Microsoft Office All Shortcut Keys.

1
Ctrl + Shift + A
AllCaps
Makes the selection all capitals (toggle)

2
Alt + Ctrl + 1
ApplyHeading1
Applies Heading 1 style to the selected text

3
Alt + Ctrl + 2
ApplyHeading2
Applies Heading 2 style to the selected text

4
Alt + Ctrl + 3
ApplyHeading3
Applies Heading 3 style to the selected text

5
Ctrl + Shift + L
ApplyListBullet
Applies List Bullet style to the selected text

6
Alt + F10
AppMaximize
Enlarges the application window to full size

7
Alt + F5
AppRestore
Restores the application window to normal size

8
Ctrl+B
Bold
Makes the selection bold (toggle)

9
Ctrl + PgDn
BrowseNext
Jump to the next browse object

10
Ctrl + PgUp
BrowsePrev
Jump to the previous browse object

11
Alt + Ctrl + Home
BrowseSel
Select the next/prev browse object

12
Esc
Cancel
Terminates an action

13
Ctrl+E
CenterPara
Centers the paragraph between the indents

14
Shift+F3
ChangeCase
Changes the case of the letters in the selection

15
Left arrow
CharLeft
Moves the insertion point to the left one character

16
Shift + Left arrow
CharLeftExtend
Extends the selection to the left one character

17
Rt arrow
CharRight
Moves the insertion point to the right one character

18
Shift + Rt arrow
CharRightExtend
Extends the selection to the right one character

19
Alt + Shift + C
ClosePane
Closes the active window pane (if you are in Normal View and have, for example, the Footnote pane open)

20
Alt+Drag (or press Ctrl + Shift + F8 and drag, but Alt + Drag is far easier!)
ColumnSelect
Selects a columnar block of text

21
Ctrl +Shift+C
CopyFormat
Copies the formatting of the selection

22
Shift + F2
CopyText
Makes a copy of the selection without using the clipboard (press Return to paste)

23
Alt + F3
CreateAutoText
Adds an AutoText entry to the active template

24
Ctrl+ Backspace
DeleteBackWord
Deletes the previous word without putting it on the Clipboard

25
Ctrl + Del
DeleteWord
Deletes the next word without putting it on the Clipboard

26
Ctrl+W, Ctrl+F4
DocClose
Prompts to save the document and then closes the active window. (But doesn't intercept the menu command)

27
Ctrl + F10
DocMaximize
Enlarges the active window to full size

28
Ctrl + F7
DocMove
Changes the position of the active window

29
Ctrl + F5
DocRestore
Restores the window to normal size

30
Ctrl + F8
DocSize
Changes the size of the active window

31
Alt + Ctrl + S
DocSplit
Splits the active window horizontally and then adjusts the split

32
Alt + Shift + F9
DoFieldClick
Executes the action associated with macrobutton fields

33
Ctrl + Shift + D
DoubleUnderline
Double underlines the selection (toggle)

34
Alt R, G
DrawGroup
Groups the selected drawing objects

35
Alt R, I
DrawSnapToGrid
Sets up a grid for aligning drawing objects

36
Alt R, U
DrawUngroup
Ungroups the selected group of drawing objects

37
Ctrl+Shift+F5 (Or: Alt I, K)
EditBookmark
Brings up the bookmark dialog

38
Del
EditClear
Performs a forward delete or removes the selection without putting it on the Clipboard

39
Ctrl+C
EditCopy
Copies the selection and puts it on the Clipboard

40
Ctrl+X
EditCut
Cuts the selection and puts it on the Clipboard

41
Ctrl+F
EditFind
Finds the specified text or the specified formatting

42
F5, Ctrl+G
EditGoTo
Jumps to a specified place in the active document

43
Alt E, K
EditLinks
Allows links to be viewed, updated, opened, or removed

44
Ctrl+V
EditPaste
Inserts the Clipboard contents at the insertion point

45
Alt E, S
EditPasteSpecial
Inserts the Clipboard contents as a linked object, embedded object, or other format

46
Alt + Shift + Backspc
EditRedo
Redoes the last action that was undone

47
F4
EditRedoOrRepeat
Repeats the last command, or redoes the last action that was undone (unfortunately, doesn't work for as many commands in Word 2000 as in Word 97 and below, but this is still one of Word's most useful shortcuts, if not the most useful)

