & was wondering if this was true as well. I want to be as thorough with the research as possible. What if h were to cut his nails & cut himself without realizing by accident for example.

Q] I read something small about a Glucose shot which can be administered in the thigh area. I’m not sure but I believe it’s sort of like the tablets but a bit faster as it’s administered whereas the tablets would be slower so I’m sure it’s more of an emergency situation blood sugar too low type of thing. I was wondering if someone can explain what this is & what type of situations this would be present in the best where no other options would help. I think it’s supposed to boost the blood sugar level a little. What symptoms happen with this shot & how is it administered? Is medication mixed & what is in the shot as well as how does a Glucose shot work? What symptoms are led to this being used?

Q] For a supposed example, what if said character were to be really sick with an infection, possibly chest, or a cold, which leads to the flu or pneumonia. The doctors might for example try & balance the Insulin manually with the calories the character is able to eat in the hospital. Being this sick, said character might not be able to keep anything down food related wise so I’m assuming his blood sugar levels would be way off. If this were the case would a Nasal Gastric feeding tube be the best way to be sure that he would be able to have enough nutrients to attempt to fight this infection? & if so how would this type of tube be inserted, & what complications may arise versus the benefits to fighting infection & keeping food down? What would be the steps following this to fighting the flu or infections?

Q] What would be the complications of a person with Diabetes getting a cold & what about if they were to catch something stronger such as the flu? What would those complications be if their fever spikes too high, & what temperature would be worrisome for a hospital visit, & what would happen if they could not eat or keep their food or any medication down? What about if they could not drink much on top of it? How would the flu effect someone with Diabetes? How would the flu or cold effect blood sugar levels? How would a hospital treat this? What sort of Insulin would they use to treat this & how would they properly treat this? Would their be fasting, would their be an I.V? I’m aware that with a person with Diabetes is admitted into the hospital that manual adjustments in Insulin & controlling Diabetes is usually made, but what are the type of adjustments & how are they made? What are the Benefits & complications?

Q] Opinion wise, would it be easier for a doctor to recommend that when the character is first diagnosed with Diabetes, that he should begin a journal to record the high’s, low’s, of blood sugar, their activities & feelings & recordings of medications taken & for this character to carry this through for his life until his current age which is early twenties, late teens?

Thanks for the welcome and I’m glad you liked how I separated the questions and answers, I just found it a bit easier to do things that way! I’ll try to help you some more, but I feel like most of these questions aren’t ones I know anything about. I’m sorry and I hope someone who does know will come along and answer. I broke down the questions into Q&A again, this time combining and splitting some of your questions up so I could answer only the parts I know something about. I hope that’s okay.

Q: Conventional vs. flexibility therapy and which a newly diagnosed 10 year old would be most likely to get.

A: I don’t really know for sure (didn’t even realize there was more than one way to do this) but I think everyone I know is on the flexibility treatment based on your descriptions, so that might be more likely for a newly diagnosed person (it seems like it might be more common). I really would get a second opinion on this one though, because that’s just a guess.

Q: What sort of adjustments must first be made when establishing a Therapy? Would a young kid speak to a doctor regularly? Would he & his parents first speak to a Nutrition & Diet specialist to help him first adjust?

A: When he first starte therapy, he would probably have to check his blood sugar more frequently during the day than he will once he gets his medication dosage right and his blood sugar levels balanced. His doctor may suggest more or less insulin depending on how his blood sugar levels are. He may also try a few different kinds of insulin until he finds the best one or combination. Yes, he and his parents would speak to an endocrinologist reguarly (likely every 3 months, more or less depending on his blood sugar control). They would also speak to a nutritionist when he first starts treatment, and possibly every so often after that. They will help explain what foods to eat, which to mostly avoid, how to read labels, and that sort of thing.

Q: How would activities such as running or playing sports such as Softball & such effect blood sugar level when he is younger if he’s not used to taking his Insulin doses?

A: Exercise can improve blood sugar control by helping make the body more sensitive to insulin, so my guess is that he may need smaller doses of insulin after exercising since his body will be using it more effectively. I’m not sure about this for type 1 diabetics though.

Q: Morning Doses consist of a mixture of Basal Insulin [Intermediate Insulin correct?] & Bolus Insulin which may be either rapid or short acting?
Both Rapid & Short acting Insulin have varying acting times such as between 5-15 minutes before short acting begins to work and between 30 - 45 minutes before the short acting begins to work.
This will mean that you are able to have a meal sometime close by if you were to use the rapid acting but you may not be eating for a bit if you chose the short acting? Is this right? & you would take the Insulin before the meal & not eat until after the medicine begins to work? Am I right? & if so how would you know it has begun to work? What if he were to assume it has worked and it hasn’t?
The Immediate Insulin is cloudy where as the Short or Rapid acting is clear? Is this correct? This insulin is mixed first from drawing up from the clear & then from the cloudy. Using the same syringe right?
For the morning dose, you should have alcohol wipes, Syringe, Intermediate Insulin & either short or Rapid depending on the meal time. What about throughout the day? If this is the case, would you still use the Intermediate Insulin or just the Rapid or Short acting?
A Fresh bottle of Insulin lasts about 30 days when first opened? So it would be best to write the date opened on first right.
One of the examples they use that I read was 15 units [What are the unites exactly measured in?] for the Intermediate Insulin & 42 units for short acting for example. Would this be a good calculation to use for somebody/? At about a child’s age or a teenager? I know it depends on weight, number of injections, calories of meals, but is there a sort of math example I might be able to follow or a sort of online calculator.

