Diabetes Related Frequently Asked Questions (FAQs)

Transcription

1 Diabetes Related Frequently Asked Questions (FAQs) 1. How do I get a glucose meter? Before leaving the hospital, your doctor will give you a prescription for the meter, strips and lancets. The meter comes with instructions to explain its use and a number for troubleshooting problems. If you do not have health insurance, ask the hospital s Care Manager about available resources and help. With a referral from your healthcare provider, the Exempla Diabetes Center can provide information about blood sugar testing and management after discharge. 2. What can I eat? See Survival Skill 3: Eating the right foods. A Registered Dietitian can assist with meal planning and provide detailed information about calorie count, fat, sodium and nutrients specific to your health goals. Carbohydrate counting is particularly important when you are dosing insulin with meals according to the carbs you eat. The Exempla Diabetes Center can provide detailed information in individual or group sessions. Your provider can give you a referral to the Exempla Diabetes Center. 3. Can I continue using my insulin pump in the hospital? You must be able to manage your pump independently while hospitalized. While in the hospital your health care team may contact the Exempla Diabetes Center/Endocrinologist to help troubleshoot or answer questions about your pump. Your health care provider can give you a referral to an out-patient diabetes educator. For additional education about insulin pump use, contact the Exempla Diabetes Center. 4. What do I need to know about hypoglycemia (low blood sugar)? See Survival Skill 5: Recognizing high/low blood sugar (hyperglycemia/hypoglycemia). Learn the Rule of 15. Always check blood sugars before exercising and driving. Always carry a source of sugar in case of blood sugar lows. Eat three meals per day and 1-2 snacks per day. 5. How do I get a referral for out-patient education? Ask your health care provider for a diabetes education referral. If you need assistance with the referral process, contact the Exempla Diabetes Center at (303) Appointments will be set up 1-3 weeks after leaving the hospital unless your healthcare provider indicates an earlier appointment is needed. Most insurances cover the cost of diabetes education but you must verify coverage before making your appointment with the Exempla Diabetes Center. Page 1

2 SURVIVAL SKILLS FOR DIABETES Where do I begin? Diabetes can be an overwhelming diagnosis. This guide outlines the seven survival skills needed to begin managing your diabetes. The guide provides information about: Survival Skill 1: Diabetes and its treatment Survival Skill 2: Taking medications and giving injections accurately Survival Skill 3: Eating the right foods Survival Skill 4: Testing your blood glucose Survival Skill 5: Recognizing high/low blood sugar (hyperglycemia/hypoglycemia) Survival Skill 6: The importance of regularly scheduled exams to prevent complications Survival Skill 7: Key contact information for follow-up education Page 2

3 Survival Skill 1 What Is Diabetes & How Is It Treated? Diabetes is a condition that causes high blood glucose (blood sugar) levels. Diabetes cannot be cured and does not go away but CAN be managed. You can have diabetes, live well, and be healthy. Type 1 and Type 2 diabetes have different causes and treatments. Type 1 Diabetes Causes: The body s immune system destroys the insulin-producing cells in the pancreas. As a result, people with Type 1 diabetes do not make any insulin because those insulinmaking cells have been destroyed. Onset: Type 1 diabetes usually develops in: Children and adolescents Or Adults under the age of 30 Note: People of any age can develop type 1 diabetes. Symptoms: Frequent urination Unusual thirst, especially for sweet or cold drinks Extreme hunger Unusual weight loss Weakness Stomach pain Blurred vision or other changes in eyesight Irritability Nausea and vomiting Susceptibility to illness Treatment: Type 1 diabetes is treated with daily insulin injections. Following a healthy diet and activity plan are also important. Insulin pumps and sensor devices are new ways to manage diabetes. Type 2 Diabetes Causes: The pancreas does not make enough insulin or the body does not properly use the insulin it makes. Onset: Type 2 diabetes is most common in adults who are: Over the age of 40 Have a family history of diabetes Overweight and inactive Are of Hispanic, American Indian, African American, or Asian Pacific Islander decent Note: Young children are also developing type 2 diabetes. Symptoms*: Any of the type 1 symptoms Fatigue Blurred vision Frequent infections Cuts/bruises that are slow to heal Increased thirst *Often people with Type 2 diabetes have no symptoms at all. Treatment: The first line of treatment for type 2 diabetes is diet modification and implementing an activity plan. Your physician may prescribe oral medications or injections that may include insulin. Page 3

