ABCs. of Diabetes Care
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- Gwen Joseph
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1 ABCs of Diabetes Care
2
3 Stayig healthy whe you have diabetes ca be challegig. But the more you focus o the positive results of a healthy diet, medicatio routie ad regular exercise, the easier it will be to keep your blood glucose, blood pressure ad cholesterol i good cotrol. This booklet will help you uderstad three parts of your diabetes maagemet ad the self-care behaviors that will help meet your health goals i each area. It s as easy as learig your ABCs! By kowig ad cotrollig your A (A1C), B (Blood Pressure), ad C (Cholesterol), you ca stay healthy, achieve your goals, ad live well with diabetes.
4 What are the ABCs? A is for A1C A1C is a blood test that measures a idividual s average blood sugar or blood glucose levels over the last 2 3 moths. A1C is a percetage, ofte ragig from High A1C results put you at risk for future health problems. Aother way to express this average is called estimated average glucose (eag). The differece is that it s writte i mg/dl (the same umber you see whe you check your blood glucose o your home moitor) istead of a percetage. Your healthcare provider will work with you to set a A1C/eAG goal specifically for you. However, the America Diabetes Associatio recommeds that most people with diabetes aim for a A1C of less tha 7.0 (eag of 154) ad the America Academy of Edocriologists ad the America Associatio of Diabetes Educators (AADE) recommed a A1C of 6.5 or lower (eag of 140). This will help you remai healthy ad reduce your risk for complicatios of diabetes. My A1C My Goal A1C
5 B is for Blood Pressure Blood pressure As your heart pumps blood through your body, pressure is applied to the iside walls of your blood vessels. If you have high blood pressure, your heart is workig harder tha it should ad this ca cause health problems. Blood pressure is easily measured at the doctor s office or with a home blood pressure moitor. For most people with diabetes, blood pressure should be less tha 130/80mmHg. High blood pressure icreases your risk for stroke, heart attack ad kidey disease. It is importat to take actio to get your blood pressure i cotrol. My Blood Pressure My Goal Blood Pressure
6 C is for Cholesterol Cholesterol is a form of fat that ca build up i your blood, puttig you at a icreased risk for heart attacks ad strokes. It has three parts that ca be measured: low desity lipoproteis or LDL, high-desity lipoproteis or HDL, ad triglycerides. Levels of LDL, the bad cholesterol, that are too high ca lead to a buildup of cholesterol i your arteries. HDL, or good cholesterol, helps remove cholesterol from your blood. High triglycerides (a form of fat that floats i the blood alog with cholesterol) may icrease your risks as well. It s importat that all parts of your cholesterol are withi healthy levels. For most people with diabetes, cholesterol goals are: LDL less tha 100 mg/dl HDL greater tha 40 mg/dl for me ad 50 mg/dl for wome Triglycerides less tha 150 mg/dl
7 Be sure to discuss your idividual cholesterol goals with your care team. My Curret Levels (mg/dl) My Goal Levels (mg/dl) LDL HDL Triglycerides
8 AADE7 Self-Care Behaviors The America Associatio of Diabetes Educators has idetified seve self-care behaviors, called the AADE7 TM that will help you maage your blood glucose, blood pressure ad cholesterol ad live a healthier life with diabetes. 1 Healthy Eatig If you have diabetes, you do ot have to give up your favorite foods. But you will eed to pay attetio to how much you eat, whe you eat, ad what effect food has o your health goals. How ca what you eat affect your ABCs? A1C: The types of food you eat, how much ad whe you eat them all affect the amout of glucose i your blood. By learig to eat regular meals, makig healthy food choices, watchig your portio sizes, ad moitorig your blood glucose levels, you ca decrease your A1C/eAG over time! There are three mai types of utriets i food: carbohydrates, proteis ad fats. A healthy meal will iclude all three types, but it is especially importat to cotrol the amout of carbohydrates you eat because they raise your blood glucose more tha the other two. Carbohydrates are foods such as: bread, rice, pasta, fruits, cereals, grais, starchy vegetables (like potatoes, cor, squash ad dry beas), cady, cookies, baked goods ad sweet beverages. All of these foods have a effect o your blood glucose. Meats, like poultry, beef ad pork, ad cheese, as well as fats ad oils ad o-starchy vegetables have very little effect o your blood sugar. Try to balace high carbohydrate-cotaiig foods with those that do ot cotai may carbohydrates.
9 Blood Pressure: Foods higher i salt (sodium) may raise your blood pressure. Try to reduce the sodium i your food choices usig these tips: Use herbs ad spices to flavor your foods istead of addig table salt. Reduce your use of salt (sodium) to o more tha 2,300 mg of sodium each day. Read food labels to choose foods that are lower i sodium ad added fats. Avoid caed, processed, coveiece ad fast foods that are geerally higher i sodium tha fresh foods. Choose vegetables ad fruits more ofte they are aturally low i sodium. Cholesterol: Foods high i aimal fats (saturated fats) ted to raise your levels of bad (LDL) cholesterol. To lower the amout of saturated fat i your meals: Trim visible fat off of meats ad remove the ski from chicke before cookig. Use liquid oil i cookig like caola or olive oil, which are high i healthier moo-usaturated fats. Choose skim or 1% milk ad reduced-fat cheeses. Whole milk ad high-fat cheeses have lots of cholesterol-raisig aimal fats. Choose foods high i fiber like whole grai breads ad cereals, fruits ad vegetables (leave the peels o). Dry beas ad peas are also high i fiber. Self-Check Why is it importat to eat healthy meals? What is oe thig you ca do today that will make your meals healthier?
