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Changing Diabetes in Children - diagnosis, treatment and organizing of diabetes care for children PowerPoint Presentation

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Description : In collaboration with ISPAD, Novo Nordisk developed Changing Diabetes in Children (a training manual) especially for the diagnosis, treatment and organizing of diabetes care for children in developing countries. Download educational material for patients and Healthcare Professionals. It talks about Injecting human insulin, why need insulin, how much insulin should be taken, Low blood sugar (hypoglycaemia) and how to recognizes it, etc.

Tags : Pediatric Populations, pediatrician, physician, healthcare, Low blood sugar, hypoglycaemia, insulin

Published on : Jul 03, 2020 | Views : 1986 | Downloads : 20

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Slide 1-

PATIENT EDUCATION MATERIALS DEVELOPED FOR USE IN THE CHANGING DIABETES ® IN CHILDREN PROGRAMME The information provided is not a substitute for the advice of a healthcare professional. Consult your doctor or nurse for advice on your treatment. Name: Surname: Clinic: These materials have been developed specifically for the Changing Diabetes® in Children (CDiC) programme. They are offered “as is” and Novo Nordisk A/S and Roche Diagnostics Deutschland GmbH make no representations or warranties, expressed or implied, including but not limited to the implied warranties of merchantability, fitness for a particular purpose or non-infringement as to the completeness, accuracy, timeliness, availability, functionality and compliance with applicable laws. By using these materials you accept the risk that the information may be incomplete or inaccurate or may not meet your needs or requirements. Novo Nordisk A/S and Roche Diagnostics Deutschland GmbH disclaim any and all liability for direct, indirect, incidental, consequential, punitive and special or other damages, lost opportunities, lost profit or any other losses or damages of any kind. Copyright © Novo Nordisk A/S 2012. All Rights Reserved. No part of this document may be reproduced without written consent from Novo Nordisk A/S. The Apis bull logo and Changing Diabetes® are registered trademarks of Novo Nordisk A/S. 2015 © Novo Nordisk A/S, Novo Allé, DK-2880, Bagsværd, Denmark. ZINC# HQMMA/CD/0815/0370c. Approval date: August 2015.
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The information provided is not a substitute for the advice of a healthcare professional - consult your doctor or nurse for advice on your treatment. 6 1 11 9 10 2 Hasdicuntconsequunturet.Meaid laboredeseruisse,vidererfastidiiexvix.Estmodoaccumsanad,eum at vocentnusquamintellegebat.Laboresnoluissehisno,quoadaccusamfacilisisdisputationi. Injecting human insulin Date completed: Loremipsumdolorsitamet, veniamvidererinqui,proadsaleaccusam.Cuduosaleancillae.Idquedicantnamei,tollitutinamsoleatusuei.Nam nolaborefacetetorquatos,ataliquidhonestatispro. Injecting insulin is something you need to practice, but you will soon become good at it Here are the steps involved: 1. Wash your hands place 2. Have a syringe, cotton wool, alcohol or other disinfectant ready 3. Roll the insulin between your hands 4. Clean the vial with alcohol 5. Clean the injection site with alcohol 6. Draw air into the syringe 7. Draw insulin into the syringe 8. Make sure there is no air in the syringe 9. Inject insulin in the appropriate 10. Throw away the syringe 11. Put insulin back in a cool place 12. Remember to eat 30 minutes after an injection zzz Find your way out by going through the insulin injection steps in the right order Well done! 3 12 My body does not make insulin, so I need to inject it. First I wash my hands. Have insulin, syringe, cotton wool and alcohol ready. I pinch my skin and inject the insulin. I don’t use the syringe again. I place it in a glass jar and return the full jar to the clinic. Roll the vial of insulin 15-20 times between your hands 4 Clean the top of the vial with alcohol 5 Clean the injection site with alcohol Draw air into the syringe 7 Push air into the vial and then draw insulin into the syringe 8 Make sure there is no air in the syringe Put the vial of insulin back into the refrigerator or other cold place Eat 30 minutes after injecting your insulin Injecting human insulin 1
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These materials have been developed specifically for the Changing Diabetes® in Children (CDiC) programme. They are offered “as is” and Novo Nordisk A/S and Roche Diagnostics Deutschland GmbH make no representations or warranties, expressed or implied, including but not limited to the implied warranties of merchantability, fitness for a particular purpose or non-infringement as to the completeness, accuracy, timeliness, availability, functionality and compliance with applicable laws. By using these materials you accept the risk that the information may be incomplete or inaccurate or may not meet your needs or requirements. Novo Nordisk A/S and Roche Diagnostics Deutschland GmbH disclaim any and all liability for direct, indirect, incidental, consequential, punitive and special or other damages, lost opportunities, lost profit or any other losses or damages of any kind. Copyright © Novo Nordisk A/S 2012. All Rights Reserved. No part of this document may be reproduced without written consent from Novo Nordisk A/S. z z z Well done! The Apis bull logo and Changing Diabetes® are registered trademarks of Novo Nordisk A/S. 2015 © Novo Nordisk A/S, Novo Allé, DK-2880, Bagsværd, Denmark. ZINC# HQMMA/CD/0815/0370c. Approval date: August 2015. Injecting insulin is something you need to practise, but you will soon become good at it. These are the steps to follow: Wash your hands Have a syringe, cotton wool and alcohol or other disinfectant ready Roll the insulin vial between your hands Clean the vial with alcohol Clean the injection site with alcohol Draw air into the syringe Draw insulin into the syringe Make sure there is no air in the syringe Inject insulin in the right part of your body (see card number 9) Throw away the syringe Put the insulin back in a cold place Remember to eat 30 minutes after an injection Find your way through the maze by following the insulin injection steps in the right order Injecting human insulin
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The information provided is not a substitute for the advice of a healthcare professional - consult your doctor or nurse for advice on your treatment. Stomach Glucose Glucose Glucose Glucose Glucose Glucose Glucose Insulin z z z We all need energy to grow and be strong. We get energy from the food we eat. The food we eat is broken down into glucose. Glucose needs to enter the cells in your body before it can be used as energy. Insulin opens the doors to the cells in your body, so that glucose can enter the cells and be used. If the glucose cannot enter the cells, you will get tired. Why I need insulin 2
