什麼是糖尿病
WHAT IS DIABETES?
Diabetes is the common term for several metabolic disorders in which the
body no longer produces insulin or uses the insulin it produces ineffectively. It is
a common condition and is characterized by abnormally high blood sugar levels.
Diabetes is known as "diabetes mellitus" - where diabetes comes from the Greek
word for siphon, which describes the excessive thirst and urination of this
condition, and mellitus is the Latin word for honey, because diabetic urine is
filled with sugar and is sweet.
Diabetes essentially changes the way your body uses food
The key to the problem is insulin - as insulin's role in the body is to help
glucose get into the body cells where it is used to make energy. Diabetes is
characterized by a partial or complete lack of insulin production by the body. The
most common forms of diabetes are type-Ι diabetes and typeⅡ diabetes. In
both types of diabetes, people have little or no ability to move sugar out of the
blood stream and into the cells, where it is used as the body's primary fuel.
Symptoms and complications
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Frequent urination
Extreme thirst and/or hunger
Weight loss
Fatigue
Numbness
Sores that are slow to heal, and Increased infections
Learning how to best manage your diabetes is key to your treatment. Poor
control of diabetes can lead to an increased risk of:
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Heart disease
High blood pressure
Stroke
Kidney and bladder failure
Gum disease
Blindness
Foot and leg infections
什麼是糖尿病
Type-II diabetes
Type-II diabetes is a term for several disorders with different causes and
degrees of severity. It is the most common type of diabetes. Often, people with
type-II diabetes can still make their own insulin in the pancreas, but the insulin
that is produced is not used as effectively by the body.
Many people manage type-II diabetes simply by following a healthy diet and
regular exercise. In overweight individuals, type-II diabetes often improves as a
result of weight loss, a healthy diet and exercise.
With the progression of the disease, some people may have to take oral
medication(s) or insulin injections. Type-II diabetes is much more common than
type-I diabetes. Although the cause of type-II diabetes is unknown, there are
some risk factors that can predispose some people to this condition. Risk factors
of type-II diabetes include:
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Age (being over 45 years old)
Being overweight or obese
Having a family history of diabetes
Ethnic background or race (Native/Indigenous, African,
Hispanic or Asian descent)
Having given birth to a large baby (over 4 kg or 9 lbs)
Impaired glucose intolerance
The symptoms of type-II diabetes are the same as type-I diabetes. Some
people may also experience slow healing cuts and bruises, recurring gum or
bladder infections, or tingling in their hands or feet. Other terms previously used
for type-II diabetes are adult-onset diabetes and Non-Insulin Dependent Diabetes
Mellitus (NIDDM).
Keeping well with diabetes
By following a diabetes treatment plan, you are trying to keep an even
balance of glucose and insulin in the blood at all times. Just like on the ocean,
4-foot waves are fine and normal, but 12-foot waves can mean rough sailing
ahead!
Since extremely high or low blood glucose levels are hard on your body, it
is important to try to keep your blood glucose levels as even as possible to avoid
long-term complications.
什麼是糖尿病
Stress and illness
It is important to understand the effects that stress and illness can have on
your blood glucose levels and be prepared to handle them effectively.
Complications
Finding the right balance of nutrition, exercise, and insulin and/or oral
medication is the key to living well with diabetes. Working day-to-day to achieve
good blood glucose control is essential to avoid complications.
Exercise
Regular exercise is one of the best ways to help keep your blood glucose
levels more stable. If you exercise regularly, you already understand how much
better it makes you feel. The main thing is to start doing something active on a
regular basis.
Remember: Always check with your doctor before starting any new exercise
routine.
You'll be surprised how quickly you can build up your exercise time if you
include these simple tips for active living! Don't break into a sweat over a little
exercise! Exercise is an important part of your diabetes treatment. With a bit of
planning and common sense, people with diabetes can explore the world of
adventure sports.
什麼是糖尿病
運動
EXERCISE FOR DIABETES PATIENTS
The antidote is exercise. Exercise is good for everyone. It has extra benefits
for those with diabetes.
