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. 30 minutes walking is equal to a pill for diabetes.

Monitoring (glucose, blood pressure, 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) 745-6556.
- Updated, February 2007

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