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First Steps to Managing Your Diabetes at Home

(A basic guide until you see a Registered Dietitian or Diabetes Educator)

What is diabetes? To understand diabetes, you must first understand the role of glucose (sugar) and insulin in your body. • Glucose comes from the food you eat. Your blood carries glucose to all the cells in your body. These cells use the glucose for energy. • Insulin is a hormone made by the pancreas. It enters the blood and acts as a “key” to open the body’s cells so glucose can enter.
		Why did I get diabetes? We don’t know what causes type 1 diabetes. If you have type 2 diabetes, you could have a combination of risk factors. The more risk factors a person has, the higher the risk for type 2 diabetes. Risk factors that can be managed include: • Having excess weight • Lack of physical activity • High blood pressure • High cholesterol Other risk factors include: • Family history of diabetes • Increasing age • Being in a higher risk ethnic group • Having diabetes while you were pregnant or a baby bigger than 9 pounds Can diabetes be cured? There is no cure, but there are a number of ways to help manage diabetes. Healthy eating, exercise, losing weight and prescribed medication can help you lead a longer life with fewer health problems. Many cases of diabetes can be linked to two things that can be managed – too much weight and too little physical activity. Taking care of your diabetes every day will help keep blood sugar levels in an acceptable range. It will help to prevent health problems that diabetes can cause over time.
Diabetes means that your blood sugar or blood glucose is too high on average. If your body doesn’t make enough insulin, or if the insulin doesn’t work the way it should, glucose can’t get into your cells. Instead, glucose stays in your blood. • Type 1 diabetes means that the pancreas no longer makes insulin. Therefore, people with Type 1 diabetes need insulin. • Type 2 is the most common form of diabetes. The body’s cells no longer use insulin the right way. Eventually, the pancreas may lose its ability to make enough insulin. It can be treated with healthy eating, exercise and medications. • There are other types of diabetes. What are the symptoms of high blood sugar? Not everyone will have or notice symptoms of high blood sugar. Symptoms may include: • Extreme thirst or hunger • Blurred vision • Feeling tired • Frequent urination

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First Steps to Managing Your Diabetes at Home, Page 2

Healthy Eating for Diabetes

Why learn about healthy eating?

You can make a difference in your blood sugar

management by making good food choices. The food that is healthy for you is the same as the food that is healthy for people without diabetes.

A meal plan can help you decide what, when and how much to eat. You do not need special or diet foods. When you learn how food affects your diabetes, you will be able to fit most of your favorite foods in your meal plan.

When can you eat?

• Eat at least 3 small-to-medium meals a day.

• Space meals 4 to 5 hours apart, especially if

you are taking diabetes pills or insulin.

• Eat meals at about the same time every day.

• Avoid skipping meals.

• If you snack between meals, keep the

portion small.

What can you eat?

• Eat small-to-medium-sized portions.

• Eat about the same amount of food each day.

• Cut down on foods and drinks with a lot of added sugar (candy, regular soft drinks, rich desserts and sweet baked goods) until you learn how to fit them into your meal plan.

• Be aware of foods that contain natural sugars, like fruit and fruit juices. These foods cause your

blood sugar to rise just like foods that have added

sugar. Limit fruit juice to ½ cup (4 oz.) a day.

• Avoid drinking alcohol until the dietitian shows

you how to fit it into your meal plan.

Keep track of your eating

• Keep a record of everything you eat and drink for 3 days before you see the dietitian or diabetes educator.

• Write down what and how much you had right

after you eat (don’t wait and try to remember).

• Bring the food record with you to help your

dietitian or diabetes educator figure out the best meal plan for you.

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How much can you eat?

• Your dietitian or diabetes educator will help you with portion sizes that are right for you.

• Imagine a standard size (9-inch) dinner plate divided as shown here.

• Fill one quarter of the plate with starchy foods, such as bread, potato, rice, pasta, cereal, peas and corn.

• Fill another quarter of the plate with your meat or meat substitute serving.

• On the remaining half of your plate, put lots of

low-calorie, low-fat vegetables prepared without fat, sauce or frying, such as salad, greens, asparagus, green or wax beans, broccoli, carrots, tomatoes, cucumbers or cauliflower.

• A small piece of fruit or a small glass of

milk serving can be “on the side.”