48
Ctrl+H
EditReplace
Finds the specified text or the specified formatting and replaces it

49
Ctrl+A
EditSelectAll
Selects the entire document

50
Ctrl+Z
EditUndo
Reverses the last action

51
Alt + PageDn (to select to end of column, use Alt + Shift + PgDn)
EndOfColumn
Moves to the last cell in the current table column

52
Ctrl+Shift+End
EndOfDocExtend
Extends the selection to the end of the last line of the document

53
Ctrl+End
EndOfDocument
Moves the insertion point to the end of the last line of the document

54
End
EndOfLine
Moves the insertion point to the end of the current line

55
Shift+End
EndOfLineExtend
Extends the selection to the end of the current line

56
Alt+End
EndOfRow
Moves to the last cell in the current row

57
Alt + Ctrl + PgDn
EndOfWindow
Moves the insertion point to the end of the last visible line on the screen

58
Shift + Alt + Ctrl + PgDn
EndOfWindowExtend
Extends the selection to the end of the last visible line on the screen

59
F8 (press Esc to turn off)
ExtendSelection
Turns on extend selection mode and then expands the selection with the direction keys

60
Alt + F4 (<9>)
FileCloseOrExit
Closes the current document, or if no documents are open, quits Word. Horrible command, as it makes it a long winded business to quit Word. But there's a simple solution - assign Alt+F4 to FileExit instead.

61
Alt + F4 (Word 97)
FileExit
Quits Microsoft Word and prompts to save the documents (does intercept the menu item, but not the keyboard shortcut, or the x button. An AutoExit macro is usually a better way of intercepting this).

62
NOT Ctrl+N!!
FileNew
Creates a new document or template (brings up the dialog). Note that: Word pretends that Ctrl+N is assigned to FileNew but it isn't, it's assigned to FileNewDefault You can fix this in Word 2000 by assigning Ctrl+N to the FileNewDialog command. In Word 97 the only way to fix it is to create a macro called FileNew (to do this, press Alt + F8, type "FileNew" without the quotes and Click "Create". The macro will automatically contain the code needed to make it work).

63
Ctrl+N
FileNewDefault
Creates a new document based on the Normal template.

64
Ctrl+O
FileOpen
Opens an existing document or template

65
Alt F, U
FilePageSetup
Changes the page setup of the selected sections

66
Ctrl + P
FilePrint
Prints the active document (brings up the dialog)

67
Ctrl+F2
FilePrintPreview
Displays full pages as they will be printed

68
Alt F, I
FileProperties
Shows the properties of the active document

69
Ctrl+S
FileSave
FileSave

70
Alt F, A (or F12)
FileSaveAs
Saves a copy of the document in a separate file (brings up the dialog)

71
Ctrl+Shift+F
Font
Activates the Fonts listbox on the formatting toolbar

72
Ctrl+Shift+P
FontSizeSelect
Activates the Font Size drop-down on the formatting toolbar

73
Alt + Ctrl + K
FormatAutoFormat
Automatically formats a document (or sometimes, automatically screws it up)

74
Alt O, B
FormatBordersAndSha ding
Changes the borders and shading of the selected paragraphs, table cells, and pictures

75
Alt O, E
FormatChangeCase
Changes the case of the letters in the selection

76
Alt O, C
FormatColumns
Changes the column format of the selected sections (brings up the dialog)

77
Alt O, D
FormatDropCap
Formats the first character of current paragraph as a dropped capital (must select it first)

78
Ctrl+D
FormatFont
Brings up the Format + Font dialog

79
Alt + Shift + R
FormatHeaderFooterL ink
Links the current header/footer to the previous section (but does not intercept the button on the Header Footer toolbar)