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These materials have been developed specifically for the Changing Diabetes® in Children (CDiC) programme. They are offered “as is” and Novo Nordisk A/S and Roche Diagnostics Deutschland GmbH make no representations or warranties, expressed or implied, including but not limited to the implied warranties of merchantability, fitness for a particular purpose or non-infringement as to the completeness, accuracy, timeliness, availability, functionality and compliance with applicable laws. By using these materials you accept the risk that the information may be incomplete or inaccurate or may not meet your needs or requirements. Novo Nordisk A/S and Roche Diagnostics Deutschland GmbH disclaim any and all liability for direct, indirect, incidental, consequential, punitive and special or other damages, lost opportunities, lost profit or any other losses or damages of any kind. Copyright © Novo Nordisk A/S 2012. All Rights Reserved. No part of this document may be reproduced without written consent from Novo Nordisk A/S. Glucose The Apis bull logo and Changing Diabetes® are registered trademarks of Novo Nordisk A/S. 2015 © Novo Nordisk A/S, Novo Allé, DK-2880, Bagsværd, Denmark. ZINC# HQMMA/CD/0815/0370c. Approval date: August 2015. When you eat food, your body turns most of the food you eat into glucose (a kind of sugar). Insulin is the key that allows this glucose to enter all the cells of your body and be used as energy. If you have diabetes, your body doesn’t make enough insulin or can’t use it properly, so the glucose builds up in your blood instead of moving into the cells. Too much glucose in the blood can lead to serious health problems. Everybody with type 1 diabetes needs to take insulin to help control their blood sugar levels. The goal of taking insulin is to keep your blood sugar level as normal as possible so you stay healthy. Why I need insulin Circle the correct answer We get energy from: The food we eat is broken down into: Insulin is like a:
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The information provided is not a substitute for the advice of a healthcare professional - consult your doctor or nurse for advice on your treatment. My diabetes diary Bedtime Fasting 2 hrs before meal 2 hrs after meal Bedtime Fasting 2 hrs before meal 2 hrs after meal Fasting 2 hrs before meal 2 hrs after meal Bedtime Day 1 Day 2 Day 3 LOW HIGH Insulin Dose Size S, M, L S M L S M L S M L S M L Blood Glucose 241 167 201 280 282 198 260 292 272 171 220 283 am pm am am am pm am pm 8 11.25 Time 6.30 4 pm 8.10 2.10 6.45 11.20 3.30 2 am 6.30 3.45 pm pm lu 7u 7u 7u M S front back Lorem ipsumdolorsitamet, veniam vidererinqui,proad saleaccusam. Cu duo saleancillae.Idquedicantnam ei,tollitutinam soleatusuei.Nam nolaborefacetetorquatos,ataliquidhonestatispro. Has dicuntconsequunturet.Mea idlaboredeseruisse,vidererfastidiiex vix.Estmodo accumsan ad,eum atvocentnusquam intellegebat.Labores noluissehisno, quo ad accusam facilisisdisputationi. Where should I inject insulin? I must adjust the insulin amounts to what I do and what I eat. Your doctor or nurse will help you find out how much insulin you should inject each time. Adjust the dose of insulin according to your activities and how you feel. Talk to your doctor or nurse about which insulin you need to adjust and by how much. If I will be more physically active than normal. If I have eaten more than usual. Your insulin dose needs to be adjusted if you have signs of low blood sugar. Your insulin dose needs to be adjusted if you urinate more than usual. REDUCE INCREASE How much insulin should I take? 3
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These materials have been developed specifically for the Changing Diabetes® in Children (CDiC) programme. They are offered “as is” and Novo Nordisk A/S and Roche Diagnostics Deutschland GmbH make no representations or warranties, expressed or implied, including but not limited to the implied warranties of merchantability, fitness for a particular purpose or non-infringement as to the completeness, accuracy, timeliness, availability, functionality and compliance with applicable laws. By using these materials you accept the risk that the information may be incomplete or inaccurate or may not meet your needs or requirements. Novo Nordisk A/S and Roche Diagnostics Deutschland GmbH disclaim any and all liability for direct, indirect, incidental, consequential, punitive and special or other damages, lost opportunities, lost profit or any other losses or damages of any kind. Copyright © Novo Nordisk A/S 2012. All Rights Reserved. No part of this document may be reproduced without written consent from Novo Nordisk A/S. My diabetes diary M S 2 1 3 Fasting 2 hrs before meal 2 hrs after meal Bedtime Fasting 2 hrs Bedtime before meal 2 hrs after meal Fasting 2 hrs before meal 2 hrs after meal Bedtime Day 1 Day 2 Day 3 LOW HIGH Insulin Dose am pm am am am pm am pm 8 11.25 Time 6.30 4pm 8.10 2.10 6.45 11.20 3.30 2 am 6.30 3.45 pm pm Size S, M, L S M L S M L S M L S M L Blood Glucose 241 167 201 280 282 198 260 292 272 171 220 283 lu 7u 7u 7u M S front back Lorem ipsum dolor sit amet, veniam viderer in qui, pro ad sale accusam. Cu duo sale ancillae. Idque dicant nam ei, tollit utinam soleat usu ei. Nam no labore facete torquatos, at aliquid honestatis pro. Has dicunt consequuntur et. Mea id labore deseruisse, viderer fastidii ex vix. Est modo accumsan ad, eum at vocent nusquam intellegebat. Labores noluisse his no, quo ad accusam facilisis disputationi. Where should I inject insulin? The Apis bull logo and Changing Diabetes® are registered trademarks of Novo Nordisk A/S. 2015 © Novo Nordisk A/S, Novo Allé, DK-2880, Bagsværd, Denmark. ZINC# HQMMA/CD/0815/0370c. Approval date: August 2015. You must always follow the doctor and nurse’s instructions, but sometimes you will need to adjust the amount of insulin yourself. Ask your doctor or nurse to teach you when and by how much you need to adjust your insulin. How much insulin should I take? Circle the activities that may require you to adjust the insulin amount yourself
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? ? ? z z z If my blood sugar gets very low I can get hypoglycaemia. Most people call it low blood sugar or hypos. Sweating Extreme hunger Itchy lips Blurred vision Tiredness Dizziness Irritability Difficulty talking Sometimes low blood sugar can get very serious and you can lose consciousness or have convulsions. Crying without reason Trembling The information provided is not a substitute for the advice of a healthcare professional - consult your doctor or nurse for advice on your treatment. Low blood sugar (hypoglycaemia) and how to recognise it 4
