What is diabetes? If you or someone you know has diabetes, you’re not alone. Millions of people have diabetes. Diabetes cannot yet be cured. But it can be managed.

The most common types of diabetes are type 1 and type 2

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What happens in diabetes? Diabetes is a condition in which the body doesn’t make or use insulin correctly. The image below shows, in a simple way, what happens normally when you eat.

In people without diabetes:

Type 1

Type 2

In type 1 diabetes, the body makes little or no insulin, due to an overactive autoimmune system. So people with type 1 diabetes must take insulin every day. Type 1 diabetes usually occurs in children and young adults, but it can also appear in older adults. (An autoimmune disease means that the body attacks its own cells by mistake.)

In type 2 diabetes, your body prevents the insulin it does make from working right. Or it may not make enough insulin. Most people with diabetes have type 2. Some risk factors for this kind of diabetes include older age, being overweight or obese, family history, and having certain ethnic backgrounds.

nW  hen you eat, some of your food is broken down When into sugar (also called glucose). Sugar travels in your blood to all your body’s cells. Your cells need sugar for energy. Sugar from food makes your blood sugar level go up n IIn n response to increased sugar, beta cells in the pancreas release a hormone called insulin. IInsulin nsulin is like a key that unlocks the doors of your cells so that sugar can get into the cells, where it is used as a source of energy  here are other hormones that play important n TThere roles in how the body uses sugar. For example, amylin and GLP-1 help reduce the amount of sugar made by the liver and slow the emptying of food from the stomach. Another hormone called glucagon tells the liver to release stored sugar if your blood sugar gets too low or if you have not eaten for many hours, such as overnight

The information below focuses on type 2 diabetes. For more information about type 1 diabetes, visit Cornerstones4Care.com. Blood sugar

Food

Digestion

Cells

Hormones (like GLP-1)

Pancreatic beta cells (release insulin and amylin)

Insulin

What is diabetes?

In people with diabetes: n Your pancreas makes little or no insulin, or

Knowing your A1C

n Your body prevents the insulin you do make from working right. This is called insulin resistance

The A1C test measures your estimated average blood sugar level over the past 2 to 3 months. It’s like a “memory” of your blood sugar levels. It shows how well you’re controlling your blood sugar levels over time.

Checking your blood sugar

Your A1C is made up of 2 other blood sugar measurements:

Checking your blood sugar yourself can be an important part of a diabetes care plan. Checking often will tell you:

n FPG is your fasting plasma glucose. This is your blood sugar number when you have been fasting (not eating) for at least 8 hours

n If your insulin or other diabetes medicine is working

n PPG is your postprandial plasma glucose. This is your after-meal blood sugar level, which you check about 1 to 2 hours after you eat. It measures the blood sugar spikes that happen after you eat

n How physical activity, the foods you eat, and stress affect your blood sugar You’ll usually feel better and have more energy when your blood sugar stays at or near your goal. Managing your blood sugar can also reduce your risk of developing problems from diabetes.

Both your FPG and your PPG have to be at their targets in order for your A1C to be at target. Your A1C and your blood sugar levels go up and down together. Here is how A1C relates to the estimated average blood sugar level: A1C levels

Average blood sugar

6%

126 mg/dL

7%

154 mg/dL

8%

183 mg/dL

9%

212 mg/dL

10%

240 mg/dL

11%

269 mg/dL

12%

298 mg/dL

Adapted from the American Diabetes Association. Standards of medical care in diabetes—2016. Diabetes Care. 2016;39(suppl 1):S1-S112

It is recommended that you get an A1C test: n At least 2 times a year if your blood sugar is under good control n 4 times a year if you’re not meeting your goals or if your treatment has changed According to the American Diabetes Association, lowering your A1C to below 7% may reduce your risk of some diabetes-related problems, like problems with your nerves, eyes, and kidneys. Your health care provider will tell you what your personal A1C goal should be.

How to check your blood sugar and keep track of your numbers Many different kinds of blood sugar meters are available today. Your diabetes care team can help you choose a meter and show you how to use it. It’s important to write down your blood sugar levels so that you can keep track of what makes them go up or down. Some meters also keep a log of your past blood sugar levels. You can also ask your diabetes care team for a copy of the Cornerstones4Care® booklet Staying on Track. Or go to Cornerstones4Care.com for an online tracker.

Talk with your diabetes care team about your A1C goal and write it here: __________

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You and your diabetes care team will decide when and how often you should check your blood sugar. Here are some times when you may want to check:

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trackers, To order additional please call 1-800-727-6500.

I am taking non-insulin diabetes

medicine

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Date: _________________________________

My most recent A1C: __________________

07/2015

a diary of your blood sugar

your blood sugar tracker

August 2015

Cornerstones4Care.com

55

You and your doctor can use the example under this flap to see how you might add mealtime insulin one meal at a time.