Sample Breakfast Sample Lunch

First Steps to Managing Your Diabetes at Home, Page 3

Managing Your Type 2 Diabetes

Exercise

Exercise is an important part of diabetes management.Regular exercise can lower blood sugar, improve blood flow and help manage weight. Talk with your doctor before starting an exercise program.

Medication

You may need pills or shots (insulin or other

diabetes shots) if your diabetes is not managed

with meal plans and exercise.

• Take your medicine exactly as told. Never skip or stop taking your pills or shots. Talk to your doctor if you have questions or concerns.

• Check with your doctor or pharmacist before

taking over-the-counter medicines (medicine or

supplements you can buy without a prescription)

Preventing complications

Taking care of your diabetes every day will help

keep blood sugar levels in your target range. It will also help prevent health problems that high blood sugar can cause, such as:

• Damage to blood vessels over time, which may lead to a heart attack or stroke.

• Damage to blood vessels in the eyes, which may lead to blurred vision or blindness.

• Nerve damage that can lead to a loss of feeling

or pain in your feet. A cut or sore can become

infected before you know it.

• Damage that causes the kidneys to stop working (kidney failure).

• Infections in your gums and teeth, which could

cause your teeth to become loose or fall out.

The best way to prevent these problems is to take care of yourself and your diabetes. Your diabetes educator will help you learn about the things you can do every day to keep your blood sugar in the range that’s best for you. You will also learn how to test your blood sugar at home to help you manage your diabetes and prevent the damaging effects of high blood sugar. There are many types of blood sugar meters to choose from. The diabetes educator or clinic staff can help you choose the meter that is best for you. The needles (sharps) you use with your meter cannot go into the regular trash. Ask the diabetes educator, clinic staff or pharmacist

what to use and how to dispose of your sharps.

People taking certain diabetes medications, may experience low blood sugars. This is more likely to happen with:

• Too much insulin or diabetes medication

• Too little food

• Extra exercise or activities

• Late or skipped meals

• Drinking alcohol

Symptoms of low blood sugar can include:

• Dizzy, lightheaded or not thinking clearly

• Anxious or irritable

• Hungry (a “panic” to eat)

• Weak, shaking

• Sweaty – especially upper body

• Your heart pounding or beating fast

• Trembling

What to do if you have these symptoms

Drink or eat 15 grams of a fast-acting sugar:

• ½ cup regular soda or juice (not sugar-free)

• 1 cup milk

• Candy (4 to 5 Lifesavers or small gumdrops, or 2 to 3 pieces of hard candy)

• Honey (2 teaspoons)

• Sugar (2 to 3 cubes or 2 teaspoons granulated)

• Glucose tablets or gels, which can be bought in

your pharmacy. Take as shown on the package

Always carry one of these fast-acting sugar sources with you if you are taking a medication that can lower your blood sugars.

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First Steps to Managing Your Diabetes at Home, Page 4

Final Tips and Resources

Call your doctor if you:

• Are sick for 1 or 2 days and not getting better

• Are not able to eat or drink

• Have a before meal blood sugar reading of over

240 for two readings in a row

• Are not sure what you need to do to take care

of yourself

• Cannot see a diabetes educator and need more

information

You have the most important role in

managing your diabetes

By taking control, you will increase your chances

for a long and healthy life. Good diabetes management starts with learning and we recommend you see a diabetes educator or a registered dietitian to help you learn what you need to know to stay well with diabetes and to help build a plan specific to you. If a referral is made, it will help if you contact your insurance company to find out what coverage you have for diabetes education or nutrition counseling. You can ask specifically for coverage of billing codes: 97802, 97803, 97804, G0108, G0109.

My questions: Write down any questions you

have for the diabetes educator or your provider and

bring this form to your appointment.

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Finding a Registered Dietitian or Diabetes Educator at AdvocateAurora

Visit: https://www.aurorahealthcare.org/doctors/ enter specialty of "Dietitian" or Diabetes Educator" and your zip code. You can call the clinic directly to schedule if your provider has entered orders for service to Diabetes Education or Nutrition Counseling.

Other resources

You may also find helpful information by contacting the organizations listed below or by visiting their websites on the Internet:

Association of Diabetes Care and Education Specialists:

diabeteseducator.org

800-338-3633

American Diabetes Association

diabetes.org

800-DIABETES (800-342-2383)

Academy of Nutrition and Dietetics

eatright.org

800-877-1600

National Diabetes Education Program

ndep.nih.gov

1-800-860-8747

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