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These materials have been developed specifically for the Changing Diabetes® in Children (CDiC) programme. They are offered “as is” and Novo Nordisk A/S and Roche Diagnostics Deutschland GmbH make no representations or warranties, expressed or implied, including but not limited to the implied warranties of merchantability, fitness for a particular purpose or non-infringement as to the completeness, accuracy, timeliness, availability, functionality and compliance with applicable laws. By using these materials you accept the risk that the information may be incomplete or inaccurate or may not meet your needs or requirements. Novo Nordisk A/S and Roche Diagnostics Deutschland GmbH disclaim any and all liability for direct, indirect, incidental, consequential, punitive and special or other damages, lost opportunities, lost profit or any other losses or damages of any kind. Copyright © Novo Nordisk A/S 2012. All Rights Reserved. No part of this document may be reproduced without written consent from Novo Nordisk A/S. ? ? ? z z z The Apis bull logo and Changing Diabetes® are registered trademarks of Novo Nordisk A/S. 2015 © Novo Nordisk A/S, Novo Allé, DK-2880, Bagsværd, Denmark. ZINC# HQMMA/CD/0815/0370c. Approval date: August 2015. Low blood sugar can be harmful – if severe even dangerous. The symptoms are easy to recognise, but it can still be difficult to know if they are due to low blood sugar. Remember: you can always use the glucometer to measure your blood sugar level. When you are sure the symptoms are caused by low blood sugar, you should do as it says on card number 6. Remember that: people around a person with low blood sugar need to ACT FAST! Low blood sugar (hypoglycaemia) and how to recognise it Circle the symptoms of low blood sugar
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The information provided is not a substitute for the advice of a healthcare professional - consult your doctor or nurse for advice on your treatment. When you have diabetes and take insulin your blood sugar level can get very low, this is called hypoglycaemia. You can get low blood sugar when: You have taken too much insulin at once. You have been more physically active than usual and have not adjusted your insulin dose. You have taken an extra insulin injection. You have taken your insulin but have not eaten enough, or soon enough or have thrown up. 5 Why do I get low blood sugar (hypoglycaemia)?
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These materials have been developed specifically for the Changing Diabetes® in Children (CDiC) programme. They are offered “as is” and Novo Nordisk A/S and Roche Diagnostics Deutschland GmbH make no representations or warranties, expressed or implied, including but not limited to the implied warranties of merchantability, fitness for a particular purpose or non-infringement as to the completeness, accuracy, timeliness, availability, functionality and compliance with applicable laws. By using these materials you accept the risk that the information may be incomplete or inaccurate or may not meet your needs or requirements. Novo Nordisk A/S and Roche Diagnostics Deutschland GmbH disclaim any and all liability for direct, indirect, incidental, consequential, punitive and special or other damages, lost opportunities, lost profit or any other losses or damages of any kind. Copyright © Novo Nordisk A/S 2012. All Rights Reserved. No part of this document may be reproduced without written consent from Novo Nordisk A/S. sweating hunger The Apis bull logo and Changing Diabetes® are registered trademarks of Novo Nordisk A/S. 2015 © Novo Nordisk A/S, Novo Allé, DK-2880, Bagsværd, Denmark. ZINC# HQMMA/CD/0815/0370c. Approval date: August 2015. Low blood sugar can happen if: You have taken too much insulin at once You have taken an extra insulin injection You have taken insulin as normal, but afterwards have not eaten enough food, or thrown up You have taken insulin as normal but have been more physically active than usual Why do I get low blood sugar (hypoglycaemia)? Circle the things that can make your blood sugar drop
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The information provided is not a substitute for the advice of a healthcare professional - consult your doctor or nurse for advice on your treatment. 3 M S mg/dL Low blood sugar can be very dangerous. You, your family and friends must take action quickly. If your blood sugar is too low: 1 STOP all activity 2 MEASURE your blood sugar if possible If your blood sugar is low you should eat some sugar or drink a sugary drink or juice If you are not feeling better, you should repeat step 3. If you are feeling better, you should eat something. Severe low blood sugar If your blood sugar is very low it can quickly become serious and you can go into a coma. Your family and friends must act quickly. They should insert a cube of sugar into your mouth. They must NOT give you ythin g else an to eat or dri nk. It’s important that you are taken to a clinic! How to treat low blood sugar (hypoglycaemia) 6
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These materials have been developed specifically for the Changing Diabetes® in Children (CDiC) programme. They are offered “as is” and Novo Nordisk A/S and Roche Diagnostics Deutschland GmbH make no representations or warranties, expressed or implied, including but not limited to the implied warranties of merchantability, fitness for a particular purpose or non-infringement as to the completeness, accuracy, timeliness, availability, functionality and compliance with applicable laws. By using these materials you accept the risk that the information may be incomplete or inaccurate or may not meet your needs or requirements. Novo Nordisk A/S and Roche Diagnostics Deutschland GmbH disclaim any and all liability for direct, indirect, incidental, consequential, punitive and special or other damages, lost opportunities, lost profit or any other losses or damages of any kind. Copyright © Novo Nordisk A/S 2012. All Rights Reserved. No part of this document may be reproduced without written consent from Novo Nordisk A/S. M S mg/dL hunger The Apis bull logo and Changing Diabetes® are registered trademarks of Novo Nordisk A/S. 2015 © Novo Nordisk A/S, Novo Allé, DK-2880, Bagsværd, Denmark. ZINC# HQMMA/CD/0815/0370c. Approval date: August 2015. How to treat low blood sugar (hypoglycaemia) Cross out the wrong answers When you have low blood sugar you should: To treat low blood sugar you should: If you have SEVERE low blood sugar you should: You, your family and friends must act FAST if you have symptoms of hypoglycaemia, or it can be very dangerous. Stop all activity and take a rest Eat some sugar or drink a sugary drink or juice If this makes you feel better, you should have something solid to eat If this doesn’t make you feel better, you should have some more sugar and continue to rest Remember to use your glucometer to do a blood glucose test to check for low blood sugar If your blood sugar is very low you should hurry to contact a doctor or nurse!