Because diabetes changes over time, your doctor may decide to add mealtime insulin to your plan to help control blood sugar when you eat. There are many ways to add mealtime insulin to your care plan. Together, your doctor and you will decide on the insulin plan that is right for you.

n 1 to 2 hours after meals, to see how the food you eat affects your blood sugar

your diabetes.

0615-00027363-1

today to sign up Go to Cornerstones4Care.com help you reach program to for a free personalized your diabetes care goals.

All rights reserved.

numbers and managing

Go to Cornerstones4Care.com today to sign up for a free personalized program to help you reach your diabetes care goals.

To order additional trackers, please call 1-800-727-6500.

Adding or starting mealtime insulin

If your doctor wants you to adjust your mealtime insulin. Use this section based on your doctor’s instructions.

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Depending on the medicine you’re taking, your health care professional may want you to check your blood sugar more or less often. Talk with him or her about how often and when you should be checking.

55

If you’ve received this tracker without the Staying on Track booklet, you can ask your diabetes care team for the booklet. It will give you more information about knowing your numbers and managing your diabetes.

staying on track

your blood sugar tracker and guide to tracking and adjusting mealtime insulin

The photographs used in this booklet are for illustration only. The models in the photographs Cornerstones4Care® is a registered do not necessarily have diabetes trademark of Novo Nordisk A/S. or other ailments. Novo Nordisk is a registered trademark of Novo Nordisk A/S.

© 2015 Novo Nordisk

n Before and within minutes after physical activity, to see how being active affects your blood sugar

mealtime insulin

Adding or starting

may decide to add over time, your doctor eat. Because diabetes changes blood sugar when you your plan to help control mealtime insulin to to your care to add mealtime insulin There are many ways decide on doctor and you will plan. Together, your is right for you. the insulin plan that

What is diabetes?

Managing type 2 diabetes

Without diabetes

As part of your diabetes care plan, your care team may start by asking you to take different diabetes medicines such as pills or other non-insulin medicines.

In people without diabetes, beta cells in the pancreas make and release insulin to keep blood sugar levels normal.

Your diabetes care team will help you develop a diabetes care plan that is right for you. In addition to taking medicine, you should aim for a balanced and healthy eating plan, making physical activity a regular part of your daily routine, getting to and staying at your target weight, and tracking your blood sugar numbers. It is now clear that type 2 diabetes will continue to change over time:

Pancreas

Beta cells

With diabetes

n The beta cells may stop working. Research suggests that many people with type 2 diabetes may already have lost about 50% to 80% of their beta cell function by the time their diabetes is diagnosed

In people with type 2 diabetes, there may be fewer working beta cells in the pancreas. The beta cells may stop working and may make too little insulin. Or they may make enough insulin, but the body doesn’t use it properly. That prevents it from working to lower blood sugar.

n As the number or function of beta cells goes down, the pancreas may make less and less insulin. As a result, your treatment may also need to change over time To avoid problems related to diabetes, it is important to keep your blood sugar as close to your target as possible. You can learn more at Cornerstones4Care.com. Or ask your diabetes care team for more information. And talk with them about which diabetes treatment is right for you.

Release of insulin

Pancreas

Release of insulin

Beta cells

For more information about diabetes, visit Cornerstones4Care.com

Novo Nordisk Inc. grants permission to reproduce this piece for nonprofit educational purposes only on condition that the piece is maintained in its original format and that the copyright notice is displayed. Novo Nordisk Inc. reserves the right to revoke this permission at any time. Cornerstones4Care® is a registered trademark of Novo Nordisk A/S. Novo Nordisk is a registered trademark of Novo Nordisk A/S. © 2016 Novo Nordisk

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August 2016

Cornerstones4Care.com

Support and diabetes management tools built around you. Enroll today to get FREE, personalized diabetes support with Cornerstones4Care®. Meal Planning Tools Create tasty, diabetes-friendly meals

Diabetes Health Coach An online program that builds a customized action plan around your needs to help you learn healthy habits

Interactive Trackers Record A1C, weight, and blood sugar numbers

Review and complete below.

Enrolling is easy. Just complete this form. All fields with asterisks (*) are REQUIRED. * q I have diabetes

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* Phone number:

* First name_______________* Last name _______________ MI _____

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* Cell phone number:

Address 2 ____________________________________________________

(

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* City ________________________ * State __________________________ * ZIP_______________ * Email ___________________________________ * Birth date mm/dd/yyyy

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* What type of diabetes do you or the person you care for have? (Check one) q Type 2

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* What type of diabetes medicine has been prescribed? (Check all that apply) q Insulin q GLP-1 medicine q None q Other q Diabetes pills (also called oral antidiabetic drugs, or OADs) * If you checked “Insulin,” “GLP-1 medicine,” or “Other,” please fill in the following for each: Product 1:____________________________________ How long has this product been taken? q Prescribed but not taken q 0-3 months q 4-6 months

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Product 2:____________________________________ How long has this product been taken? q Prescribed but not taken q 0-3 months q 4-6 months

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