DISCHARGE INSTRUCTIONS:

Call for help if:

You have any of the following signs of a stroke:

o Numbness or drooping on one side of your face
o Weakness in an arm or leg
o Confusion or difficulty speaking
o Dizziness, a severe headache, or vision loss
You have any of the following signs of a heart attack:
o Squeezing, pressure, or pain in your chest that lasts longer than 5 minutes or
returns
o Discomfort or pain in your back, neck, jaw, stomach, or arm
o Trouble breathing
o Nausea or vomiting
o Lightheadedness or a sudden cold sweat, especially with chest pain or trouble
breathing

Seek care immediately if:

You have severe abdominal pain, or the pain spreads to your back. You may also be
vomiting.
You have trouble staying awake or focusing.
You are shaking or sweating.
You have blurred or double vision.
Your breath has a fruity, sweet smell.
Your breathing is deep and labored, or rapid and shallow.
Your heartbeat is fast and weak.

Contact your healthcare provider if:

You are vomiting or have diarrhea.

You have an upset stomach and cannot eat the foods on your meal plan.
You feel weak or more tired than usual.
You feel dizzy, have headaches, or are easily irritated.
Your skin is red, warm, dry, or swollen.
You have a wound that does not heal.
 You have numbness in your arms or legs.
You have trouble coping with your illness, or you feel anxious or depressed.
You have questions or concerns about your condition or care.

Medicines:

You may need any of the following:

Hypoglycemic medicines or insulin may be given to decrease the amount of sugar in

your blood.
Blood pressure medicine may be given to lower your blood pressure. Your blood
pressure should be less than 140/90.
Cholesterol lowering medicine may be given to prevent heart disease.
Antiplatelets , such as aspirin, help prevent blood clots. Take your antiplatelet medicine
exactly as directed. These medicines make it more likely for you to bleed or bruise. If you
are told to take aspirin, do not take acetaminophen or ibuprofen instead.
Take your medicine as directed. Contact your healthcare provider if you think your
medicine is not helping or if you have side effects. Tell him or her if you are allergic to
any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the
amounts, and when and why you take them. Bring the list or the pill bottles to follow-up
visits. Carry your medicine list with you in case of an emergency.

Check your blood sugar level as directed:

You will be taught how to use a glucose monitor. Ask your healthcare provider when and how
often to check during the day. You will need to check your blood sugar level at least 3 times each
day if you are on insulin. If you check your blood sugar level before a meal , it should be
between 80 and 130 mg/dL. If you check your blood sugar level 1 to 2 hours after a meal , it
should be less than 180 mg/dL. Ask your healthcare provider if these are good goals for you.
Write down your results, and show them to your healthcare provider. He may use the results to
make changes to your medicine, food, or exercise schedules.

If your blood sugar level is too low:

Your blood sugar level is too low if it goes below 70 mg/dL. If the level is too low, eat or drink
15 grams of fast-acting carbohydrate. These are found naturally in fruits. Fast-acting
carbohydrates will raise your blood sugar level quickly. Examples of 15 grams of fast-acting
carbohydrate are 4 ounces ( cup) of fruit juice or 4 ounces of regular soda. Other examples are
2 tablespoons of raisins or 3 to 4 glucose tablets. Check your blood sugar level 15 minutes later.
If the level is still low (less than 100 mg/dL), eat another 15 grams of carbohydrate. When the
level returns to 100 mg/dL, eat a snack or meal that contains carbohydrates. This will help
prevent another drop in blood sugar. Always carefully follow your healthcare provider's
instructions on how to treat low blood sugar levels.

Check your feet each day for sores:

Wear shoes and socks that fit correctly. Do not trim your toenails. Ask your healthcare provider
for more information about foot care.

Maintain a healthy weight:

Ask your healthcare provider how much you should weigh. A healthy weight can help you
control your diabetes. Ask your provider to help you create a weight loss plan if you are
overweight. Together you can set manageable weight loss goals.

Follow your meal plan:

A dietitian will help you make a meal plan to keep your blood sugar level steady. Do not skip
meals. Your blood sugar level may drop too low if you have taken diabetes medicine and do not
eat.

Keep track of carbohydrates (sugar and starchy foods). Your blood sugar level can
get too high if you eat too many carbohydrates. Your dietitian will help you plan meals
and snacks that have the right amount of carbohydrates.
Eat low-fat foods , such as skinless chicken and low-fat milk.
Eat less sodium (salt). Limit high-sodium foods, such as soy sauce, potato chips, and
soup. Do not add salt to food you cook. Limit your use of table salt. You should have less
than 2,300 mg of sodium per day.
Eat high-fiber foods , such as vegetables, whole grain breads, and beans.
Limit alcohol. Alcohol affects your blood sugar level and can make it harder to manage
your diabetes. Limit alcohol to 1 drink a day if you are a woman. Limit alcohol to 2
drinks a day if you are a man. A drink of alcohol is 12 ounces of beer, 5 ounces of wine,
or 1 ounces of liquor.

Exercise as directed:

Exercise can help keep your blood sugar level steady, decrease your risk of heart disease, and
help you lose weight. Stretch before and after you exercise. Exercise for at least 150 minutes
every week. Spread this amount of exercise over at least 3 days a week. Do not skip exercise
more than 2 days in a row. Include muscle strengthening activities 2 to 3 days each week. Older
adults should include balance training 2 to 3 times each week. Activities that help increase
balance include yoga and tai chi. Work with your healthcare provider to create an exercise plan.

Check your blood sugar level before and after exercise. Healthcare providers may tell you
to change the amount of insulin you take or food you eat. If your blood sugar level is
 high, check your blood or urine for ketones before you exercise. Do not exercise if your
blood sugar level is high and you have ketones.
If your blood sugar level is less than 100 mg/dL, have a carbohydrate snack before you
exercise. Examples are 4 to 6 crackers, banana, 8 ounces (1 cup) of milk, or 4 ounces
( cup) of juice. Drink water or liquids that do not contain sugar before, during, and after
exercise. Ask your dietitian or healthcare provider which liquids you should drink when
you exercise.
Do not sit for longer than 30 minutes. If you cannot walk around, at least stand up. This
will help you stay active and keep your blood circulating.

Do not smoke:

Nicotine and other chemicals in cigarettes and cigars can cause lung damage and make it more
difficult to manage your diabetes. Ask your healthcare provider for information if you currently
smoke and need help to quit. Do not use e-cigarettes or smokeless tobacco in place of cigarettes
or to help you quit. They still contain nicotine.

Check your blood pressure as directed:

Ask your healthcare provider what your blood pressure should be. Most adults with diabetes and
high blood pressure should have a systolic blood pressure (first number) less than 140. Your
diastolic blood pressure (second number) should be less than 90.

Ask about vaccines:

You have a higher risk for serious illness if you get the flu, pneumonia, or hepatitis. Ask your
healthcare provider if you should get a flu, pneumonia, or hepatitis B vaccine, and when to get
the vaccine.

Follow up with your healthcare provider as directed:

You may need to return to have your A1c checked every 3 months. You will need to return at
least once each year to have your feet checked. You will need an eye exam once a year to check
for retinopathy. You will also need urine tests every year to check for kidney problems. You may
need tests to monitor for heart disease such as an EKG, stress test, blood pressure monitoring,
and blood tests. Write down your questions so you remember to ask them during your visits.