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Essential Tasks in Diabetes Self-Care

Monitoring Blood Glucose

Presently, there are multiple ways blood glucose can be monitored. At home, a patient can monitor blood glucose using finger-stick blood glucose meters or by wearing a continuous glucose monitor. The type of monitoring prescribed to patients is individually determine based on a number of factors, so your provider will discuss a plan for monitoring with you. In addition to these two daily monitoring options, getting an A1C blood test done periodically can help monitor blood glucose through your healthcare provider.

Monitoring Blood glucose levels is an important care task in Diabetes self-care, as this information helps you and your provider make treatment decisions and plans. Without tracking blood glucose readings, it is difficult to know if your medication plan is effective. Additionally, this gives a somewhat immediate feedback on how your lifestyle changes, like diet adjustment and being active, are affecting your blood sugar.

Aside from providing helpful information to you and your provider, monitoring blood sugar also helps you know if you are having concerning high or low blood sugar levels. Both have the potential to be dangerous, making this important to catch through monitoring blood sugar.

Taking Medications as Prescribed

As a patient with Diabetes, you may be prescribed one or multiple medications to help manage your blood sugar levels and reduce your risk of developing complications. Medication plans, like monitoring plans, differ from patient to patient due to various influences. An individualized plan will be made through discussion with your Diabetes care provider, and it is important to adhere to this plan to improve your overall health and help prevent complications related to Diabetes. Medications your doctor may discuss with you include: Oral Medications, Non-Insulin Injectable medications, Injectable Insulin. When being prescribed a new medication, you may wish to have additional education to understand how to take medications. Your provider may even recommend this when prescribing a new medication.

Healthy Eating

Eating a diet that is heart healthy and monitoring carb intake with meals and snacks is a means to help you blood sugar that is not medication. This is considered a “lifestyle change” in diabetes self-care. Assistance from a registered dietician trained diet management can be extremely useful. Not only can a Dietician help you understand how to eat or develop a plan, but they can offer support in sticking with this plan through regular follow-up visits.

Exercise and Activity

Being active and exercising is another “lifestyle change” that can help to manage your Diabetes and reduce risks of complication. The American Diabetes Association recommends getting at least 150 minutes of exercise per week. This breaks down to be about 30 minutes a day, 5 days a week. This can be achieved fairly easily by making even subtle changes to your day, like parking farther from the building at work or taking the stairs instead of the elevator. Breaking activity up into smaller more attainable sessions can help you reach this without feeling overwhelmed. However, you may also prefer to complete exercise all at once, either option is beneficial if you meet the overall goal of 150 minutes, or 2.5 hours per week. Over time you may gradually increase this as tolerate, but this gives an excellent starting goal, that is more attainable.

Treating Low and High Blood Glucose

Having a very low or very high blood sugar can introduce potential danger to your health, making it important to identify and treat these situations appropriately. To do this, you must understand signs and symptoms of low or high blood sugar, as well as actively monitor blood glucose to catch readings that are greatly out of range.

Low Blood Sugar

Often sudden or quick onset of symptoms, can be dangerous more immediately than high blood sugar, making it especially important to identify and treat.

Signs and Symptoms: Shakiness, sweating, dizziness, confusion or trouble speaking, hunger, weakness, feeling tired, headache, nervousness.

Treatment Decision: Blood glucose reading of <70

Treating Low Blood Sugar: The ADA discusses using the “15-15 Rule”, which includes eating 15 grams of carbohydrates and checking blood sugar in 15 minutes. If blood sugar is still <70 repeat this process.

High Blood Sugar

Typically, this is a gradual onset. Frequent or consistent high blood glucose increases risk of developing complications of diabetes and could lead to Ketoacidosis a serious medical condition, according to the American Diabetes Association.

Signs and Symptoms: Frequent urination, blurred vision, increased thirst, hunger, drowsiness, altered mental state.

Serious Signs and Symptoms (Ketoacidosis): Shortness of breath, fruity smelling breath, nausea and vomiting, very dry mouth.

Treatment Decisions:  Blood Glucose >180 1-2 hours after meals is considered high blood sugar according to the American Diabetes Association.

Treatment: Take diabetes medication if due and uses as prescribed, limit carbohydrate intake, drink plenty of water, exercise, monitor for signs of Ketoacidosis developing

**Seek immediate medical care if you have signs of Ketoacidosis **

 **if glucose is above 240, check urine for ketones and DO NOT exercise if Ketones are in urine, according dot the American Diabetes Association, this has been found to potentially INCREASE glucose, raising risk of Ketoacidosis. **

Monitoring for Complications

Daily Foot care

Inspect your feet every day for any signs of infection, cuts, blisters, sores, corns, redness or other discolored skin. Along with inspecting feet, working promote healthy feet is important. To do this the American Diabetes Association recommends the following:

  • check shoes for sharp object prior to putting on
  • do not go barefoot, wear proper fitting shoes
  • moisturize feet, avoid soaking feet
  • trim and file toenails regularly
  • wash feet daily
  • dry feet thoroughly after bathing or washing feet.

    Download "Foot Care for People With Diabetes"

Yearly Dilated Eye Exam

Seeing an eye doctor at least once a year helps ensure any early signs of eye complications related to Diabetes are found early, so a plan of treatment and monitoring can be established.

Dental Check-ups every six months

Regular dental visits are especially important for patients with Diabetes. Development of cavities or other oral conditions is a higher possibility for patients with Diabetes.

Regular follow-up visit with your Diabetes provider

Follow-up with your Diabetes provider regularly. Each patient will have an individualized recommended check-up visit frequency that their provider will recommend. It is important to follow-up with your doctor as often as recommended to ensure your health is being monitored and treatment plans continue to be appropriate.

Completion of labs as instructed by your Diabetes provider

Along with regular office visits, patients with diabetes may be recommended to have specific labs completely regularly. This helps your Diabetes provider assess the current treatment plan for effectiveness, monitor for worsening condition, adjust treatment plans if needed. This, like much of Diabetes care, differs for each patient and each patient will have an individualized plan recommended by their provider.

Injection Site Assessment and Care

If your treatment includes an injectable medication, areas where injections are given should be regularly inspected. Areas that are frequently used for injections, may develop fatty deposits or hard lumps. Injecting into one of these areas make insulin less reliable. You should avoid injecting in these spots.

Rotating sites helps promote healthy injection site and effectiveness of medication. The American Diabetes Association recommends moving around the same area.

Reference:     https://www.diabetes.org/