4 STEPS TO BETTER DIABETES CARE
An individual with diabetes can, in general, lead a normal, healthy, and long
life. Looking after yourself and learning about your diabetes provide the best
chance to do this. Your doctor and the other members of the health-care team
(made up of doctors, nurses, dietitians, and chiropodists) are there to advise
you and to provide the information, support, and technology for you to look
after yourself and live your life in the way you choose. It is important for you
to know what your health-care providers should provide to help you reach these
goals and what you should do.
1 Your Rights
The health-care team should provide:
- A treatment plan and self-care targets
- Regular checks of blood sugar (glucose) levels and of your physical
condition
- Treatment for special problems and emergencies
- Continuing education for you and your family
- Information on available social and economic support
Your role is to build this advice into your daily life and to be in control
of your diabetes on a day-to-day basis.
2 Treatment Plan and Self-Care Targets
You should receive the following:
- Personalized advice on proper eating -- types of food, amounts, and timing
of meals
- Advice on physical activity
- Your dose and timing of tablets or insulin and how to take them; advice on
how to change doses based on your self-monitoring
- Your target values for blood glucose, blood fats, blood pressure, and
weight
3 Regular Assessments
At each visit, your health-care professional should:
- Review your self-monitoring results and current treatment
- Talk about your targets and change where necessary
- Talk about any problems and questions you may have
- Continue diabetes education
The health-care team should check:
- Your blood glucose control by taking special tests. (These tests -- done
two to four times per year if diabetes is well controlled -- include
measures of "glycohemoglobin" (sometimes abbreviated as HbA1c or
GHb) or "fructosamine." Fasting blood glucose tests are advised
for individuals treated without insulin.
- Your weight
- Your blood pressure and blood fats, if necessary
The following should be checked at least once per year:
- Your eyes and vision
- Your kidney function (blood and urine tests)
- Your feet
- Your risk factors for heart disease, such as blood pressure, blood fats,
and smoking habits
- Your self-monitoring and injection techniques
- Your eating habits
4 Continuing Education
The following are important items you should learn about:
- Why to control blood glucose levels
- How to control your blood glucose levels through proper eating, physical
activity, tablets, and/or insulin
- How to monitor your control with blood or urine tests (self-monitoring)
and how to act on the results
- The signs of low and high blood glucose levels and ketosis, how to treat
them, and how to prevent them
- What to do when you are ill
- Prevention and treatment of long-term complications, including possible
damage to eyes, nerves, kidneys, feet, and hardening of the arteries
- How to deal with life-style variations, such as exercise, traveling, and
social activities (including alcohol consumption)
- How to handle possible problems with employment, insurance, and driving
licenses
Information from the UNIVERSITY OF MASSACHUSETTS MEDICAL CENTER Worcester, MA