A: I actually found a great link that might help you a lot with these questions (it also contains brand names of insulins that may prove useful for finding common dosages and the like). I’ve never posted a link on here and I don’t know if I will be able to, but I thought I’d try: http://diabetes.webmd.com/diabetes-types-insulin. If that didn’t show up, trying going to webmd and look up “types of insulin for diabetes treatment”. There’s a great chart that has a lot of this information on it.

Yes, you take the insulin and then begin to eat during the given time period (some rapid ones can actually be taken a short while after you’ve eaten instead, like 15 minutes or so—I have a friend who usually does this). You wouldn’t really know when the insulin begins to work; you just assume that it does what it is supposed to do. If something is wrong, you’ll notice in a few hours/days because of abnormally high blood sugar despite eating well and taking the insulin. I don’t know about the cloudy/clear color thing, sorry. No one I know uses intermediate insulin (I’ve actually never heard of it before you mentioned it and I found that chart).

I think most people would either use rapid or short acting insulin, and not have both that they would choose to use depending on how soon they want to eat. Their doctor would probably just suggest one and if they had a hard time keeping up with it, they may decide to switch from one to the other. Most of the time, if people are taking insulin throughout the day, it would be rapid or short acting, which are usually taken at meals. Yes, if the insulin expires, writing a date on it would be a good idea. I’m not sure how long they usually last, sorry. I also honestly couldn’t give you any information at all about how much of the various kinds a child/teenager would take. Insulin is measured in international units (IU) in pharmacology.

Q: Air bubbles can mess up the Insulin taking the place in certain spots of the medicine so it will not be as effective. How would this effect him if he has not noticed? Will he have symptoms for short times he does not notice or if he does this regularly without notice?

A: I don’t really know if that would have a big impact or not, I guess it might depend on how many air bubbles he gets and how often this happens. It probably wouldn’t be too big of a deal if it only happens once in the while.

Q: Some injection sites can include Abdomen, Thigh, the back of your arm, or buttocks. Would the Abdomen & thigh be easier if he wanted to hide his Diabetes?
I read the Abdomen has the most Muscle & usually is the easiest to use.
You clean the site with a Wipe then push the plunger & inject for up to 5 seconds to prevent the Insulin from leaking. Is any of this correct & again will someone please add details of how it feels or personal stories they would like to share of what taking the medication is like or what effects might be experienced at first.

A: Yes, the abdomen and thigh would make it easier to hide than the arms. I actually think the abdomen is the preferred place for people to inject insulin in most cases. Yes, you clean the area and then inject, waiting to make sure it all goes in and doesn’t leak back out. I don't have diabetes and have never injected insulin before, but I’ve been told that it doesn’t hurt too much. The needle is just a small stick, but once in the while the actual injection part will sting, especially if the insulin has been refrigerated and is cold. I have let myself be finger-pricked a few times though (like to test blood sugar), and that doesn’t really hurt much, especially if you do it slightly off to the side of the finger tip and/or on the ring finger, which has the least nerve endings.

Q: Is it true that a person with Diabetes would have poor circulation in their feet? Is this at any age or only within a certain age range for people such as can someone young have this or is it more of a symptom of someone older? How would a person know they have poor circulation in their feet? What are the symptoms‘? Numbing? Pins & Needles feeling? How would you be able to tell if you have this? Could poor circulation in the feet lead to more infections if you may not be able to detect an open wound or cut as easily? Would you be less likely to feel the cut unless you flat out see the blood or can a scrape become infected easier if it can not be cleaned?
If an infection does occur in the feet & has to be treated with antibiotics to prevent Amputation so the infection does not spread [Is it true this could happen if it’s not treated long term], what antibiotics is best to be given?

A: A person with diabetes may have poor circulation and nerve damage, especially if they’ve had diabetes for a long time and/or have poor blood sugar control. There’s no set age limit, but it does usually occur in older people who have had diabetes for many years. The symptoms you described sound pretty accurate. Yes, poor circulation can make it harder for injuries to heal (all over, not just on the feet) and some people who have nerve damage may not feel/notice that they have injuries. If an infection does occur, I think the type of treatment and antibiotics would depend on the location and extent of the injury, the person (allergies and whatnot), and things like that. I don’t really know what the most common antibiotics are.

Q: Can Amputation happen in the long run of infection? At any age of not having proper self-caring?

A: Yes, pretty much, though it would not be preferred and there would be a lot of attempts made to get the wound to heal up before amputating.

Q: In keeping with maintaining proper blood sugar levels if proper foot care also essential to living with Diabetes & if so what sort of care is involved? Is there more of a proper way to wash the feet for cuts & scrapes as well as to check for them. I also read there was a more careful way for little things such as cutting the toe nails & was wondering if this was true as well. I want to be as thorough with the research as possible. What if h were to cut his nails & cut himself without realizing by accident for example.

A: Yes, basically just checking the feet daily for any cuts/scrapes and to keep an eye on any cuts/scrapes that may already be there. The doctor will also check their feet at each visit. People with nerve damage and healing problems should be especially careful when cutting their nails, making sure not to cut the skin and to trim the nail straight across. If your character cut himself, he would probably need to wash it off and put some ointment on it. If it didn’t start healing up in a few days or got worse, he’d need to see a doctor.

Q: Very severe illnesses/feeding tubes/not able to keep anything down.

