Healthy Living With Diabetes. Improve & Maintain Your Lifestyle.
Diabetes is a condition in which your body can’t properly use sugar, or glucose, for the energy it needs.
Having diabetes means that your blood glucose levels get too high. (1)
Left untreated, high blood glucose levels can lead you to a number of health problems. (2)
Learn more about diabetes and what you can do to stay happy & healthy if you have diabetes.
Diabetes Quick Facts.
WHAT IS DIABETES?
The cells in our bodies run on sugar, also known as glucose. For glucose to get into our cells, it needs help from a hormone called insulin. If there is no insulin or not enough insulin in your body, glucose can’t get into the cells. It stays in the bloodstream and the levels of glucose build up. This is what diabetes is-high levels of glucose in the blood. There are three main types of diabetes: type 1, type 2 and gestational.
- With type 1 diabetes, the pancreas does not make insulin. Without insulin, glucose levels in the blood become too high.
- With type 2 diabetes-the more common type-the pancreas does not make enough insulin or the body does not use the insulin properly.
- Pregnant women can also get a type of diabetes called gestational diabetes that usually goes away after the baby is born. However, women who have had gestational diabetes are at higher risk for developing diabetes later on in life. (3)
HOW DOES DIABETES AFFECT MY BODY?
Diabetes complications are caused by damage to the blood vessels, nerves, or both. Left untreated, high blood glucose can damage your eyes, kidneys and nerves. Diabetes can also cause heart disease and stroke, and can
increase the chances of losing a limb. (4)
HOW IS DIABETES DIAGNOSED?
Your healthcare provider can determine if you have diabetes by doing a simple blood test to measure the amount of glucose in your blood. Sometimes, you will be asked to drink a special glucose drink and wait two hours before having a second blood sample taken. (5)
WHO IS AT RISK FOR DIABETES?
Some of the risk factors for diabetes include:
- A higher-than-normal blood glucose level (prediabetes)
- A family history of diabetes
- Being older than 45 years of age
- Not being physically active
- Being overweight
- Having low HDL “good” cholesterol, high triglycerides or high blood pressure. (6)
WHAT ARE THE SYMPTOMS OF DIABETES?
- Extreme thirst
- Having to urinate often
- Feeling very hungry or tired
- Weight loss for no known reason
- Sores or cuts that heal slowly
- Dry, itchy skin
- Tingling or numbness in your feet/hands
- Blurred vision
- You may have one or more of these symptoms, or you may have no symptoms at all. (7)
Blood Glucose Testing
WHY IS IT IMPORTANT TO CHECK BLOOD GLUCOSE?
Once you’ve been diagnosed with diabetes checking your blood glucose levels regularly with a meter can help you make choices about your food, physical activity and medications. (8) Keep a record of your results and use them to understand your readings. Take your blood glucose records to your healthcare provider visits, which will help you both decide how often you should check your blood glucose and if any changes are needed in your diabetes treatment plan. (9)
Ask your pharmacist or Healthcare Clinic nurse practitioner to help you choose the blood glucose meter that is best for you.
Speak to your healthcare provider about your blood glucose targets.
FOR MOST PEOPLE, THEY ARE:
- Before meals: 70-130 mg/dL
- Two hours after meals: below 180 mg/dL
- At bedtime: 90-150 mg/dL (10)
WHAT SHOULD I CONSIDER WHEN CHOOSING A BLOOD GLUCOSE METER?
- ls it accurate?
- ls it easy to use?
- ls it easy to carry?
- ls the display screen large enough to see my results?
- Can I use blood from my forearm or other non finger sites?
- Will insurance cover the meter and strips?
- Can I upload the results to a computer? (11)
ABCs of Diabetes
WHAT ARE THE ABCS OF DIABETES?
- Measures your average blood glucose over the last three months.
- Blood pressure. High blood pressure makes your heart work too hard.
- LDL or “bad” cholesterol, can clog your blood vessels.
Speak to your healthcare provider about how to reach your ABC target numbers to lower your risk for a heart attack, stroke and other diabetes problems. (12)
TARGET FOR MOST PEOPLE
HOW OFTEN TO MEASURE
Less than 7%
2-4 times a year
Less than 130/80
At every regular provider visit
Less than 100
At least once a year (12-13)
HOW CAN I REACH MY ABC TARGETS?
