Yellow skin. It is quite common for the skin of patients with diabetes have yellowing, best seen in palms and soles of the feet, but is of no clinical importance. It is known that the problem arises when high blood sugar levels affect collagen, a protein that is found naturally in the human body and is responsible for providing strength to bones, skin, hair and nails.
Diabetic dermopathy. It is the most common problem and is due to the disruption of small blood vessels, characterized by the appearance of red spots on ½ to 2 inches in diameter, which will eventually become darker and are small scab. They have serious consequences, do not generate pain and are preferentially located in the knees, ankles, thighs and forearms are most common in men than in women. They do not require treatment and more or less strict control of diabetes prevents its evolution.
Necrobiosis lipoidica. Of unknown cause, characterized by papules (rash) small, reddish, which tend to harden, grow slowly converge with one another into plaques of variable size, with yellow edges, do not generate complaints, while sometimes itchy. It is more common in women and is usually found on hands, forearms, thighs, abdomen, face and scalp. No treatment is finished completely with the problem, although tests have been satisfactory with oral corticosteroids.

Bullosis diabeticorum. consists in the spontaneous appearance of blisters of variable size and contained clear, healthy skin on the forearms, legs, feet and toes. They usually do not cause discomfort and, unless they become infected, they heal within 1 to 4 weeks, sometimes leaving small scars. There is no specific treatment and only have to have rest and applying local antiseptics, control of blood sugar levels does not prevent or accelerate its relief.

Granuloma annulare. It is characterized by the appearance of small purplish papules that converge resulting in plaques of 1 to 5 cm in diameter with healthy skin in the center. They are found most often in the arms, legs, back of hands and fingers, respecting the mucous cause is unknown. Healing can take from 1 to 3 years without sequelae, although frequent new outbreaks which, incidentally, do not cause discomfort. As a treatment using topical application (in the place of injury) of corticosteroids.

Erythema diabetic. It usually occurs in patients older diabetes, is the emergence of well-defined painless red areas on the lower legs and feet. A variant of this box is Diabetic rubeosis, where the spots appear on the face and less frequently on the hands and in no case be treated.

While the above are relatively common disorders of the skin of patients with diabetes, should be emphasized that there may be thickening of the largest organ in the human body, a problem called scleredema diabeticorum , and appears more frequently in the top posterior region of the chest and neck, extending progressively to face and shoulders, seldom reaching abdomen, arms or hands. It affects patients with diabetes many years, usually obese and cardiovascular complications, it causes discomfort and no treatment . On the other hand, there is thickening and hardening of the skin back of hands and feet in 30% of patients who must inject insulin and between 10 and 60% of patients who depend on it, the problem results in some limitation in joint mobility in those areas. Unfortunately there is no treatment to reverse the condition. Go problem skin surface of patients with diabetes easily housed certain germs that make it easier to develop infections, the main energy source of these microorganisms are carbohydrates or sugars; the latter are found in high concentrations in the blood of those who suffer from this condition. The same reason promotes the growth of certain fungi, yeasts such as Candida, which are established in skin folds or genital area. Similarly, patients with diabetes facilitates colonization of bacteria such as staphylococci, which often damage the nasal mucous membranes. Another factor favoring the presence of infections is poor irrigation or supply of nutrients and oxygen to the tissues through blood. Occur with ease ulcers, which can be defined as any break in the skin barrier that usually extends through the dermis (layer that houses numerous blood vessels that provide elasticity and smoothness to the skin). However, the problem grows when these high glucose levels damage nerves (diabetic neuropathy) that emit signals as pain that can warn the patient of an injury, so that it does not realize that there are cuts or sores and let complicated step, as known to occur with regrettable consequences. It should be noted that poorly controlled diabetes leads to alterations in the body’s defense system (immune), which operation will be reduced compared to a skin infection, allowing it to grow if not taken appropriate action. The most common forms of infection are:
Candidiasis. The female genital area easily houses the fungus Candida albicans, which is favorable feeding conditions in poorly controlled patients, producing extreme itching at the entrance (vulva) and inside the vagina, but also often occurs in regions breast and groin. For the correct treatment is appropriate glycemic control with topical application of antifungal agents.
Candida paronychia. nail infection by Candida, which cause redness, some pain and swelling, with loss of the cuticle, thus favoring secondary bacterial superinfection. The correct treatment is the application of topical antiseptics during the day and antifungal ointment or ointment at night, for weeks or months. The proper blood sugar control speeds healing.