A: I don’t really know enough to give an answer on these questions. The only thing I can say is they would probably give him IV fluids to keep him hydrated if he can’t drink on his own or keep it down. I guess if he can’t eat, they might give him a feeding tube too. I really don’t know.

Q: Opinion wise, would it be easier for a doctor to recommend that when the character is first diagnosed with Diabetes, that he should begin a journal to record the high’s, low’s, of blood sugar, their activities & feelings & recordings of medications taken & for this character to carry this through for his life until his current age which is early twenties, late teens?

A: Yes, when the character is first diagnosed, his doctor is quite likely to recommend a journal like this. He may even give him a special chart to fill out for a few weeks and then return. This will help the doctor see if his treatment is working or not and make any adjustments that are needed. Your character probably wouldn’t need to keep this up for the rest of his life. Once he gets everything balanced, he would probably quit. He might start writing things down again if he starts having trouble keeping his blood sugar balanced, or changes medications, or something like that.

I hope I’ve helped you some more. Sorry I couldn’t answer so many of your questions this time!

I also have a suggestion to make... Have you considered calling or emailing an endocrinologist in your area (you may also consider contacting a diabetes educator) and telling him/her that you’re doing research for a novel that features a diabetic character and you want to ask some questions so you can portray your character as accurately as possible? I can’t promise, but it just might be possible to find one who would be willing to answer some of your questions in person or by phone or email. That way you could get the most accurate answers possible for these questions!

Take care. :-)

Another Quill, Thank you again for the thought out [& nicely separated] reply, the way you grouped each question with an answer really helped things from getting too tangled together. I especially appreciate you being able to answer the things you were able to & for posting the link for the medical site. It really does help with the research & I would really appreciate it some more if you might be able to, in your spare time, maybe post a few more links you might come across such as examples of the chart you mentioned & other types maybe such as blood sugar level ranges etc. Every little bit helps especially when looking up unfamiliar info. I also wanted to ask if it would be alright if maybe I could message you here & there if I have any more little questions. With these things there’s also a small topic here or there that might need to be explained more & I’m a bit of a question bugger who hopes it might be alright to, “bug” you once in a while. =)

Also, if anyone doesn’t mind, would a visit for a doctor be every three months continuously depending on blood sugar level balance or might that lessen to twice a year or so as the person might get older & in better control?

I've been watching this thread for a little while and I'd just like to say that I'm impressed by the level of detail you're investigating this in. It makes me very pleased to see people actually trying to learn about diabetes, because my experience has mostly been clueless people telling me why and how I'm wrong about my own condition!

Most of your questions seem to have been answered, so I'll just add a little...

Injection sites: I've only ever used my stomach, my lower back and my thighs. I only tried my thighs once, on an insulin pump. The site didn't work and I got ketones. Haven't tried again since -- my stomach and back work and I don't see the point in switching.

Trying to hide your diabetes: I've only felt the need a few times, when people have made my life unnecessarily difficult. People aren't usually too observant but in my experience, it's my friends who've always given me away. If I subtly pull out my blood testing kit, they might shout "WHAT LEVEL HAVE YOU GOT? ARE YOU OKAY?"

I think a pump would be subtler than injections.

Recording levels: I've always done it. Keeping a record makes it much easier to recognise patterns and correct problems. I used to do it by hand every night before I went to bed. More recently, I switched to an insulin pump and that has software that records everything for me. It saves a lot of time.

Complications: I haven't got any yet and my long term blood tests have always been within a safe range. That being said, I get tests done reasonably often to make sure nothing is going to conk out on me. I get the blood vessels in my eyes looked at, I check my feet for cuts every day and annually, I have tests to see if my kidneys are beginning to fail.

Air Bubbles: You're not injecting anything vital. Air bubbles shouldn't have enormous complications, as far as I'm aware. It just means that you get less insulin. I've been told that 'wine bubbles' (small bubbles in a syringe) are okay but you should get rid of larger bubbles.

High Blood/Low Blood: I think I'm lucky on this front. I can feel when my blood is not right but my symptoms aren't usually as bad as I've heard other people get. When I'm low, I get a headache behind my temples, my skin goes clammy and it becomes hard to pronounce words properly. Sometimes when I'm low, everything becomes very, very funny. When I'm driving and I dip too low, I have to pull over because I lose the ability to stay in my lane. The lowest I've ever been is around 21.6 and that was when I was doing exercise. I felt like I was being pressed down into the floor and it was too difficult to sit up. I kind of melted onto the floor until my blood came back up.
When I'm high, I feel ill. Sometimes my hands will tingle, although I'm not totally sure if that's related. I get very sleepy and it becomes difficult to concentrate on any one thing. I can generally get a lot higher than most people without fainting. Once when I was a kid, I went up to 900 and I stayed conscious (not a good place to be but I've always been a little bit smug about that.) Since then, the highest I've been is around 450 and while it doesn't feel nice, I don't tend to get violently ill.
I find it difficult to tell the difference between low and high but I can always pick when something is wrong.

With the rise in childhood obesity, children are being diagnosed with type 2 diabetes.

However, by and large, children are diagnosed with type 1.

And I disagree with the patient below that a character diagnosed at 17-19 would be diagnosed with type 2, because type 1 and type 2 are treated radically differently. Type 1 is always insulin dependent, whereas type 2 can be managed with diet alone, or with some other medications that may kill someone with type 1.