10 2 Beig Active Regular physical activity ca help you feel strog, improve your isuli sesitivity, reduce your blood glucose levels ad improve your cholesterol ad blood pressure. Before you begi, ask your healthcare provider to assess your curret fitess level ad help you set some exercise goals. They do t have to be huge goals just addig more physical activities to your daily routie will help you stay healthy. Here are some first steps to take: Create a activity pla based o your eeds ad abilities. If you are exercisig maily to lose weight or maitai a healthy weight, icrease your amout of physical activity ad work up to 30 miutes a day, 5 days a week. Try somethig ew. Try yoga, hula hoop, salsa dacig, bike ridig, or take a class at a commuity ceter or local gym. If you are exercisig at home, try exercise DVDs or follow alog with exercise shows o televisio. Measure your progress. Keep a record of your efforts. Review your short- ad log-term accomplishmets to make chages if eeded. Reward your achievemets ad keep yourself motivated. Self-Check Name oe activity that you might ejoy doig more ofte. Recruit a fried, family member or co-worker to exercise with you for support ad motivatio. Start movig! Start with somethig easy like walkig for 10 miutes a few days a week, ad slowly build from there. If you have a hard time stadig or keepig your balace, try chair, bed or floor exercises to icrease your stregth ad flexibility. What ca you do today to get started?
11 3 Moitorig Keepig track of your blood glucose levels ad kowig your other health umbers is importat for diabetes maagemet. If glucose moitorig is ew to you, talk with your diabetes educator about how ad whe to check your blood glucose, ad what to do whe it s too high or low. Your ABCs eed watchig too, ad it s importat to keep track of your umbers i each area so that you kow your target goals ad how well you are doig. A1C: For most people with diabetes, this test should be doe every 3 6 moths. Remember to cotiue regularly checkig your blood glucose as recommeded by your care team. Blood Pressure: Be sure your blood pressure is checked at every visit with your care team. If you have high blood pressure, your healthcare provider may suggest that you take blood pressure readigs at home i betwee your regular appoitmets. Cholesterol: This test is doe every 6 moths to 1 year. It should be part of your aual diabetes check, eve if your umbers were previously healthy. Self-Check Which oe of your ABC umbers are you most cocered about ad why? What ca you do today that will help you moitor this area of your diabetes care?
12 4 Takig Medicatios There are several types of medicatios for people with diabetes isuli, pills to help maage your blood sugar, blood pressure medicatios, cholesterol-lowerig medicatios, ad others that may work together to help you lower your blood sugar levels, reduce your risk of complicatios ad help you feel better. Medicatios ca be prescribed i each oe of the ABC areas, but they are oly effective if you take them the correct way ad at the right times. It s importat to kow the ames, doses ad istructios for the medicatios you re takig, as well as the reasos they were prescribed for you. Self-Check Do you ever forget to take your medicatio or skip it o purpose? How ca you chage this i the future?
13 5 Problem Solvig Everyoe ecouters problems with their diabetes cotrol; you ca t pla for every situatio you may face. However, there are some problem-solvig skills that ca help you prepare for the uexpected: Whe you have a special occasio, such as a holiday, weddig, or goig out to eat, check out what will be o the meu. Pla what you will eat ahead of time. If you do t like to exercise outside durig the witer, explore ways to be active idoors. Make a sick day pla before you get the flu. Keep umbers for your healthcare team hady i case of emergecy. Make a pla for situatios whe alcohol will be served. Thik of other situatios i which you might feel out of cotrol. Develop a way to deal with these ahead of time. Self-Check How have you prepared for the uexpected i your diabetes maagemet? What ca you do to prepare for hypoglycemia at home? At work? At a social activity?
14 6 Reducig Risks Havig diabetes icreases your chaces of developig other health problems, but you ca prevet or delay the oset of complicatios by keepig your ABCs withi your goal rages. If you have healthy blood pressure ad cholesterol levels, you are less likely to get heart disease. By payig close attetio to your A1C, ad takig actio to keep it i a safe rage, you ca help keep your eyes, feet ad kideys healthy. To help reduce your risk of complicatios: Do t smoke if you do, seek help i quittig. See your care team o a regular basis usually every 3 6 moths. Visit a eye doctor, called a ophthalmologist, for a dilated eye exam oce per year. Take care of your feet ask your diabetes educator for iformatio o foot care procedures. Your healthcare provider should do a complete foot exam every year. Check your blood sugar ad blood pressure regularly. Report ay results out of your goal rage to your care team. Visit your detist twice a year ad remember to brush at least twice a day ad to floss your teeth daily. Have your cholesterol ad A1C checked regularly. Self-Check Look at the list above. Which oe of these thigs do you have trouble doig? What is oe thig that you ca do today to reduce your risks?
15 7 Healthy Copig Diabetes ca affect you physically ad emotioally. It is atural to have mixed feeligs about your diabetes maagemet ad experiece emotioal highs ad lows. That s what healthy copig is all about fidig ways to ackowledge those egative feeligs ad deal with them i a way that will help you stay o track, or get back o track. Here are some strategies to help you cope with the tough times i your diabetes self-maagemet: Do somethig physical. Physical activity ca positively ifluece your mood. If you are sad, axious, stressed or upset, go for a walk, stad up ad stretch, take a bicycle ride or do aythig you ca to move your body more eve i a chair. Exercise actually icreases the chemicals i your brai that help make you feel good! Self-Check How ca you deal with stress i a positive way? Develop a support etwork. Be sure to develop ad urture relatioships i your persoal life. Go to group educatioal or support sessios where you ca meet ad relate to other people goig through the same experieces. Talk to your doctor or educator if you feel dow ofte, have chages i appetite or sleep, ad do t feel like takig care of yourself. Do thigs that you ejoy garde, talk with frieds, read. List three activities you ejoy doig that help you relax
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