U.S. Department 

of Health and 

Human Services 

Your Guide to Diabetes:
 

Type 1 and Type 2 1 and Type 2

NATIONAL INSTITUTES OF HEALTH National Diabetes Information Clearinghouse 

Your Guide to Diabetes: 

Type 1 and Type 2 

U.S. Department 

of Health and 

Human Services 

NATIONAL INSTITUTES OF HEALTH National Diabetes Information Clearinghouse 

Contents
 

Introduction............................................................................ 1
 

What Diabetes Is.................................................................... 3
 

How do you get high blood glucose?............................... 3
 

What is pre-diabetes? ....................................................... 4
 

What are the signs of diabetes? ....................................... 4
 

What kind of diabetes do you have? .............................. 5
 

Why do you need to take care of your diabetes? ........... 7
 

What’s a desirable blood glucose level?.......................... 8 


Taking Care of Your Diabetes Every Day........................... 9
 

Follow Your Meal Plan .................................................. 11
 

Be Physically Active........................................................ 12
 

Take Your Diabetes Medicines Every Day .................. 15
 

Check Your Blood Glucose as Recommended............ 19
 

Take Other Tests for Your Diabetes ........................... 21
 

Keep Daily Records........................................................ 23
 

When Your Blood Glucose Is Too High or 

Too Low ................................................................................ 27
 

What You Need to Know about High Blood 


Glucose ............................................................................ 27
 

What You Need to Know about Low Blood 


Glucose ............................................................................ 28
 
Why Taking Care of Your Diabetes Is Important ............ 32
 

Diabetes and Your Heart and Blood Vessels .............. 33
 

Diabetes and Your Eyes................................................. 38
 

Diabetes and Your Kidneys ........................................... 40
 

Diabetes and Your Nerves............................................. 43
 

Foot Care Tips ................................................................ 46
 

Diabetes and Your Gums and Teeth ........................... 48
 

Taking Care of Your Diabetes at Special Times............... 50
 

When You’re Sick........................................................... 50
 

When You’re at School or Work................................... 53
 

When You’re Away from Home.................................... 55
 

When There’s an Emergency or Natural Disaster....... 57
 

When You’re Planning a Pregnancy ............................. 58
 

Where to Get More Help with Your Diabetes ................. 61
 

People Who Can Help You ........................................... 61
 

Organizations That Can Help You ............................... 62
 

Pronunciation Guide............................................................ 65
 
Introduction 

Your doctor says you have diabetes. You can learn how to 

take care of your diabetes and how to prevent some of the 

serious problems that diabetes can cause. You may want to 

share this booklet with your family and friends so they too 

will understand more about diabetes and how they can help 

you live a healthy life. And remember, you can always ask 

your health care team any questions you might have. 

You can learn how to take care of your diabetes. 

1 
2 
 

 

What Diabetes Is 

Diabetes means your blood glucose*, also called blood sugar, 

is too high. Your blood always has some glucose in it because 

your body needs glucose for energy to keep you going. But 

too much glucose in the blood isn’t good for your health. 

How do you get high blood glucose? 

Glucose comes from the food you eat and is also made in 

your liver and muscles. Your blood carries the glucose to 

all the cells in your body. Insulin is a chemical, also called 

a hormone, made by the pancreas. The pancreas releases 

insulin into the blood. Insulin helps the glucose from food 

get into your cells. If your body doesn’t make enough insulin, 

or if the insulin doesn’t work the way it should, glucose can’t 

get into your cells. It stays in your blood instead. Your 

blood glucose level then gets too high, causing pre-diabetes 

or diabetes. 

*See pages 65 to 66 for tips on how to say the words in bold 

type. 

3 
 

 

What is pre-diabetes? 

Pre-diabetes is a condition in which blood glucose levels are 

higher than normal but not high enough for a diagnosis of 

diabetes. People with pre-diabetes are at increased risk for 

developing type 2 diabetes and for heart disease and stroke. 

The good news is, if you have pre-diabetes, you can reduce 

your risk of getting diabetes. With modest weight loss and 

moderate physical activity, you can delay or prevent type 2 

diabetes and even return to normal glucose levels. 

What are the signs of diabetes? 

The signs of diabetes are 

l being very thirsty 

l urinating often 

l feeling very hungry or tired 

l losing weight without trying 

l having sores that heal slowly 

l having dry, itchy skin 

l losing the feeling in your feet or having tingling in 

your feet 

l having blurry eyesight 

You may have had one or more of these signs before you 

found out you had diabetes. Or you may have had no signs at 

all. A blood test to check your glucose levels will show if you 

have pre-diabetes or diabetes. 

4 
 

What kind of diabetes do you have? 

People can get diabetes at any age. Type 1, type 2, and 

gestational diabetes are the three main kinds. Type 1 

diabetes, formerly called juvenile diabetes or insulindependent diabetes, is usually first diagnosed in children, 

teenagers, or young adults. With this form of diabetes, the 

beta cells of the pancreas no longer make insulin because 

the body’s immune system has attacked and destroyed 

them. Treatment for type 1 diabetes includes taking insulin 

and possibly another injectable medicine, making wise food 

choices, being physically active, taking aspirin daily—for 

some—and controlling blood pressure and cholesterol. 

Type 2 diabetes, formerly called adult-onset diabetes or 

noninsulin-dependent diabetes, is the most common form 

of diabetes. People can develop type 2 diabetes at any 

age—even during childhood. This form of diabetes usually 

begins with insulin resistance, a condition in which fat, 

muscle, and liver cells do not use insulin properly. At first, 

the pancreas keeps up with the added demand by producing 

more insulin. In time, however, it loses the ability to secrete 

enough insulin in response to meals. Being overweight and 

inactive increases the chances of developing type 2 diabetes. 

Treatment includes using diabetes medicines, making wise 

food choices, being physically active, taking aspirin daily— 

for some—and controlling blood pressure and cholesterol. 

5 
 

 

Some women develop gestational diabetes during the 

late stages of pregnancy. Although this form of diabetes 

usually goes away after the baby is born, a woman who has 

had it is more likely to develop type 2 diabetes later in life. 

Gestational diabetes is caused by the hormones of pregnancy 

or a shortage of insulin. 

The National Diabetes Information Clearinghouse 

offers a free booklet called What I need to know 

about Gestational Diabetes. Read it online at 

www.diabetes.niddk.nih.gov/dm/pubs/gestational or call 

1–800–860–8747 to request a printed copy. 

