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Diabetes and Self Diabetes and Self MonitoringMonitoring

What is Diabetes?

Diabetes is a condition in which there is too much sugar

(glucose) in the blood. Although sugar is needed to provide

energy for the body, when in excess, it causes problem.

Persons with diabetes have excess sugar because they lack or

have deficient supply of insulin.

Diabetes

“Mild Disease”

Serious consequences

Diabetes Mellitus A Serious Disease

Leading cause of newcases of blindness 25 times more prone to eye problems

6 times higher risk forParalysis (stroke)

5 times more prone toKidney failure

20 times more prone tolower limb amputationNerve damage causes loss of sensation

2-3 times higher risk forheart attack

What Are Common Symptoms of Diabetes ?

Frequent Urination

Hunger

Weight loss

Excessive thirst

Other Symptoms like: Fatigue

Unusual Infections

Blurred vision

Dry and itchy skin etc

How do you Manage Your Diabetes?

Follow a Healthy

Meal Plan

Take your

Medication

Regular Exercise

Test blood sugar

Regularly

Diabetes Self-management Understanding diabetes, its management and the problems

associated with it

Participation in decision making and taking an active part in day

to day management

Monitoring and keeping track of your blood sugar It requires determination, effort and time It requires willingness for self-care It requires close co-ordination with your doctor and the diabetes care team

Benefits of Normal Blood Sugar

Normal blood sugar

Improves your sense of well being

Restores energy

Makes you symptom free

Helps prevent long term complications of diabetes

Self Management What Is Required?

Test and record blood and /or urine sugar regularly as advised

Record your medication, food and activity pattern

Identify blood sugar pattern in relation to the above and learn how your blood sugar reacts to changes

Use the learning and your blood sugar results to adjust your food, activity and medication

Learn to recognize and manage hypoglycemia and sick day

problems

Visit your doctor and diabetes care team regularly and carry out

other tests and examinations as advised

Make all efforts to control your diabetes with help of your

diabetes care team to prevent long term complications

Self Management What is Required?

Methods of Self-monitoring

Home monitoring and recording of blood sugar using glucose meters, or color strips

urine sugar and ketones using strips or reagents

Self Monitoring of Blood Sugar Your Tool to Good Control !

It allows you to determine pattern of blood sugar level and

make necessary changes in your food and activity program or

insulin / OHA dose

Allows you to respond quickly to a rise or fall in blood sugar

Useful in preventing long term complications

Home Monitoring of Blood Sugar

Check when and how often to monitor - suggested times

include Fasting, before lunch and dinner

2 hrs after breakfast, lunch and dinner

3 AM

Test more often When not well

Suspect hypoglycemia

During pregnancy

When changing treatment or not in control

What is needed Lancet Test strips Cotton swab Glucose meter or color chart

Steps Clean and dry hands Puncture skin of finger (side), squeeze out large drop of blood Apply blood to test strip, and do as per instructions Apply cotton swab to puncture

Note and record result

Home Monitoring of Blood Sugar

Urine Testing Positive only when blood sugar is high > 180 mg/dl. Messy, not accurate but non invasive and less expensive Not useful to detect and document hypoglycemia Very useful in testing for ketones

What is needed Test tube to collect urine Test strips

Steps Collect urine in test tube (second void preferable for urine sugar) Dip test strip in urine and do as per instructions Note and record result

Home Monitoring of Urine Sugar and Ketones

Why Test for Ketones in the Urine?

Ketones are acid waste products formed when the liver burns

fat for energy

Produced when level of insulin is very low and blood sugar is rising

Accumulate in the bloodstream and spill into the urine

Can be detected by special test strips

Provide warning that blood sugar is out of control

High levels can lead to life threatening Ketoacidosis requiring prompt

treatment and frequent monitoring

When to Test for Ketones?

Sick, high fever or a stressful medical, physical or emotional

condition

Blood sugar >250 mg/dl

Nausea, vomiting, or abdominal pain accompanied by severe

thirst and confusion

Peculiar fruity smell in breath

What Is Glycosylated Hemoglobin ?

HbA1c is a test that reflects the average of your blood sugar

levels over the past 2-3 months

Optimal value of the HbA1c is 7%

Higher value means, you had higher blood sugar levels for last

2 – 3 months

HbA1c maybe high despite one or two near normal blood sugar

values in between

Your Daily Diabetes Diary!

An important tool to learn and manage your diabetes

Helps keep record of

Food, activity and medications

Blood sugar and other tests

Weight changes

Hypos

It will help you to understand how your body responds to

different foods, to different situations, and to your medications

Your Daily Diabetes Diary!

It will also help your diabetes care team to discuss and plan your treatment effectively

Set Your Goals and Achieve Them

Goal must be realistic and based on your need, lifestyle, health and age

You and your diabetes care team must be equally involved in setting the goal

Once set, you and your diabetes care team must make all efforts to achieve it by appropriate monitoring and adjustments to your food, activity and medication

Blood Sugar

mg/dl

Good Borderline Poor

Fasting 80-110 111-140 > 140

Post Prandial 80-144 145-180 > 180

Keep your blood sugar as close to good as possible to prevent long term complications. Take insulin, if advised.

Set Your Goals and Achieve Them

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