Diabetes Care Diary. To speak to a nurse 24-hours a day call

Transcription

1 Diabetes Care Diary To speak to a nurse 24-hours a day call

2 Introduction W elcome to the Diabetes program! We congratulate you on your decision to participate in this program and learn how to better manage your diabetes. This booklet contains several resources that will help you become a better self-manager of your diabetes. Your nurse may also refer to this booklet during your conversations, so be sure to keep it handy. You will find the following materials in this booklet. Diabetes Plan of Care - Following your doctor s prescribed plan of care is the best way for you to get your diabetes under control. Take this form to your doctor to fill out and keep it at home as reference. This way you will know how you are doing and where you need to improve. Your nurse may ask you for this information to help you keep on track with your treatment plan. Daily Diabetes Diary - Completed by you, this daily record of your home self-glucometer readings will help you track your blood glucose (sugar) levels. Tracking these readings over time will help you learn about yourself: when your blood glucose is usually high or low and what factors may cause the change in glucose levels. Daily Medicine Diary - Completed by you, this daily medication schedule will help ensure that you are taking your medications the right way. Sick Day Guidelines - Getting sick isn t fun for anyone, but a stomach virus or a case of the flu can pose special concerns for a person with diabetes. If you have a loss of appetite or can t keep food down these are guidelines you should follow to manage your blood glucose levels and medication. Wallet Card - Please tear out this card and keep it with you at all times. Be sure to fill in all the information blanks. The card will serve as a convenient reference for you while providing you with important information on the signs and symptoms of low and high blood glucose reactions. Please note: this card does not take the place of a Medic Alert bracelet. You should always wear your Medic Alert bracelet. Educational Resources - Knowledge is power! That s why we have included this listing of diabetes organizations, books, and web sites. If you are interested in learning more about your condition, please refer to these resources. Also, be sure to look up the diet and nutrition web sites for great sugarfree recipes! If you have any questions about these materials or the program, or if you want to speak to a registered nurse, please call us at We are available to help you 24-hours a day!

3 Diabetes Plan of Care Please take this form to your doctor so that your plan of care can be completed appropriately. Let your doctor know if your self monitored blood glucose readings are consistently out of range or your symptoms are more severe. Name: Type 1 Type 2 Primary Care Physician: Today s Date: / / Plan of Care Medical Tests & Measures Blood Sugar Self-Testing before breakfast glucose 2 hour after meal glucose bedtime glucose A1c Blood Test (formerly HbA1c) Cholesterol (Lipid Profile) LDL HDL Triglycerides Blood Pressure Cardiovascular Stress Test BMI (Body Mass Index) Medication Dose and Frequency Diabetes Medicine(s) Exam Schedule Glucometer Skill Check Eye Exam Foot Exam Self Exam Lifestyle Factors Exercise Diet Smoking Stress American Diabetes Association & American Association of Clinical Endocrinologists 2001 Standards frequency prescribed by doctor quarterly; <6.5% annual testing less than 100 men - greater than 45 women - greater than 55 less than 200 less than 130/80 adults as needed men: <27.8, women: <27.3 as prescribed by doctor annually at minimum annual dilated eye & visual annual weekly as prescribed by doctor individualized medical nutrition therapy (MNT) no reduce Months 1-3 Months 4-6 Months 7-9 Months 10-12

4 Daily Diabetes Diary Completed by you, this daily record of your home self glucometer readings will help you track your blood glucose (sugar) levels. Let your doctor know if your blood glucose readings are consistently out of range or your symptoms are more severe. Date 10/18 Time 7:00 am Blood Glucose Level 180 Urine Glucose Level Urine Ketone Level Type/ Dose Insulin Humilin 70/30 Injection Site left thigh Any Reactions (yes/no) No Exercise/ Activity (duration) 30 min. Comments felt shaky, better after eating

5 Daily Medicine Diary Complete this daily medication schedule to help you track your medications and make sure that you are taking them properly. Remember: Always take medicine as prescribed. If you miss a dose, do not take two doses at once. If you have side effects, let your doctor or nurse know. Never stop taking your medicine without talking to your doctor or nurse first. Always keep your medicine out of children s reach. Sample Diary Entry Medicine Name Humillin 70/30 Dose 15 units Date Freq. 2 times/day Comments breakfast/dinner 2/19 8am, 2:30pm, 10pm Felt shaky after 6pm shot, relieved after eating Medicine Medicine Medicine Medicine Name Name Name Name Dose Dose Dose Dose Date Freq. Freq. Freq. Freq. Comments