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The information provided is not a substitute for the advice of a healthcare professional - consult your doctor or nurse for advice on your treatment. 8 4 8 4 8 4 8 4 8 4 8 4 7 6 5 7 6 5 7 6 5 7 6 5 7 6 5 7 6 5 11 12 1 11 12 1 11 12 1 11 12 1 11 12 1 11 12 1 10 2 10 2 10 2 10 2 10 2 10 2 9 3 9 3 9 3 9 3 9 3 9 3 11 12 1 11 12 1 11 12 1 11 12 1 11 12 1 11 12 1 10 2 10 2 10 2 10 2 10 2 10 2 9 3 9 3 9 3 9 3 9 3 9 3 8 4 8 4 8 4 8 4 8 4 8 4 7 6 5 7 6 5 7 6 5 7 6 5 7 6 5 7 6 5 8 4 8 4 8 4 8 4 8 4 8 4 7 6 5 7 6 5 7 6 5 7 6 5 7 6 5 7 6 5 11 12 1 11 12 1 11 12 1 11 12 1 11 12 1 11 12 1 10 2 10 2 10 2 10 2 10 2 10 2 9 3 9 3 9 3 9 3 9 3 9 3 11 12 1 11 12 1 11 12 1 11 12 1 11 12 1 11 12 1 10 2 10 2 10 2 10 2 10 2 10 2 9 3 9 3 9 3 9 3 9 3 9 3 8 4 8 4 8 4 8 4 8 4 8 4 7 6 5 7 6 5 7 6 5 7 6 5 7 6 5 7 6 5 11 12 1 11 12 1 11 12 1 11 12 1 11 12 1 11 12 1 11 12 1 10 2 9 3 8 4 7 6 5 9 3 8 4 7 6 5 9 3 8 4 7 6 5 9 3 8 4 7 6 5 9 3 8 4 7 6 5 11 12 1 11 12 1 11 12 1 11 12 1 10 2 10 2 10 2 10 2 11 12 1 10 2 9 3 8 4 7 6 5 11 12 1 10 2 9 3 8 4 7 6 5 11 12 1 10 2 9 3 8 4 7 6 5 11 12 1 10 2 9 3 8 4 7 6 5 7 6 5 9 3 10 2 11 12 1 2 1 NPH Insulin: Short Acting Insulin: Mixed Insulin: FAST SLOW FAST & SLOW Short acting - 30 minutes Short lasting - up to 8 hours Slow acting - 2 hours 11 12 1 11 12 1 10 2 10 2 9 3 9 3 8 4 8 4 7 6 5 7 6 5 Long lasting - up to 18 hours 11 12 1 11 12 1 11 12 1 11 12 1 11 12 1 11 12 1 10 2 10 2 10 2 10 2 10 2 10 2 9 3 9 3 9 3 9 3 9 3 9 3 8 4 8 4 8 4 8 4 8 4 8 4 7 6 5 7 6 5 7 6 5 7 6 5 7 6 5 7 6 5 8 4 Short acting - 30 minutes 8 4 8 4 8 4 8 4 8 4 8 4 Long lasting - up to 18 hours 10 2 10 2 10 2 10 2 10 2 10 2 9 3 9 3 9 3 9 3 9 3 9 3 7 6 5 7 6 5 7 6 5 7 6 5 7 6 5 7 6 5 OR You can use a combination of Short Acting Insulin and NPH Insulin Mixed Insulin The insulin types depicted here aren’t representative of all the types of insulin available. 7 Some of the different types of insulin
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These materials have been developed specifically for the Changing Diabetes® in Children (CDiC) programme. They are offered “as is” and Novo Nordisk A/S and Roche Diagnostics Deutschland GmbH make no representations or warranties, expressed or implied, including but not limited to the implied warranties of merchantability, fitness for a particular purpose or non-infringement as to the completeness, accuracy, timeliness, availability, functionality and compliance with applicable laws. By using these materials you accept the risk that the information may be incomplete or inaccurate or may not meet your needs or requirements. Novo Nordisk A/S and Roche Diagnostics Deutschland GmbH disclaim any and all liability for direct, indirect, incidental, consequential, punitive and special or other damages, lost opportunities, lost profit or any other losses or damages of any kind. Copyright © Novo Nordisk A/S 2012. All Rights Reserved. No part of this document may be reproduced without written consent from Novo Nordisk A/S. Three of the types of insulin are: The Apis bull logo and Changing Diabetes® are registered trademarks of Novo Nordisk A/S. 2015 © Novo Nordisk A/S, Novo Allé, DK-2880, Bagsværd, Denmark. ZINC# HQMMA/CD/0815/0370c. Approval date: August 2015. Some of the different types of insulin Short acting: This insulin acts very fast, but only lasts a short time. It will work 30 minutes after injection and last for up to 8 hours. NPH – slow acting: This insulin takes up to 2 hours to work, but will last up to 18 hours. Mixed: This insulin is a mix of the fast and the slow. It takes up to 2 hours to work, and will last up to 18 hours. The insulin types depicted on this poster are not representative of all insulins available. Connect the animal to the correct insulin vial Short acting NPH - slow acting Mixed
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? ? ? ? ? ? ? 11 12 1 10 2 9 3 8 4 7 6 5 11 12 1 10 2 9 3 8 4 7 6 5 3 4 7 6 5 8 10 2 9 11 12 1 How often I need to inject insulin depends on which insulin I use. The doctor or nurse will help you work out how often you need to take insulin. The information provided is not a substitute for the advice of a healthcare professional - consult your doctor or nurse for advice on your treatment. How often should I inject insulin? 8
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These materials have been developed specifically for the Changing Diabetes® in Children (CDiC) programme. They are offered “as is” and Novo Nordisk A/S and Roche Diagnostics Deutschland GmbH make no representations or warranties, expressed or implied, including but not limited to the implied warranties of merchantability, fitness for a particular purpose or non-infringement as to the completeness, accuracy, timeliness, availability, functionality and compliance with applicable laws. By using these materials you accept the risk that the information may be incomplete or inaccurate or may not meet your needs or requirements. Novo Nordisk A/S and Roche Diagnostics Deutschland GmbH disclaim any and all liability for direct, indirect, incidental, consequential, punitive and special or other damages, lost opportunities, lost profit or any other losses or damages of any kind. Copyright © Novo Nordisk A/S 2012. All Rights Reserved. No part of this document may be reproduced without written consent from Novo Nordisk A/S. Insulin type: How much: Insulin type: How much: Insulin type: How much: The Apis bull logo and Changing Diabetes® are registered trademarks of Novo Nordisk A/S. 2015 © Novo Nordisk A/S, Novo Allé, DK-2880, Bagsværd, Denmark. ZINC# HQMMA/CD/0815/0370c. Approval date: August 2015. My insulin injection schedule Which insulin should I take, when and how much? In the morning, before breakfast Before the evening meal Before going to bed Name: Date:
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Ensure that each injection is about 2 finger widths from the one done before. Avoid injecting too closely to your belly button. Remember to rotate injection sites. On the back of my body there is one place where I can inject my insulin - the top outer area of my buttocks. On the front of my body there are three places I can inject my insulin: the top of my thighs, my upper arms and my abdomen. Front Back The information provided is not a substitute for the advice of a healthcare professional - consult your doctor or nurse for advice on your treatment. 9 Where should I inject my insulin?