4 Survival Skill 2 Medications and Injections If your doctor prescribes medication, you should receive detailed information on your dosage, when to take your medication and common side effects. Be sure to carefully review this information. Keep a list of all the medications you take, and take the list with you to all health care appointments. Tip: Talk to a pharmacist about medication uses, side effects and problems that might occur from interactions with other medications and herbal supplements. How to Inject Insulin 1. Choose a site for injection (abdomen is best), rotating the sites daily. 2. With your thumb and forefinger about three inches apart, bulge up the skin slightly. 3. Holding the syringe as you would a pencil, quickly insert the needle at a degree angle into the skin. 4. Push the plunger down slowly as far as it will go to inject the insulin. 5. Leave the needle in the skin for approximately five seconds. 6. Withdraw the needle from the skin, immediately placing a finger over the injection site to prevent insulin from leaking. 7. Syringes need to be disposed of properly to make sure others are not injured. 8. Syringes and most pen devices are made for single use. Do not re-use. Survival Skill 3 Eating the Right Foods Understanding food and how your body uses it is very important. You will need to understand what foods contain carbohydrates and how to adjust what you eat and drink according to the medications you take and your activity level. Carbohydrates make your blood sugar rise. Insulin produced in your body (or injected) lowers your blood sugar. Activity can also cause a decrease in blood glucose. Consistency is the Key Eat three meals and one to three snacks per day. Do not skip meals or snacks. Eat about the same amount of food at the same time each day. To lose weight, cut down on your portion size and increase your activity level. A dietitian can answer more detailed questions regarding your meal planning. Page 4

5 Survival Skill 4 Self-testing Blood Glucose Blood glucose testing is very important because it gives you and your healthcare team information about the balance between your food, activity and medications. ALWAYS take your blood glucose records with you to your appointments. Acceptable Target Blood Glucose Range Fasting and Before Meals mg/dl Two Hours After Meals....Less Than 160 mg/dl Before Bedtime mg/dl How to Perform a Blood Glucose Test 1. Gather your supplies, meter, test strips, lancing device and lancet. Tip: Keep test strips in a vial or foil wrapper. Air and humidity can damage the strips resulting in inaccurate results. Keep strips and your meter away from extreme heat and cold. 2. Wash the test site with soap and water, then dry thoroughly. Tip: Hang your hand below your heart to increase the blood flow. If your hands are cold, wash with warm water. 3. Follow the meter instructions for testing procedures. Tip: Be sure the test strip code number matches the meter code if you have a meter that needs to be coded. 4. With the lancing device, stick your finger on the side (not the center). Tip: Test results can be inaccurate if there is too little blood on the test strip. 5. Gently milk your finger until a large drop of blood forms. Fill up the target area on your test strip. Often there will be a symbol or beep when the meter correctly reads the strip. 6. Record the results and date/time of the test in your record book. Tip: Evaluate your results to see if changes need to be made to your treatment plan. 7. Discard your lancet in a puncture resistant container or a sharps container after each use. If your blood glucose level falls BELOW 70 more than two times in a week OR If your blood glucose level is ABOVE 240 more than two times in a row CALL YOUR PRIMARY CARE PROVIDER! Be sure you have your prescription for your glucose testing strips and lancets. Meter companies have a number on the back of the meter and are staffed 24 hours a day to help with meter issues. Page 5