Dermatophytosis. trichophytic fungal infection of the feet and creases between the toes is very common and its true significance is not in itself mycosis, but that is excellent gateway for secondary bacterial infections that can seriously compromise the integrity of the foot. Therefore, treatment should be energetic, with topical antifungal or oral, after carrying out a mycological culture.

Pyoderma. It is most common, but more severe, occurs at the level of the beard, legs and feet. Your treatment will be extended, based on broad spectrum antibiotics, along with local application of antifungal agents. It should be strict control of blood sugar levels because decompensation can aggravate the problem.

Erythrasma. Produced by the bacterium Corynebacterium minutissimum , is quite common in obese diabetics. Plaques appear well defined, red, scaly superficial, inguinal folds, axillary, submammary and less often between the toes. Treated with erythromycin for a week and / or topical antifungal. Weight loss and prevent moisture in the areas mentioned in part prevents relapse.

Eruptive xanthomas. A further problem in patients with diabetes who are overweight, and cholesterol and high triglycerides. Are there tiny red-yellow nodules up to 5 millimeters in diameter, which are grouped in the extremities and buttocks. They do not generate complaints, while sometimes itchy. Treatment to lower fat levels often provide encouraging results.

While diabetes is a problem that will accompany the patient for the rest of his life, it can be lived with better quality if attention is given to minor injuries and kept in regular levels of blood glucose levels.

The body has a complex system of hormones that are responsible for maintaining blood glucose within appropriate levels. When sugar levels begin to decline, the glucagon , the adrenaline and glucocorticoid is responsible for stimulating the production of glucose through the use of muscle protein and fat stored in adipose tissue, so called hyperglycemic hormones . By contrast, when blood sugar levels begin to rise is the insulin which is responsible for keeping them “at bay”, through several mechanisms: it stimulates glucose uptake in muscle and adipose tissue (withdrawing the bloodstream), stimulates the formation of glycogen (using glucose) in the liver and muscles, stimulates fat formation (from glucose) in the liver and adipose tissue, stimulates amino acid uptake by the and promotes muscle protein synthesis in the same. Therefore we say that is a hormone hypoglycemic (low blood sugar levels) and anabolic (promotes the formation of muscle and adipose tissue).

But what does it depend to rise more or less the levels of blood sugar after a meal? As the amount and type of carbohydrates consumed, and how cooking and other foods (fats and proteins) to accompany this meal. It is now that the concept of glycemic index (GI) is highly significant, since it is a measure used to classify foods (carbohydrates) as the increase occurring in the blood glucose levels at two or three hours of having consumed, and are measured relative to a reference food, glucose, which is assigned value of 100. In the picture above shows the effect they have two meals (a high GI and a low GI) on blood glucose levels and how these levels fluctuate in the dor hours after the consumption of such foods. The concept was devised by Dr. David Jenkins in 1981. Several factors affect the GI of foods:

The size of particles: the smaller the particle size, the higher the GI, and crushed food (purees, baby food) have a higher GI versions of “whole”.
Other foods eaten at the same meal, fats and proteins tend to delay gastric emptying and therefore decrease the GI.
The cooking, the cooking of certain foods produces prolonged rupture of the starch into smaller molecules, allowing more rapid digestion and up both the IG. For example, cooked carrots, pasta or boiled for a long time have a higher GI than raw carrots or pasta al dente.
The fiber content, integrated versions generally have lower GI than their refined versions.
We can classify the carbohydrates in those high GI such as glucose, maltose, honey, cereals, corn flakes, white bread, potatoes, pumpkin, cooked carrots, honey, and those with moderate-low GI such as fructose, whole grains, bread rye bread, spaghetti, macaroni, beans in general, and most fruits.

In the above so far, what applications have the classification of foods according to IG? It is of great importance in diabetic patients because they have compromised the ability of insulin production, and therefore must choose foods that produce moderate increases in blood glucose. He is also a useful concept in weight control diets, it is important to keep blood sugar and insulin levels in blood. They are also very useful in feeding the athletes, who choose foods high or low GI at the time and the goals they wish to achieve. Thus, in the hours before a competition or training should opt for foods with moderate-low GI, which maintain more stable blood glucose levels, increase endurance time and maintain higher plasma glucose concentrations towards the end of the year . However, during the conduct of the activity (competition or training) is preferable to high-GI, which are usually easier to digest and produce rapid elevations in blood glucose, available immediately as an energy source for muscle. In the moments after training or competition, you must also choose high GI foods, which trigger blood sugar and insulin both to take advantage of this anabolic qualities and stimulate the production of muscle glycogen ( see post refill glycogen ) and stimulate the repair and formation of muscle mass.