Biochemically speaking, a type 1 diabetic with high blood sugar and someone who is hypoglycemic have the same problem. The type 1 diabetic with high blood sugar can't get the sugar into their cells to use as fuel, so they begin to digest fats and other things, which can upset acid/base balance in the body, leading to a life-threatening condition called diabetic ketoacidosis (DKA). The person who is hypoglycemic doesn't have the sugar to use as fuel and will do the same sort of thing. Since the brain basically requires sugar to function properly, both people will feel lethargic and sick.

Of course, the treatments are radically different. In someone with DKA, you're going to put them on an insulin drip, and they'll have to go to the ICU to recover. In someone with hypoglycemia, you can treat them pretty quickly with something like orange juice.

As far as emergency treatment, when someone passes out and there's some sort of medical personnel around, the first thing they will do is check blood sugar levels. Glucometers are on every ambulance, and are all over the hospital (course, if you're in the hospital as an employee and pass out, they actually have to admit you to do a blood sugar level usually, which is a bit of a pain). I believe paramedics are trained to give anyone with low blood sugar glucagon, which stimulates the liver to release sugar.

As far as complications of diabetes go... if you have good blood sugar control, it's as if you don't have diabetes at all, at least as far as nerve and blood vessel damage. The patients who get nerve damage (which starts in the feet, works up to the knees, then starts in the hands) are usually type 2 diabetics who don't monitor their sugar levels closely enough. You can also go blind from damage to blood vessels in your eye, and have poor healing due to damage to other blood vessels (the white cells can't get to the site of infection and clean it up).

If you have any questions about the medicine behind it, feel free to PM me and I'll do my best to answer. I don't have diabetes, so I can't give much in the way of personal experience, but I can describe the mechanism of the disease fairly well (I'm a medical student).

I was diagnosed 20 years ago this month, when I was 5. I've only really skimmed the last half of this thread, but some things I didn't notice being said:

Insulin

I used to use a combination of Regular (fast acting) and NPH (intermediate) insulins. The NPH was cloudy and had to be mixed before use - done by rolling the bottle between my hands. A few years later I switched to Humalog instead of Regular. The Humalog is a bit faster acting than Regular. Then in the early 2000s I started using Lantus instead of NPH. The Lantus is clear and works basically all day. Right now the Lantus acts basically like the basal rate insulin that your pancreas or an insulin pump would put out through the day and I add Humalog whenever I eat carbs. I currently use a pen for the Humalog and a vial and syringes for Lantus. I started using the pen as a teenager because it's much easier to carry around through the day, but I'm usually at home by the time I take the Lantus at night. If not I can pre-fill a syringe and put it in a little pre-filled syringe holder to bring with me. I've forgotten the link tags, but you can see an example here: http://www.walgreens.com/store/c/medicool-prefilled-syringe-case/ID=prod3927783-product

My Lantus vial is not quite 2 1/2 inches tall and about 3/4 inch wide. The other vials were all a little shorter and wider. I have broken them before - by dropping, I think - but they'd be pretty hard to break in your hand. When I was younger I also ruined some insulin once when trying to be helpful by putting it in the freezer instead of the refrigerator.

When I was diagnosed, they taught my parents in the hospital how to give shots using a sponge thing with a rough, skin-like outer layer. I've heard they also use oranges for this. I started giving my own when I was about 10 or 11.

Ketoacidosis

If your body can't use sugar for energy (because it doesn't have enough insulin to use the sugar, for example), it burns fat. This process produces ketones. I'm a little fuzzy on the exact effects of the ketones right now, but you don't want them building up. To treat, you generally correct blood sugars with fast-acting insulin and drink a lot of water to flush the ketones out of your system.

Stress can raise the likelihood of ketoacidosis because stress hormones interfere with insulin.

Doctor visits

Like I said, I've been diabetic for 20 years. My endocrinologist has been raving about my good control for years. I still see him every 3-4 months. During these visits we look for patterns of things I can still improve on, checks my 3 month average blood sugar with an HbA1c, renew prescriptions, and check for signs of complications. I am weighed and have my blood pressure taken. He does a quick check of my eyes and gums and feels my thyroid because I have hypothyroidism, which is fairly commonly co-morbid with diabetes. A couple times a year he'll check my feet with a little wire thing, pressing on the foot until it bends and seeing if I can feel it. Once a year I have a dilated eye exam to check for retinopathy. At the same appointment I generally have my glasses prescription checked too, but that's unrelated. Also once a year I have a fasting (overnight + skip breakfast) urine test to check my kidney functioning and have some blood drawn to see how my thyroid's doing. These I do at a separate lab and have them send my doctor the results. The thing is, even with my apparently amazing control, my blood sugars aren't as good as non-diabetics, so I do have some risk for complications.

Thank you to everyone who replied to this post, & for all the information, I will be sure to read this thoroughly and then reply to everyone individually in a few days. I just managed to get to a computer now and I appreciate all the help.

AnotherQuill, thank you so much and i will be sure to message you when I can and I really appreciate your help.

I had to monitor my blood sugar for awhile because I was on a medication that had a high risk for causing diabetes and had ambiguous test results. I just wanted to add some random experiences.

My blood sugar monitor kept a memory of the sugar measurements and then it had a cable to plug into a computer. So I would just bring it in and my doctor would download the results instead of keeping a paper log. Also this also measures it in mg/dL not sure if that's been addressed. You can find probably healthy levels for before/after a meal, etc. online.

