Diabetes 101 & Keys to Diabetes Self-Management

What is diabetes?

• A disease of high blood glucose (sugar) levels.

How does diabetes happen?

• Typically hereditary, the diabetes gene is activated with certain situations (obesity, age, stress, injury, sleep deprivation, smoking).

What about food and insulin?

• We get energy from food, primarily in the form of glucose.
• All food turns into glucose, and we have glucose stored internally in our liver.
• A gland behind the stomach called the pancreas should make enough of the hormone insulin to handle any food.
• Insulin unlocks the cells (the smallest component of the body) and allows glucose to enter.
• With diabetes, the pancreas doesn't make enough insulin or use insulin efficiently.
• Without enough insulin, the glucose piles up in the bloodstream and can cause many problems.

What are the goals of diabetes self-management?

• Lower your glucose, blood pressure and cholesterol to a safe level.
• Live a full life!

When to call the doctor?

• If your glucose is less than 70 or more than 250 for two days.
• If your glucose is less than 180 and you can't keep food down
  (your medication dose may need changing).
• If you are vomiting or have diarrhea.
• If you are not tolerating your medication.

What do I do when I'm sick?

• Check glucose at least every four hours.
• Drink plenty of sugar-free, caffeine-free liquids (examples include water, tea, broth).
• You still need small amounts of carbohydrate food for healing.
• If you take diabetes medication and glucose is more than 180, continue the usual dose.

Keys to Diabetes Self-Management

• Healthy Eating - Balance, timing, eating from a variety of nutrient-rich foods and being carbohydrate aware (not cutting them out!).
• Being Active - Helps control the amount of glucose and increases good (HDL) cholesterol. Just 30 minutes of walking is equal to a pill for diabetes.
• Monitoring (glucose, blood pressure, and cholesterol) - Test glucose before breakfast and before dinner, at the least. Premeal goal: 70 to 120
  • To learn from meal choices: Two hours after meal goal: less than 160
• Healthy Coping - Stress raises glucose and blood pressure. Stress can come from pain, lack of sleep, work, planning for a trip, steroids, etc.
• Taking Medication - Which ones are you taking? Don't skip, double up on or change medicine without checking with your doctor.
• Secretagogues - makes the pancreas release insulin
  • (Glucotrol, Glyburide, Amaryl, Starlix, Prandin)
  • *Risk of hypoglycemia; take 15 to 30 minutes before a meal
• Biguanides - decrease liver glucose production (Glucophage)
  • *Risk of diarrhea, nausea (take WITH food to minimize)
  • *Takes a couple of weeks to reach full effect
• Thiazolidinediones - decreases insulin resistance (Actos, Avandia)
  • *Risk of swelling, weight gain, 4 to 8 weeks for full effect
• Insulin: the hormone; know its peak time to avoid low glucose
  • BASAL = background (Lantus, Levemir, NPH)
  • BOLUS = mealtime or correction (Novolog, Humalog, Regular)

Problem Solving

• Hypoglycemia (low glucose); less than 70
  • Causes: medications, missed meal, exercise, alcohol
  • Signs: shakiness, hunger, sleepiness, weakness, headache, irritability, sweating
  • Treatment: Sugar! Rule of 15 (15 grams sugar, wait 15 minutes, retest. If low, 15 grams of sugar, retest, if above 70, eat)
• Hyperglycemia (high glucose); above 200
  • Causes: too little medicine, stress, food choices
  • Signs: tired, increased urination, poor would healing
  • Treatment: medications

Reducing Risks

Certain tests reduce your risk of complications (yearly exams for eyes, feet, cholesterol; regular A1C tests and dental visits)

Created by the Washington Hospital Diabetes Program Team. 510.818.6556.