80
Alt O, P
FormatParagraph
Brings up the Format Paragraph dialog

81
Alt O, S
FormatStyle
Applies, creates, or modifies styles

82
Alt O, T
FormatTabs
Brings up the Format Tabs dialog

83
Shift + F5
GoBack
Returns to the previous insertion point (goes back to up to 3 points, then returns to where you started; this is one of the most useful shortcuts of them all. Also useful when opening a document, if you want to g straight to where you were last editing it)

84
Ctrl + >
GrowFont
Increases the font size of the selection

85
Ctrl + ]
GrowFontOnePoint
Increases the font size of the selection by one point

86
Ctrl + T (or drag the ruler)
HangingIndent
Increases the hanging indent

87
F1
Help
Microsoft Word Help

88
Shift + F1
HelpTool
Lets you get help on a command or screen region or examine text properties

89
Ctrl + Shift + H
Hidden
Makes the selection hidden text (toggle)

90
Click on it
HyperlinkOpen
Connect to a hyperlink's address

91
Ctrl + M (or drag the ruler)
Indent
Moves the left indent to the next tab stop

92
Alt + Ctrl + M (or Alt I, M)
InsertAnnotation
Inserts a comment

93
F3
InsertAutoText
Replaces the name of the AutoText entry with its contents

94
Alt I, B
InsertBreak
Ends a page, column, or section at the insertion point

95
Alt I, C
InsertCaption
Inserts a caption above or below a selected object

96
Ctrl + Shift + Return
InsertColumnBreak
Inserts a column break at the insertion point

97
Alt + Shift + D
InsertDateField
Inserts a date field

98
Alt + Ctrl + D
InsertEndnoteNow
Inserts an endnote reference at the insertion point without displaying the dialog

99
Alt I, F
InsertField
Inserts a field in the active document

100
Ctrl+F9
InsertFieldChars
Inserts an empty field with the enclosing field characters

101
Alt I, L
InsertFile
Inserts the text of another file into the active document

102
Alt I, N
InsertFootnote
Inserts a footnote or endnote reference at the insertion point

103
Alt + Ctrl + F
InsertFootnoteNow
Inserts a footnote reference at the insertion point without displaying the dialog

104
Ctrl + K
InsertHyperlink
Insert Hyperlink

105
Alt I, D
InsertIndexAndTable s
Inserts an index or a table of contents, figures, or authorities into the document

106
Alt + Ctrl + L
InsertListNumField
Inserts a ListNum Field

107
Alt + Shift + F
InsertMergeField
Brings up a dialog to insert a mail merge field at the insertion point. (It does not intercept the button on the Mail merge. toolbar)

108
Ctrl + Return
InsertPageBreak
Inserts a page break at the insertion point

109
Alt + Shift + P
InsertPageField
Inserts a page number field

110
Ctrl + Shift + F3
InsertSpike
Empties the spike AutoText entry and inserts all of its contents into the document

111
Alt + Shift + T
InsertTimeField
Inserts a time field

112
Ctrl + I
Italic
Makes the selection italic (toggle)

113
Ctrl + J
JustifyPara
Aligns the paragraph at both the left and the right indent

114
Ctrl + L
LeftPara
Aligns the paragraph at the left indent

115
Down arrow
LineDown
Moves the insertion point down one line

116
Shift + down arrow
LineDownExtend
Extends the selection down one line

117
Up arrow
LineUp
Moves the insertion point up one line

118
Shift + up arrow
LineUpExtend
Extends the selection up one line

119
Ctrl + F11
LockFields
Locks the selected fields to prevent updating

120
Alt + Shift + K
MailMergeCheck
Checks for errors in a mail merge

121
Alt+Shift+E
MailMergeEditDataSo urce
Lets you edit a mail merge data source

122
Alt + Shift + N
MailMergeToDoc
Collects the results of the mail merge in a document

123
Alt Shift + M
MailMergeToPrinter
Sends the results of the mail merge to the printer

124
Alt + Shift + I
MarkCitation
Marks the text you want to include in the table of authorities

125
Alt + Shift + X
MarkIndexEntry
Marks the text you want to include in the index

126
Alt + Shift + O
MarkTableOfContents Entry
Inserts a TC field (but it is far better to use Heading Styles to generate your Table of Contents instead)

127
Alt or F10
MenuMode
Makes the menu bar active

128
Alt + Shift + F11
MicrosoftScriptEdit or
Starts or switches to Microsoft Development Environment application, allowing you to view the HTML/XML source code that would be behind the document if it were in ..htm format (or that is behind it if it already is in .htm format).