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These materials have been developed specifically for the Changing Diabetes® in Children (CDiC) programme. They are offered “as is” and Novo Nordisk A/S and Roche Diagnostics Deutschland GmbH make no representations or warranties, expressed or implied, including but not limited to the implied warranties of merchantability, fitness for a particular purpose or non-infringement as to the completeness, accuracy, timeliness, availability, functionality and compliance with applicable laws. By using these materials you accept the risk that the information may be incomplete or inaccurate or may not meet your needs or requirements. Novo Nordisk A/S and Roche Diagnostics Deutschland GmbH disclaim any and all liability for direct, indirect, incidental, consequential, punitive and special or other damages, lost opportunities, lost profit or any other losses or damages of any kind. Copyright © Novo Nordisk A/S 2012. All Rights Reserved. No part of this document may be reproduced without written consent from Novo Nordisk A/S. The Apis bull logo and Changing Diabetes® are registered trademarks of Novo Nordisk A/S. 2015 © Novo Nordisk A/S, Novo Allé, DK-2880, Bagsværd, Denmark. ZINC# HQMMA/CD/0815/0370c. Approval date: August 2015. Where should I inject my insulin? Insulin must be injected into the fatty layer just under your skin. There are 4 safe areas for insulin injections: THIGHS: Top and outer areas only. Do not use the inner side or back of your thigh. UPPER ARMS: Fleshy area on the side and back of your arms. Avoid the muscle in the shoulder. ABDOMEN: Right across your abdomen, from just below your ribcage to below the belt line. BUTTOCKS: The top outer area. Remember to do your injections in a different place each time, going in a circle around your body. Injecting in the same place over and over can cause the skin to swell. Draw circles around the correct insulin injection sites
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Eat more from the groups at the bottom of the pyramid, and avoid from the top Sweets Dairy Meat & Fish Vegetables Fruit Starches 6 What should I eat? Work with your nurse to make your own food pyramid Sweets DairyMeat&Fish VegetablesFruit Starches nursetomake yourownfood Eatmorefromthe groups atthebottom ofthepyramid,and Starches 17 What should I eat? Workwithyour pyramid Sweets Dairy Meat & Fish avoidfromthetop Sweets Dairy Meat&Fish Vegetables Fruit Vegetables Fruit Starches WhatshouldIeat? Wynouourr psrkyeowratwoimtnhmifdyoaookuedr gloerEofsastuhtfprmeaostpoamtyrthertteahhfrmeteooigbmdpro,ottatuhnopedms I work with my nurse to make my own food pyramid. I eat more from the groups at the bottom of the pyramid and avoid foods from the top. Sweets Dairy Meat & Fish Vegetables Fruit Starches The information provided is not a substitute for the advice of a healthcare professional - consult your doctor or nurse for advice on your treatment. REMEMBER: You should always drink a lot of water. WATER What should I eat? 10
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These materials have been developed specifically for the Changing Diabetes® in Children (CDiC) programme. They are offered “as is” and Novo Nordisk A/S and Roche Diagnostics Deutschland GmbH make no representations or warranties, expressed or implied, including but not limited to the implied warranties of merchantability, fitness for a particular purpose or non-infringement as to the completeness, accuracy, timeliness, availability, functionality and compliance with applicable laws. By using these materials you accept the risk that the information may be incomplete or inaccurate or may not meet your needs or requirements. Novo Nordisk A/S and Roche Diagnostics Deutschland GmbH disclaim any and all liability for direct, indirect, incidental, consequential, punitive and special or other damages, lost opportunities, lost profit or any other losses or damages of any kind. Copyright © Novo Nordisk A/S 2012. All Rights Reserved. No part of this document may be reproduced without written consent from Novo Nordisk A/S. The Apis bull logo and Changing Diabetes® are registered trademarks of Novo Nordisk A/S. 2015 © Novo Nordisk A/S, Novo Allé, DK-2880, Bagsværd, Denmark. ZINC# HQMMA/CD/0815/0370c. Approval date: August 2015. What should I eat? If you have diabetes, what you eat is important, because it affects how well you feel and how the insulin works. You and your family can use the food pyramid to find out how to put different foods together Eat more from the bottom of the pyramid Eat some from the middle of the pyramid Eat less from the top of the pyramid Together with your nurse, draw the types of food you eat in the food pyramid
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The information provided is not a substitute for the advice of a healthcare professional - consult your doctor or nurse for advice on your treatment. M S My diabetes diary My diabetes diary M S 2 1 3 10 2 10 2 9 3 9 3 8 4 8 4 7 6 5 7 6 5 11 12 1 11 12 1 + My diabetes diary My diabetes diary My diabetes diary My diabetes diary M S mmol/l M S M S M S M S 2 1 3 Fasting Bedtime 2 hrs before meal 2 hrs after meal Fasting Bedtime 2 hrs before meal 2 hrs after meal Fasting Bedtime 2 hrs before meal 2 hrs after meal Day 1 Day 2 Day 3 LOW HIGH Size S, M, L S M L S M L S M L S M L Insulin Dose Blood Glucose 241 167 201 280 282 198 260 292 272 171 220 283 am pm am am am pm am pm 11.25 Time 6.30 4pm 8.10 2.10 6.45 11.20 3.30 2 am 6.30 3.45 8 pm pm lu 7u 7u 7u 1 2 3 You always need to know if you have too much or too little sugar in your blood. My diabetes diary We give you a glucometer, strips, a diabetes diary, lancets and a lancing device. You must use your glucometer at least 4 times a day and write down the number you get. A healthy blood sugar level is between 4.5 and 10 mmol/l (80 and 180 mg/dl).* AT LEAST 4 X 2 hours after you eat breakfast. 4 Before you go to sleep. When you wake up, before breakfast. In the evening, before you eat dinner. You must always bring your glucometer and diabetes diary when you go to the clinic. Measuring my blood sugar 11 * Post prandial blood glucose - 2011 Global IDF/ISPAD Guideline for Diabetes in Children and Adolescence (http://www.ispad.org/NewsFiles/IDF-ISPAD_ Diabetes_in_Childhood_and%20Adolescence_Guidelines_2011.pdf).