I thought a finger prick hurt more than a shot but I never figured out what someone said above about the sides of the fingers being less sensitive. Pretty sure my typical spot would be the tip of my index finger which is probably the worst possible choice, lol.

I had to do the glucose tolerance test. They gave me this huge cup of what basically tasted like very highly concentrated orange Hi-C. My dad came with me and was grossed out by even looking at it but I was probably like 12 and LOVED the sugar. LOL

A1C is a measure of the average blood sugar level over time. It can give you a trend of about three months. I think over 10 is bad, but I don't remember (maybe 12? This was awhile ago). I think someone mentioned this but didn't say what it was.

Also, this medication was given by injection and I used insulin needles/syringes. They are tiny and if you get good at it, sometimes you can barely feel the needle prick (obviously you might feel the medication going in depending on what it is and it sounds like you do feel that with insulin). When I first started my mom and I met with a nurse and she showed us how to do the injection on an orange. Then we got oranges and practiced. I wrote a report in 5th grade on how to administer an injection, lol. Here is a detailed guide of how you would give an subq injection, which is usually what an insulin injection is: http://www.cc.nih.gov/ccc/patient_education/pepubs/subq.pdf I never actually ended up doing the shots myself because I was only on the medication for a few years, and my mom used to be a nurse so it sort-of made sense for her to do it. However, I have heard from diabetics and parents that it is a good idea for a child to learn how to do it because someday they are going to grow up, and their parents won't be there to give them their insulin. (To be honest, I am totally fine with most procedures but the idea of actually injecting MYSELF squicks me out a lot... maybe a factor to include if you talk about adjusting to the diagnosis?) I know someone who uses the pen injections and it seems like they are a bit simpler.

As for medic alert bracelets, not a bad idea. They have improved. The person above who uses the pen insulin injections have a few that look basically like regular bracelets. They have pretty beads and then a little charm or flat bead that has the alert symbol and says "diabetic". I would have liked a similar one as a preteen/young teen when I had problems with people being nosy about mine because it would have made me feel better about wearing it. I wear one for other reasons, and mine is quite plain but I also have a lot of info I needed to fit on it. I had issues in middle school (or maybe it was early high school?) with kids trying to grab my wrist and read it and ended up taping a piece of paper over the text part so they couldn't. For awhile I had a necklace, and only wore it when nobody had access to my record like on an airplane. It got in the way and was pretty obvious, but my bracelet, although utilitarian, doesn't really call attention to itself unless you are a nosy preteen. (Honestly I can't think of one person who has noticed it since then without me pointing it out. And people don't need to know - paramedics would look and that's when it's important.) My parents kind-of forced me to wear it for awhile, but after the bullying stopped I decided it was important to me to wear the bracelet. I never really rebelled against my diseases though so I had no motivation not to wear it besides people being nosy. I am actually very obsessive about making sure I am always safe, in control of my health, on top of my meds, etc. and have always been like that. I have heard about a lot of teens "rebelling" and it seems strange to me but maybe that is because most of my emergency situations happened in my teen years (I had had a serious disease as a baby, and then long-term side effects bit me in the butt throughout high school) so the reality of what would go wrong if I screwed up was very in my face. (These were situations beyond my control, but I knew that say, stopping a medication because I didn't feel like taking it could result in the same type of thing.) Also, I think part of it was/is that I am really interested in medicine, so I'd always be reading up on everything I had and how I could best control it, stuff like that. That is kind-of how I deal with it, by learning how to take care of myself and knowing everything I can about it. Kind-of having to do with that, the person I know with diabetes struggles with body image and disordered eating at times, and this does affect how well she manages her disease. She's said when she isn't in a good place with herself she is less likely to care about taking care of herself and therefore managing her disease, which was really interesting to me. So the teenage rebelling against routines/just wanting to be free from it is one attitude that really anyone with a chronic illness could hold and this is another one, I guess.

Thank you everyone for all your answers, & I am sorry this may haven taken a bit to respond to. As I am still having internet issues & finding it difficult at times to be able to log on here, I really appreciate people still responding & keeping this topic to where it’s current & as always the stories & your experiences whether your own or your friends, or being a med student (Wow all these nice diverse perspectives!), are much appreciated. Please, anyone can feel free to answer any of these. I have responded to each person individually based on their answers & topics yet please do not think it means you can not add anything someone might have mentioned or if you have some information based on a medication someone has stated or details for any of these questions. Thank you so much everyone.

Chelle-Lynn -
First, thank you so much for taking the time to answer some of my questions. It’s always great to have another perspective, especially someone with part of a medical background, as me & my friend would love to be able to write some of a, ‘doctor’ type point of view. After all, the main character should learn their information somewhere & be able to get advice as needed. I would love to know more about the mechanism of the disease as you put it & will definitely be messaging you about this. As far as the points you were able to bring up here, a lot of people have been bringing up more & more information on Ketones, & forgive me, I’m still a bit fuzzy on the details.

Is there a specific way to test only for Ketones? I know there are some testing strips sold in stores, there usually seems to be a small area for diabetic care, but as far as major or minor symptoms go, is there a way for someone to just know something is off or have some sort of symptoms relating to them wanting to test for Ketones? I would imagine it would be best to usually have some sort of testing strips for things such as this on hard for a person with diabetes or maybe keep on hand some of those glucose tablets. As far as you mentioning that diabetic ketoacidosis (DKA) is a life threatening illness, I wanted to know if you may be able to explain a bit more detail about this, as far as symptoms of this as it begins & progresses enough to the point the patient should be monitored at a hospital. As well as what this might feel like to the person in question, opinion wise. You mentioned how to treat this with an insulin drip and ICU recovery but may I ask if an Insulin drip is connected the same way as a regular I.V or if this is alongside a regular I.V & what might the ICU Recovery time frame be between admittance & release from the hospital care? A person who might not understand, such as my character may or may not be, may be a bit more impatient to leave than to understand the medical terms no matter how important they may be & may need someone to detail each of these points in specifics.