129
Alt + Ctrl + F1
MicrosoftSystemInfo
Execute the Microsoft System Info application

130
F2
MoveText
Moves the selection to a specified location without using the clipboard (press Return to execute the more)

131
Tab
NextCell
Moves to the next table cell

132
F11
NextField
Moves to the next field

133
Alt + F7
NextMisspelling
Find next spelling error

134
Alt + down arrow
NextObject
Moves to the next object on the page

135
Ctrl + F6
NextWindow
Switches to the next document window, equivalent to selecting a document from the Window menu.

136
Ctrl+Shift+N
NormalStyle
Applies the Normal style

137
Ctrl + 0
OpenOrCloseUpPara
Sets or removes extra spacing above the selected paragraph

138
F6
OtherPane
Switches to another window pane in Normal View (for instance, if you have if you have a Footnotes pane open in Normal view and want to switch to the main document and back without closing the pane).

139
Alt + _
OutlineCollapse
Collapses an Outline in Outline View by one level

140
Alt+Shift+rt arrow
OutlineDemote
Demotes the selected paragraphs one heading level

141
Alt + +
OutlineExpand
Expands an Outline in Outline View by one level

142
Alt+Shift+down arrow
OutlineMoveDown
Moves the selection below the next item in the outline

143
Alt+Shift+up arrow
OutlineMoveUp
Moves the selection above the previous item in the outline

144
Alt+Shift+left arrow
OutlinePromote
Promotes the selected paragraphs one heading level

145
Alt + Shift + L
OutlineShowFirstLin e
Toggles between showing the first line of each paragraph only or showing all of the body text in the outline

146
Ins
Overtype
Toggles the typing mode between replacing and inserting

147
PgDn
PageDown
Moves the insertion point and document display to the next screen of text

148
Shift+ PgDn
PageDownExtend
Extends the selection and changes the document display to the next screen of text

149
PgUp
PageUp
Moves the insertion point and document display to the previous screen of text

150
Shift + PgUp
PageUpExtend
Extends the selection and changes the document display to the previous screen of text

151
Ctrl + down arrow
ParaDown
Moves the insertion point to the beginning of the next paragraph

152
Shift + Ctrl + down arrow
ParaDownExtend
Extends the selection to the beginning of the next paragraph

153
Ctrl + up arrow
ParaUp
Moves the insertion point to the beginning of the previous paragraph

154
Shift + Ctrl + up arrow
ParaUpExtend
Extends the selection to the beginning of the previous paragraph

155
Ctrl+Shift+V
PasteFormat
Applies the previously copied formatting to selection

156
Shift + Tab
PrevCell
Moves to the previous table cell

157
Shift + F11
PrevField
Moves to the previous field

158
Alt + up arrow
PrevObject
Moves to the previous object on the page

159
Ctrl + Shift + F6
PrevWindow
Switches back to the previous document window

160
Sfift+F4
RepeatFind
Repeats Go To or Find to find the next occurrence

161
Ctrl+Spacebar
ResetChar
Makes the selection the default character format of the applied style

162
Ctrl+Q
ResetPara
Makes the selection the default paragraph format of the applied style

163
Ctrl +R
RightPara
Aligns the paragraph at the right indent

164
Ctrl + *
ShowAll
Shows/hides all nonprinting characters

165
Alt + Shift + A
ShowAllHeadings
Displays all of the heading levels and the body text in Outline View

166
Ctrl + <
ShrinkFont
Decreases the font size of the selection

167
Ctrl + [
ShrinkFontOnePoint
Decreases the font size of the selection by one point

168
Ctrl + Shift + K
SmallCaps
Makes the selection small capitals (toggle)

169
Ctrl + 1
SpacePara1
Sets the line spacing to single space

170
Ctrl + 5
SpacePara15
Sets the line spacing to one-and-one- half space

171
Ctrl + 2
SpacePara2
Sets the line spacing to double space

172
Ctrl + F3
Spike
Deletes the selection and adds it to the "Spike" AutoText entry (which allows you to move text and graphics from nonadjacent locations)

