Self-management
Finding the right balance of food, exercise and insulin is the key to living a good and healthy life with diabetes. Take good care of yourself! You know your own body. Only you can recognize the subtle feelings that may indicate a change.
Self-management means
Self-management means that YOU keep track of YOUR blood sugar and take an active part in the treatment of YOUR diabetes. This is important because so many things you do in your daily life affect your blood sugar. You decide when and what to eat. You choose how much and when to exercise. You are the one who takes your medication.
Treating your diabetes
Before you got diabetes your pancreas kept your blood sugar within the normal range, by producing the right amount of insulin at the right time. Your body's tissues were responsive to that insulin. Now when you have Type 2 diabetes your body may not make enough insulin and may not respond to that insulin properly. Therefore, YOU must help your body do what it once did more efficiently. You will not be alone. Your diabetes care team will help you create and stick to your treatment goals, but YOU are the main person to treat YOUR diabetes.
Setting YOUR targets
It is important for you and your diabetes team to agree on set targets for your blood glucose, blood pressure and cholesterol (see also section 'Your heart and circulatory system').
Learning self-management
It takes effort to learn about and use the tools of self-management. You cannot learn this just by reading about it. Learning by doing is a must. It takes time and practice and requires that you work closely with your doctor and other members of the diabetes care team. They'll guide you to maintain the best possible blood sugar control.
Testing your blood sugar
Testing your blood sugar tells you how well you are managing your diabetes. It helps you plan your medicine, food and exercise, and allows you to detect patterns in your sugar levels. This in turn helps decide the best treatment for you.
Recording blood sugar measurements
A single blood sugar test at the clinic is usually of little value. It takes much more to keep good control of your diabetes. It requires that you test your blood sugar regularly during the course of the day and keep track of the readings in a diary and adjust your treatment accordingly. Taking the diary to the clinic will help your doctor decide on the best treatment for you. Although it sounds like hard work, the benefits of improving your blood sugar control are so great that it really is worth the effort.
Why is good blood sugar control important?
You benefit from good blood sugar control, because it can make you feel better in your daily life. When your blood sugar is either too low or too high, you'll feel sick, tired and uncomfortable. Good blood sugar control also helps to prevent serious long-term complications of diabetes. Research shows that tight blood sugar control delays the start of complications, and slows them down if they have started. If you are motivated to keep tight control of your blood sugar, you will reap the benefits of a healthier and, perhaps, longer life.
Test your blood sugar
You can test your blood sugar in two ways - using either your eyes or a meter. Either way you apply a drop of blood, taken from your fingertip, to a test strip. After a short time, you can match the colour on the strip with the colours on the strip-bottle. If you're using a meter, the result will be displayed automatically. Meter testing gives you the most accurate reading, because the meter reads the colour of the strip more accurately than your eyes.
When to test blood sugar
Since blood sugar control is one of the most important aspects of your diabetes management, learning your own patterns is extremely valuable. It is a good idea to start keeping a diary of your sugars at different times during the day, soon after you find out that you have diabetes. Exactly how often and when is best to test varies among individuals. It depends on your particular reasons for testing. Talk with your diabetes care team about what is best for you. To make good decisions about your treatment, it is also helpful to test before and after exercise, whenever you suspect that your blood sugar is low or high, and when you are ill.
A 24-hour profile
You'll get the most valuable information if you test before and 2 hours after meals and at bedtime. Talk with your doctor or nurse to decide how often to do this.
A1c
Your diabetes care team are also likely to assess your blood sugar control by measuring the level of ‘A1c’ in your blood. Although you will not be able to measure this yourself (special equipment and techniques are required) you can use information about your A1c to improve your self-management. A1c is a measure of the amount of sugar bound to the haemoglobin in your red blood cells. This will correspond to the average level of blood sugar over the previous couple of months. Therefore, A1c is a useful indicator of your overall blood sugar control, because rather than being a one-off ‘spot-check’, it indicates how well-controlled your sugar has been over a period of time. It helps you and your doctor discuss the best treatment plan for you, and helps you keep track of how well you are doing. Current guidelines recommend keeping your A1c below 7% and if possible below 6.5%. However, levels vary depending on where the test is carried out, so talk to your diabetes team about the recommended level for you.
Testing urine for sugar
Testing your urine for sugar tells you much less about your condition than testing your blood for sugar. Urine testing will only tell you whether your blood sugar is above 10 mmol/1. This form of testing is unable to tell you if your blood sugar is within your target range. It can't warn you of hypoglycaemia either. Testing the urine only reflects the level of sugar in the blood at the time the urine was formed. Obviously that is not good enough, if you want to know what your blood sugar is right now.
Fill in your diary
A diary is a good way to keep track of your blood sugar readings. It may enable you and your diabetes care team to treat your diabetes more effectively. Enter your blood sugar readings in the diary, along with the date and time of testing, and the time of your meals. Be sure to note the dose of your medication. It's a good idea to make personal notes about things that may have affected your blood sugar, how you felt about it and what you did to keep your blood sugar under control. This is all valuable information that you and your doctor can use to make decisions about your treatment. Always take your diary to appointments with the diabetes care team.
APP/KOL/AC 22/02/07