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These materials have been developed specifically for the Changing Diabetes® in Children (CDiC) programme. They are offered “as is” and Novo Nordisk A/S and Roche Diagnostics Deutschland GmbH make no representations or warranties, expressed or implied, including but not limited to the implied warranties of merchantability, fitness for a particular purpose or non-infringement as to the completeness, accuracy, timeliness, availability, functionality and compliance with applicable laws. By using these materials you accept the risk that the information may be incomplete or inaccurate or may not meet your needs or requirements. Novo Nordisk A/S and Roche Diagnostics Deutschland GmbH disclaim any and all liability for direct, indirect, incidental, consequential, punitive and special or other damages, lost opportunities, lost profit or any other losses or damages of any kind. Copyright © Novo Nordisk A/S 2012. All Rights Reserved. No part of this document may be reproduced without written consent from Novo Nordisk A/S. My diabetes diary M S mg/dL 2 1 3 You need to know if you have too much or too little sugar in your blood. It is best if you measure your blood sugar 4 times a day, using your testing equipment: When you wake up in the morning 2 hours after eating breakfast In the evening before dinner Before going to sleep You should write these numbers down every day in your diabetes diary. Always take your diabetes diary to the clinic. The number will be higher after meals or if you have been angry or even sick. It will be lower after physical exercise. Keeping track of your blood sugar will help you feel good. Measuring my blood sugar Circle the items you need to keep track of your blood sugar The Apis bull logo and Changing Diabetes® are registered trademarks of Novo Nordisk A/S. 2015 © Novo Nordisk A/S, Novo Allé, DK-2880, Bagsværd, Denmark. ZINC# HQMMA/CD/0815/0370c. Approval date: August 2015.
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M S mg/dL M S mmol/l M S mg/dL My diabetes diary 3 M S mg/dL 2 1 4 M S mg/dL M S Fasting Bedtime 2 hrs before meal 2 hrs after meal Day 1 Fasting Bedtime 2 hrs before meal 2 hrs after meal Fasting Bedtime 2 hrs before meal 2 hrs after meal Day 2 Day 3 LOW HIGH Time Size S, M, L S M L S M L Insulin Dose Blood Glucose 241 167 201 280 282 198 260 292 272 171 220 283 6.30 4 am pm pm S M L am am am pm S M L 8.10 2.10 6.45 11.20 3.30 2 6.30 3.45 8 11.25 am am pm pm pm lu 7u 7u 7u 2 1 3 M S My diabetes diary Testing my blood sugar is important and easy. To test my blood sugar, I need to get some things ready. I need: soap, a lancing device and lancet, glucometer and strips and my diabetes diary. Less than 30 seconds later the glucometer will show a number. This is my blood sugar level. I must write this number down in my diabetes diary. I must always remember to take my glucometer and diabetes diary with me to the clinic and give it to the nurse. This helps her help me! Wash your hands with soap Insert the strip into the glucometer Prick your finger with the lancet Put a small drop of blood on the strip The information provided is not a substitute for the advice of a healthcare professional - consult your doctor or nurse for advice on your treatment. How to use my glucometer? 12
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These materials have been developed specifically for the Changing Diabetes® in Children (CDiC) programme. They are offered “as is” and Novo Nordisk A/S and Roche Diagnostics Deutschland GmbH make no representations or warranties, expressed or implied, including but not limited to the implied warranties of merchantability, fitness for a particular purpose or non-infringement as to the completeness, accuracy, timeliness, availability, functionality and compliance with applicable laws. By using these materials you accept the risk that the information may be incomplete or inaccurate or may not meet your needs or requirements. Novo Nordisk A/S and Roche Diagnostics Deutschland GmbH disclaim any and all liability for direct, indirect, incidental, consequential, punitive and special or other damages, lost opportunities, lost profit or any other losses or damages of any kind. Copyright © Novo Nordisk A/S 2012. All Rights Reserved. No part of this document may be reproduced without written consent from Novo Nordisk A/S. M S mg/dL M S mg/dL M S mg/dL My diabetes diary Connect the steps for testing your blood sugar from start to finish Before testing your blood sugar, you need to get these things ready: Soap Lancing device and lancet Strip Glucometer To do the test, follow these steps: Wash your hands Turn on the glucometer and insert a strip Prick your finger with the lancet Put a small drop of blood on the strip Wait and read the number on the glucometer Write the number in your diabetes diary How to use my glucometer? The Apis bull logo and Changing Diabetes® are registered trademarks of Novo Nordisk A/S. 2015 © Novo Nordisk A/S, Novo Allé, DK-2880, Bagsværd, Denmark. ZINC# HQMMA/CD/0815/0370c. Approval date: August 2015.