173
Alt + PgUp
StartOfColumn
Moves to the first cell in the current column

174
Ctrl+Shift+Home
StartOfDocExtend
Extends the selection to the beginning of the first line of the document

175
Ctrl +Home
StartOfDocument
Moves the insertion point to the beginning of the first line of the document

176
Home
StartOfLine
Moves the insertion point to the beginning of the current line

177
Shift+Home
StartOfLineExtend
Extends the selection to the beginning of the current line

178
Alt+Home
StartOfRow
Moves to the first cell in the current row

179
Alt+Ctrl+PgUp
StartOfWindow
Moves the insertion point to the beginning of the first visible line on the screen

180
Shift+ Alt+Ctrl+PgUp
StartOfWindowExtend
Extends the selection to the beginning of the first visible line on the screen

181
Strl + Shift + S
Style
Activates the Style drop-down on the Formatting toolbar

182
Ctrl + =
Subscript
Makes the selection subscript (toggle)

183
Ctrl + +
Superscript
Makes the selection superscript (toggle)

184
Ctrl + Shift + Q
SymbolFont
Applies the Symbol font to the selection

185
Alt A, F
TableAutoFormat
Applies a set of formatting to a table

186
Alt A, H
TableHeadings
Toggles table headings attribute on and off

187
Alt + click
(Alt + drag to select several)
TableSelectColumn
Selects the current column in a table

188
Click in left margin
TableSelectRow
Selects the current row in a table

189
Alt + double-click
TableSelectTable
Selects an entire table

190
Alt + Ctrl + U
TableUpdateAutoForm at
Updates the table formatting to match the applied Table Autoformat settings

191
Shift + F9 (Alt + F9 toggles all field codes on or off)
ToggleFieldDisplay
Shows the field codes or the results for the selection (toggle)

192
Alt T, C
ToolsCustomize
Allows you to customizes the Word user interface (menus, keyboard and toolbars) and store the customizations in a template (defaults to Normal.dot, so be careful!)

193
Alt + F8
ToolsMacro
Runs, creates, deletes, or revises a macro

194
F7
ToolsProofing
Checks the spelling and grammar in the active document

195
Ctr.l + Shift + E
ToolsRevisionMarksT oggle
Toggles track changes for the active document

196
Shift + F7
ToolsThesaurus
Finds a synonym for the selected word

197
Ctrl+U
Underline
Formats the selection with a continuous underline (toggle)

198
Ctrl + Shift + T
(or drag the ruler)
UnHang
Decreases the hanging indent

199
Ctrl + Shift + M
(or drag the ruler)
UnIndent
Moves the left indent to the previous tab stop

200
Ctrl+Shift+F9
UnlinkFields
Permanently replaces the field codes with the results

201
Ctrl + Shift + F11
UnlockFields
Unlocks the selected fields for updating

202
F9
UpdateFields
Updates and displays the results of the selected fields

203
Ctrl + Shiift + F7
UpdateSource
Copies the modified text of a linked file back to its source file

204
Hover over comment
ViewAnnotations
Show or hide the comment pane

205
Dbl-click the endnote reference
ViewEndnoteArea
If in Normal View, opens a pane for viewing and editing the endnote (toggle). If in Page/Print Layout View, switches from the body text to the endnote or vice versa

206
At + F9
ViewFieldCodes
Shows the field codes or results for all fields (toggle)

207
Dbl-click the footnote reference
ViewFootnoteArea
If in Normal View, opens a pane for viewing and editing the footnote (toggle). If in Page/Print Layout View, switches from the body text to the footnote or vice versa.