Active people with diabetes can expect to:

Sleep and handle stress better
 Have stronger bones and a healthier heart
 Control blood pressure and blood fats (lipids)
 Maintain or reduce weight more easily
 Be stronger, have more energy and be more flexible
 Need less insulin. Being active uses up blood sugar and helps the body better
use the insulin it has.
A plan can be as simple as stretching before taking a daily walk. Or, it can
involve much more. You may need help putting together a plan that fits your
needs. If there's an exercise plan on your healthcare team, you're in luck. If not,
you might try the fitness specialists at a cardiac rehab. program. They are often
familiar with the special needs of people with diabetes. And finally, most towns
have exercise professionals, gyms, and trainers. Your doctor or diabetes educator
could help you start an exercise plan.
Getting started
Before you begin any exercise program, talk to your doctor about creating a
program that's right for you. To be successful in an exercise program, you need to
"just do it". However, a little planning can help you go beyond "just do it" to
"stick with it". Here are some things to think about before you take the plunge.
 Pick an activity you enjoy. There are a lot of possibilities. Walking. Swimming.
Bike riding. Dancing. Bowling. Roller-skating. Gardening. You are a lot more
likely to stick with an activity that makes you smile.
 Make sure it's right for your current level of fitness. If you've been doing very
little, even a very small amount will give you results. At every level of fitness,
you make progress by doing just a little more.
 Get good shoes that fit well. Wear them with smooth cotton socks. Okay, that's
not so important if you're going to swim!
 Plan to do it safely.
Any increase in activity is likely to make you feel better. You may not need or
want to do anything more than taking a walk after supper. To get all the benefits
什麼是糖尿病
listed in the introduction, though, you will need to do more. Maybe not at first,
but eventually. Your exercise will need to:
 Happen at least a few times a week. Every day is best.
 Add up to at least 30 minutes a day.
 Be hard enough to make you break a light sweat (moderate intensity).
 Include activities that move large muscles.
 Include a warm up and a cool down to avoid injury.
When you exercise
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Start slowly. Just five or ten minutes can be enough. This is the only safe way to
start if you have been very inactive.
Comfortable, supportive shoes and cotton socks help protect your feet. Take
them off after you exercise. Look for red or tender spots. They are signs of poor
shoe fit or injury.
Wear diabetes identification jewelry, because it can always be with you.
Stretch and warm up at the beginning of your activity. This helps prevent
injuries.
Drink more liquids when you exercise. Water is usually best.
Check your blood sugar before and after exercise.
This is very important for anyone who takes insulin, a sulfonylurea, or a
meglitinide. These medicines can create risk for low blood sugar.
If your blood sugar is higher than 300 mg/dL, delay your workout. Exercise now
could just send it higher (or increase ketones if you are type -Ⅰdiabetes).
If your blood sugar is less than 70 mg/dL, eat something. Make sure your blood
sugar is up to a safer level before you work out.
 Carry something to eat that contains glucose. Use it to prevent or treat low
blood sugar if you need to. You may want to drink diluted juice during long
workouts. It both helps prevent lows and provides the extra liquid you need.
 If you have leg or chest pains, stop exercising and call your doctor.
If your answers tell you that you're not ready to begin your exercise program,
you may want to talk to someone about it to figure out why. Or, give it some
more thought. Try to think of what might be standing in your way.
Know that everyone's exercise plans lapse sometimes. When it happens to you,
just try to get started again as soon as you can.
Here are some more thoughts:
 Decide what you want from being more active. People do hard things all the
time, as long as it gives them something they want.
什麼是糖尿病
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Make an appointment with yourself to exercise.
Make it social. Four legs can work as well as two!
Keep a record of what you do. For example, write the step total from a
pedometer on your blood sugar record every night.
Keep your main goal in mind. Maybe you are exercising to feel better, lower
your blood sugars or lose weight. Whatever it is, keep track of how you are
doing.
什麼是糖尿病
低血糖
WHAT IS THE LOW BLOOD SUGAR?