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The information provided is not a substitute for the advice of a healthcare professional - consult your doctor or nurse for advice on your treatment. z z z M S mg/dL You probably have hyperglycaemia if you: Check your blood glucose level to confirm high blood sugar (hyperglycaemia). If it is a serious case of high blood sugar you might also experience: If you have any of these signs - you should go to the clinic! If my blood sugar gets too high, I can get hyperglycaemia. are very thirsty all the time nausea have blurry vision abnormal breathing loss of conciousness need to urinate a lot stomach pains are very tired all the time breath that smells like alcohol have a dry mouth 13 High blood sugar (hyperglycaemia) and how to recognise it
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These materials have been developed specifically for the Changing Diabetes® in Children (CDiC) programme. They are offered “as is” and Novo Nordisk A/S and Roche Diagnostics Deutschland GmbH make no representations or warranties, expressed or implied, including but not limited to the implied warranties of merchantability, fitness for a particular purpose or non-infringement as to the completeness, accuracy, timeliness, availability, functionality and compliance with applicable laws. By using these materials you accept the risk that the information may be incomplete or inaccurate or may not meet your needs or requirements. Novo Nordisk A/S and Roche Diagnostics Deutschland GmbH disclaim any and all liability for direct, indirect, incidental, consequential, punitive and special or other damages, lost opportunities, lost profit or any other losses or damages of any kind. Copyright © Novo Nordisk A/S 2012. All Rights Reserved. No part of this document may be reproduced without written consent from Novo Nordisk A/S. z z z High blood sugar (hyperglycaemia) and how to recognise it High blood sugar or hyperglycaemia happens when the body has too little insulin or when the body can’t use insulin properly, leaving too much sugar in the blood? Blood sugar that is too high can be a serious problem if you don’t treat it, so it’s important to begin treatment as soon as you as soon as you discover it. Part of controlling your diabetes is checking your blood glucose often. Checking your blood and then treating high blood glucose early will help you avoid problems caused by hyperglycaemia. If you have any of these symptoms, go and see a doctor quickly: Shortness of breath Breath that smells like alcohol Nausea and vomiting Very dry mouth Remember to tell the doctor or nurse that you have type 1 diabetes and that your blood sugar is very high. Circle the symptoms of a severe case of high blood sugar Nausea Breath smells like alcohol Very thirsty all the time Stomach pains Very tired all the time Abnormal breathing The Apis bull logo and Changing Diabetes® are registered trademarks of Novo Nordisk A/S. 2015 © Novo Nordisk A/S, Novo Allé, DK-2880, Bagsværd, Denmark. ZINC# HQMMA/CD/0815/0370c. Approval date: August 2015.
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The information provided is not a substitute for the advice of a healthcare professional - consult your doctor or nurse for advice on your treatment. When you have diabetes your blood sugar level can get too high, this is called hyperglycaemia. You can get high blood sugar when: You have taken too little insulin or missed an injection. You have been less physically active than usual. You have taken insulin that was bad because it was too old or not stored correctly. You have an infection or fever. You have eaten too much food. Why do I get high blood sugar (hyperglycaemia)? 14
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These materials have been developed specifically for the Changing Diabetes® in Children (CDiC) programme. They are offered “as is” and Novo Nordisk A/S and Roche Diagnostics Deutschland GmbH make no representations or warranties, expressed or implied, including but not limited to the implied warranties of merchantability, fitness for a particular purpose or non-infringement as to the completeness, accuracy, timeliness, availability, functionality and compliance with applicable laws. By using these materials you accept the risk that the information may be incomplete or inaccurate or may not meet your needs or requirements. Novo Nordisk A/S and Roche Diagnostics Deutschland GmbH disclaim any and all liability for direct, indirect, incidental, consequential, punitive and special or other damages, lost opportunities, lost profit or any other losses or damages of any kind. Copyright © Novo Nordisk A/S 2012. All Rights Reserved. No part of this document may be reproduced without written consent from Novo Nordisk A/S. sweating hunger Why do I get high blood sugar (hyperglycaemia)? Circle the pictures of things that can cause high blood sugar You can get high blood sugar when you: Have taken to little insulin or missed an injection Have been less physically active than normal Have eaten too much food Have taken insulin that was bad because it was too old or not stored properly Have an infection, a fever or perhaps a foot sore You have taken too little insulin or missed an injection You have taken an extra insulin injection You have taken too much insulin at once You have been less physically active than usual You have been more physically active than usual You have not eaten You have eaten too much food You have an infection or fever You have taken insulin that was bad, because it was too old or not stored correctly The Apis bull logo and Changing Diabetes® are registered trademarks of Novo Nordisk A/S. 2015 © Novo Nordisk A/S, Novo Allé, DK-2880, Bagsværd, Denmark. ZINC# HQMMA/CD/0815/0370c. Approval date: August 2015.
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The information provided is not a substitute for the advice of a healthcare professional - consult your doctor or nurse for advice on your treatment. 2 3 M S mg/dL M S mg/dL M S mg/dL M S mg/dL Most cases of high blood sugar are easily treated. To treat high blood sugar you should: 1 Measure your blood glucose Take short acting insulin Measure your blood glucose again after 2 hours HIGH BLOOD SUGAR If my blood glucose is between 11 and 22 mmol (200 and 400mg/dl) SEVERE BLOOD SUGAR If your blood glucose is more than 22 mmol (400mg/dl) Ask you doctor or nurse how much extra insulin you should take. You must measure your blood sugar after 2 hours. If your blood sugar is still high: repeat the extra dose contact your doctor or nurse You should contact the clinic quickly! I must take extra insulin. I must take insulin immediately - 10% of my total daily dose. INCREASE INCREASE REMEMBER: You should always drink a lot of water. WATER Contact your doctor or nurse if you are not sure of what to do. 15 How to treat high blood sugar (hyperglycaemia)
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These materials have been developed specifically for the Changing Diabetes® in Children (CDiC) programme. They are offered “as is” and Novo Nordisk A/S and Roche Diagnostics Deutschland GmbH make no representations or warranties, expressed or implied, including but not limited to the implied warranties of merchantability, fitness for a particular purpose or non-infringement as to the completeness, accuracy, timeliness, availability, functionality and compliance with applicable laws. By using these materials you accept the risk that the information may be incomplete or inaccurate or may not meet your needs or requirements. Novo Nordisk A/S and Roche Diagnostics Deutschland GmbH disclaim any and all liability for direct, indirect, incidental, consequential, punitive and special or other damages, lost opportunities, lost profit or any other losses or damages of any kind. Copyright © Novo Nordisk A/S 2012. All Rights Reserved. No part of this document may be reproduced without written consent from Novo Nordisk A/S. M S mg/dL M S mg/dL How to treat high blood sugar (hyperglycaemia) In most cases it is easy to treat high blood sugar (hyperglycaemia): Measure your blood glucose Take insulin Measure your blood glucose again, 2 hours later When you measure the second time, your number should have gone down. If not, you must inject again. If your blood sugar is very high (more than 22mmol), you must see a doctor or nurse quickly. You need their help to treat a serious case of high blood sugar. It can’t be treated at home. Circle the right answers If you get high blood sugar, you should: Measure your blood glucose If the high blood sugar is severe you should: Go to school See a doctor or a nurse quickly! Wash your feet The Apis bull logo and Changing Diabetes® are registered trademarks of Novo Nordisk A/S. 2015 © Novo Nordisk A/S, Novo Allé, DK-2880, Bagsværd, Denmark. ZINC# HQMMA/CD/0815/0370c. Approval date: August 2015.