208
Alt V, F
ViewFootnotes
If in Normal View, opens a pane for viewing and editing footnotes and endnotes (toggle). If in Page/Print Layout View, switches from the body text to the footnotes/endnotes or vice versa.

209
Alt V, H
ViewHeader
Displays header in page layout view

210
Alt V, N
(or Alt + Ctrl + N)
ViewNormal
Changes the editing view to normal view

211
Alt V, O
(or Alt + Ctrl + O)
ViewOutline
Displays a document's outline

212
Alt V, P
(or Alt + Ctrl + P)
ViewPage
Displays the page more-or-less as it will be printed, and allows editing (In Word 2000 the menu item is called Print Layout, but fortunately the command hasn't changed.

213
Alt + F11
ViewVBCode
Shows the VB editing environment (Tools + Macro + Visual Basic Editor)

214
Alt + left arrow
WebGoBack
Backward hyperlink (useful if you clicked on a page number hyperlink in the table of contents and then want to return to the TOC)

215
Alt + rt arrow
WebGoForward
Forward hyperlink

216
Alt W, A
WindowArrangeAll
Arranges windows as non-overlapping tiles

217
Ctrl + left arrow
WordLeft
Moves the insertion point to the left one word

218
Shift + Ctrl + left arrow
WordLeftExtend
Extends the selection to the left one word

219
Ctrl + rt arrow
WordRight
Moves the insertion point to the right one word

220
Shift + Ctrl + rt arrow
WordRightExtend
Extends the selection to the right one word

221
Ctrl + Shift + W
WordUnderline
Underlines the words but not the spaces in the selection (toggle)

---

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Diabetes:

Definition
Diabetes is a life-long disease marked by high levels of sugar in the blood.

Causes, incidence, and risk factors

Diabetes can be caused by too little insulin (a hormone produced by the pancreas to control blood sugar), resistance to insulin, or both.

To understand diabetes, it is important to first understand the normal process of food metabolism. Several things happen when food is digested:

A sugar called glucose enters the bloodstream. Glucose is a source of fuel for the body.
An organ called the pancreas makes insulin. The role of insulin is to move glucose from the bloodstream into muscle, fat, and liver cells, where it can be used as fuel.
People with diabetes have high blood sugar. This is because their pancreas does not make enough insulin or their muscle, fat, and liver cells do not respond to insulin normally, or both.

There are three major types of diabetes:

Type 1 diabetes is usually diagnosed in childhood. The body makes little or no insulin, and daily injections of insulin are needed to sustain life.
Type 2 diabetes is far more common than type 1 and makes up most of all cases of diabetes. It usually occurs in adulthood. The pancreas does not make enough insulin to keep blood glucose levels normal, often because the body does not respond well to the insulin. Many people with type 2 diabetes do not know they have it, although it is a serious condition. Type 2 diabetes is becoming more common due to the growing number of older Americans, increasing obesity, and failure to exercise.
Gestational diabetes is high blood glucose that develops at any time during pregnancy in a woman who does not have diabetes.
Diabetes affects more than 20 million Americans. About 54 million Americans have prediabetes. There are many risk factors for diabetes, including:

A parent, brother, or sister with diabetes
Obesity
Age greater than 45 years
Some ethnic groups (particularly African Americans, Native Americans, Asians, Pacific Islanders, and Hispanic Americans)
Gestational diabetes or delivering a baby weighing more than 9 pounds
High blood pressure
High blood levels of triglycerides (a type of fat molecule)
High blood cholesterol level
Not getting enough exercise
The American Diabetes Association recommends that all adults over age 45 be screened for diabetes at least every 3 years. A person at high risk should be screened more often.

Symptoms
High blood levels of glucose can cause several problems, including frequent urination, excessive thirst, hunger, fatigue, weight loss, and blurry vision. However, because type 2 diabetes develops slowly, some people with high blood sugar experience no symptoms at all.

