Living Well With Diabetes
American Association of Diabetes Educators have established 7 self-care behaviors to help keep you moving forward on a happy, healthy journey!
· Healthy Eating - There are a few important skills to master as a part of your healthy eating plan. Counting carbohydrates is important when maintaining in range glucose levels.
o The American Diabetes Association recommends about 45-60 grams of carbohydrate per meal. If you follow that recommendation, you would be eating a total of 135-180 grams of carbohydrates throughout the day. However, some people may need more and some people may need less depending on your daily calorie range.
o Generally speaking, we aim for about 50% of our calories to come from carbs. You can prevent high and low blood sugars by tracking your food intake and counting carbs, reading food labels, paying attention to the portion sizes you consume, eating breakfast and spacing all meals throughout the day so you do not go more than 4 or 5 waking hours without eating (overall goal, smaller more frequent meals).
Building a healthy plate is a simple and effective for both managing diabetes and losing weight. Creating your plate lets you still choose the foods you want but changes the portion sizes so you are getting larger portions of non-starchy vegetables and a smaller portion of starchy foods. When you are ready, you can try new foods within each food category.
· Being Active - Being active is not just about losing weight. There are many other benefits you will receive from moving your body, including lowering cholesterol, improving blood pressure, lowering stress and anxiety, and more.
o Plan for an exercise session. How much activity and what intensity is planned? You should consider having a carbohydrate snack on hand (~20-30 grams of carbohydrates per 30 minutes of exercise)
o Exercise with a partner. This is a good idea, especially initially, as you learn how you respond to activity. This is also a built-in support system.
o Wear a diabetes I.D. (and update your Medical ID info in your phone). Never leave home without it. Hypoglycemia and other problems can arise that may require an understanding of the condition.
o Wear good shoes. Proper fitting footwear can minimize the risk of foot irritations and sores, as well as reduce your risk of injury.
o Practice good hygiene. You should always take extra care to inspect your feet for infection or irritation. Consider using vaseline on your feet, wearing socks inside out, or purchasing ‘diabetic socks’ from a specialty running store or your podiatrist.
o Modify caloric intake accordingly. With frequent SBGM, caloric intake can be modified daily to meet your needs.
· Reducing Risks - Having diabetes puts you at a higher risk for developing other health problems. However, if you understand the risks, you can take steps now to lower your chances of diabetes related complications. In addition to the recommended tests shown here, you can take other precautions to lower your risks.
o Don’t use tobacco
o Schedule your regular medical checkups and medical tests
o See an eye doctor once a year
o Keep your feet clean and dry. Look out for redness or sores, and report these to your healthcare team as soon as you find them. If you have trouble seeing the bottom of your feet, ask a family member or friend to help you.
o Be sensitive to your body and recognize when you aren't feeling well. Contact a member of your care team if you need help identifying the problem.
o Participate in a diabetes self management program or support group
o Get adequate sleep
· Healthy Coping - There are healthy coping methods you can use to get through tough times. For example, faith-based activities, exercise, meditation, enjoyable hobbies, thinking positive, or support groups.
o Having a support network is key. Be sure to develop and nurture relationships with your spouse, family, friends and co-workers.
o Sometimes emotional lows can be lengthy and have a more serious impact on your life, healthy and relationships. This may be a sign of depression. Talk to a counselor and or diabetic educator if you:
o Don’t have interest or find pleasure in activities you used to enjoy
o Avoid discussing your diabetes with family and friends
o Sleep most of the day
o Don’t see the benefit in taking care of yourself
o Feel like diabetes is conquering you
o Feel like you can’t take care of yourself.
o The most important thing to realize is that help is available.
· Taking Medication - There are several medications that are frequently prescribed to people with diabetes. Insulin, blood pressure and cholesterol medications may be a part of your care routine. If medications have been prescribed to you, it is important you take them according to the instructions. If you often forget to take your medications, try to remind yourself by linking it to a specific activity – for example eating dinner or brushing your teeth. Or you can also set an alarm on your phone or watch. Checklist of Knowledge and Skills for Medication Regimen:
o Amount of medication to take, best times to take it and how often to take it
o Whether you need to take it with food or on an empty stomach
o How the medication works and how to monitor to see if it is effective
o Any side effects to report
o What to do if you experience a problem
o What to do if you miss a dose of medication or are delayed in taking it
o How to store the medication so it keeps its effectiveness over time
· Problem Solving - Problem solving involves 3 steps:
o Step 1 Identify the problem
§ What has changed or is going to change?
§ Some common scenarios where you need to problem solve around your food, activity, monitoring and medications are going on vacation, getting sick, eating out or playing a sport
o Step 2 Find solutions
· Have you misunderstood anything about your treatment plan?
· Has your life situation changed?
· Are there new tools, resources or medications out there to help you?
· Do you need more information to come up with the right solution for your problem?
o Step 3 Take Action
§ Which possible solutions do I want to try? Do I need help to make it work?
· Monitoring - Ideally, we aim for fasting glucose to be below 100. If you have a fasting glucose of 100 – 125, you are considered pre-diabetic. If your fasting glucose is above 126, you are considered diabetic. If you have a fasting glucose of 100 or above, you should connect with your physician to establish a plan, if you have not already done so.
o The CDC suggests the following targets for most adults with diabetes. More or less strict glycemic goals may be appropriate for each individual.
o A1C: 7%
o Before a meal: 80 to 130 mg/dL.
o Two hours after the start of a meal: Less than 180 mg/dL.
o Checking your blood sugar and A1C are an important part of diabetes self-care, but monitoring your overall health includes a lot of other things too, especially when you have diabetes. You and your healthcare team will also need to monitor your:
Cardiovascular health—blood pressure, weight, cholesterol levels
o Kidney health—urine and blood testing
o Eye health—dilated eye exams
o Foot health—foot exams and sensory testing