This booklet is for people who have either type 1 diabetes or 

type 2 diabetes. 

If you use insulin, look at the white 

boxes like this one for “Action Steps.” Action Steps 

If You Use Insulin 

Action Steps 

If You Don’t Use Insulin 

If you don’t use insulin, look at the 

blue boxes like this one for “Action 

Steps.” 

6 
 

Why do you need to take care of your diabetes? 

After many years, diabetes can lead to serious problems with 

your eyes, kidneys, nerves, and gums and teeth. But the most 

serious problem caused by diabetes is heart disease. When 

you have diabetes, you are more than twice as likely as people 

without diabetes to have heart disease or a stroke. 

If you have diabetes, your risk of a heart attack is the same as 

someone who has already had a heart attack. Both women 

and men with diabetes are at risk. You may not even have 

the typical signs of a heart attack. 

You can reduce your risk of developing heart disease by 

controlling your blood pressure and blood fat levels. If you 

smoke, talk with your doctor about quitting. Remember that 

every step toward your goals helps! 

See pages 32 to 48 to learn how you can try to prevent or 

delay long-term problems. The best way to take care of your 

health is to work with your health care team to keep your 

blood glucose, blood pressure, and cholesterol in your target 

range. 

7 
Blood Glucose Targets for 

Most People with Diabetes 

When Target Levels My Target Levels 

Before meals 70 to 130 __________ to __________ 

1 to 2 hours 

after the start 

of a meal below 180 below __________ 

 

 

What’s a desirable blood glucose level? 

Everyone’s blood has some glucose in it. In people who don’t 

have diabetes, the normal range is about 70 to 120. Blood 

glucose goes up after eating but 1 or 2 hours later returns to 

the normal range. 

Ask your health care team when you should check your blood 

glucose with a meter. Talk about whether the blood glucose 

targets listed below are best for you. Then write in your own 

targets. 

It may be hard to reach your target range all of the time. But 

the closer you get to your goal, the more you will reduce your 

risk of diabetes-related problems and the better you will feel. 

Every step helps. 

8 
 

Taking Care of Your Diabetes Every Day 

Do four things every day to take care of your diabetes: 

l Follow your meal plan. 

l Be physically active. 

l Take your diabetes medicines. 

l Check your blood glucose. 

Experts say most people with diabetes should try to keep 

their blood glucose level as close as possible to the level 

of someone who doesn’t have diabetes. The closer to 

normal your blood glucose is, the lower your chances are of 

developing serious health problems. 

Check with your doctor about the right range for you. The 

chart on page 8 shows target blood glucose ranges. 

Your health care team will help you learn how to reach your 

target blood glucose range. Your team may include a doctor, 

a nurse, a dietitian, and others. 

9 
 

 

When you see your health care provider, ask lots of questions. 


Before you leave, be sure you understand everything you need to 


know about taking care of your diabetes.
 

A diabetes educator is a health care worker who teaches 

people how to manage their diabetes. Your educator may 

also be a nurse, a dietitian, or other kind of health care 

worker. 

A dietitian is someone who’s specially trained to help people 

plan their meals. For more information about these health 

care providers, and for help in finding them, see pages 61 to 62. 

10 
 

Follow Your Meal Plan 

You should have your own meal plan. Ask your doctor to 

give you the name of a dietitian who can work with you to 

develop a meal plan. Your dietitian can help you plan meals 

that include foods that you and your family like to eat and 

that are good for you too. Ask your dietitian to include foods 

that are heart-healthy to reduce your risk of heart disease. 

Your diabetes meal plan will include breads, cereals, rice, 

and grains; fruits and vegetables; meat and meat substitutes; 

dairy products; and fats. People with diabetes don’t need to 

eat special foods. The foods on your meal plan are good for 

everyone in your family! Making wise food choices will help 

you 

l	 reach and stay at a weight that’s good for your body 

l	 keep your blood glucose, blood pressure, and cholesterol 

under control 

l	 prevent heart and blood vessel disease 

Action Steps 

If You Use Insulin 

•	 Follow your meal plan.

•	 Don’t skip meals, especially if you’ve already taken your insulin,

because your blood glucose may go too low. See page 28 for 

information about how to handle low blood glucose, also called 

hypoglycemia. 

11 
 

•	 Follow your meal plan.

•	 Don’t skip meals, especially if you take diabetes medicines,

because your blood glucose may go too low. Eat several small 

meals during the day instead of one or two big meals. 

Action Steps 

If You Don’t Use Insulin 

Be Physically Active 

Physical activity helps you stay healthy. Try walking, 

swimming, dancing, riding a bicycle, playing baseball, or 

bowling. You can even get exercise when you clean your 

house or work in your yard. Physical activity is especially 

good for people with diabetes because it 

l helps keep weight down 

l helps insulin work better to lower blood glucose 

l is good for your heart and lungs 

l gives you more energy 

12 
Before you begin exercising, talk with your doctor. Your 

doctor may check your heart and your feet to be sure you 

have no special problems. If you have high blood pressure 

or eye problems, some exercises like weightlifting may not be 

safe. Your health care team can help you find safe exercises. 

Being active helps you stay healthy. 

13 
 

Try to be active almost every day for a total of about 

30 minutes. If you haven’t been very active lately, begin 

slowly. Start with 5 to 10 minutes, and then add more time. 

Or exercise for 10 minutes, three times a day. 

If you use insulin or take diabetes pills that help your body 

make insulin, you may need to eat a snack before you 

exercise. Check your blood glucose before you exercise. If 

your blood glucose is below 100, have a snack before you 

exercise. 

Action Steps 

If You Use Insulin 

•	 See your doctor before starting a physical activity program.

•	 Check your blood glucose before, during, and after exercising.

Don’t exercise when your blood glucose is high and you have 

ketones in your blood or urine. See page 21 for information about 

ketones. 

•	 Don’t exercise right before you go to sleep because it could cause

low blood glucose during the night. 

•	 See your doctor before starting a physical activity program.

•	 Ask your doctor about whether you need to eat before you

exercise. 

Action Steps 

If You Don’t Use Insulin 

14 
 

 

When you exercise, carry glucose tablets or a carbohydrate 

snack with you in case you have low blood glucose. Wear or 

carry an identification tag or card that says you have diabetes. 

The groups listed on pages 63 and 64 have more information 

about diabetes and physical activity. 

Take Your Diabetes Medicines Every Day 

Three kinds of diabetes medicines can help you reach your blood 

glucose targets: pills, insulin, and other injectable medicines. 