Is particularly high among diabetics, the risk of coronary heart disease. This is due to the fact that here is a arteriosclerosis (hardening of the arteries colloquially called) is much faster and more intensively developed. The consequence of a poorly controlled metabolism is often an overactive clotting. This means that blood platelets sticky and tend to form clumps more quickly. Represent a serious hazard in addition to the damaged nervous system of diabetic patients. Because of nerve damage, the pain that induces a reduced perfusion of the heart, not perceived. It may be that a heart attack occurs without any warning pain, not being noticed and therefore goes untreated.

Symptoms of coronary heart disease
The symptoms of coronary heart disease are numerous technical. They are regarded as warning signs that something is wrong and a doctor should be consulted. Primary symptoms are pain in the chest and shortness of breath or palpitations or irregular heartbeats. This unusual referred pain in the arms should be, in the jaw or back, tiredness or nausea, heartburn, and excessive sweating will be given more consideration.

Other cardiac complications
But not only with coronary heart disease have to reckon with diabetes. Other complications around the heart are just as widespread. Heart failure occurs, for example also increasingly on people with diabetes. This is due to a thickening, in turn, a stiffening of the walls of the smallest blood vessels and capillaries causes. Because of this failure, the pumping of the heart is significantly reduced. For this reason, diabetics should avoid especially smoking.

Diabetic neuropathy in diabetic patients is often pioneer of a diabetic foot ulcers. Nerve damage can also occur in the nerves that control the heart rate. This is referred to as: cardiac autonomic neuropathy. For the limitation of our heartbeat is the parasympathetic nervous system responsible. If this fails, predominates in the conduct of our heartbeat of the sympathetic nervous system is responsible for the performance. A consistent and not necessary, increased heart rate is the consequence, which in turn causes Frequenzstarre. The slowdown associated with the expiration of the pulse takes place here and not the heart is overwhelmed due to lack of recovery phases.

Prevention of Cardiovascular Diseases
An important component of diabetes treatment is therefore mainly the prevention of cardiovascular diseases. It begins with the patient knows about his diabetes, a healthy, balanced diet and enough exercise movement. In addition, the observation of his blood lipid levels is essential. A lipid metabolism disorder is considered a major cardiovascular risk factor. Also, the intake of bad cholesterol (and lipo-protein) should be avoided, since this is deposited on the walls of blood vessels and leads to narrowing.
The diabetes guideline of the German Diabetes Society, moreover, show that to be achieved as the main prevention is a must normal glycemic control. This assumes that the HbA1c did not – value in diabetic patients is higher than 7%. The A1C test indicates the long-term blood sugar levels. The doctor can because of this value, determined regardless of the current measurement, the average blood sugar levels of the last two to three months. The UK prospective diabetes study (UKPDS) has shown that a reduction was achieved by 16% incidence of heart attacks by lowering of HbA1c from 7.9 to 7.0%.

When we talk about blood sugar we refer to a particular carbohydrate, glucose. For proper use in the body, there is insulin, a hormone secreted by the pancreas as well withdraw from circulation the surplus glucose is responsible for facilitating their entry into cells of the liver and muscles where it is deposited in glycogen, and that penetrates the fat cells to be stored as fat. Thus, the body energy reserves.

But this regulatory mechanism can fail and increase the level of blood glucose, also called glucose, which is the most visible manifestation of the diabetic disease.

Much is said of diabetes and is described as a silent disease, with emphasis on family history and symptoms such as excessive thirst and urination abundant, but in reality, the high values ??of blood glucose are due to different causes . In other words, the symptom is one but two diabetes.

The problem with most
90% of diabetic patients presents a variant of the disease known as type II or noninsulin-dependent diabetes. The basic change is in the resistance to insulin action at the level of tissues, primarily in the liver and muscles. The body has insulin, but it can not get sugar into the cells. Given this situation, the pancreas produces larger amounts of hormone, with time, if the organ is still required, can reach a total exhaustion and the patient will need an external input.

Strongly influenced by genetic factors and family history, this type of diabetes is also due to other causes such as obesity, which increases insulin resistance. Usually occurs between 30 and 40 and, as no symptoms, 50% of sufferers, it is ignored.

