GuidetoCare for patients

Diabetes
(over about 180 mg/dL) Did you know? and you might feel tired, Exercise can also weak, thirsty, experience improve cholesterol frequent urination, or nolevels, help you lose tice changes in your vision. weight, get stronger If you are having blood bones and muscles, increase exibility, glucose readings greater and give you more than 180 mg/dL, call your energy. primary care provider in order to make the appropriate changes in medication. High blood glucose can also occur because of eating too many carbohydrates, forgetting to take medication, being sick, or experiencing an increase in stress. Very high blood glucose can be an emergency and requires immediate attention and possible admission to the hospital to treat dehydration and bring the blood glucose down to the normal range.
RESOURCES
1. American Diabetes Association. www.diabetes.org 2. National Diabetes Education Program. www.ndep.nih.gov 3. Diabetes Prevention Program. www.diabetes.niddk.nih.gov DOI-10.1097/01.NPR.0000407609.07247.7e

Diabetes mellitus (diabetes) occurs when the glucose (sugar) in the blood is too high because the body does not make enough insulin or is resistant to insulin. Insulin is released from the pancreas and delivers glucose to the cells to be used for energy. Type 1 diabetes is caused when the pancreas stops making insulin. Only about 5% to 10% of people with diabetes have type 1. Type 2 diabetes is more common and occurs when cells are resistant to insulin and the pancreas does not make enough insulin. People may be more likely to develop type 2 diabetes if they have a family history of diabetes, are overweight, and dont exercise. Gestational diabetes occurs during pregnancy and usually goes away after the pregnancy is over. However, women who have had gestational diabetes are at risk of developing type 2 diabetes in the future.

This teaching aid may be photocopied by healthcare professionals for use in their clinical practice. Attach your business card here, then copy.

What is a normal blood glucose level? The normal fasting blood glucose is 70 to 99 mg/dL. If you have diabetes, keeping your blood glucose as close to normal as possible can help prevent or delay damage to your body. Treatment Diabetes is treated with medicine and following healthy habits such as eating right, exercising, taking medication, and properly managing emotions and stress.
www.tnpj.com

Supported by the

53 The Nurse Practitioner Vol. 35, No. 3

Copyright 2012 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.

Fold Here

Healthy eating Making healthy food choices can help you manage your blood glucose. Ask your primary care provider to help you create a diet that works specically for your health needs. Healthy eating includes eating a variety of foods, practicing portion control, and eating at regular times. Reading the nutrition label on food packages is a quick and easy way to get facts about the food for a specic serving size. To learn how to read a food Fast Fact label, visit http://www. The American Diabetes fda.gov/Food/Resources Association recommends ForYou/Consumers/NFLPM/ the following for people ucm274593.htm. with diabetes: It is also important Keep A1C less than 7%. to pay attention to the Blood glucose should be 70 to 130 mg/dL carbohydrates and fats before eating. listed on the nutrition label The blood glucose because foods that contain level should be less carbohydrates raise blood than 180 mg/dL glucose. Examples of foods 1 or 2 hours after that contain carbohydrates eating. are pasta, bread, rice, desserts, juice, soda, and fruit. Fats do not raise blood glucose but should be limited. Healthy fats are in foods like avocado, nuts, and sunower oil. Unhealthy fats are in foods like butter, cheese, and bacon. Exercise The American Diabetes Association and the American Heart Association recommend that adults, including people with diabetes, do about 30 minutes of moderate exercise, ve times a week. This can include anything from walking or running to dancing and cleaning the house. Exercise can lower blood glucose and A1C levels by helping the body use insulin more efciently and burn off calories. Discuss exercise with your diabetes team, who can help you develop workout plans and individual goals. Medication Pills can help control blood glucose for people with type 2 diabetes and gestational diabetes. There are several different types of pills that work in different ways to help the body produce or use insulin better. Ask your primary care provider how your pills work, exactly when you should take them, and if there are any side effects or other information you should know about the pills. Insulin injections are needed when the body does not make insulin or does not make enough
54 The Nurse Practitioner Vol. 35, No. 3

Fold Here

insulin. People with type 1 diabetes must always take insulin. People with type 2 diabetes, gestational, or other types of diabetes might need insulin too. There are many different types and combinations of insulins and you may need injections several times a day. Some people get their insulin through an insulin pump, which delivers insulin continuously into the tissue. Managing stress and emotions A diabetes diagnosis can be difcult to cope with and can cause stress. Some things that may help are learning about your diabetes and feeling in control of your own care, getting support from family and friends, and connecting with others who have diabetes. If you are feeling overwhelmed or depressed, talk to your primary care provider.

How will I know if my blood glucose is too low or too high? Part of managing diabetes is checking your blood glucose at home with your own blood glucose meter. If you check your blood glucose often, you will know if your blood glucose is normal, too low, or too high and you will learn how food, exercise, and medications affect your blood glucose. Hypoglycemia means your blood glucose is low (less than 70 mg/dL) and you might feel weak, shaky, sweaty, hungry, or you feel like you are not thinking clearly. Low blood glucose can be caused from skipping meals, too much diabetes medication, medication taken at the wrong time, or more exercise than usual. The fastest way to raise blood glucose back to normal is to eat or drink some form of sugar such as 1/2 cup of juice or regular soda, 5 to 6 pieces of hard candy, or 3 glucose tablets. Recheck your blood glucose 15 minutes after you have a low to see if you are back up to normal. If you are still low, then repeat the treatment, and if you are still low after the repeat treatment, call 911 or your primary care provider. If you are getting frequent low blood glucose levels, call your primary care provider because changes might need to be made to your medications, eating, or exercise routine. Hyperglycemia means your blood glucose is high

www.tnpj.com

Copyright 2012 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.