Many people with type 2 diabetes take pills to help keep 

blood glucose in their target range. 

15 
 

 

 

 

If You Take Diabetes Pills 

If your body makes insulin but the insulin doesn’t lower your 

blood glucose enough, you may need diabetes pills. Some 

pills are taken once a day, and others are taken more often. 

Ask your health care team when you should take your pills. 

Be sure to tell your doctor if your pills make you feel sick or if 

you have any other problems. 

Sometimes, people who take diabetes pills may need insulin 

for a while. If you get sick or have surgery, the diabetes pills 

may no longer work to lower your blood glucose. 

You may be able to stop taking diabetes pills if you lose 

weight. Always check with your doctor before you stop 

taking your diabetes pills. Losing 10 or 15 pounds can help 

you reach your target blood glucose levels. 

If You Use Insulin 

You need insulin if your body has stopped making insulin 

or if it doesn’t make enough. Everyone with type 1 diabetes 

needs insulin, and many people with type 2 diabetes do too. 

Some women with gestational diabetes also need to take 

insulin. 

16 
You may need insulin to control your blood glucose. 

Your doctor can tell you which of these ways to take insulin is 

best for you. 

l	 Taking shots, also called injections. You’ll use a needle 

attached to a syringe—a hollow tube with a plunger— 

that you fill with a dose of insulin. Some people use 

an insulin pen, a pen-like device with a needle and a 

cartridge of insulin. 

17 
 

 

 

 

l	 Using an insulin pump. A pump is a small device, worn 

on a belt or in a pocket, that holds insulin. The pump 

connects to a small plastic tube and a very small needle. 

The needle is inserted under the skin and stays in for 

several days. 

l	 Using an insulin jet injector. This device sends a fine 

spray of insulin through the skin with high-pressure air 

instead of a needle. 

l	 Using an insulin infuser. A small tube is inserted just 

beneath the skin and remains in place for several days. 

Insulin is injected into the end of the tube instead of 

through the skin. 

If You Use Other Injectable Medicines 

Some people with diabetes use other injectable medicines to 

reach their blood glucose targets. These medicines are not 

substitutes for insulin. 

If You Don’t Use Pills, Insulin, or Other Injectable 

Medicines 

Many people with type 2 diabetes don’t need diabetes 

medicines. They can take care of their diabetes by using a 

meal plan and exercising regularly. 

18 
 

 

Check Your Blood Glucose as Recommended 

You’ll want to know how well you’re taking care of your 

diabetes. One way to find out is to check your blood to see 

how much glucose is in it. If your blood has too much or 

too little glucose, you may need a change in your meal plan, 

physical activity plan, or medicines. 

Checking your blood glucose will help you see if your diabetes 

treatment plan is working. 

19 
 

 

Ask your doctor how often you should check your blood 

glucose. Some people check their blood glucose once a 

day. Others do it three or four times a day. You may check 

before and after eating, before bed, and sometimes in the 

middle of the night. 

Your doctor or diabetes educator will show you how to 

check your blood using a blood glucose meter. Your 

health insurance or Medicare may pay for the supplies and 

equipment you need. 

Your health care team should also check your blood glucose 

levels with a lab test called the A1C test. See page 22 for 

more information about the A1C test. 

20 
 

 

Take Other Tests for Your Diabetes 

Tests for Ketones 

You may need to check your blood or urine for ketones 

if you’re sick or if your blood glucose is above 240. Your 

body makes ketones when you burn fat instead of glucose 

for energy. Ketones can make you very sick. If you have 

ketones, you are at risk for having a serious condition called 

ketoacidosis. If ketoacidosis isn’t treated, it can cause death. 

Signs of ketoacidosis are vomiting, weakness, fast breathing, 

and a sweet smell on the breath. Ketoacidosis is more likely 

to develop in people with type 1 diabetes. 

Your doctor or diabetes educator will show you how to test 

for ketones. 

21 
 

 

 

 

A1C Results 

Target for most people 


with diabetes below 7
 

Time to change my 


diabetes care plan 8 or above
 

My last result ___________ 

My target below ___________ 

The A1C Test 

Another test for blood glucose, the A1C, also called the 

hemoglobin A1C test, shows what your average blood 

glucose was for the past 2 to 3 months. The doctor does this 

test to see what your blood glucose is most of the time. Have 

this test done at least twice a year. 

Ask your doctor what your A1C test showed. A result 

of below 7 usually means that your diabetes treatment is 

working well and your blood glucose is under control. If your 

A1C is higher, your blood glucose may be too high. You’ll 

then have a greater risk of having diabetes problems, like 

kidney damage. You may need a change in your meal plan, 

physical activity plan, or diabetes medicines. 

Talk with your doctor about what your target should be. 

Your personal target may be lower or higher than the target 

shown below. Even if your A1C is higher than your target, 

remember that every step toward your goal helps reduce your 

risk of diabetes problems. 

22 
 

Keep Daily Records 

Make copies of the daily diabetes record on page 26. Then 

write down the results of your blood glucose checks every 

day. You may also want to write down what you ate, how you 

felt, and whether you exercised. 

By keeping daily records of your blood glucose checks, you 

can tell how well you’re taking care of your diabetes. Show 

your blood glucose records to your health care team. They 

can use your records to see whether you need changes in your 

diabetes medicines or your meal plan. If you don’t know 

what your results mean, ask your health care team. 

Action Steps 

If You Use Insulin 

Keep a daily record of 

•	 your blood glucose numbers

•	 the times of the day you took insulin

•	 the amount and type of insulin you took

•	 whether you had ketones in your blood or urine

23 
Things to write down every day in your record book are 

l results of your blood glucose checks 

l your diabetes medicines: times and amounts taken 

l if your blood glucose was very low—see page 28 

l if you ate more or less food than you usually do 

l if you were sick 

l if you found ketones in your blood or urine 

l what kind of physical activity you did and for how long 

Keep a daily record of 

•	 your blood glucose numbers

•	 the times of the day you took your diabetes medicines

• your physical activity

Action Steps 

If You Don’t Use Insulin 

24 
Daily Diabetes Record Page 

 

 

 

 

 

 

 

 

 

 

 

Week 

Starting 

July 18, 2011 

Other 

blood 

glucose 

Breakfast 

blood 

glucose Medicine 

Lunch 

blood 

glucose Medicine 

Dinner 

blood 

glucose Medicine 

Bedtime 

blood 

glucose Medicine 

Notes: 

(Special events, 

sick days, 

physical activity) 

Monday 109 122 115 

Tuesday 106 152* *Missed 

evening walk 

Wednesday 126SAMPLE 121 131 120 

Thursday 113 128 179 241* *Sick 

with flu 

Friday 159 147 162 150 

Saturday 127 152* 

*Had extrabig snack in 

afternoon 

Sunday 119 121 140 

Sample of a record page for a person who doesn’t use diabetes medicines. 