When insulin is required

Another variation is known as type I or insulin. It can occur at any age but usually starts in childhood, adolescence or young adulthood. In these cases, patients require insulin intake because your body is not generated.

Why the pancreas loses the ability to produce the hormone? The result is mixed: a genetic predisposition and environmental factors, usually a virus, triggers the process. It is an autoimmune phenomenon in which antibodies that attack the insulin-producing pancreatic cells. The environ-mental component is dominant, so even if there are family members with diabetes or a genetic predisposition, if the person is not affected by the environmental factor, the condition is never revealed.

It is a highly symptomatic disease, characterized by increased nocturnal emission of urine, excessive thirst and weight loss without other cause.

Uncomplicated

The lack of diagnosis or inadequate blood sugar control may allow disease progression and complications. Excess glucose in the circulation tends to damage arteries. The consequences are varied, but usually presented as: kidney problems, eye, cardiovascular and lower limbs.

Today, experts stress the importance of prevention of chronic complications from the disease. This is a test that detects the percentage of glycated hemoglobin, a substance that we have in the body. Dr. Maximiliano Ruiz gives us his professional opinion: “This figure equals the average blood glucose over the past two months. It is important to ask the patient to perform this analysis at least three times a year. If we can get the values ??remain below 8%, prevent chronic complications. “

In the United States, a study in 1500 patients showed the existence of a direct relationship between metabolic control, the glycated hemoglobin level and the occurrence of complications. Two important conclusions arise from this: first, those who remain below the indicated value will have no complications in the future, or will have far fewer than today, and second, is an encouraging development, led to people being monitored. “We treat the patient is aware of these things and they themselves can ask the medical analysis – says Dr. Ruiz -. Because the pivot chronic diseases in the control and treatment is the patient. The doctor accompanying support and guidance, but when the patient is educated, better manage their controls and manages the treatment is effective. “

The mainstays of treatment

A fundamental aspect of therapy is pharmacological. The application of insulin or oral hypoglycemic use is decided on the type of diabetes.

Some patients may require insulin hormone application for a more adequate control of blood glucose. “The biggest breakthrough in diabetes health care in recent years – examines Dr. Ruiz – is self-control at home. This allows patients to perform a daily check and provide the necessary adjustments in their treatment.” Self-control is important in the drug plan but also in other aspects of treatment, the eating plan. “In this regard – continues specialist – are more liberal than before, especially with those using insulin. They can eat virtually all foods, what matters are the numbers. Of course not everyone can enjoy this possibility. The condition is not neglecting their controls, knowing the daily blood glucose values ??can know how sweet they are able to consume. ” Recommendations such as the choice of complex carbohydrates – starch – instead of the simple – sugar – remain in place. But today the emphasis is on quantity rather than quality of carbohydrates, to such an extent that it stimulates the consumption of diet foods because they can give a false sense of freedom.

Specialists support the treatment of diabetes on four pillars: drug therapy, meal planning, diabetes education and physical activity increases insulin sensitivity and allows the body make better use of glucose . However, leaving aside related to stress. “One of the most important factors descompensantes; – Dr. Ruiz reflects – in some cases is worse than a poor diet. For this reason, treatment includes psychotherapeutic support in those cases where necessary, the mode is selected by the therapist, according to the needs of each patient. “

Specialists are looking for if there is any relationship between both conditions, while many patients with diabetes wonder if the lack of sleep can affect their treatment or alter your blood glucose (sugar) levels.

While there is no completely accurate answer in this regard, some research shows that poor sleep itself could affect the treatment of people with diabetes.

Although sleep requirements vary from one person to another, it is recommended that adults sleep between 7 and 9 hours per day. It is possible that this information will not be new, but it can also be a mission impossible with the current lifestyle you lead. However, it is worth trying.

If you have diabetes, sleeping well can help prevent disease and maintain adequate levels of glucose in the blood. And if diabetes is already part of your life, maybe it’s time you start to rethink this and look how to rest better.

Some sleep experts say that when you have diabetes is as important as a healthy diet and appropriate to treat diabetes. Others add that it does not rest that people with diabetes to eat more, since the energy for no gain to sleep looking for other sources such as carbohydrates or other foods.

Moreover, it seems to be a relationship between diabetes and one of the disorders known as sleep apnea. This disorder is sleep apnea which can commonly cause snoring, as the person stops breathing for a few seconds during sleep.