6 Survival Skill 5 Recognizing and Treating Hypoglycemia (Low Blood Sugar) and Hyperglycemia (High Blood Sugar) Hypoglycemia: Untreated low blood sugars can lead to serious immediate complications. If you think your blood sugars are low, test your blood sugar (blood glucose) and treat appropriately. Always wear a medical ID bracelet or necklace that identifies you as a diabetic. Symptoms of Low Blood Sugar Causes of Low Blood Sugar Shaking Not enough food Dizziness Skipping or delaying a meal or snack Confusion Extra activity (e.g., exercising more than usual) Blurred vision Too much insulin or diabetes medication Weakness Rapid heartbeat Complications of Low Blood Sugar Irritability Loss of consciousness progressing into coma Numbness around lips and even death. Treatment of Low Blood Sugar (The Rule of 15) If you have low blood sugar symptoms or a blood sugar less than 70, treat with a fast acting sugar = 15 grams of carbohydrate (carb): 3-4 glucose tablets glucose gel (check label for 15 grams of carb) 1/2 cup (4 oz) juice 1 cup (8 oz) skim milk 1/2 cup (4 oz) regular soda (not diet soda!) Wait 15 minutes and retest your blood sugar. If it is still less than 70, treat again with 15 grams of carbohydrate. Re-test your blood sugar. If blood sugar is above 70 and the next meal is more than one hour away, eat a snack. Determine the cause of the low blood sugar and prevent future lows. Always carry some form of carbohydrate with you. It is especially important to have a fast-acting carbohydrate available in your car in case you have low blood sugar while driving. Pull over and stop driving if your blood sugar is low. Remember Untreated low blood sugars can lead to serious complications. Test your blood sugar if you suspect you are low and treat appropriately. Always wear a medical ID bracelet or necklace that identifies you as a diabetic. My doctor s phone number is: Page 6

7 Hyperglycemia (High Blood Sugar) Hyperglycemia (High Blood Sugar) occurs when the blood glucose level is higher than normal. Symptoms of High Blood Sugar Causes of High Blood Sugar Thirst Eating more food than normal Hunger Too little or no diabetes medication Blurred vision Physical illness/infections Frequent urination Emotional or physical stress Fatigue/tired Some medications Frequent recurring infections Sick Day Guidelines Test blood sugar every four (4) hours. Call your primary care provider if your blood sugar is greater than 240 twice in a row. Always take your diabetes medication even if you are unable to eat normally. Try to drink an 8-ounce glass of water each hour to prevent dehydration, especially if you have a fever, diarrhea, or have been vomiting. If you cannot eat normally, eat or drink grams of carbohydrate every four (4) hours. If you have type 1 diabetes and your blood sugar is greater than 240, test for ketones at every meal. Examples of Grams of Carbohydrates Orange/Grapefruit Juice. 1 ½ cups Grape Juice. 1 cup Regular Jell-O. 1 cup Regular Popsicle.2 ½ full bars Regular Soda..12 ounces Ice Cream..1 ½ cups Sherbet...1 cup Canned Fruit..1 ½ cups Pudding. 1 cup Cooked Cereal...1 ½ cups Toast....3 slices Saltine Crackers Chicken Noodle Soup cups Regular Yogurt.. 1 cup Page 7

8 Survival Skill 6 Schedule and Do Preventive Exams to Prevent Complications Diabetes can cause even the tiniest cuts or scrapes to develop into major infections that may result in the loss of limbs if left untreated. The loss of sensation in the feet and legs commonly experienced by diabetics means you may not feel that you have injured your skin! This is why it is important to check your feet daily. Seeing your eye doctor every year and treating high blood pressure are also very important for preventing long term complications. Kidneys can also be damaged by high sugars so be sure to discuss the health of your kidneys with your doctor. Survival Skill 7 Contact Information and Support The Exempla Lutheran Diabetes Center s team of educators has years of experience helping clients manage their diabetes. Contact the Exempla Lutheran Diabetes Center to meet others living with diabetes, receive personalized meal planning assistance and get all your questions answered. New classes start every week and are conveniently scheduled during the morning and evening hours. Support persons are encouraged to attend. Call for class dates and times. Contact Information: Exempla Diabetes Center (Carl A. Streufert Pavilion, entrance # 4) 3655 Lutheran Parkway, Suite 304 Wheat Ridge, CO Phone: (303) Fax: (303) Programs and Services Include: Individual Consults Group Classes (Insulin, Coping, Insulin Pumps, Gestational) Support Groups on the first Tuesday of every month from 6:00-7:30 p.m. at the Diabetes Center. Basic Education and Meal Planning Insulin Initiation and Dose Management Gestational (Pregnancy) Diabetes Care You will need a referral from your primary care provider to attend our program. Most insurance companies cover all or part of the cost of diabetes education/management. Coverage may vary with individual policies. **Verify coverage of treatment before entering any program. ** Website Resources: Page 8