6 Sick Day Guidelines I f you are sick and have a loss of appetite or if you can t keep food down, please refer to these guidelines to help you manage your blood glucose levels and medication. If you have questions or concerns, please call us at to speak to a registered nurse. 1. Test blood sugar. If blood glucose is 240 mg/dl or higher and remaining elevated, call your physician. 2. Type 1 diabetes, test urine for ketones. If there are moderate to high levels of ketones in your urine, call your physician. 3. Drink plenty of sugar-free liquids like broth, tea, coffee, water and diet soda (at least 8 ounces every hour) 4. Rest as much as possible 5. If you cannot eat solid food, replace food with fruit juice, regular Sprite or Seven-Up, and check blood sugar frequently to be sure it doesn t increase 6. Remember to take insulin or pills even if you are sick. When you are sick and cannot eat for more than 6 hours, CALL YOUR DOCTOR. He/She may need to adjust your medications. Diabetes Educational Resources Books The American Diabetes Association Complete Guide to Diabetes, 2 nd edition Caring for Young Children Living With Diabetes: A Manual for Parents. Margaret T. Lawlor, M.S., C.D.E., Lori M. Laffel, M.D., M.P.H., Barbara Andersom Ph.D. and Anna Bertorelli, R.D., M.B.A.,C.D.E Diabetes Burnout. William H. Polonsky, Ph.D., C.D.E., American Diabetes Association, Diabetes for Dummies. Alan L. Rubin, M.D. IDG Books Worldwide, Diabetes Cookbook for Dummies. Alan L. Rubin, M.D. and Fran Stach, R.D., CDE IDG Books Worldwide, Diabetes Meal Planning Made Easy, 2 nd edition. Hope Warshaw, MMSc, R.D., C.D.E. American Diabetes Association, The Diabetes Problem Solver. Nancy Touchette, Ph.D. American Diabetes Association, The John Hopkins Guide to Diabetes for Today and Tomorrow. Christopher D. Saudek, M.D., Richard R. Rubin, Ph.D., C.D.E., Cynthia S. Shump, R.N., C.D.E. A John Hopkins Press Health Book, Foot Care Tips for People with Diabetes. Jesse H. Ahroni, Ph.D., A.R.N.P., C.D.E. American Diabetes Association, Tips for Improving Your Blood Sugar, 2 nd edition. University of New Mexico Diabetes Care Team. American Diabetes Association, Medication Tips for People with Diabetes. Betsy A. Carlisle, PharmD, Lisa A. Kroon, PharmD and Mary Anne Koda-Kimble, PharmaD, C.D.E. American Diabetes Association, Nutrition Tips for People with Diabetes. Patti B. Geil, M.S., R.D., C.D.E. and Lea Ann Holzmeister, R.D., C.D.E.. American Diabetes Association, Tips for Staying Healthy with Diabetes. University of New Mexico Diabetes Care Team. American Diabetes Association, 1999.

7 Diabetes Educational Resources Sixteen Myths of a Diabetic Diet. Karen Hanson Chalmers, M.S., R. D. C.D.E. and Amy E. Peterson, M.S., R.D., C.D.E. American Diabetes Association, Sugar Was My Best Food. Carol Antoinette Peacock, Adair Gregory, and Kyle Carney Gergory. Albert Whitman and Company, Twelve Things You Must Know About Diabetes Care Right Now! Irl B. Hirsch, M.D. American Diabetes Association, The Uncomplicated Guide to Diabetes Complications. Edited by Michael E. Levin and Michael A. Pfeiffer. American Diabetes Association, Women and Diabetes, 2 nd edition. Laurinda M. Poirier, R.N., M.P.H., C.D.E. and Katherine M. Coburn, M.P.H. American Diabetes Association, Magazines and Newsletters Diabetes Forecast, American Diabetes Association, 1701 Beaureguard Street, Alexandria, VA 23211, , Diabetes Self-Management, Diabetes Self-Management, P.O. Box 52890, Boulder, CO 80322, Internet Sites National Organizations Center For Disease Control Diabetes and Public Health Resource National Institute of Diabetes and Digestive and Kidney Diseases General Information American Association of Diabetes Educators American Diabetes Association Internet Resources Pharmaceutical Information Network Diabetes Information Center diab_info.html The Diabetes Mall Veterans Health Administration Diabetes Program Diet and Nutrition American Dietetic Association American Society for Nutritional Sciences Food and Nutrition Information Center Heart Information Network Michael D. Myers, MD Objective Medical Information on Obesity & Weight National Heart, Lung & Blood Institute Stay Young at Heart Recipes syahrecp.htm National Institute of Diabetes and Digestive and Kidney Diseases Nutrition & Obesity Pharmaceutical Information Network Obesity Information Center obesity_info.html Pediatric Diabetes Camp Jordan for Children with Diabetes Juvenile Diabetes Foundation International Starbright Organization for Chronically Ill Children National Resources American Association of Diabetes Educators - (800) American Diabetes Association - (800) DIABETES Juvenile Diabetes Foundation International - (800) JDF CURE Medic Alert (800) National Diabetes Information Clearinghouse - (301)

8 To speak to a nurse 24-hours a day call Revised 10/2001/441295