People with diabetes need a lot of discipline in terms of diet, exercise and adherence to their medications. Not having a good balance of any one of these can complicate the disease and may lead to severe consequences. So as a healthcare provider and a certified diabetes education, I present the following tips helpful for caregivers:
- Type 1 Diabetics must test blood sugar at least 3 times per day in addition to testing before meals for insulin dosage determination as directed by your physician. First reading must be fasting (right after you wake up), the other 2 or 3 readings (postprandial) must be taken 2 hours after breakfast, lunch and/or dinner.
- Continuous glucose monitoring or CGM is recommended in most cases of diabetes 1, especially kids. This set of devices measure sugar throughout the day and can alert the patient or parents if blood glucose goes beyond the set range. Most insurances cover them and most patients get copay assistance from manufacturers. Talk to your doctor for a prescription. Ask your pharmacist about copays. Dexcom for example, is growing popularity simply because of its ease of use and once daily calibration requirement.
- Type 2 Diabetics must test blood at least 1-2 times per day. Fasting and one post-prandial.
- People on insulin pump or severe cases of juvenile diabetes must test more frequently as directed by your doctor. These are ideal cases for CGM.
- Keep a log of your blood sugar readings. Use “Daily blood glucose monitoring” function in Glucocious app to email your results to yourself or your doctor.
- Know your A1C value. It is important to test A1C every 3, 6 or 12 months depending on the severity of the condition.
- Always carry Glucagon Kit with you, especially school going kids or juveniles.
- Keep glucose tablets or other form of immediate sugar in your pocket as a rescue in case you feel dizziness, palpitations, sweating, headache or have other symptoms of hypoglycemia.
- You should eat smaller meals but can eat more frequently. Make sure your meals are consistent every day.
- Please record any discrepancies in your diet or physical activity in the blood sugar log.For example: If you ate a Pizza today, write it down on the log sheet. Or if you ate an ice cream after dinner, document it. It is important to note these irregularities so your doctor can relate the significantly different glucose readings to these diet changes.
- Scientific studies have proven that brisk walking is one of the top most calorie burning exercise besides sprinting. Brisk walking for 15-20 minues per day will help you control your diabetes on a long run.
Please note that people with heart disease, respiratory disease, chest pain and shortness of breath must be cautious while exercising. Do not continue if symptoms present.
- Measure ketones in urine. Do not exercise if ketones are high. Learn more about Ketoacidosis in Glucocious app or any good diabetes literature.
- It is very important to be adherent to your medications daily on time. Missing a single dose can shoot up the blood sugar and may even become life-threatening.
- It may be harder to control your blood sugar during times of stress, illness or infection. Make a note of abnormal readings in your log about your illness so your doctor can understand the reason.
- Ask your doctor if you are or going to be pregnant or breastfeeding. Benefits/risks need to be evaluated with your doctor. Avoid alcohol in diabetes.
- It is very important to consult a cardiologist, nephrologist, podiatrist, ophthalmologist and a nutritionist to prevent any complications from diabetes. Ulcers in feet or other extremities have led to amputations. Damages in retina have led to blindness. Kidney failure is also a big concern for uncontrolled blood sugar.
- Prevent conditions like FLU, Pneumonia, Tetanus, Diphtheria, Whooping cough, Shingles, etc by getting these vaccines from your pharmacist or doctors. All of these vaccines are covered by your insurances in countries like US. These vaccines are considered as part wellness visits. I hope there could be similar awareness in India where providers are not very proactive in immunization.
- Learn proper injection techniques from your pharmacist. Check CONSULT A PHARMACIST section in Glucocious app.