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Diabetes: The diagnosis

Living better with diabetes
You can live better with diabetes by:

• Following your doctor’s and healthcare team’s advice about medication and self-management of your diabetes.
• Following your meal plan.
• Exercising regularly to lower glucose levels.
• Taking care of your feet and having annual eye exams.

Treatment
There is no cure for diabetes. The short-term goal is to stabilize your blood sugar and eliminate the side effects of high or low blood sugar. The long-term goal is to prolong life and prevent complications such as heart disease and kidney failure.

Basic diabetes management skills to learn include:

• Recognizing and treating low blood sugar and high blood sugar
• Knowing what to eat and when
• Knowing how to take medications
• Learning to test and record blood glucose
• Testing urine for ketones (if indicated, for Type I and GDM usually)
• Adjusting when changing exercise and eating habits
• Handling sick days
• Obtaining and storing diabetes supplies.
• Managing stress
• Perform preventative actions to avoid short-term and long-term complications.
• Know local resources

Eating right
A diabetes nutrition plan does not mean a severe restriction of foods.  In fact, the plan is geared towards healthy nutrition habits, which everyone could benefit from.  Plans usually include a focus on obtaining a wide variety of foods, portion control, weight management (if needed), and timing of meals and snacks.  A registered dietitian is the best resource to use when learning what foods to eat.  A book or pamphlet cannot tell you what is best for you, and may be more limiting than you really need. 

The best way to see how your nutrition plan is working is to do record keeping with food diaries and blood sugar log books. 

Periodically, your nutrition plan will need to be adjusted -- especially for children during growing times, pregnancy, and other lifestyle and health changes that may occur.  Resources are available to help you plan meals, measure foods, and learn new recipes to try.  It is essential that every member of the household supports the nutrition plan for best success.

Working it out
Moving it is a great way to lower your blood glucose level. Before starting an activity program, be sure to check with your doctor and find out what he or she recommends.  The most important thing is to keep your body moving.  You do not have to drive to a gym and work out for hours to stay healthy -- walking a dog, sweeping the porch, and chair exercises may be more your style.  There are many options for inside the home, and out in the yard, that are safe and cost-free ways to stay active.  A physical therapist may be needed in helping you plan a regular exercise or activity schedule if you have had injures in the past, or have physical limitations.  Make the activity something you can do year-round, and something you enjoy.  It is recommended that you carry medical identification if you leave your home.

Here are some basic guidelines for getting started:

• Wear medical identification if you leave your home
• Exercise after a meal, rather than before
• Wear comfortable, breathable clothing and supportive shoes
• Start slowly. If you’ve been a couch potato, a 10-minute walk two or three times a week may be enough for the first week or two.
• Warm up before your exercise and cool down afterward by walking slowly for five to seven minutes. End your workout with gentle stretches.
• Test your blood glucose level before you exercise. Don’t exercise if it is higher than 250 mg/dl and/or if there are ketones in your urine.  For extended periods of activity (>1 hour) or for active children, you may need to test during the activity as well.  You may need to talk to a registered dietitian or certified diabetes educator about guidelines for regular exercise periods to maintain good blood sugar control. You may need an extra snack, or medication adjustments -- Check before making big changes!
• Try to exercise at the same time each day to make the effect on your blood glucose more predictable.
• Be prepared to treat hypoglycemia by carrying juice, a soft drink, glucose tablets or gel, or other sugar source with you. If you feel a reaction coming on, stop and treat it right away.
• Stop exercising if you feel sick, dizzy, out of breath or if exercising becomes painful.

Foot care: The bottom line
People with diabetes may have trouble with their feet because of poor blood flow and nerve damage. Injuries may take longer to heal. Take care to prevent them from ever happening.

See your doctor or podiatrist if you injure your foot, have cuts or breaks in the skin, an ingrown toenail, the skin changes color or if you experience a numb or tingling sensation.

Good foot care includes:

• Wash and carefully dry them each day. Put on lotion.
• Check them for sores, calluses, red spots, swelling and blisters each day.
• If you injure your foot, clean it immediately with soap and water and call your doctor.
• Carefully cut your toenails to follow the curve of your nail.
• Wear comfortable and supportive shoes -- forget high heels!
• Wear socks that fit and do not have big seams or bumps.
• Never go barefoot -- even at home.

Help for living with diabetes
Your doctor/diabetes educator can help guide you to resources for better living with diabetes.

Central Baptist Hospital offers the following educational services for diabetes patients:

• Diabetes education for Type 1 diabetes, for all ages
• Diabetes education for Type 2 diabetes, for all ages
• Gestational diabetes (our program provides free or loaner meters to participants)
• Diabetes nutrition counseling
• Pre-diabetes class
• Polycystic Ovarian Syndrome class
• Blood glucose meter instruction
• Insulin instruction
• Insulin pump education
• Computerized blood glucose meter downloading
• Free glucose screening (by appointment)
• New diabetes technology training

We stay in touch with all of our patients and encourage them to attend a free follow-up appointment. We offer support groups for people with diabetes and have free group refresher classes.

Call one of the following for more information:

• Outpatient diabetes program coordinator: (859) 260-6674
• Outpatient diabetes dietitian: (859) 260-6722
• Inpatient diabetes education services: (859) 260-6737