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Friday, November 11, 2011

Taking Care of Your Diabetes Every Day; 4 everyday tips

The four things you have to do every day to lower high blood sugar are:
1. Eat healthy food
2. Get regular exercise
3. Take your diabetes medicine
4. Test your blood sugar.

Experts say most people with diabetes should try to keep their blood sugar level as close as possible to the level of someone who does not have diabetes. This may not be possible or right for everyone. Check with your doctor about the right range of blood sugar for you.
You will get plenty of help in learning how to do this from your health care providers. Your main health care providers are your doctor, nurse, and dietitian. (A dietitian is someone who is specially trained to help people plan their meals.)
Bring a family member or friend with you when you see your doctor. Ask lots of questions. Before you leave, be sure you understand everything you need to know about taking care of your diabetes.

Eat Healthy Food

People with diabetes do not need special foods. The foods on your diabetes eating plan are the same foods that are good for everyone in your family! Try to eat foods that are low in fat, salt, and sugar and high in fiber such as beans, fruits and vegetables, and grains. Eating right will help you:
1. Reach and stay at a weight that is good for your body.
2. Keep your blood sugar in a good range.
3. Prevent heart and blood vessel disease.
People with diabetes should have their own eating plan. Ask your doctor to give you the name of a dietitian who can work with you to develop an eating plan for you and your family. Your dietitian can help you plan meals to include foods that you and your family like to eat and that are good for you.

Action Steps...

If You Use Insulin
  • Give yourself an insulin shot before you eat.
  • Eat at about the same time and the same amount of food every day.
  • Don't skip meals, especially if you have already given yourself an insulin shot because your blood sugar may go too low. 
If You Don't Use Insulin
  • Follow your meal plan.
  • Don't skip meals, especially if you take diabetes pills because your blood sugar may go too low. Skipping a meal can make you eat too much at the next meal. It may be better to eat several small meals during the day instead of one or two big meals.

Get Regular Exercise

Exercise is good for those with diabetes. Walking, swimming, dancing, riding a bicycle, playing baseball, and bowling are all good ways to exercise. You can even get exercise when you clean house or work in your garden. Exercise is especially good for people with diabetes because:
1. Exercise helps keep weight down.
2. Exercise helps insulin work better to lower blood sugar.
3. Exercise is good for your heart and lungs.
4. Exercise gives you more energy.

Before you begin exercising, talk with your doctor. Your doctor may check your heart and your feet to be sure you have no special problems. If you have high blood pressure or eye problems, some exercises like weight-lifting may not be safe. Your doctor or nurse will help you find safe exercises.
Try to exercise regularly. Exercise at least three times a week for about 30 to 45 minutes each time. If you have not exercised in a while, begin slowly. Start with five to 10 minutes, and then work up to more time.
If you haven't eaten for over an hour or if your blood sugar is less than 100-120, eat or drink something like an apple or a glass of milk before you exercise.
When you exercise, carry a snack with you in case of low blood sugar. Wear or carry an identification tag or card saying that you have diabetes.
Regular exercise such as walking and bicycling can help keep your blood sugar in a good range.

Action Steps...

If You Use Insulin
  • Exercise after eating, not before.
  • Test your blood sugar before, during, and after exercising. Don't exercise when your blood sugar is over 240.
  • Avoid exercise right before you go to sleep, because it could cause low blood sugar during the night.
If You Don't Use Insulin
  • See your doctor before starting an exercise program.
  • Test your blood sugar before and after exercising if you take diabetes pills.

Take Your Diabetes Medicine Every Day

Insulin and diabetes pills and injections (Byetta, Symlin, or Victoza) are the kinds of medicines used to lower blood sugar.

If You Use Insulin
You need insulin if your body has stopped making insulin or if it doesn't make enough insulin. Everyone with insulin-dependent diabetes (or type 1 diabetes) needs insulin, and many people with type 2 diabetes need insulin.
Insulin cannot be taken as a pill. You will have to give yourself shots every day. Some people give themselves one shot a day. Some people give themselves two or more shots a day. You need to take your insulin every day. Never skip a shot, even if you are sick.
Insulin is injected with a needle. Your doctor will tell you what kind of insulin to use, how much, and when to give yourself a shot. Talk to your doctor before changing the type or amount of insulin you use or when you give your shots. Your doctor or the diabetes educator will show you how to draw up insulin in the needle. They will also show you the best places on your body to give yourself a shot. Ask someone to help you with your shots if your hands are shaky or you can't see well.