No one with diabetes has perfect blood sugars all the time. In diabetes, a
blood sugar less than 70 mg/dL is considered to be "low" (this number is lower
for women who have diabetes while they are pregnant). That number is actually
in the normal range, near the lower end. It's picked as the "take action" number to
keep people safe. Blood sugar can fall very quickly in diabetes. If you treat a
blood sugar of 70 mg/dL, you can stop it from falling to a dangerous level.
What causes lows?
Here are the usual ways you could end up with too much insulin:
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Your doses of injected insulin are too high.
Your insulin plan doesn't fit your schedule.
The dose or type of diabetes pill you take is wrong for you.
You were more active than usual.
You ate too little for the medicine you took.
You ate at the wrong time for the medicine you take.
You drank alcohol without also eating.
How do lows feel?
Low blood sugar feels different to different people. There are a lot of possibilities.
Here are some of the more common ones:
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Shaky
Sweaty
Anxious
Fast heartbeat
Dizzy
Hungry
Crabby
Confused
Clumsy
Difficulty concentrating
What is the best way to treat lows?
When you feel your symptoms of low blood sugar or have a reading below
70 mg/dL without symptoms, do this:

Take 15 grams of a "quick-acting" carbohydrate. Use choices like these:
什麼是糖尿病
3 or 4 glucose tablets (These are the quickest for most people)
1/2can of regular (not diet) soda
1cup of fruit juice
If your reading is below 50 mg/dL, double the amount of carb recommended
above.
1. Wait 15 minutes. Recheck your blood sugar if you can. If your blood sugar is
still low, repeat steps 1 and 2. If it is dropping instead of rising, you need
help. Call 911 or have someone drive you to an emergency room.
2. Have an extra snack when you feel better. Try half a sandwich or some
cheese and crackers.
It's tempting — and common — to go overboard treating lows. It takes that first
15 grams of carbohydrate from 10 to 15 minutes to get into your blood stream.
There's no way you're going to feel better much sooner than that — no matter
how much you eat or drink. If you eat and drink for that whole 10 to 15 minutes,
that next blood sugar is going to be one for the record books! It's so much easier
to say than to do, but try to wait after taking that first 15 grams of carb.
什麼是糖尿病
高血糖
HIGH BLOOD SUGAR
You have "high blood sugar," or hyperglycemia, when your blood sugar level is
above normal. Your measure of "high" depends on your own blood sugar targets.
For most people, "high" means:
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Before-meal blood sugars average above 110 mg/dL
After-meal blood sugars average above 140 mg/dL
Here are some of the causes for high blood sugar. When you are having highs,
think about which one might be the cause.
 Being sick or in pain
 Eating more food than your insulin can handle
 Getting less exercise than usual
 Being upset or under stress and eating more than usual
 Not taking enough diabetes medicine
 Not taking the right diabetes medicine
 Extra sugar made by the liver (this can happen when insulin levels are too low)
 Taking a medicine that raises blood sugar. Do you take anything other than
diabetes medicines? Think of both medicines you buy over the counter and
those prescribed by a doctor. Ask your pharmacist if they could be raising your
blood sugar.
How dose high blood sugar feel?
Most of the time, high blood sugar feels just fine, thank you! You might feel
nothing unus slowly you don't notice them. Here's an approach that can help you
find those "hidden" highs:
 Test blood sugar regularly. Do some checks both before and after meals.
Regular tests help you find highs that you might not otherwise notice.
 Do an extra test if you have any of these symptoms:
 More hunger or thirst than usual
 Need to urinate often, especially at night
 Dry or itchy skin
 Tiredness or sleepy feeling
 Blurred vision
 Frequent infections
 Slow healing of cuts or sores
What can I do about high blood sugar?
The first step in solving any problem is to describe it in detail. Without a specific
description of your problem, it's hard to come up with specific tactics to solve the
什麼是糖尿病
problem. A general problem like "I have high blood sugars" tends to lead to
general advice, such as:

Follow your meal plan
 Take your medicine
 Test more often
When you can describe your problem in detail, take it to your health care
team. Show them where the problem lies. Tell them what you've tried, if anything.