This problem can be very serious and it is recommended that if you have it, talk to your doctor about it to see what the best therapy in your particular case. There are currently several very effective treatments for this condition that, in general, is detected by those who sleep with people who suffer from apnea during sleep (or sleep apnea).

In addition to diabetes, lack of sleep is also associated with other chronic conditions such as cardiovascular diseases, obesity and depression. So, increasingly it is recognized that adequate sleep is essential to prevent and to maintain good health.

If you have trouble sleeping, here are some recommendations that can help you sleep better:
* Go to bed at the same time every night and get up at the same time every morning.
* Sleep in a quiet, dark and relaxing, which is neither too hot nor too cold.
* Make sure your bed is comfortable and use it only for sleeping, not for activities such as reading, watching television or listening to music.
* Where possible, removed from the room televisions, computers (PCs) and other appliances.
* Avoid exercising a couple of hours before bed and slows your physical activity 30 minutes before bedtime, doing something relaxing.
* Avoid large meals before bedtime.
* Avoid caffeine, nicotine and alcohol 2 hours before bedtime.
* If you can not sleep 20 minutes after bedtime, get up and do something quiet.
* If you snore, you can try to lose weight, limiting consumption of alcohol and smoking and sleeping on your side, not back. All this can help reduce snoring. If it persists require treatment.
* If you have apnea, avoid alcohol, smoking and sleeping pills. If it persists require treatment.

Now that you know the importance of sleep, you have no excuses to avoid much needed rest. Sometimes he plays down the issue and you believe that “has times” in which lies better than others, that “it will happen”, that “it was a bad night” or “bad week” but those are only excuses.

When you have trouble sleeping, you may break those bad times are longer than you think. Similarly, it is also possible that there are effective treatments to remedy that situation. And now you know that not only help you sleep better but also keep you healthy and protect against diabetes and / or its complications.

Do not waste time, consult your doctor or if necessary, with a specialist, and … sleep with the angels to keep diabetes under control.

The truth, we can say that diabetes is an epidemic, since according to IDF (International Diabetes Federation) have it about 246 million people worldwide, a tremendous figure.

But for those who wonder what diabetes is, we can say that it is a chronic disease that is characterized by blood sugar levels high. To counter this excess sugar, diabetics (some, we) have to take insulin, a hormone produced by the pancreas and is necessary for life.

There are two types of diabetes: type 1 and type 2. The first is between young people, usually less than 35 years, and are characterized by people who are unable to produce insulin in their pancreas. For its part, the type 2 diabetes, was among older people, usually brought about by hyperglycemia.

We consider an epidemic of diabetes as being a very common disease. There are factors that contribute to the onset of diabetes, such as sedentary lifestyle, lack of exercise, obesity or poor nutrition. It is essential to a healthy diet, exercising and controlling blood glucose levels to be aware of health.

Diabetes can be prevented by following these little tips, on the other hand, are nothing new, because regardless of the disease we want to avoid or prevent, are practices that we must always do to lead a healthy life, I am referring mainly to what I said before, that is, a healthy diet and exercise.

In short, the relationship between diabetes and the epidemic is something that we must begin to consider and take into account. It is a disease that once you have it, not loose, and this is most disturbing. Hence the importance to prevent it before getting it.

Thus the continuous blood sampling is not always the annoying and painful matter, should make diabetes a few things before and while they control themselves. With a gentle pricking of the blood collection is far more relaxed.

When do you measure
How often blood glucose should be monitored on a case generally depends on the diabetes therapy. Additional blood sugar provisions may be particularly important, however, in special situations. For example, if signs of hypoglycaemia or a disease that is associated with fever, vomiting and diarrhea. Also in sports, travel, before a long car ride or a change in diet may be important that people know their blood glucose levels and responds appropriately to changes.

Fear of discomfort
The need for blood sugar measurements in diabetes therapy is controversial. Yet many fear affected pain during stinging, calluses or impairment of sensation in his fingers. Often triggers even from the sight of “naked” lancet fear. Modern lancing devices, in which the lancet is not visible, can contribute greatly to lose that fear.

How
This pain can be largely avoided with the right approach. Therefore, it is helpful to know that there are at the fingertip – the most common site of blood collection – places which are sensitive to pain than others. The reason is that the nerve receptors in the skin are not evenly distributed: At your fingertips, for example, bales are significantly more nerve fibers than on the lateral fingers. Therefore, it hurts the least, if you prefer to lateral fingertip blood sample. There is, incidentally, the blood supply to most, so there are not unnecessarily deep and painful sting to be.