Chelle-Lynn, you also mentioned something titled a, “Glucagon” along with some info on how it stimulates the liver to release sugar, but maybe you might be able to help with some details of how a paramedic might be able to administer this along with what this may be in appearance, & what levels might be checked for the Diabetic patient afterwards to make sure they are given the all clear as far as health wise? You’ve given me some great things to think abut after all & some interesting topics to be able to research & question about. I’m also wondering if you may be able to explain more about how a patient might be effected by blood vessels in the eyes & what symptoms might be worrisome for blindness? Is blindness something that may happen, ‘out of the blue’ or rather, be, slow building to the point where it began gradually? Is there specific eye problems that may happen before blindness? Such as they had normal clear vision, would there be problems might lead, before blindness, or would their eyesight gradually get worse to the need of glasses or thicker glasses overtime? & if they already had glasses, would their eyesight begin to get worse & worse if they do not take care of themselves to the point it may lead to blindness?

Also if anyone knows if their eyesight may become to the point where they may not be able to see well in the dark. I mean, dark is dark, well what if to this character, dark is blindness? [Night blindness condition].

Top Secret -
You’re experiences are definitely around the time frame my character might have begun being diagnosed & the types of medicines you mentioned are names I have yet to hear about, if you wouldn’t mind, may I ask you a few questions about them & maybe you might be able to add some more detail? NPH, you mentioned how you used to mix this with rolling, something I haven’t read about a person doing & it’s really interesting, but I was wondering if the initials for this stood for anything in specific or if you might remember what they were. Now, you also managed to detail a bit about how you switched to another medicine titled, “Humalog” for a bit faster acting then regular. I haven’t heard of this name before, or how long it has been around. While I research a bit about this, if there’s anything you might remember as far as appearance wise or how often this medicine was used. Also, Basal rate Insulin, this is naturally made by the body, I believe you mean when you mentioned it’s what the Pancreas puts out. You also mentioned that you use pens because it’s much easier to carry, but I don’t believe I asked anyone yet, about, appearance wise, how small are pens for this & how are they carried on the person? Can you also explain more about the Lantus & what this medicine does? Also, thank you for mentioning your story about accidentally putting Insulin in the freezer and messing it up, if you wouldn’t mind, I would love to be able to consider putting a similar story in my character’s history. It seems so innocent & an easy mistake you may only have to learn once, or in this character’s case, at least twice. I also, love how you gave the about sizes of the vials, this really helps with the image of describing the character’s and what they are holding.

Top Secret, thank you also for the small details you managed to mention for Ketones. I’ll research more about drinking water to flush out the system & fast acting Insulin, but if anyone has anymore info on this it would be appreciated.

Now here, if you wouldn’t mind, I have a bit more questions regarding doctor visits as you mentioned, mostly because you’re thankfully really specific on a few terms I have yet to read anywhere or has yet to be mentioned by a prior post. You wrote that your doctor checks your three month blood sugar average with an HbA1c yet I’m unsure if you mean this, & forgive my small lack of knowledge on this part, to be a sort of scale level or testing instrument or even what the initials and numbers for each part of the term represent? If you may be able to, will you please, please, be able to describe this system in as much detail as possible. As I wrote earlier to Chelle-Lynn, we would love to b e able to write a doctor perspective at times & the testing that would be done & explained to the main character as each one progresses. Such as more info on the wire test on the foot, how is this done exactly, what is it testing for, & what sort of wire does this resemble. What is hypothyroidism, if you do not mind me asking, & how does this relate or not relate to Diabetes. Again, I never heard of any of this, & I’m full of questions, questions, questions, on just about everything you mentioned. Yes, I am quite inquisitive, but this helps make this piece of work the best yet, or at least, the best that seems the most real. You also wrote about having a dilated eye exam to check for retinopathy, such as the amount of details you may be able to add, symptoms, causes of this illness, & how it may or may not relate to diabetes as this character tends to wear glasses & I was wondering how this would affect a character wearing them. If it’s not too much trouble, can you tell me more about the fasting test, I’m sure my character would despite it, but it would be nice to know about it for him to have to learn. & what sort of tests would a doctor use to check gums, I mean, what would signify that there is a cause for concern to be addressed. & maybe can you explain more about the meter’s memory & how far back that may be tracked.

KitandKat
I really like the idea of a monitor that was able to be plugged it & the results for downloadable for the doctor to read. If this isn’t too much trouble, KitandKat, would you mind telling me more about this such as what yours may be like in appearance, or roughly the size of this. I’m guessing, & I may be wrong, but that it might have a USB cable to plug into a computer or some other way to the doctor you see to maybe download them to another device? Thank you so much for the link on the SUBQ injection, it has been really informative. Also for the small mention of A1C, I know you couldn’t remember much, but the small bit of info helps. If anyone might be able to add onto this info & which levels are important, normal, and worrisome, please let me know. Thanks for adding the details, also, on the designs for the past & present medical alert bracelet for diabetes. Mind if I ask, do you think you can describe the necklace you mentioned a bit more in detail? It’s really interesting to hear about another way of putting the important information on display for if it’s needed in an emergency. & I was wondering if it’s almost exactly the same information as a bracelet would cover or maybe what it might have resembled in appearance. I can see this happening with my character, the re belling & feeling as if it’s a bad day, he may well, decide if he’s really into taking care of himself, which he may be reminded is wrong but it may be what he decides. I too think it’s better to learn all we can.

