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How To: Keep Healthy with Diabetes PDF Print E-mail

This section is for everyone.


Overview

Meal Planning

Self-monitoring of Blood Glucose

Use of Insulin and Diabetes Medications

Foot Care

Urine Testing for Ketones

Annual Health Checks

You need to be confident about...

 

Overview

The Joslin Diabetes Centre have a check list so you can see what sort of things you need to know to look after yourself with diabetes. This list covers type one and type two diabetes. For each heading I will list what we have already covered on this course and what we will be covering in more depth in the Type One Section *
 
There is a considerable overlap between both types of diabetes. To start with most people with insulin dependent diabetes diagnosed in childhood or young adulthood are  not overweight or insulin resistant. As time goes on this may change so Type Ones would benefit from reading the earlier sections to see if any of it applies to them. The majority of the carb counting methods have also already been covered in the Metabolic and Type 2 section.
 
For type twos who start off on diet or oral medications they may find that after  a while this is no longer sufficient to maintain normal blood sugars. You may benefit by reading on to find out how to deal with insulin now or in the future.
 
If you don't feel really confident about any of the things I have listed please take advantage of some of the books and internet resources in the help sections. It is important that you know what to do ahead of any emergency developing so please contact your diabetes support team for further personal training.

 

MEAL PLANNING

Your own meal plan
know how carbs, proteins* and fats affect the body
special foods and occasions
dining out
portion control
label reading
how to fit in treats*
alcohol*


 
 

SELF MONITORING OF BLOOD SUGAR

blood glucose goals
how to use the meter
monitoring schedule*
storing supplies*
interpreting blood glucose values and making decisions in diabetes treatment plan*
 

 

USE OF INSULIN AND DIABETES MEDICATIONS

Action and side effects of medication*
timing and schedule*
insulin injection techniques*
storage, refrigeration and disposal of supplies*
what to do if you miss a dose*
 
 

EXERCISE

What type, how long, how hard, how often and when.*
snacking adjustments*
preventing high and low blood sugars*
 

 

KNOWLEDGE OF HIGH AND LOW BLOOD GLUCOSE

Factors that cause high and low blood glucose*
symptoms*
how to treat*
when to call a healthcare provider*
how to prevent*
 
 

FOOT CARE

daily foot care*
emergency treatment for cuts, sores and abrasions.
how to do a proper foot exam*
proper footwear
 
 

URINE TESTING FOR KETONES

When and how to check for ketones*
What ketones mean*
When to call a doctor*
 

 

YOUR HEALTH TEAM WILL DO THESE ANNUAL CHECKS AND TESTS

A1C ( 2-4 times a year)*
kidney function*
cholesterol, ldl, hdl, triglycerides*
foot exam*
eye exam*
blood pressure*
general health check eg thyroid, tests for coeliac disease and anything relevant to you*
 

 

YOU NEED TO BE VERY CONFIDENT ABOUT...

Your own meal plan 
The medication you are taking
Your glucose monitoring system
The treatment of high and low blood sugars
How to manage your sick days  
Your risk factors for developing other health problems
Your foot care

 


Quick Quiz:
1. A test type twos should have done every six months is...
     a Liver function and creatine kinase.
     b Hbaic.
     c Fasting lipids.
     d Sex hormone binding globulin.

Have you got it?
1. You must have your hbaic checked every 3-6 months. If statins are being taken, fasting blood lipids, liver and creatine kinase levels may be taken episodically.

Where to Next?
Please all proceed to the  How To: Safely Dispose of Needles and Other Sharps section.

 

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Comments (1)Add Comment
...
written by Dr Katharine Morrison, February 08, 2008

Blood Pressure Targets


On this course we spend a lot of time discussing how to normalise your blood sugar. A subject we haven't spent much time on is blood pressure.

If you have high blood pressure this has been shown to accelerate kidney disease, cardiovascular disease such as heart attacks, heart failure and strokes, and retinopathy.

At the present time all of the checks that are recommended for diabetics are not being done as frequently as they should for most diabetics who attend the clinics. Only 7% of the diabetic population meet current ADA targets for glycaemic control, blood pressure and lipids.

What blood pressure control is ideal?

115/75 or lower is ideal. After this heart risk doubles for every 20/10 increment.

The ADA target is 130/80
The ACP (American College of Physicians) target is 135/80.

You will certainly need treatment if you have diabetes and your blood pressure is 140/90 or over.

If you have chronic kidney disease you are aiming for a blood pressure of 120/75 or less.

Many people get "white coat" hypertension. Perhaps the best way to figure out what your blood pressure really is would be to buy yourself an electronic blood pressure monitor, check your bp at different times of the day and if you are up at night and let your doctor see the results.


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