Small tips make it easier to trade fairs
To further facilitate the measurement it is advisable to wash your hands and then rub with a towel – we promote circulation. The finger should not be squeezed too much, if not immediately leak blood. The resulting tissue fluid could be leaking is likely to distort value. If no blood, should the puncture depth of the lancing device to be changed. Even with the first drop of blood glucose can be measured. In contrast to the earlier views, it is totally unnecessary to wipe away the first drop.

Just prick as deep as necessary
The deeper you pricks in the skin, the more blood vessels are taken. With the depth increases, the number of nerve fibers – and therefore the pain this -. Lancing devices, which allow adjustment of puncture depth of the individual skin thickness, helping therefore absolutely crucial in reducing the pain this. Middle, ring finger and little finger are the most appropriate finger for blood collection, because small injuries to disrupt the thumb and index finger handles many more. Pressure on the puncture site to prevent bleeding of small blood sample that could later hurt when touched.

This high-risk diabetic patients develop mouth problems can be the cause of the variation in levels of blood glucose.

The relationship between diabetes and gum problems is reciprocal and bidirectional. This means that diabetes predisposes the sufferer to have tender gums, gums and the problem of making the control of diabetes more difficult. One way to avoid falling into this vicious circle is to visit a periodontist is a dentist specializing in gum.

The specialist will initiate a treatment to reduce inflammation and infection, the most common problems of the gums. Once the swelling is down, the dentist can start a more intensive therapy if required.

According to Dr. Campos, health institutions have specific protocols for treating diabetes. Because of its low defenses, such as “is regulatory, in some offices, the dentist may prescribe antibiotics to patients 24 hours before beginning treatment.”

One of the things that people with diabetes notice in your mouth is the dryness that causes depletion of the saliva. “This problem results in the tooth enamel and tooth decay tend to become more vulnerable. Dryness also tends to produce alitosis or odor in the mouth, “said Dr. Campos.

Occasionally, diabetic patients complain of taste loss. This is due to the treatment prescribed by a doctor, so be sure to share this information with the doctor.

Tips
Research shows that a deficiency in vitamin C and calcium is the cause of gum problems. Why doctors recommend people with diabetes, especially young people and women who are in menopause, do not forget to eat citrus fruits and dairy products.

To strengthen as far as possible the tooth enamel, brush with a toothpaste that has fluoride. Do it often and with a soft brush. If you can choose to rinse with fluoride, this is the best option.

Smoking, dentures, and dry mouth increases the risk of developing dental problems. Take precautions in this regard, thorough cleaning and rinsing the mouth accessories. Also drink plenty of fluids and yoghurt to prevent dryness.

Finally, remember that diabetic patients should visit their dentist at least every six months.

Glucose levels in these patients are constantly monitored by sensors and stored in a small receiver carried by the patient with diabetes and then transmit to your PC wirelessly and to send it to your endocrinologist.

The system tested in the Diabetes Unit of the Regional Hospital of Malaga is part of a study that attempts to regulate glucose levels steadily thanks to control levels and the daily recommendations of professionals who, after receiving the Patient results are sent via email or SMS to allow further steps to improve their diabetes significantly.

These tests is the second time you make and has been extended taking into account the success of the first test in which patients improved significantly their usual levels of blood glucose. Currently, the Regional Hospital of Malaga, there are 200 people with systems subcutaneous insulin infusion and over 35 also have monitoring systems such levels so that your diabetes is controlled alone.

The only way you can know if you are controlling your diabetes is through self-monitoring, that means you have to sting your finger at least once a day. This procedure is uncomfortable for people with diabetes because it is painful, but here we offer a guide to hurt a little less:

• Wash your hands with warm water to increase blood flow to the fingers.

• Before the puncture, stretch your arm down and squeeze the tip of the finger to swell with blood. • Sink your finger to the side and not in the center. The fingertips have many nerve endings which causes the needle hurt more. If you make one side feel a picket smaller because you do not have much feeling in that area.

• Before taking the fingerstick, extend your arm downward and pull the tip of the finger to swell with blood.

• Use both sides of every finger, rotating the sites, so that each finger touches the puncture less frequently.

• Preferred acquires a meter that requires less blood.