25
 
Daily Diabetes Record Page 

Week 

Starting 

__________ 

Other 

blood 

glucose 

Breakfast 

blood 

glucose Medicine 

Lunch 

blood 

glucose Medicine 

Dinner 

blood 

glucose Medicine 

Bedtime 

blood 

glucose Medicine 

Notes: 

(Special events, 

sick days, 

physical activity) 

Monday 

Tuesday 

Wednesday 

Thursday 

Friday 

Saturday 

Sunday 

26
 
 

 

 

 

 

When Your Blood Glucose Is Too High or 


Too Low
 

Sometimes, no matter how hard you try to keep your blood 

glucose in your target range, it will be too high or too low. 

Blood glucose that’s too high or too low can make you feel 

sick. Learn how to handle these emergencies. 

What You Need to Know about High Blood Glucose 

If your blood glucose stays above 180, it may be too high. 

See the chart on page 8. High blood glucose means you 

don’t have enough insulin in your body. High blood glucose, 

also called hyperglycemia, can happen if you miss taking 

your diabetes medicines, eat too much, or don’t get enough 

exercise. Sometimes, the medicines you take for other 

problems cause high blood glucose. Be sure to tell your 

doctor about other medicines you take. 

Having an infection, being sick, or being under stress can also 

make your blood glucose too high. When you’re sick, be sure 

to check your blood glucose and keep taking your diabetes 

medicines. For more about how to take care of yourself 

when you’re sick, see page 50. 

If you’re very thirsty and tired, have blurry vision, and have 

to go to the bathroom often, your blood glucose may be too 

high. Very high blood glucose may also make you feel sick to 

your stomach. 

If your blood glucose is high much of the time, or if you have 

symptoms of high blood glucose, call your doctor. You may 

need a change in your diabetes medicines or your meal plan. 

27 
 

 

 

What You Need to Know about Low Blood Glucose 

Low blood glucose, also called hypoglycemia, happens if 

your blood glucose drops too low. It can come on fast. Low 

blood glucose can be caused by taking too much diabetes 

medicine, missing a meal, delaying a meal, exercising more 

than usual, or drinking alcoholic beverages. Sometimes, 

medicines you take for other health problems can cause blood 

glucose to drop. 

Low blood glucose can make you feel weak, confused, irritable, 

hungry, or tired. You may sweat a lot or get a headache. You 

may feel shaky. If your blood glucose drops lower, you could 

pass out or have a seizure. 

If you have any of these symptoms, check your blood glucose. 

If the level is below 70, have one of the following right away: 

l	 3 or 4 glucose tablets 

l	 1 serving of glucose gel—the amount equal to 15 grams 

of carbohydrate 

l	 1/2 cup, or 4 ounces, of any fruit juice 

l	 1/2 cup, or 4 ounces, of a regular—not diet—soft drink 

l	 1 cup, or 8 ounces, of milk 

l	 5 or 6 pieces of hard candy 

l	 1 tablespoon of sugar or honey 

28 
 

After 15 minutes, check your blood glucose again to make 

sure your level is 70 or above. Repeat these steps until your 

blood glucose level is 70 or above. Once your blood glucose 

is stable, if it will be at least an hour before your next meal, 

have a snack. 

Have one of these “quick fix” foods when your 

blood glucose is low. 

29 
 

 

If you take diabetes medicines that can cause low blood 

glucose, always carry food for emergencies. You should also 

wear a medical identification bracelet or necklace. 

If you take insulin, keep a glucagon kit at home and at other 

places where you often go. Glucagon is given as an injection 

with a syringe and quickly raises blood glucose. Show your 

family, friends, and co-workers how to give you a glucagon 

injection if you pass out because of low blood glucose. 

Action Steps 

If You Use Insulin 

Tell your doctor if you have low blood glucose often, especially at

the same time of the day or night several times in a row. 

•	

•	 Tell your doctor if you’ve passed out from low blood glucose.

Ask your doctor about glucagon. Glucagon is a medicine that

raises blood glucose. If you pass out from low blood glucose, 

someone should call 911 and give you a glucagon shot. 

•	

30 
When you have low blood glucose, have a snack 

to bring your blood glucose back to normal. 

You can prevent low blood glucose by eating regular meals, 

taking your diabetes medicines, and checking your blood 

glucose often. Checking will tell you whether your glucose 

level is going down. You can then take steps, like drinking 

fruit juice, to raise your blood glucose. 

•	 Tell your doctor if you have low blood glucose often, especially at

the same time of the day or night several times in a row. 

•	 Be sure to tell your doctor about other medicines you are taking.

•	 Some diabetes pills can cause low blood glucose. Ask your doctor

whether your pills can cause low blood glucose. 

Action Steps 

If You Don’t Use Insulin 

31 
Why Taking Care of Your Diabetes Is 

Important 

Taking care of your diabetes every day will help keep your 

blood glucose, blood pressure, and cholesterol in your target 

range and help prevent other health problems that diabetes 

can cause over the years. You can do a lot to prevent 

diabetes problems. 

l Follow your meal plan every day. 

l Take your diabetes medicines every day. 

32
 
 

 

 

l Be physically active every day. 

l Check your blood glucose as recommended. 

Diabetes and Your Heart and Blood Vessels 

The biggest problem for people with diabetes is heart and 

blood vessel disease. Heart and blood vessel disease can lead 

to heart attacks and strokes. It also causes poor blood flow, 

also called circulation, in the legs and feet. 

To check for heart and blood vessel disease, your health care 

team will do some tests. At least once a year, have a blood 

test to see how much cholesterol is in your blood. Your health 

care provider should take your blood pressure at every visit. 

Your provider may also check the circulation in your legs, 

feet, and neck. 