Fuzz
Thank you so much for the compliment on the research. Me & my friend believe that it’s better to ask as much in depth questions as possible because you never know what situation a character may want to throw themselves into when us writer’s aren’t planning on it. I think character’s should try their best to be as believable as possible. So thank you again, it means so much. & it’s always great to take the time to learn about something new. I see the point of using the injection sites which work best for a person, as you mentioned, if it works better than why switch them. & I love how you talked about getting Ketones the one time you did. Not saying that will always happen but it’s something that can easily be fit into writing for my character. & that is why it’s great hearing stories, all these small details of people’s lives make writing the character’s seem more natural to have a lil’ similar experience. Such as how you mentioned about your friends worrying about your levels at the site of a kit, I think that’s interesting, especially given that the people who know this character tend to want to know how another person is. I can see one worrying to this point or more & to know that people do worry even for something simple as just showing a kit makes it seem much more realistic. Would you mind if I also ask you, do you mind describing the software you use to record levels & maybe more about an insulin pump. & maybe you if it’s alright, do you think you can describe perhaps your doctor visits as well? Or perhaps how you were diagnosed? Each person’s story is individual & interesting. I love how you used the term, ‘wine bubbles’ for small air bubbles in the medicine, it’s a nice term, one I might end up using. Your experiences with High/Low blood sugar are really helpful as well, especially detailing driving & how things tend to be, ‘a bit funny’. It’s really interesting & I can see some of these things happening to this character. As for those levels, wow, 21.6, thank you for telling me how this felt, & for the level itself, & always remember though to stay healthy, alright. Same thing with the High sugar level, 900, although I can see a bit about being smug about this lol Thank you again for all this information & experiences. & yes, this really does help a lot, everything does & you have given me a lot to consider & think about. & I always appreciate this.

I'll answer the insulin questions now and come back later for the others.

(1) NPH, you mentioned how you used to mix this with rolling, something I haven’t read about a person doing & it’s really interesting, but I was wondering if the initials for this stood for anything in specific or if you might remember what they were.

The initials do stand for something, but I'll have to look up exactly what that is. Just a second... okay, it's neutral protamine Hagedorn. I've maybe heard it actually called that once in my life.

(2) Now, you also managed to detail a bit about how you switched to another medicine titled, “Humalog” for a bit faster acting then regular. I haven’t heard of this name before, or how long it has been around. While I research a bit about this, if there’s anything you might remember as far as appearance wise or how often this medicine was used.

Humalog looks basically like water - just a clear liquid. I still use it now, basically every time I eat carbohydrates.

(3) You also mentioned that you use pens because it’s much easier to carry, but I don’t believe I asked anyone yet, about, appearance wise, how small are pens for this & how are they carried on the person?

I carry them in my purse or pocket. To give you an idea of the size, here's a picture of a pen in somebody's hand: http://petdiabetes.wikia.com/wiki/File:InsulinPenDial.jpg

(4) Can you also explain more about the Lantus & what this medicine does?

Lantus is just a long-lasting, 18 - 26 hour insulin analogue (a modified human insulin molecule) with more of a steady rate of action than most - basically peakless. I started using it in the fall of 2002 when it was still in trial. It can't be mixed with other insulins, so whereas I used to mix my NPH and Regular insulins in one syringe at breakfastime, now if I need to take Humalog at the same time as I take my Lantus, I give myself two shots and would even if I used a syringe for both.

(5) Also, thank you for mentioning your story about accidentally putting Insulin in the freezer and messing it up, if you wouldn’t mind, I would love to be able to consider putting a similar story in my character’s history. It seems so innocent & an easy mistake you may only have to learn once, or in this character’s case, at least twice.

Go right ahead.

And just some random extra information from my Insulin Dependent Diabetes Mellitus book I got when first diagnosed. Unfortunately, the covers and front matter have come off so I can't properly attribute the author or publisher. I'll keep trying to find that information, though.

"INSULIN also comes from various sources:

BEEF INSULIN - from the pancreas of cattle
PORK INSULIN - from the pancreas of pigs
HUMAN INSULIN
a) Bio-synthetic - bacteria are genetically altered to create human insulin
b) Semi-synthetic - pork insulin is chemically altered to produce human insulin

(Note: from what I understand, the pork and beef insulins, at least from the time I was diagnosed, were created in labs, not taken directly from cattle and pigs. And I was under the impression those were also made through altered bacteria but might have misread something.)

There is also a Beef-Pork mixture.

For most persons, all of these insulins are effective when given in the proper dosage and at the proper times.

Some persons develop high antibody titers to beef and pork insulins. In such persons, the insulin dose tends to get quite high and is not effective in lowering blood glucose.

In such persons, human insulin is indicated and often produces dramatic results."

Doctor Visits - I'll probably link to another page for more detailed information on most of these.

You wrote that your doctor checks your three month blood sugar average with an HbA1c yet I’m unsure if you mean this, & forgive my small lack of knowledge on this part, to be a sort of scale level or testing instrument or even what the initials and numbers for each part of the term represent?