Ask what your options are. Your options may include:
 A change in medicines or doses
 More attention to food or a different approach to food
 More exercise or more regular exercise
 A plan for acting on your blood sugar results
什麼是糖尿病
血糖自我監測
BLOOD SUGAR TESTING
Here's the bottom line. If you want to control diabetes, you need to test your
blood sugar. Otherwise, you're flying blind. You can't know if what you're doing
is working. You can't make good decisions about what to do next. Blood sugar
testing can help you:

Understand your diabetes
 Improve control
 Increase your choices
 Stay safe
Here's what it takes to get those results:
 Test enough to really see what's happening. You won't do all these tests
every day. You need to test at different times to get a complete picture.
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1. First thing in the morning and before meals. These tests tell you about
Your basal insulin (sometimes called background insulin). You need this
information whether your body makes insulin or you take it. The target
for these times is less than 110 mg/dL. Are you coming close?
2.Two hours after eating. These tests tell you if you have enough insulin for
the food you ate. The target for these times is less than 140 mg/dL. How
often do you hit that one?
3.In the middle of the night. People who take an insulin that lasts through the
night need to do this test once in a while. Lows can happen in the middle
of the night if your dose is not right.
Use the numbers when you get them. The numbers can tell you a lot when
you get them. They won't mean much 3 months later in the doctor's office.
They are your feedback on what you just did. They can also help you decide
what to do next.
Think about them in context. Blood sugar numbers by themselves don't tell
you much. When you pair them with information about what you eat, they
Get good equipment. Testing is getting easier, quicker, and more
comfortable with every day that passes. See what's new. It may mean you
test more often. You can print out a record keeping form to help you
experience the full power of blood testing. If your doctor hasn't talked to
you about testing, ask him or her about it. Think about this:
Testing shows you the effect of what you did. It helps you decide what to do
next.
Control can change through no fault of yours - and you may not feel it.
什麼是糖尿病
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Testing keeps you in the know and in charge.
胰島素治療
INSULIN TREATMENT
What is the insulin and how dose it work?
Insulin is a hormone. The body needs it for the correct use of food and
energy. All hormones are made by glands. The gland that makes insulin is the
pancreas. People with diabetes don't make enough insulin. So you might say
they're "pancreatically challenged!"
Luckily, we have a way to replace the insulin the pancreas can't make. Insulin is a
protein. It can't be taken by mouth. It would be digested, just like a hamburger.
That is why insulin is taken by injection.
How the body uses insulin?
We need energy all the time. Sugar is our main source of that energy. Insulin is a
"key" player in how the body gets and uses it.
when you have diabetes：
1. You make too little insulin.
If you have type-Ⅰdiabetes, you have normal insulin needs but make almost
none. If you have type-Ⅱdiabetes, you have high insulin needs and cannot
make enough to meet them.
2. When you have too little insulin, the liver makes sugar that's not needed. The
sugar from food can't get into cells.
3. Sugar builds up in the blood. These high levels of blood sugar are not
normal.
4. This is diabetes.
What types of insulin are there?
 Rapid-acting insulins start very quickly and work for a only a short time.
These are the best insulins for mealtime.
什麼是糖尿病
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Short-acting insulins start more slowly and have a peak several hours after
you take them. These are also used to provide mealtime needs.
Intermediate- and long-acting insulins start the slowest and last the longest.
These are the best basal insulins.
Premixed insulins are combinations of intermediate-acting and either
rapid-acting or short-acting insulins.
The chart below shows the average onset, peak, and duration of some insulins.
These times vary from person to person.
Onset is when the insulin usually starts to work. The start of the curve (left side)
shows this.
Peak is when the insulin usually has its strongest effect. The highest part of the
curve shows this.
Duration is how long the insulin usually works. The end of the curve (right side)
shows this.
Will insulin alone control my diabetes?
Insulin makes it possible to control your diabetes, but it doesn't make it a
certainty. That's because insulin only works when it is balanced with all the other
things that affect your blood sugar.
Consider this. If ALL you did about diabetes was to take insulin, you'd almost
surely have poor control. You may be no better off than before you started taking
insulin.