33 
 

 

The best way to prevent heart and blood vessel disease is to 

take good care of yourself and your diabetes. 

l	 Eat foods that are low in sodium. Check the amount 

of sodium by looking at the Nutrition Facts on food 

packages. Limit the amount of salt you use when you 

cook and at the table. Choose foods naturally low in 

sodium, such as vegetables, fruits, dry beans and peas, 

and unprocessed meats, poultry, and fish. 

l	 Limit how much you have of these kinds of fat: 

•	 saturated	fat,	such	as	bacon,	butter,	cream,	lard,	and

high-fat dairy products such as whole milk 

•	 trans	fat,	found	in	processed	foods	with	partially

hydrogenated or hydrogenated oil 

•	 cholesterol,	found	in	high-fat	dairy	products,	high-fat

meats and poultry, egg yolks, and liver 

l	 Keep your blood glucose on track. Know your A1C. The 

target for most people is below 7. 

l	 Keep your blood pressure on track. The target for most 

people is below 130/80. If needed, take medicine to 

control your blood pressure. 

l	 Keep your cholesterol level on track. The target for LDL 

cholesterol for most people is below 100. If needed, take 

medicine to control your blood fat levels. 

34 
Blood Pressure Results 

Target for most people 

with diabetes below 130/80 

My last result ___________ 

My target below ___________ 

l If you smoke, quit.
 

l Be physically active.
 

l Lose weight if you need to.
 

l Ask your health care team whether you should take an
 

aspirin every day. 

What’s a desirable blood pressure level? 

Blood pressure levels tell how hard your blood is pushing 

against the walls of your blood vessels. Your pressure is 

given as two numbers: The first is the pressure as your 

heart pushes blood out into your blood vessels and the 

second is the pressure as your heart rests. If your blood 

pressure is higher than your target, talk with your health care 

team about changing your meal plan, exercising, or taking 

medicine. 

35 
 

 

 

Target Blood Fat Levels for People with Diabetes 

My Last Result My Target 

Total cholesterol 

below 200 ___________ below ___________ 

LDL cholesterol 

below 100 ___________ below ___________ 

HDL cholesterol 

above 40 (men) ___________ above ___________ 

above 50 (women) ___________ above ___________ 

Triglycerides 

below 150 ___________ below ___________ 

What are desirable blood fat levels? 

Cholesterol, a fat found in the body, appears in several forms. 

If your LDL cholesterol, also called “bad” cholesterol, is 100 

or above, you are at increased risk of heart disease and may 

need treatment. A high level of total cholesterol also means a 

greater risk of heart disease. But HDL cholesterol, also called 

“good” cholesterol, protects you from heart disease, so the 

higher it is, the better. You should keep your triglyceride— 

another type of fat—levels below 150. All of these target 

numbers are important for preventing heart disease. But 

the most important target to reach first is for your LDL 

cholesterol. 

36 
 

 

 

 

 

Rose is 55 years old and teaches at a high school on an American 

Indian reservation in New Mexico. Rose has had type 2 diabetes 

for almost 10 years. When she first found out she had diabetes, she 

weighed too much and didn’t get much exercise. After talking it over 

with her doctor, Rose began an exercise program. She lost weight, 

and her blood glucose began to come down. She felt better too. 

Now Rose teaches an exercise class in her spare time. 

37 
 

 

Diabetes and Your Eyes 

Have your eyes checked once a year. You could have 

eye problems that you haven’t noticed yet. Yearly exams 

may catch eye problems early so problems can be treated. 

Treating eye problems early can help prevent blindness. 

High blood glucose can make the blood vessels in the eyes 

bleed. This bleeding can lead to blindness. You can help 

prevent eye damage by keeping your blood glucose and 

blood pressure as close to normal as possible. If you already 

have eye problems, your eye doctor may be able to suggest 

treatments that can help. 

The best way to prevent eye disease is to have a yearly eye 

exam. In this exam, the eye doctor puts drops in your eyes to 

dilate your pupils. When the pupils are dilated, or big, the 

doctor can see into the back of the eye. This type of exam is 

called a dilated eye exam and it doesn’t hurt. If you’ve never 

had this kind of eye exam before, you should have one now, 

even if you haven’t had any trouble with your eyes. Be sure 

to tell your eye doctor that you have diabetes. 

Follow these tips to take care of your eyes: 

l	 For adults and adolescents—10 years old and older— 

with type 1 diabetes: Have your eyes examined within 

5 years of being diagnosed with diabetes. Then have an 

exam every year. 

l	 For people with type 2 diabetes: Have an eye exam every 

year. 

38 
See your eye doctor for a dilated eye exam every year. Early 

treatment of eye problems can help save your sight. 

l	 Have an eye exam before becoming pregnant or as soon 

as possible after becoming pregnant. 

l	 If you smoke, quit. 

l	 Keep your blood glucose and blood pressure as close to 

normal as possible. 

Tell your eye doctor right away if you have any problems 

like blurry vision or seeing dark spots, flashing lights, or rings 

around lights. 

39 
 

 

 

 

Diabetes and Your Kidneys 

Your kidneys help clean waste products from your blood. 

They also work to keep the right balance of sodium and fluid 

in your body. 

Too much glucose in your blood is hard on your kidneys. 

After a number of years, high blood glucose can cause the 

kidneys to stop working, a condition called kidney failure. If 

your kidneys stop working, you’ll need dialysis—a treatment 

that does some of the work your kidneys used to do—or a 

kidney transplant. 

Make sure you have the following tests at least once a year to 

make sure your kidneys are working well: 

l	 a urine test for protein, called the microalbumin test 

l	 a blood test for creatinine, a waste product made by your 

body 

Some types of blood pressure medicines can help prevent 

kidney damage. Ask your doctor whether these medicines 

could help you. You can also help prevent kidney problems by 

l	 taking your medicine if you have high blood pressure 

l	 asking your doctor or your dietitian whether you should 

eat less high-protein foods, such as meat, poultry, cheese, 

milk, fish, and eggs 

40 
 

l	 keeping your blood glucose and blood pressure as close 

to normal as possible 

l	 quitting smoking 

You should see your doctor right away if you get a bladder 

or kidney infection. Signs of bladder or kidney infections are 

cloudy or bloody urine, pain or burning when you urinate, 

and having to urinate often or in a hurry. Back pain, chills, 

and fever are also signs of kidney infection. 

41 
 

 

 

 

 

 

Mike is a migrant farm worker with type 2 diabetes 

and high blood pressure. Mike, 47, is married, and he 

and his wife have three children. The family is often 

on the move, depending on where the work is. Mike 

has his blood pressure and kidneys checked at clinics 

in migrant worker camps. Some of the clinics also 

offer diabetes classes. Whenever they can, Mike and 

his wife attend these classes. They especially like the 

cooking classes because they learn how to prepare lowcost, healthy meals for the whole family. 