Good places on your body to give shots are:
  • The outside part of your upper arms.
  • Around your waist and hips.
  • The outside part of your upper legs.
  • Avoid areas with scars and stretch marks.
  • Ask your doctor or nurse to check your skin where you give your shots.
You may be a little afraid at first to give yourself a shot. But most people find that the shots hurt less than they expected. The needles are small and sharp and do not go deep into your skin. Always use your own needles and never share them with anyone else.
Your doctor or diabetes educator will tell you how to throw away used needles safely.
Keep extra insulin in your refrigerator in case you break the bottle you are using. Do not keep insulin in the freezer or in hot places like the glove compartment of your car. Also, keep it away from bright light. Too much heat, cold, and bright light can damage insulin.
If your body makes insulin, but the insulin doesn't lower your blood sugar, you may have to take diabetes pills. Diabetes pills only work in people who have some insulin of their own. Some pills are taken once a day, some are taken more often. Ask your doctor when you should take your pills.
Diabetes pills are safe and easy to take. Be sure to tell your doctor if your diabetes pills make you feel bad or if you have any other problems. Remember, diabetes pills do not lower blood sugar all by themselves. You will still have to follow an eating plan and exercise to help lower your blood sugar.
Sometimes, people who take diabetes pills may need insulin shots for a while. This may happen if you get very sick, need to go to a hospital, or become pregnant. You may need insulin shots if the diabetes pills no longer work to lower your blood sugar.
You may be able to stop taking diabetes pills if you lose weight. Losing even a little bit of weight can sometimes help to lower your blood sugar.

If You Don't Use Insulin or Take Diabetes Pills 
 
Many people with type 2 diabetes don't have to use insulin or take diabetes pills. However, everyone with diabetes needs to follow their doctors advice about eating and getting enough exercise.
Ask your doctor when you should take your pills or insulin. Tell your other doctors that you take insulin or diabetes pills.

Test Your Blood Sugar Every Day

You need to know how well you are taking care of your diabetes. You need to know if you are lowering your high blood sugar. The best way to find out is to test your blood to see how much sugar is in it. If your blood has too much or too little sugar in it, your doctor may need to change your eating, exercise, or medicine plan.
Some people test their blood once a day. Others test their blood three or four times a day. Your doctor may want you to test before eating, before bed, and sometimes in the middle of the night. Ask your doctor how often and when you should test your blood sugar. 
 
How to Test Your Blood Sugar
 
To test your blood, you need a small needle called a lancet. You also need special blood testing strips that come in a bottle. Your doctor or diabetes educator will show you how to test your blood. Here are the basic steps to follow:
1. Depending on your home glucose monitoring device, prick your finger or another area of your body with the lancet to get a drop of blood.
2. Place the blood on the end of the strip.
3. Put the strip into the meter. The meter will display a number for your blood sugar, like 128.
Pricking your finger with a lancet may hurt a little. It's like sticking your finger with a pin. Use the lancet only once and be careful when you throw away used lancets. Ask your doctor or nurse how to throw them away safely.
You can buy lancets, strips, and meters at a drug store. Some of these items are costly, especially the blood testing strips. Lancets do not cost very much, and meters are often on sale. There are many different kinds of meters available in drug stores. If you decide to buy one, ask your doctor or diabetes educator for advice on what kind to buy. Take your blood testing items with you when you see your doctor or nurse so that you can learn how to use them correctly.

Other Tests for Your Diabetes

Urine Tests
You may need to test your urine or blood for ketones when you are sick or if your blood sugar is over 240 before eating a meal. These test will tell you if you have "ketones" in your urine or blood. Your body makes ketones when there is not enough insulin in your blood. Ketones can make you very sick. Call your doctor right away if you find ketones when you test. You may have a sickness called "ketoacidosis." Ketoacidosis is serious. If not treated, it can cause death. Signs of ketoacidosis are vomiting, weakness, fast breathing, and a sweet smell on the breath. Ketoacidosis is more likely to develop in people with insulin-dependent diabetes.
You can buy strips for testing urine ketones at a drug store. Also, some blood glucose meters can detect ketones with specializes strips. Your doctor or diabetes educator will show you how to use testing monitors correctly.

The Hemoglobin A1c Test
 
Another test for blood sugar, the hemoglobin A1c test, shows what your average blood sugar was for the past 3 months. It shows how much sugar is sticking to your red blood cells. The doctor does this test to see what level your blood sugar is most of the time.
See your doctor for a hemoglobin A1c test every three months. To do the test, the doctor or nurse takes a sample of your blood. The blood is tested in a laboratory. The laboratory sends the results to your doctor.
If most of the blood sugar tests you do yourself show that your blood sugar is around 150, the hemoglobin A1c test should be almost near optimal levels. If most of your tests show high levels of blood sugar, then the hemoglobin Alc test is usually high. Ask your doctor what your hemoglobin A1c test showed.
 
Keep Daily Records
 
Write down the results of your blood tests every day in a record book. You can use a small notebook or ask your doctor for a blood testing record book. You may also want to write down what you eat, how you feel, and how much you have exercised.
By keeping daily records of your blood and urine tests, you can tell how well you are taking care of your diabetes. Show your book to your doctor. The doctor can use your records to see if you need to make changes in your insulin shots or diabetes pills, or in your eating plan. Ask your doctor or nurse if you don't know what your test results mean.
Things to write down every day in your notebook are:
  • if you had very low blood sugar
  • if you ate more or less food than you usually do
  • if you felt sick or very tired
  • what kind of exercise you did and for how long

Reviewed by Brunilda Nazario, MD on October 28, 2011



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