Diabetes

Diabetes


So You Have Diabetes, Now What?


So you have diabetes! I'm here to help you. This handout is only meant to have only the most important information. If you have any questions, write them down and bring them to the next appointment. Research this online from reputable sources, you will soon be an expert!

Diet and exercise.

  • You need to be eating a healthy diet with lots of vegetables. Carbohydrates and sugars are not your friends. Stop eating and drinking things that are sugary and sweet.

    • Eat less of:

      • Soda pop and juices (if you must have a soda, get a diet soda)

      • Candy

      • Breads and pastas

      • Instant rice and oatmeal

      • Potatoes, especially fried

    • Eat more of:

      • Green and colorful vegetables

      • Beans and Fiber

      • Chicken, turkey and fish

  • Exercise

    • You don’t have to go crazy; any exercise you do is better than none.

    • Try to get at least 20 minutes 3 times a week where you are breathing so hard that you can't easily carry on a conversation.

    • I would say the sweet spot would be 30-45 minutes 4-5 times per week.

What is the A1c and blood sugar?

  • Blood sugar is a test that we may do, or you may do at home. This tells you how much sugar is in your blood right now.

  • Checking your blood sugar at home

    • Fasting blood sugar is your blood sugar right after you wake up in the morning and before you eat. We want this to be less than 130.

    • Postprandial blood sugar is your blood sugar 2 hours after you eat. We want this to be less than 180.

    • If your blood sugar drops below 70, you may need to eat some sugar, or drink some juice or soda pop to bring it up. Check your blood sugar 15 minutes later. Repeat if needed and call the office or go to the ER if you are at all concerned or confused about what to do.

  • A1c is done in the office or in the lab. It tells the doctor the average sugar in your blood over the last 3 months. It does not give us details about your blood sugar right now.

Taking your medications

  • If your medications are too expensive, let me know. A medication is not helpful if you are not taking it.

  • Set a reminder on your phone for when you are supposed to take it.

  • When you start metformin, you may have an upset stomach. Take it with food to help. Most of the time these get better, try to tough out the first little bit. It is an amazing medication.

  • We’ll work on getting you up to 2,000 mg a day. This is the best dose of metformin to be on.

  • Insulin

    • Make sure you have written down somewhere how much you are taking, so you don't get confused and give yourself too much or too little. Especially if we are figuring out your dose.

    • Insulin is a great medication, it is the most customizable way to treat your diabetes (and if you have type 1 diabetes, it is the only way).

    • There are 3 major types of insulin: Long acting, Short acting, and mixed insulin (70/30)

      • Long acting - You take this once or twice a day. It helps your body maintain a low blood sugar level

      • Short acting insulin – you will give this to yourself before you eat. 2 hours after you eat, check your blood sugars. If it is over 180 for 2 days in a row, we need to adjust the dose

      • Mixed insulin - this is the cheapest insulin. I usually use it when the cost. If you use this injection YOU HAVE TO EAT SOMETHING or your sugars may drop too low.

  • Most of my patients with diabetes will need to be on a statin. This medication is helpful because you are at an increased risk of heart disease. This medication will lower your cholesterol and help prevent strokes and heart attacks.

  • Get a pneumonia vaccination as soon as you find out you have diabetes. You wont need another one until you are 65 years old.


Lab work

  • I want you to be in charge of your health, so make sure we have these tests done and up to date.

    • A1c – tests your average blood sugar. Lower is better. Most people should aim for less than 7%, Repeat every 3 months, or every 6 months.

    • BMP – this tests your electrolytes and kidney function. Important to know how far along you are in diabetes. Your kidneys and eyes are the first things to go in diabetes. Repeat every 6 months

    • UA or microalbumin – also tests for your kidneys, Repeat every year

Other Screening and Self Care

  • You need your eyes checked every year by an ophthalmologist for a "Diabetic retinopathy screening"

  • Flu shot near October every year

  • Regular dental checkups and make sure you brush and floss daily! Diabetes will make you more prone to gum disease called periodontal disease.

  • You need to check your feet for sensation every so often. They can go numb and you may not know if you step on something sharp. Keep them clean and dry to avoid diabetic infections. You need your feet checked by a podiatrist.