42 
 

 

 

 

 

 

Diabetes and Your Nerves 

Over time, high blood glucose can harm the nerves in your 

body. Nerve damage can cause you to lose the feeling in 

your feet or to have painful, burning feet. You may not feel 

pain from injuries or sore spots on your feet. If you have 

poor circulation because of blood vessel problems in your 

legs, the sores on your feet can’t heal and might become 

infected. If the infection isn’t treated, it could lead to 

amputation. 

Nerve damage can also cause pain in your legs, arms, or 

hands or cause problems with digesting food, going to the 

bathroom, or having sex. 

Nerve damage can happen slowly. You may not even 

realize you have nerve problems. Your doctor should 

check the nerves in your feet at least once a year. Your 

doctor should check your sense of feeling and the pulses 

in your feet. 

Tell the doctor about any problems with your feet, legs, 

hands, or arms. Also, tell the doctor if you have trouble 

digesting food, going to the bathroom, or having sex, or if 

you sometimes feel dizzy. 

43 
 

Ask your doctor whether you already have nerve damage 

in your feet. If you do, you should take good care of your 

feet. To help prevent complications from nerve damage, 

check your feet every day. See Foot Care Tips on 

pages 46 to 47. 

You can prevent nerve problems by 

l keeping your blood glucose and blood pressure as 

close to normal as possible 

l limiting the amount of alcohol you drink 

l checking your feet every day 

l quitting smoking 

44 
Joe is a 65-year-old retired letter carrier with type 2 

diabetes. Every time he visits his doctor, he takes his 

shoes and socks off so the doctor can check his feet for 

sores, ulcers, and wounds. The doctor also checks the 

sense of feeling in Joe’s feet. Joe and his doctor talk 

about ways to prevent foot and nerve problems. Since 

Joe has lost some feeling in his toes, the doctor also talks 

with him about the importance of good foot care and 

keeping his blood glucose in a good range. 

45 
 

 

 

 

 

Foot Care Tips 

You can do a lot to prevent problems with your feet. 

Keep your blood glucose in your target range and follow 

these tips to take care of your feet and help protect them. 

l	 Check your bare feet every day. Look for cuts, 

sores, bumps, or red spots. Use a mirror or ask a 

family member for help if you have trouble seeing 

the bottoms of your feet. 

l	 Wash your feet in warm—not hot—water every 

day, but don’t soak them. Use mild soap. Dry your 

feet with a soft towel, and dry carefully between 

your toes. 

l	 After washing your feet, cover them with lotion 

before putting your shoes and socks on. Don’t put 

lotion or cream between your toes. 

l	 File your toenails straight across with an emery 

board. Don’t leave sharp edges that could cut into 

your toe. 

l	 Don’t try to cut calluses or corns off with a razor 

blade or knife, and don’t use wart removers on your 

feet. If you have warts or painful corns or calluses, 

see a podiatrist, a doctor who treats foot problems. 

46 
 

 

 

l	 Wear thick, soft socks. Don’t wear mended socks 

or socks with holes or seams that might rub against 

your feet. 

l	 Check your shoes before you put them on to be 

sure they have no sharp edges or objects in them. 

l	 Wear shoes that fit well and let your toes move. 

Break new shoes in slowly. Don’t wear flip-flops, 

shoes with pointed toes, or plastic shoes. Never go 

barefoot. 

l	 Wear socks if your feet get cold at night. Don’t use 

heating pads or hot water bottles on your feet. 

l	 Have your doctor check your feet at every visit. 

Take your shoes and socks off when you go into the 

examining room to remind the doctor to check your 

feet. 

l	 See a podiatrist for help if you can’t take care of 

your feet yourself. 

47 
Diabetes and Your Gums and Teeth 

Diabetes can lead to infections in your gums and the 

bones that hold your teeth in place. Like all infections, 

gum infections can cause blood glucose to rise. Without 

treatment, teeth may become loose and fall out. 

Help prevent damage to your gums and teeth by 

l seeing your dentist twice a year 

l brushing and flossing your teeth at least twice a day 

l quitting smoking 

l keeping your blood glucose as close to normal as possible 

l having regular checkups with your dentist 

Be sure to tell your dentist that you have diabetes. 

48 
 

 

 

 

 

James runs a bookstore in California. He’s 35 years old 

and has had type 1 diabetes for 15 years. James takes 

good care of his teeth and sees his dentist twice a year. He 

makes his appointments in the morning, after breakfast, 

so he won’t get low blood glucose while at the dentist. He 

always carries glucose tablets for treatment of low blood 

glucose and wears a medical identification bracelet. 

49 
 

 

 

Taking Care of Your Diabetes at 


Special Times
 

Diabetes is part of your life. You can learn how to take care 

of yourself and your diabetes when you’re sick, when you’re 

at work or school, when you travel, when you’re thinking 

about having a baby or are pregnant, or when there’s an 

emergency or natural disaster. 

When You’re Sick 

Having a cold, the flu, or an infection can raise your blood 

glucose levels. You can have serious health problems leading 

to a coma if your blood glucose levels are very high. 

Be prepared for illness. Make a plan ahead of time for sick 

days. Ask your health care team 

l how often to check your blood glucose levels 

l whether you should check for ketones in your blood or 

urine 

l whether you should change your usual dose of your 

diabetes medicines 

l what to eat and drink 

l when to call your health care provider 

Action Steps 

If You Use Insulin 

•	 Take your insulin, even if you are sick and have been throwing up.

Ask your doctor about how to adjust your insulin dose based on 

your blood glucose test results. 

50
 
 

 

 

 

Your health care team may recommend the following: 

l	 Check your blood glucose level at least four times a day 

and write down the results in your record book. Keep 

your results handy so you can report results to your 

health care team. 

l	 Keep taking your diabetes medicines, even if you’re not 

able to eat. 

l	 Drink at least 1 cup, or 8 ounces, of water or other 

calorie-free, caffeine-free liquid every hour while you’re 

awake. 

l	 If you can’t eat your usual food, try eating or drinking 

any of the following: 

•	 juice

•	 saltine	crackers

•	 dry	toast

•	 soup

•	 broth	or	bouillon

•	 popsicles	or	sherbet

•	 regular—not	sugar-free—gelatin

•	 milk

•	 yogurt

•	 regular—not	sugar-free—soda	

•	 Take your diabetes medicines, even if you are sick and have been

throwing up. 

