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Taking Care of Your Diabetes Every Day In this chapter:
Do four things every day to lower high blood glucose:
Experts say most people with diabetes should try to keep their blood glucose
level as close as possible to the level of someone who doesn't have
diabetes. The closer to normal your blood glucose is, the lower your chances
are of developing damage to your eyes, kidneys, and nerves. Check with your doctor about the right range for you. Your health care team will help you learn how to reach your target blood
glucose range. Your main health care providers are your doctor, nurse,
diabetes educator, and dietitian. When you see your health care provider, ask lots of questions. Before you
leave, be sure you understand everything you need to know about taking care
of your diabetes. A diabetes educator is a health care worker who teaches people how to manage
their diabetes. Your educator may be a nurse, a dietitian, or another kind
of health care worker. A dietitian is someone who's specially trained to help people plan their
meals. For more information about these health care providers and for help
in finding them, see chapter six. The next sections of this guide will tell you more about the four main ways
you take care of your diabetes: Follow your meal plan, by physically active,
take your diabetes medicine, and check your blood glucose. Follow Your Meal Plan People with diabetes don't need to eat special foods. The foods on your meal
plan 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, vegetables,
and grains. Eating right will help you Your daily meal plan should include foods from these groups:
Milk and milk products like yogurt; meat, chicken or other poultry, fish,
beans, cheese, and eggs; vegetables and fruits; bread, cereal, rice,
noodles, and potatoes. People with diabetes should have their own meal plan. Ask your doctor to
give you the name of a dietitian who can work with you to develop a meal
plan. Your dietitian can help you plan meals to include foods that you and
your family like to eat and that are good for you too. Ask your dietitian to
include foods that are heart-healthy to reduce your risk of heart disease. ACTION STEPS If you use insulin ACTION STEPS If you DON'T use insulin Be Physically Active Physical activity is good for your diabetes. Walking, swimming, dancing,
riding a bicycle, playing baseball, and bowling are all good ways to be
active. You can even get exercise when you clean house or work in your
garden. Physical activity is especially good for people with diabetes
because 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 weightlifting
may not be safe. Your health care team can help you find safe exercises. Try to be active almost every day for a total of about 30 minutes. If you
haven't been very active lately, begin slowly. Start with 5 to 10 minutes,
and then add more time. Or exercise for 10 minutes, three times a day. If your blood glucose is less than 100 to 120, have a snack before you
exercise. (See chapter 3 for snack ideas.) When you exercise, carry glucose tablets or a carbohydrate snack with you in
case you get hypoglycemia (low blood sugar). Wear or carry an identification
tag or card saying that you have diabetes. The groups listed in chapter six have more information about diabetes and
exercise. ACTION STEPS If you use insulin ACTION STEPS If you don't use insulin Take Your Diabetes Medicine Every Day Insulin and diabetes pills are the two kinds of medicines used to lower
blood glucose. If You Use Insulin You need insulin if your body has stopped making insulin or if it doesn't
make enough. Everyone with type 1 diabetes needs insulin, and many people
with type 2 diabetes do too. Insulin can't be taken as a pill. You'll give yourself shots every day or
use an insulin pump. An insulin pump is a small machine that connects to
narrow tubing, ending with a needle just under the skin near the abdomen.
Insulin is delivered through the needle. Keep extra insulin in your refrigerator in case you break the bottle you're
using. Don't 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, or bright light can damage insulin. If you use a whole bottle of insulin within a month, you can keep that
bottle at room temperature. If you don't use a whole bottle of insulin
within one month, then store it in the refrigerator. If You Take Diabetes Pills If your body makes insulin, but the insulin doesn't lower your blood
glucose, you may need diabetes pills. Some pills are taken once a day, and
others are taken more often. Ask your health care team when you should take
your pills. Be sure to tell your doctor if your pills make you feel sick or if you have
any other problems. Remember, diabetes pills don't lower blood glucose all
by themselves. You'll still want to follow a meal plan and be active to help
lower your blood glucose. Sometimes, people who take diabetes pills may need insulin shots for a
while. If you get sick or have surgery, the diabetes pills may no longer
work to lower your blood glucose. You may be able to stop taking diabetes pills if you lose weight. (Always
check with your doctor before you stop taking your diabetes pills.) Losing
10 or 15 pounds can sometimes help you reach your target blood glucose
level. If You Don't Use Insulin or Take Diabetes Pills Many people with type 2 diabetes don't need insulin or diabetes pills. They
can take care of their diabetes by using a meal plan and exercising
regularly. Check Your Blood Glucose as Recommended You'll want to know how well you're taking care of your diabetes. The best
way to find out is to check your blood to see how much glucose is in it. If
your blood has too much or too little glucose, you may need a change in your
meal plan, exercise plan, or medicine. Ask your doctor how often you should check your blood glucose. Some people
check their blood glucose once a day. Others do it three or four times a
day. You may check before and after eating, before bed, and sometimes in the
middle of the night. Your doctor or diabetes educator will show you how to check your blood using
a blood glucose meter. Your health insurance or Medicare may pay for the
supplies and equipment you need. Take Other Tests for Your Diabetes You may need to check your urine if you're sick or if your blood glucose is
over 240. A urine test will tell you if you have ketones in your urine. Your
body makes ketones when there isn't enough insulin in your blood. Ketones
can make you very sick. Call your doctor right away if you find moderate or
large amounts of ketones, along with high blood glucose levels, when you do
a urine test. You may have a serious condition called ketoacidosis. If it
isn't 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 type 1 diabetes. You can buy strips for testing ketones at a drug store. Your doctor or
diabetes educator will show you how to use them. Another test for blood glucose, the A1C, also called the hemoglobin A1C
test, shows what your overall blood glucose was for the past 3 months. It
shows how much glucose is sticking to your red blood cells. The doctor does
this test to see what your blood glucose is most of the time. Have this test
done at least twice a year. Ask your doctor what your A1C test showed. A result of under 7 usually means
that your diabetes treatment is working well and your blood glucose is under
control. If your A1C is 8 or above, it means that your blood glucose may be
too high. You'll then have a greater chance of getting diabetes problems,
like kidney damage. You may need a change in your meal plan, physical
activity plan, or diabetes medicine. A1C Results Talk with your doctor about what your target should be. Even if your A1C is
higher than your target, remember that every step toward your goal helps
reduce your risk of diabetes problems. Keep Daily Records Print and make copies of a daily diabetes record page. Then write down the
results of your blood glucose checks every day. You may also want to write
down what you ate, how you felt, and whether you exercised. By keeping daily records of your blood glucose checks, you can tell how well
you're taking care of your diabetes. Show your blood glucose records to your
health care team. They can use your records to see whether you need changes
in your diabetes medicines or in your meal plan. If you don't know what your
results mean, ask your health care team. Things to write down every day in your record book are
ACTION STEPS If you use insulin Keep a daily record of ACTION STEPS If you DON'T use insulin Keep a daily record of |
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