Here are some of the other tools you'll need to get the most out of your insulin.
 Food
 Exercise
 Blood testing
Here's the most important key of all: YOU. Like all tools, insulin works just
about as well as the people who use it.
什麼是糖尿病
小兒發燒的處理
How to management of pediatric fever
1. If the baby’s temperature is higher than 37.5℃, take off some of the clothes or
blankets on the baby. Take another temperature 30 minutes later.
2. When the temperature is higher than 38℃, wipe the baby with a washcloth
dipped in warm water or place a water pillow underneath the baby’s head.
Pay close attention to see if that makes your baby feel cold or shiver and
makes him/her feel even more uncomfortable or even puts him/her in danger.
Make sure that the use of a water pillow won’t cause the baby to shiver, or use
a water pillow one hour after feeding an antipyretic to your baby.
3. Take the temperature once an hour.
If the temperature still hasn’t dropped, feed nother antipyretic to your baby as
instructed by the doctor to make your baby more comfortable.
什麼是糖尿病
早產的徵兆
Most obvious sings of premature birth
37 weeks is the earliest normal birth time. So if you have any of the following
symptoms before 37 weeks, please contact the doctor who will help you give
birth or go immediately to the hospital.
1. If contractions begin and the belly is hard.
After 8 months of pregnancy, the lower abdomen will normally become
hard or soft. If you are having contractions 5-6 times per hour or every 10
minutes or less, stay calm but go to the hospital at once.
2. If your water breaks and blood comes out at the same time.
If you have a lot of red or dark red or sticky discharge, you can immediately
use soft clean gauze and then wear a sanitary napkin. Then you should
immediately go to hospital. If warm water comes out, your water has broken
and usually contractions will start immediately. Then you should lie down,
elevate the lower back, but don't move your abdomen any more than necessary,
and go to the hospital at once (Have someone call an ambulance).
3. If the fetus starts to move a lot or suddenly stops moving, go to the hospital at
once.
什麼是糖尿病
肺炎患者注意事項
Reminders to Patients that have Pneumonia
1.
Take a deep breath and make effective coughing exercise to let out some
phlegm.
2.
Drink 3,000-4,000cc water daily.
3.
Take foods with high calories , high protein , and high vitamins.
4. Take plenty rest and have appropriate amount of exercise.(take progressive
type of activities while in acute period or restorative period)
5. Keep air flow and adjust appropriate temperature to avoid dry air which causes
coughing.
6. Keep skin clean and dry and change clothes often.
7. Avoid smoking and drinking.
8. Keep your mouth clean.
9. Continue to take deep breath 6-8 times everyday after leaving hospital.
10. Be careful about changing of weather and avoid going to public places to
prevent 2 nd-time infection.
什麼是糖尿病
蜂窩組織炎患者須知
Reminders to Patients that have Cellulitis
1.
2.
3.
4.
5.
6.
Lay down and rest at acute period
Put ice pack on wounded part and raise wounded limb
Keep wounds dry and clean
Avoid scratching with hands
Cleanse both hands that will touch wounds
Maintain good personal sanitation to avoid being infected
什麼是糖尿病
慢性阻塞性肺疾病護理指導
The Guidelines for the Nursing Care of the COPD Rehabilitation
1.What is Chronic Obstructive Pulmonary Disease
Chronic Obstructive Pulmonary Disease (COPD) is a term referring to
patient’s airway and parenchyma of lung with chronic obstructive problems; that
includes chronic bronchitis, emphysema or both. This will lead to coughing,
wheezing, chronic reflex and increase of mucus and even the difficulty of
breathing. Chronic bronchitis is a term referring to the increase of thickness of
the mucus accompanied by a chronic cough. In each year, it will happen at least
three months and continue at least two years. Emphysema is a term referring to
the damage of parenchyma of lung.
2.How to have an effective way of breathing and coughing
Pursed Lip Breathing Technique: This can exhale the air in lungs, when a
heavy exercise (ex. Walking the stairs, bending over, picking up heavy objects)
and rapid breathing are used:
Procedure: ＊Relax your neck and shoulder muscles.