Action Steps 

If You Don’t Use Insulin 

51 
 

Your health care provider may say you should call right 

away if 

l your blood glucose levels are above 240 even though 

you’ve taken your diabetes medicines 

l your urine or blood ketone levels are above normal 

l you vomit more than once 

l you have diarrhea for more than 6 hours 

l you have trouble breathing 

l you have a high fever 

l you can’t think clearly or you feel sleepier than usual 

You should call your health care provider if you have 

questions about taking care of yourself. 

52 
When You’re at School or Work 

Take care of your diabetes when you’re at school or at work: 

l	 Follow your meal plan. 

l	 Take your medicines and check your blood glucose
 

as usual.
 

l	 Tell your teachers, friends, or close co-workers about the 

signs of low blood glucose. You may need their help if 

your blood glucose drops too low. 

l	 Keep snacks nearby and carry some with you at all times 

to treat low blood glucose. 

l	 Tell your company nurse or school nurse that you have 

diabetes. 

53 
 

 

 

 

 

Sally, a 12-year-old girl with type 1 diabetes, loves her 

gymnastics class. She practices every day for an hour. 

Before Sally exercises, she checks her blood glucose to make 

sure it’s okay to start her workout. If her blood glucose 

is too low, she eats a snack before beginning to practice. 

Sally has told her coach that she has diabetes. Sally’s coach 

knows that if Sally has a problem with low blood glucose, 

Sally is prepared to take care of it. 

54 
When You’re Away from Home 

These tips can help you take care of yourself when you’re 

away from home: 

l	 Follow your meal plan as much as possible when you eat 

out. Always carry a snack with you in case you have to 

wait to be served. 

l	 Limit your drinking of beer, wine, or other alcoholic 

beverages. Ask your diabetes educator how much 

alcohol you can safely drink. Eat something when you 

drink to prevent low blood glucose. 

l	 If you’re taking a long trip by car, check your blood 

glucose before driving. Stop and check your blood glucose 

every 2 hours. Always carry snacks like fruit, crackers, 

juice, or soft drinks in the car in case your blood glucose 

drops too low. 

l	 Bring food for meals and snacks with you if you’re
 

traveling by plane.
 

l	 Carry your diabetes medicines and your blood testing
 

supplies with you. Never put them in your checked
 

baggage.
 

l	 Ask your health care team how to adjust your medicines, 

especially your insulin, if you’re traveling across time 

zones. 

l	 Take comfortable, well-fitting shoes on vacation. You’ll 

probably be walking more than usual, so you should take 

good care of your feet. 

55 
 

 

When traveling by plane, bring food for meals and snacks. 

l	 If you’re going to be away for a long time, ask your 

doctor for a written prescription for your diabetes 

medicines and the name of a doctor in the place you’re 

going to visit. 

l	 Don’t count on buying extra supplies when you’re 

traveling, especially if you’re going to another country. 

Different countries use different kinds of diabetes 

medicines. 

Action Steps 

If You Use Insulin 

When you travel, 

•	 take a special insulated bag to carry your insulin to keep it from

freezing or getting too hot 

• bring extra supplies for taking insulin and testing your blood

glucose in case of loss or breakage 

• ask your doctor for a letter saying that you have diabetes and need

to carry supplies for taking insulin and testing blood glucose 

56 
 

 

 

When There’s an Emergency or Natural Disaster 

Everyone with diabetes should be prepared for emergencies 

and natural disasters, such as power outages or hurricanes. 

Always have your disaster kit ready. Include everything you 

need to take care of your diabetes, such as 

l a blood glucose meter, lancets, and testing strips
 

l your diabetes medicines
 

l a list of your prescription numbers
 

l if you take insulin—some insulin, syringes, and an
 

insulated bag to keep insulin cool 

l if you take insulin or if recommended by your doctor— 

a glucagon kit 

l glucose tablets and other foods or drinks to treat low 

blood glucose 

l antibiotic cream or ointment 

l a copy of your medical information, including a list of 

your conditions, medicines, and recent lab test results 

l phone numbers for the American Red Cross and other 

disaster relief organizations 

You also might want to include some nonperishable food, 

such as canned or dried food, along with bottled water. 

Check and update your kit at least twice a year. 

57 
 

 

 

When You’re Planning a Pregnancy 

Keeping your blood glucose near normal before and during 

pregnancy helps protect both you and your baby. Even before 

you become pregnant, your blood glucose should be close to 

the normal range. 

Your health care team can work with you to get your blood 

glucose under control before you try to get pregnant. If you’re 

already pregnant, see your doctor right away. It’s not too late 

to bring your blood glucose close to normal so that you’ll stay 

healthy during the rest of your pregnancy. 

Your insulin needs may change when you’re pregnant. Your 

doctor may want you to take more insulin and check your 

blood glucose more often. If you take diabetes pills, you’ll take 

insulin instead when you’re pregnant. 

The National Diabetes Information Clearinghouse 

offers a free booklet called For Women with Diabetes: 

Your Guide to Pregnancy. Read it online at 

www.diabetes.niddk.nih.gov/dm/pubs/pregnancy or call 

1–800–860–8747 to request a printed copy. 

58 
 

If you plan to have a baby, 

l	 work with your health care team to get your blood 

glucose as close to the normal range as possible before 

you get pregnant 

l	 see a doctor who has experience in taking care of
 

pregnant women with diabetes
 

l	 don’t smoke, drink alcohol, or use harmful drugs 

l	 follow the meal plan you get from your dietitian or 

diabetes educator to make sure you and your unborn 

baby have a healthy diet 

Be sure to have your eyes, heart and blood vessels, blood 

pressure, and kidneys checked. Your doctor should also 

check for nerve damage. Pregnancy can make some health 

problems worse. 

59 
 

 

 

 

 

Maria, a 25-year-old woman with type 1 diabetes, wanted children. 

Her doctor told Maria and her husband that before she got pregnant, 

her blood glucose should be close to normal. Her doctor also 

recommended a checkup. Maria began to watch her diabetes very 

carefully. She checked her blood glucose level often, ate healthy 

meals, and began to walk a lot. 

Once Maria became pregnant, she spent a lot of time taking care of 

her diabetes. Her hard work paid off. She gave birth to a healthy 

baby boy. 