Symptoms of type 1 diabetes:

Increased thirst
Increased urination
Weight loss in spite of increased appetite
Fatigue
Nausea
Vomiting
Patients with type 1 diabetes usually develop symptoms over a short period of time, and the condition is often diagnosed in an emergency setting.

Symptoms of type 2 diabetes:

Increased thirst
Increased urination
Increased appetite
Fatigue
Blurred vision
Slow-healing infections
Impotence in men

Signs and tests

A urine analysis may be used to look for glucose and ketones from the breakdown of fat. However, a urine test alone does not diagnose diabetes. The following blood glucose tests are used to diagnose diabetes:

Fasting blood glucose level -- diabetes is diagnosed if higher than 126 mg/dL on two occasions. Levels between 100 and 126 mg/dl are referred to as impaired fasting glucose or pre-diabetes. These levels are considered to be risk factors for type 2 diabetes and its complications.
Random (non-fasting) blood glucose level -- diabetes is suspected if higher than 200 mg/dL and accompanied by the classic symptoms of increased thirst, urination, and fatigue. (This test must be confirmed with a fasting blood glucose test.)
Oral glucose tolerance test -- diabetes is diagnosed if glucose level is higher than 200 mg/dL after 2 hours (This test is used more for type 2 diabetes.)
You should also ask your doctor how often to you need your hemoglobin A1c (HbA1c) level checked. The HbA1c is a measure of average blood glucose during the previous 2 to 3 months. It is a very helpful way to determine how well treatment is working.

Ketone testing is another test that is used in type 1 diabetes. Ketones are produced by the breakdown of fat and muscle, and they are harmful at high levels. The ketone test is done using a urine sample. High levels of blood ketones may result in a serious condition called ketoacidosis. Ketone testing is usually done at the following times:

When the blood sugar is higher than 240 mg/dL
During acute illness (for example, pneumonia, heart attack, or stroke)
When nausea or vomiting occur
During pregnancy

Treatment

There is no cure for diabetes. Treatment involves medicines, diet, and exercise to control blood sugar and prevent symptoms and complications.

LEARN THESE SKILLS

Basic diabetes management skills will help prevent the need for emergency care. These skills include:

How to recognize and treat low blood sugar (hypoglycemia) and high blood sugar (hyperglycemia)
What to eat and when
How to take insulin or oral medication
How to test and record blood glucose
How to test urine for ketones (type 1 diabetes only)
How to adjust insulin or food intake when changing exercise and eating habits
How to handle sick days
Where to buy diabetes supplies and how to store them
After you learn the basics of diabetes care, learn how the disease can cause long-term health problems and the best ways to prevent these problems. People with diabetes need to review and update their knowledge, because new research and improved ways to treat diabetes are constantly being developed.

SELF-TESTING

If you have diabetes, your doctor may tell you to regularly check your blood sugar levels at home. There are a number of devices available, and they use only a drop of blood. Self-monitoring tells you how well diet, medication, and exercise are working together to control your diabetes and can help your doctor prevent complications.

The American Diabetes Association recommends that premeal blood sugar levels fall in the range of 80 to 120 mg/dL and bedtime blood levels fall in the range of 100 to 140 mg/dL. Your doctor may adjust this depending on your circumstances.

WHAT TO EAT

You should work closely with your health care provider to learn how much fat, protein, and carbohydrates you need in your diet. A registered dietician can be very helpful in planning dietary needs.

People with type 1 diabetes should eat at about the same times each day and try to be consistent with the types of food they choose. This helps to prevent blood sugars from becoming extremely high or low.

Persons with type 2 diabetes should follow a well-balanced and low-fat diet.

HOW TO TAKE MEDICATION

Medications to treat diabetes include insulin and glucose-lowering pills called oral hypoglycemic drugs.

Persons with type 1 diabetes cannot make their own insulin, so daily insulin injections are needed. Insulin does not come in pill form. Injections that are generally needed one to four times per day. Some people use an insulin pump, which is worn at all times and delivers a steady flow of insulin throughout the day. Other people may use a new type of inhaled insulin.

