Taking Control of Diabetes

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Diabetes can bring about many changes, but the most important thing to remember is that you are in control! Making small changes in the way you manage diabetes and how you eat and live can bring about a healthier future.

Sick Day Guidelines
Illness, such as a cold or flu, can cause serious problems with your diabetes control. Because everyone reacts differently to illness, talk to your doctor or diabetes educator about the best ways to manage your diabetes when you are sick.

Following are some general guidelines:

Always take your diabetes medication, even if you are not eating. Check the dosage with your doctor.
Check your temperature four times a day.
Drink plenty of calorie-free liquids (8 to 12 ounces per hour).
Check your blood glucose every four to six hours and record results.
If you can't eat your meals, drink regular liquids (with sugar) and try eating crackers, toast, soup, hot cereal, juices, milk, eggs, etc.

Foot Care
Your feet need special attention because diabetes can reduce the body's ability to sense problems. By checking your feet daily, you can detect blisters, calluses or cuts and act to prevent bugger problems. Follow these guidelines for healthy feet:

Get your feet checked at every doctor's visit.
See a foot doctor for nail and foot care.
Inspect feet daily -- especially between toes.
File nails -- do not cut them.
Treat infections or sores right away.
Protect feet from injury - do not go barefoot.
Do not smoke.
Wear proper fitting shoes.
Elevate feet if swollen.
Exercise feet, ankles and legs.
If you can't see the bottoms of your feet, use a mirror or have someone check them for you.
Do not wear shoes without socks.
Wear cotton socks.
Do not use inserts or pads.
Avoid pointed or open-toe shoes.
Break in new shoes by wearing an hour a day.

Shoe Shopping Checklist

Material - good leather or canvas.
Width - room for toes to wiggle.
Length - 1/2 inch space between longest toe and shoe.

Check your blood sugar more often when:

You are sick.
There are changes in your treatment program, activity or food intake.
Glucose values are outside of the desired range.
There are many high or low blood glucose levels.

Daily Monitoring
You are the person making decisions about your health on a daily basis. Monitoring is the key to staying in control. Checking glucose levels allows you to:

Detect problems before they get out of hand.
Determine where changes in your diabetes plan are needed.
Wash your feet every day. Dry them, even between toes.
Determine if how you feel is because of high or low blood glucose levels.
See the effect of food or activity on glucose levels.

Exercise
There is no big secret to getting in shape. But there are some things you should know that can make it easier.

Benefits of Regular Exercise

Relieves tension and stress.
Reduces body fat.
Controls your appetite.
Improves muscle tone and strength.
Helps lower glucose levels.
Lowers blood pressure.
BEFORE STARTING ANY EXERCISE PROGRAM, CHECK WITH YOUR DOCTOR!

Know Your Target Values!
The HbA1c is a blood test done in the lab that averages all the glucose levels in your body over the past two to three months. Together with a record of your daily glucose levels, you and your doctor will be able to see how well your overall treatment plan is working and where changes are needed.

It is important to know what you are working so hard to achieve. Discuss what your glycohemoglobin and glucose levels should be most of the time with your diabetes doctor.

Making Sense of Those Blood Glucose Readings
To be in charge of your diabetes, you need to know how to respond to your glucose results. Try these steps:

Know your target glucose levels.
Monitor glucose levels for three to four days in a row.
Look for a pattern of glucose levels.
If they are higher or lower than target, determine which factors are responsible for the patterns.
If patterns are outside your desired range and you do not know what to do, call someone.
Do NOT ignore your results!

Helpful Hints For Using Insulin:

Store at room temperature. It is good for 30 days in a cool, dry place (68 - 75 degrees).
If your insulin will last longer than 30 days, keep it in the refrigerator. These bottles are good for three months.
Unopened insulin bottles are good until expiration date if they are kept in the refrigerator.

Do Not Use Bad Insulin!

Do not use regular insulin if it becomes cloudy.
Do not use cloudy insulin (NPG, Lente) if it becomes clumped or crystallized.
Do not use any insulin if it is expired. Bad insulin will result in very high glucose levels.

What Causes Bad Insulin?

Leaving it out in the sun or exposed to extreme hot or cold temperatures.
Using it past the expiration date.
Poor storage.

An Ounce of Prevention
Make sure you're doing all you can to prevent health problems later! During each visit, discuss the following points with your Diabetes Team or Doctor:

Glucose goals.
Meal plans.
Activity program.
Glucose testing schedule.
Treatment of high and low blood glucose levels.
Changes in medication.
Birth control if applicable.

Your Annual Review
At least once a year, be sure to have these tests:

Kidney function. Protein may signal that your kidneys are not working properly.
Blood fats. Cholesterol and triglycerides tell you about your risk for developing or worsening heart disease.
Eye exam by an eye doctor specializing in diabetics. Early detection and the proper treatment does make a difference.
Blood flow and nerve check of the feet. Your feet are the only ones that you have! Protect and treat them with tender loving care.
Blood pressure. Uncontrolled high blood pressure increases the chances for all the diabetes health problems.

Coping Strategies
Research shows the coping strategies can help people stay healthy. See if you can work some of these ideas into your own routine:

Take time each day to relax.
Focus on your positive qualities.
Maintain a good support system - including friends, family and pets.
Use humor and laughter to ease stressful times.
Give yourself a positive "self" message every day.

It's Your Health!

Taking Control of Diabetes

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