60 
 

 

 

 

 

 

 

Where to Get More Help with Your Diabetes 

People Who Can Help You 

l	 Your doctor. You may see your regular doctor for 

diabetes care or someone who has special training in 

caring for people with diabetes. A doctor with special 

training in diabetes is called an endocrinologist or 

diabetologist. 

You’ll talk with your doctor about what kind of 

medicines you need and how much you should take. 

You’ll also agree on a target blood glucose range and 

blood pressure and cholesterol targets. Your doctor will 

do tests to be sure your blood glucose, blood pressure, 

and cholesterol are staying on track and you’re staying 

healthy. Ask your doctor if you should take aspirin every 

day to help prevent heart disease. 

l	 Your diabetes educator. A diabetes educator may be a 

nurse, a dietitian, or another kind of health care worker. 

Diabetes educators teach you about meal planning, 

diabetes medicines, physical activity, how to check your 

blood glucose, and how to fit diabetes care into your 

everyday life. Be sure to ask questions if you don’t 

understand something. 

l	 Your family and friends. Taking care of your diabetes 

is a daily job. You may need help or support from 

your family or friends. You may want to bring a family 

member or close friend with you when you visit your 

doctor or diabetes educator. Taking good care of your 

diabetes can be a family affair! 

61 
 

l	 A counselor or mental health worker. You might feel 

sad about having diabetes or get tired of taking care of 

yourself. Or you might be having problems because of 

work, school, or family. If diabetes makes you feel sad 

or angry, or if you have other problems that worry you, 

you can talk with a counselor or mental health worker. 

Your doctor or diabetes educator can help you find a 

counselor. 

Organizations That Can Help You 

How to Find a Diabetes Educator 

To find a diabetes educator near you, call the 

American Association of Diabetes Educators toll-free at 

1–800–832–6874, or go to www.diabeteseducator.org and see 

the “Find a Diabetes Educator” section. 

How to Find a Dietitian 

To find a dietitian near you, call the American
 

Dietetic Association toll-free at 1–800–877–1600, or go to
 

www.eatright.org and see the “Find a Nutrition Professional”
 

section.
 

62 
 

How to Find Programs about Diabetes 

To find programs about diabetes or for additional 

information, contact 

American Diabetes Association 

1701 North Beauregard Street
 

Alexandria, VA 22311
 

Phone: 1–800–DIABETES (342–2383)
 

Email: AskADA@diabetes.org
 

Internet: www.diabetes.org
 

Juvenile Diabetes Research Foundation International 

120 Wall Street
 

New York, NY 10005
 

Phone: 1–800–533–CURE (2873)
 

Email: info@jdrf.org
 

Internet: www.jdrf.org
 

Both of these organizations have magazines and other 

information for people with diabetes. They also have local 

groups in many places where you can meet other people who 

have diabetes. 

63 
How to Get More Information about Diabetes 

To get more information about taking care of diabetes, 

contact 

National Diabetes Information Clearinghouse 

1 Information Way
 

Bethesda, MD 20892–3560
 

Phone: 1–800–860–8747
 

TTY: 1–866–569–1162
 

Fax: 703–738–4929
 

Email: ndic@info.niddk.nih.gov
 

Internet: www.diabetes.niddk.nih.gov
 

National Diabetes Education Program 

1 Diabetes Way
 

Bethesda, MD 20814–9692
 

Phone: 1–888–693–NDEP (6337)
 

TTY: 1–866–569–1162
 

Fax: 703–738–4929
 

Email: ndep@mail.nih.gov
 

Internet: www.ndep.nih.gov
 

64 
Pronunciation Guide 

A1C (AY-WUHN-SEE) 

beta cells (BAY-tuh) (selz) 

carbohydrate (KAR-boh-HY-drayt) 

cholesterol (koh-LESS-tur-ol) 

circulation (SUR-kyoo-LAY-shuhn) 

creatinine (kree-AT-ih-neen) 

diabetologist (DY-uh-beh-TOL-uh-jist) 

dialysis (dy-AL-ih-siss) 

endocrinologist (EN-doh-krih-NOL-uh-jist) 

gestational (jess-TAY-shuhn-uhl) 

glucagon (GLOO-kuh-gon) 

glucose (GLOO-kohss) 

hemoglobin (HEE-moh-GLOH-bin) 

hyperglycemia (HY-pur-gly-SEE-mee-uh) 

hypoglycemia (HY-poh-gly-SEE-mee-uh) 

immune (ih-MYOON) 

injectable (in-JEKT-uh-buhl) 

injection (in-JEK-shuhn) 

insulin (IN-suh-lin) 

65 
ketoacidosis (KEE-toh-ASS-ih-DOH-siss) 

ketones (KEE-tohnz) 

microalbumin (MY-kroh-al-BYOO-min) 

pancreas (PAN-kree-uhss) 

podiatrist (poh-DY-uh-trist) 

syringe (suh-RINJ) 

triglyceride (try-GLISS-ur-eyed) 

66 
 

 

 

 

 

National Diabetes 

Information Clearinghouse 

1 Information Way 

Bethesda, MD 20892–3560 

Phone: 1–800–860–8747 

TTY: 1–866–569–1162
 

Fax: 703–738–4929
 

Email: ndic@info.niddk.nih.gov
 

Internet: www.diabetes.niddk.nih.gov
 

The National Diabetes Information Clearinghouse (NDIC) is a service 

of the National Institute of Diabetes and Digestive and Kidney Diseases 

(NIDDK). The NIDDK is part of the National Institutes of Health under 

the U.S. Department of Health and Human Services. Established in 1978, 

the Clearinghouse provides information about diabetes to people with 

diabetes and to their families, health care professionals, and the public. 

The NDIC answers inquiries, develops and distributes publications, and 

works closely with professional and patient organizations and Government 

agencies to coordinate resources about diabetes. 

Publications produced by the Clearinghouse are carefully reviewed by both 

NIDDK scientists and outside experts. 

This publication is not copyrighted. The Clearinghouse encourages users of this 


booklet to duplicate and distribute as many copies as desired.
 

This booklet is also available at www.diabetes.niddk.nih.gov. 

This publication may contain information about medications. When prepared, this 

publication included the most current information available. For updates or for 

questions about any medications, contact the U.S. Food and Drug Administration toll-free 

at 1–888–INFO–FDA (463–6332) or visit www.fda.gov. Consult your doctor for more 

information. 


–

U.S. DEpArTmENT OF HEALTH 

AND HUmAN SErvICES 

National Institutes of Health 

NIH Publication No. 09 4016 

October 2008