＊
Slowly inhale for about two seconds and purse your lips slightly
as if blowing a candle
＊
slow and continous exhale the air for about 4 seconds. (The time
for exhaling must be longer than the time of inhaling, so the lung will have more
space for air)
Diaphragmatic Breathing Technique: Increase the movement of the
diaphragm to prevent acute episodes of shortness of breath.
Procedure: ＊Sit or lying down in a comfortable position with head
supporter
＊
Bendingn knees, relaxed the neck-shoulder and lumber regions.
Place one hand on the center of the stomach and one hand on the chest. Slowly
inhale and count to two.
＊
The abdomen will rise when inhaling and the chest will remain
the same. Slowly exhale and count to 4, tighten the abdomen muscle and at this
moment, the abdomen will shrink during exhaling.
Effective Coughing: Correct sitting position and deep-breathing technique
can control the coughing and easily to cough out the sputum.
Procedures:＊Sit on a chair with both legs slightly bend.
什麼是糖尿病
＊Placed both hands in a crossed position on the abdomen and use
nose to inhale and hold it for two seconds. Slightly bend the
upper body forward and the same time of exhaling cough twice
shortly. During the coughing process, use both hands to press
down the abdomen.
＊Relax for a few seconds and continue if necessary.
3.The Attentions of Daily Livings
A.Stop smoking
B.Healthy exercise: Walking, riding bicycle
C.Place the body in a relaxed position: When a difficultly of breathing occurs,
a relaxed body position can help to relax the chest and abdomen muscles, to
increase the usage of respiratory muscles.
D.Avoid stimulants: Like dust, pollens, cold air, pets and air fresheners will
stimulate the breathing system and cause breathing difficulty.
E.Prevent lung infections: Wash hands often, Stop going to public places,
Maintain a routine exercise, regular diets and good sleep, Perform more
effective cough techniques to cough out the sputum, Keep the lungs clean
and dry to prevent bacteria growing inside of lungs.
糖尿病足部照顧
什麼是糖尿病
The diabetic foot care
1.Preface：The feet of diabetes patient are the weakest part of the body,when the
feet are wounded ,they often combine with neuro vasculapathy
and cause the wound difficult to heal
,infection or necrosis.So caring of feet is very important
to the diabetes.
2.Pathological change：The diabetes feet changes are caused by neuropathy,it is apt to split and it dehumidifies the skin of lower
limbs ,causing dysfunction of sensory.when a patient's foot is
hurt,he usually does not know.Because of vasculapathy,the wound
is difficult to heal due to bad blood circulation .When infected
with bacteria ,the limbs will suffer infecion,necrosis and
amputation.
3. Care of feet：
A. Inspect locations such as the nail,in between toes,heel,and foot bottom
every day. See the doctor immediately if new wound,
rythemaous or blister shows.
B.Wash your feet every day with 35℃water, Test the water temperature
with a thermometer or your wrist before washing.
Do not test the temperature with your foot.Chose PH-6 liquid
soap without artificial perfume to clean the feet and apply
moisturizing cream afterward.
C.Do not cut nail too short.Never cut the corner of the nail or dig
down the sides.Use a nail clipper,avoid using scissors.
D. Your shoes should be purchased in the afternoon because feet
swell during the day,pick shoes with length of feet plus 2cm.
Wear the new shoes only one hour on the first day,then increase
an hour every five days until you wear them the whole
day.Always check the inside of the shoes to see if there are
rough surfaces or foreign objects to protect you feet.
E.Always wear socks with shoes to avoid blisters.White socks
are preferred in order to observe the discharge of the wound.
Cotton or wool socks are better, avoid the elastic band lace.
F. Exercise such as swimming helps blood circulation.
G. Please do not the following：
什麼是糖尿病
＊Try to remove corns or callus by corn cure or chemical liquid.
＊Use sharp instruments to cut callus.
＊Shave the hair on legs.
＊Walk barefeet.
＊Wear socks with elastic band.
＊Smoke of any kinds.