Insulin preparations differ in how quickly they start to work and how long they remain active. Sometimes different types of insulin are mixed together in a single injection. The types of insulin to use, the doses needed, and the number of daily injections are chosen by a health care professional trained to provide diabetes care.

People who need insulin are taught to give themselves injections by their health care providers or diabetes educators.

Unlike type 1 diabetes, type 2 diabetes may respond to treatment with exercise, diet, and medicines taken by mouth. There are several types of medicines used to lower blood glucose in type 2 diabetes. They fall into one of three groups:

Medications that increase insulin production by the pancreas. They include glimepiride, glipizide, glyburide, repaglinide, nateglinide, and sitaglyptin.
Medications that increase sensitivity to insulin. These include metformin, rosiglitazone, and pioglitazone.
Medications that delay absorption of glucose from the gut. These include acarbose and miglitol.
There are some injectable medicines used to lower blood sugar. They include exenatide and pramlintide.

Most persons with type 2 diabetes will need more than one medication for good blood sugar control within 3 years of starting their first medication. Different groups of medications may be combined or used with insulin.

Some people with type 2 diabetes find they no longer need medication if they lose weight and increase activity, because when their ideal weight is reached, their own insulin and a careful diet can control their blood glucose levels.

It is unknown if hypoglycemic medicines taken by mouth are safe for use in pregnancy. Women who have type 2 diabetes and take these medications may be switched to insulin during pregnancy and while breastfeeding.

Gestational diabetes is treated with insulin and changes in diet.

EXERCISE

Regular exercise is especially important for people with diabetes. It helps with blood sugar control, weight loss, and high blood pressure. People with diabetes who exercise are less likely to experience a heart attack or stroke than diabetics who do not exercise regularly. You should be evaluated by your physician before starting an exercise program.

Here are some exercise considerations:


Choose an enjoyable physical activity that is appropriate for your current fitness level.
Exercise every day, and at the same time of day, if possible.
Monitor blood glucose levels before and after exercise.
Carry food that contains a fast-acting carbohydrate in case you become hypoglycemic during or after exercise.
Carry a diabetes identification card and a mobile phone or change for a payphone in case of emergency.
Drink extra fluids that do not contain sugar before, during, and after exercise.
Changes in exercise intensity or duration may need changes in diet or medication dose to keep blood sugar levels from going too high or low.

FOOT CARE

People with diabetes are prone to foot problems because of the likelihood of damage to blood vessels and nerves and a decreased ability to fight infection. Problems with blood flow and damage to nerves may cause an injury to the foot to go unnoticed until infection develops. Death of skin and other tissue can occur.

If left untreated, the affected foot may need to be amputated. Diabetes is the most common condition leading to amputations.

To prevent injury to the feet, people with diabetes should adopt a daily routine of checking and caring for the feet as follows:

Check your feet every day, and report sores or changes and signs of infection.
Wash your feet every day with lukewarm water and mild soap, and dry them thoroughly.
Soften dry skin with lotion or petroleum jelly.
Protect feet with comfortable, well-fitting shoes.
Exercise daily to promote good circulation.
See a podiatrist for foot problems or to have corns or calluses removed.
Remove shoes and socks during a visit to your health care provider and remind him or her to examine your feet.
Stop smoking, which hinders blood flow to the feet.

Calling your health care provider

Go to the emergency room or call the local emergency number (such as 911) if symptoms of ketoacidosis occur:

Increased thirst and urination
Nausea
Deep and rapid breathing
Abdominal pain
Sweet-smelling breath
Loss of consciousness

Go to the emergency room or call the local emergency number if symptoms of extremely low blood sugar (hypoglycemic coma or severe insulin reaction) occur:
Weakness
Drowsiness
Headache
Confusion
Dizziness
Double vision
Lack of coordination
Convulsions or unconsciousness

Prevention

Maintaining an ideal body weight and an active lifestyle may prevent the onset of type 2 diabetes. Currently there is no way to prevent type 1 diabetes.