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The information provided is not a substitute for the advice of a healthcare professional - consult your doctor or nurse for advice on your treatment. 1 2 3 4 It is important to take care of my feet - not doing so can lead to complications. I check my feet everyday. Check your feet for: cuts, sores, red spots, swelling and infected toenails. Cuts Swelling Red spots Sores Infected toenails Keep your nails short and clean Always wear shoes Be active Put your feet up to rest Wash your feet everyday Dry your feet properly Put lotion on your feet Ask your nurse or doctor to check your feet with you. Taking care of my feet 16
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These materials have been developed specifically for the Changing Diabetes® in Children (CDiC) programme. They are offered “as is” and Novo Nordisk A/S and Roche Diagnostics Deutschland GmbH make no representations or warranties, expressed or implied, including but not limited to the implied warranties of merchantability, fitness for a particular purpose or non-infringement as to the completeness, accuracy, timeliness, availability, functionality and compliance with applicable laws. By using these materials you accept the risk that the information may be incomplete or inaccurate or may not meet your needs or requirements. Novo Nordisk A/S and Roche Diagnostics Deutschland GmbH disclaim any and all liability for direct, indirect, incidental, consequential, punitive and special or other damages, lost opportunities, lost profit or any other losses or damages of any kind. Copyright © Novo Nordisk A/S 2012. All Rights Reserved. No part of this document may be reproduced without written consent from Novo Nordisk A/S. Good job! If you have diabetes you must take extra care of your feet. If not, your feet can become damaged and you could lose a toe, a foot or even a leg. Taking good care of your feet can stop this from happening. You should: Check your feet every day for cuts, sores, red spots, swelling and infected toe nails Wash your feet every day, dry them well and apply lotion Keep your toe nails short and clean Put your feet up to rest Always wear your shoes but make sure they do not hurt your feet and give you cuts or blisters Be active Ask your nurse or doctor to check your feet when you are at the clinic Make your way through the maze to get to the healthy feet and to stay away from the sore feet! Make sure you pass all the good things to do for your feet on the way. Taking care of my feet The Apis bull logo and Changing Diabetes® are registered trademarks of Novo Nordisk A/S. 2015 © Novo Nordisk A/S, Novo Allé, DK-2880, Bagsværd, Denmark. ZINC# HQMMA/CD/0815/0370c. Approval date: August 2015.
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The information provided is not a substitute for the advice of a healthcare professional - consult your doctor or nurse for advice on your treatment. 2 1 3 M S mg/dL Even with diabetes, I can still take part in all normal activities. Reduce your insulin if you will be more active than usual. Increase your insulin if you will be eating more than usual. Activities are not always planned, and if you are more physically active than normal, without planning for it, you should eat foods or drink liquids that are rich in sugar. You also have to make sure that you always have your medicine and equipment with you, if you are away from home for more than 6 hours. You should always carry some sugar with you in case of low blood sugar. Reduce your insulin if you will be walking long distances. Reduce your insulin if you eat less food or no food. INCREASE REDUCE REDUCE REDUCE Living with diabetes 17
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These materials have been developed specifically for the Changing Diabetes® in Children (CDiC) programme. They are offered “as is” and Novo Nordisk A/S and Roche Diagnostics Deutschland GmbH make no representations or warranties, expressed or implied, including but not limited to the implied warranties of merchantability, fitness for a particular purpose or non-infringement as to the completeness, accuracy, timeliness, availability, functionality and compliance with applicable laws. By using these materials you accept the risk that the information may be incomplete or inaccurate or may not meet your needs or requirements. Novo Nordisk A/S and Roche Diagnostics Deutschland GmbH disclaim any and all liability for direct, indirect, incidental, consequential, punitive and special or other damages, lost opportunities, lost profit or any other losses or damages of any kind. Copyright © Novo Nordisk A/S 2012. All Rights Reserved. No part of this document may be reproduced without written consent from Novo Nordisk A/S. People with diabetes can take part in all normal activities. But you have to adjust the amount of insulin you take, to what you will be doing. If you will be more physically active, you should reduce the amount of insulin you take in the morning. If you will be travelling or walking long distances, you should also reduce the amount of insulin you take. If you will be skipping a meal, you should reduce the amount of insulin you take. If you will be eating more than usual, you should increase the amount of insulin you take. If you are more physically active but have not adjusted the amount of insulin you take, you should eat foods or drink liquids that are high in sugar. If you are away from home for more than 6 hours, make sure you always bring your medinces, needles and glucose meter, and some food and water. Draw an arrow pointing up or down, to show how you should adjust the amount of insulin you take in different situations Living with diabetes The Apis bull logo and Changing Diabetes® are registered trademarks of Novo Nordisk A/S. 2015 © Novo Nordisk A/S, Novo Allé, DK-2880, Bagsværd, Denmark. ZINC# HQMMA/CD/0815/0370c. Approval date: August 2015.

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