diabetesselfmanagementeducationcourse-141118113032-conversion-gate02.ppt

diabetesselfmanagementeducationcourse-141118113032-conversion-gate02.ppt

1. Diabetes Self Management
Education Course
Amy Bouthillette
Clinical Dietitian, Certified Diabetes Educator
Carrie Palmer
Adult Nurse Practitioner, Certified Diabetes Educator

2. Monitoring
Your
Diabetes:
Important Tests
and Goals

3. Learning Points
•Know why it is important to check
glucoses
•Be able to describe a range for normal
glucoses before food
•Be able to describe what A1c test
measures and what the goal is for A1c
•Know when you need to test your glucose
more often

4. Monitoring Your Diabetes:
Target Blood Glucose Levels
Without
Diabetes
With Diabetes
(normal)
With Diabetes
(target)

Before meals


70-115
mg/dL

 110
mg/dL

80-130
mg/dL

Before bedtime


70-120
mg/dL

 120
mg/dL

100-150
mg/dL

Hemoglobin A1c


 6%

 7%

 7%

5. Not Good
Good Control
6
Know Your Number
A1c
13
12
7
5
8
11
Blood Sugar
9
120
180
210
270
300
360
90
150
14
330
10 240
Poor Control
Pretty Good
Monitoring Your
Diabetes: What
does an A
1c
mean
An A1c measures how much
sugar has been sticking to red
blood cells over a 3 month period
of time.
An A1c is a measure of long-term
diabetes control.
Goal is A1c <7

6. Monitoring Your Diabetes:
What is an A
1c
Red
blood
cell
Normal Blood Glucose
Above-Normal Blood Glucose
Red blood cell
Glucose
particles
The higher your blood sugar, the more sugar that sticks to your red
cells and the higher your A1c

7. Monitoring Your Diabetes:
Testing your A
1c
•Your doctor will check your A
1cevery 3
to 6 months
•Your doctor may check your A
1c more
often if:
–You have blood sugars above goal
–Your last A
1c was high
–You have had symptoms of low blood sugar

8. Monitoring Your Diabetes:
Controlled blood sugars and A
1c
•Blood sugars and an A
1c at or below goal
(7% or less) can protect your:
–Heart, brain, blood vessels
–Eyes
–Kidneys
–Nerves
–Feet

9. Monitoring
Your
Diabetes:
Testing Your
Sugars at
Home

10. Testing Sugars- How often?
•Depends what kinds of medicine you take:
–Most patients taking pills test once a day
–Patients taking insulin may need to test between 1
and 4 times a day
•Determined by the type of insulin and its action
•Test more often if:
–You have had low blood sugars (BG<70)
–Sugars have been unusually high (over 200)
–You are sick
–You are starting a new exercise program

11. Monitoring Your Diabetes:
Sample Diabetes Record- Fasting

12. Monitoring Your Diabetes:
Sample Diabetes Record- Alternating

13. Monitoring Your Diabetes:
Sample Diabetes Record- Detailed
Breakfast Lunch Supper Bedtime Other
DoseBlood
Glucose
DoseBlood
Glucose
DoseBlood
Glucose
DoseBlood
Glucose
DoseBlood
Glucose
Comments:
Physical Activity, Stress,
etc.
Sun18L
6R
220 10L
4R
100
Mon18L
4R
80 120 12L
4R
170 140 30
Tues18L
4R
240 180 12L
4R
240 110 70
Wed18L
4R
90 10L
4R
120 80 90
Thur18L
4R
100 10L
4R
180
Fri18L
4R
120 150 10L
4R
160 120
Sat18L
4R
90 70 10L
4R
180 240
Number of 7 4 6 6 3
measurements
Total of blood 940 520 1050 790 190
glucose values
Average of 134 130 175 132 64
blood glucose
values

14. Monitoring Your Diabetes:
Your meter provides important
information

15. Other Points to Remember
•Make sure you know how to correctly use
your meter
•Don’t share meters
•Always bring meter to doctor’s visits

16. What Affects
Your Blood
Sugar?
What is
hypoglycemia &
hyperglycemia?

17. Learning Points
•Know signs of high blood sugar
(hyperglycemia)
• Know the signs of low blood sugar
(hypoglycemia)
•Know what to do when sugars are too high
or too low

18. Your Blood Sugar:
Hyperglycemia or High Blood Sugar
•Symptoms
–Extreme thirst
–Frequent urination
–Dry skin
–Hunger
–Blurred vision
–Drowsiness
–Decreased healing

19. Your Blood Sugar:
Hyperglycemia or High Blood Sugar
•Causes
–Too much food
–Too little insulin or diabetes medicine
–Illness
–Stress
•Onset
–Gradual
–If extremely high or you have type 1 diabetes it
may progress to diabetic coma
–Damage to your eyes, kidneys, and nerves
happens over time

20. Your Blood Sugar:
Hyperglycemia or High Blood Sugar
•What can you do when you have
symptoms?
–Test blood glucose more often
–Don’t wait, call your doctor if your blood
sugar is over 200mg/dL for several tests or
for 2 days

21. Your Blood Sugar:
Symptoms of Hypoglycemia
•Shaking
•Fast
heartbeat
•Sweating
•Dizziness
•Anxiety
•Hunger
•Impaired vision
•Weakness/fatigue
•Headache
•Irritability

22. Your Blood Sugar:
Hypoglycemia or Low Blood Sugar
•Causes
–Too little food
–Too much insulin or diabetes medicine
–Extra activity or exercise
•Onset
–Sudden
•May progress to unconsciousness,
confusion, or insulin shock

23. Your Blood Sugar:
Treatment of Hypoglycemia
4 Steps to treating your blood sugar:
1.Quick sugar, 10 to 15 grams carbohydrate
2.Recheck blood glucose in 15 to 20 minutes and
repeat treatment if necessary
3.If your glucose is normal, eat a protein meal or snack
4.If you have symptoms, but BG is over 70, have snack
*Treat all sugars under 70 mg/dl (with or without symptoms)
*If you have symptoms, but no meter, treat and try to be
prepared and have meter with you the next time.

24. Hypoglycemia or Low Sugar:
Step 1- 10 to 15 Grams of Carbs
Pick One of these
2 to 3
Glucose
Tablets
5 to 8 Life
Savers
®
1/4 to 1/3 cup
raisins
4 oz. orange juice
3 to 5 peppermint candies
8 oz. milk
½ can of
regular soda

25. Hypoglycemia or Low Sugar:
Step 2- Recheck Blood Sugar

26. Hypoglycemia or Low Sugar:
Step 3- Eat a protein snack
Pick One
½ meat sandwich
crackers & cheese
peanut butter
sandwich or
crackers

27. Hypoglycemia or Low Sugar:
Foods to avoid for lows
Ice Cream
Doughnuts
Nuts
Pizza
Potato
Chips
Chocolate
Cake
Cookies