The HbA1c is a test. Well, it's a form of hemoglobin that is measured, and we call the test by the name of what it measures. When I was first diagnosed it was done with a blood sample drawn from my arm, but they've been able to use just a fingerprick for over 10 years now.

http://health.nytimes.com/health/guides/test/hba1c/overview.html

...more info on the wire test on the foot, how is this done exactly, what is it testing for, & what sort of wire does this resemble.

It tests for nerve damage in the feet. And it's actually morel like fishing line than wire, but I never exactly looked closely.

http://www.diabetessymptom.org/the-diabetic-foot/monofilament-test.htm
Image: http://www.aafp.org/afp/2005/0601/afp20050601p2123-f1.jpg

What is hypothyroidism, if you do not mind me asking, & how does this relate or not relate to Diabetes.

It's a condition where your thyroid underproduces. It isn't directly related but occurs more often in diabetics than in non-diabetics. The kind I have is caused by the immune system attacking the thyroid, which is the same thing that happens in Type 1 diabetes, except with the pancreas.

http://en.wikipedia.org/wiki/Hashimoto%27s_thyroiditis

More later.

You also wrote about having a dilated eye exam to check for retinopathy, such as the amount of details you may be able to add, symptoms, causes of this illness, & how it may or may not relate to diabetes as this character tends to wear glasses & I was wondering how this would affect a character wearing them.

http://www.nei.nih.gov/health/diabetic/retinopathy.asp
The main difference I can think of related to wearing glasses is how much stuff is done at the eye doctor's office because a prescription check would probably be thrown in there. At least, they do that for me. The effects on vision are described in the link.

If it’s not too much trouble, can you tell me more about the fasting test, I’m sure my character would despite it, but it would be nice to know about it for him to have to learn.

Basically, you go to bed as usual one night, wake up in the morning and before eating or using the toilet, go to a lab and pee in a cup. So not really that long of a fast. And I'm not sure the fasting is always required, now that I think of it. I've just been doing it that way for years.

http://labtestsonline.org/understanding/analytes/microalbumin/tab/test

& what sort of tests would a doctor use to check gums, I mean, what would signify that there is a cause for concern to be addressed.

My doctor tells me to open my mouth, shines in a little penlight thing, and looks at my teeth and gums. I'm not really sure what he's looking for. I'll look for a page that explains it more.

http://dentistry.about.com/od/seriousdentalcondition1/a/diabtesdental.htm

& maybe can you explain more about the meter’s memory & how far back that may be tracked.

Most meters these days store a certain number of test results along with the time and date. They'll also give 7-day and 14-day averages. I used to have one that let me select from options like pre-breakfast, after breakfast (so on for other meals), before exercise, after exercise, before snack, after snack, and illness. I can't remember any other options. Then it might have also given averages of all the pre-breakfast tests and so on. That sort of thing doesn't seem to be at all common, though. Sorry, but I don't know off the top of my head how many results my meter stores and am not about to go through and count them all for you. But I'll give you the web addresses of some different meters' product pages for you to look at.

http://www.abbottdiabetescare.com/precision-xtra-blood-glucose-and-ketone-monitoring-system.html
http://www.onetouch.com/support/products/ultra
https://www.myfreestyle.com/freestyle-freedom-lite-frequently-asked-questions.html
https://www.accu-chek.com/us/glucose-meters/aviva.html


And now I'm going to ask a question of my own. Why is it that in the original post you say you are asking because of a suggestion for your friend's character, but you are doing all the research and talking about how your own character will react to things?

No worries :) Here are the answers to your questions.

At the moment, I’m on an Animas 2020 insulin pump, so I use the software that comes with that. You put the pump into suspend mode, then download all of the information on the pump to the computer (via infrared? I’m not sure… it has a dongle, so whatever that means). Once the information is in there, you can choose to make various graphs.

Me, I was diagnosed because I got really sick. I didn’t realise that there was actually anything wrong with me for a long time, because I’d been doing early morning sport (as in 4:00am starts) and being tired seemed pretty reasonable. I was physically unable to stay awake if I wasn’t thinking really hard about something. So sitting down to watch a movie, sitting and listening to someone talking, I’d be asleep, no matter how hard I tried to stay conscious.
Walking was really hard. A slight incline would make me about as tired as a really hard hour long gym workout does now. I stopped enjoying things that I’d liked previously. I lost a great amount of weight, even though I was eating about quadruple what was normal. I was *thirsty*. My routine for a while there was to come home at the end of the day, drink two family bottles of juice and then drink water for the rest of the night. Cold, wet things were the best but anything to stop being thirsty – although I was never not thirsty. You get to the point where you’ve drunk so much that it’s physically uncomfortable but your throat’s still lined with sand.
I ended up going to the doctor for something else (which turned out to be diabetes related) and he suspected that I was diabetic and did a blood test. When my results came back, I got a frantic call to get myself to the hospital that night, before I did anything else.

My doctor’s visits are fairly uneventful, because I tend to manage a lot of things without help. I’ll show my doctor a spreadsheet I’ve printed, they’ll tell me what changes to make to my levels and then I see them again in three months. I don’t tend to contact anyone in between visits, I’ll just run what’s called a temporary basal (on my pump, anyway) if I need to, which is where you can adjust the background level of insulin you’re getting for short periods of time. I have a couple of doctors that I speak to.