- Check your blood glucose and your blood pressure as often as your healthcare team recommends.
- Stop smoking. Ask for advice on how to quit, if you smoke.
- Take any medications your healthcare provider prescribes and ask if low-dose aspirin might be helpful for you.
- Get regular checkups of your kidneys, feet and eyes and report any changes too your health-care provider.
- Ask for help if you feel down or have trouble handling stress. (13)
WHAT FOOD AND ACTIVITY CHOICES CAN HELP ME REACH MY ABC TARGETS?
- Choose healthy foods. Eat more fruits and vegetables, fish, lean meats and chicken or turkey without the skin. Bake, broil or grill your meat and keep your portion sizes small. Also, eat beans, whole grains and low-fat or skim milk and cheese.
- Be active. Aim for 30-60 minutes of exercise most days of the week.
- Reach and stay at a healthy weight for you. (14)
HOW CAN I STAY HEALTHY WITH DIABETES?
- Foot care. Check your feet daily for redness and for sores or cuts that don’t heal. Wash-but don’t soak-your feet with a mild soap, rinse with water and dry well. Ask someone to check your feet for you if you have trouble seeing or reaching them. Also, foot injuries often happen in the home, so don’t walk around barefoot. Look for socks that fit well, without constricting cuffs, lumps or uncomfortable seams. (15) If you have diabetic foot nerve pain, capsaicin pain relief cream can be rubbed into the skin on your feet. (16)
- Wound care. If you have a wound, see your healthcare provider right away. Inspect and clean your wound gently once or twice a day, then apply an antibiotic ointment. (17)
- Oral care. Brush and floss your teeth every day to avoid tooth decay and prevent gum disease. (18)
- Skin care. Your skin can become dry and cracked, which can lead to infection. Look for mild lotions that add moisture, gently exfoliate, increase circulation and promote healing without heavy perfumes or alcohol. (15)
WHERE ON MY BODY SHOULD I INJECT INSULIN?
Choose one of the following sites listed below. Rotate the sites to keep scar tissue from building up:
- Inject at least 2 inches away from the navel, scars and moles.
- inject into fatty tissue on the back of the upper arm.
- Inject into the middle or outer part of the thigh, keeping at least 4 inches above your knee and at least 4 inches away from the top of your leg.
- Inject into the fatty tissue above the leg. (19)
Review how to take your injections with your healthcare provider.
HOW DO I INJECT INSULIN?
IF YOU USE A SYRINGE:
- Clean the injection site. Many people use alcohol swabs for this purpose.
- Pinch up a small area of skin (2-3 in wide).
- inject the insulin into the pinched skin at a 90-degree angle.
- Keep the needle in and let go of the pinched skin.
- Count to five slowly, then remove your needle. (20)
IF YOU USE AN INSULIN PEN:
- Screw on a new needle.
- Prime your pen with an air shot by injecting two units of insulin into the air. This removes any air and allows you to get the exact dose of insulin.
- Dial up your dose.
- Clean the injection site. Many people use alcohol swabs for this purpose.
- Hold the pen like a pencil. Make sure you can see the dosing window. Insert the needle straight into the skin. There is no need to pinch the skin.
- Push firmly on the close button and hold for five seconds, then remove the pen. (21)
Dispose of syringes, pen needles and lancets (sharps) properly. (22) Do not reuse syringes, to reduce the chance of infection.
High & Lows. Hyper- & Hypo- Gycemia Know the Difference.
WHAT ARE COMMON SYMPTOMS OF HIGH BLOOD GLUCOSE (HYPERGLYCEMIA)?
- Frequent infections
- Increased thirst
- Increased urination
- Extreme hunger
- Blurred vision
- Dry mouth or skin
- Weight loss for no reason
- Slow-healing flick cuts or sores. (23)
HOW WILL I KNOW IF MY BLOOD GLUCOSE IS TOO LOW (HYPOGLYCEMIA)?
If your blood glucose goes low, you may feel shaky, dizzy, sweaty, weak, hungry or grumpy.
If your blood glucose is 70 mg/dL or below, treat your low blood glucose with 15 g of carbohydrates, such as:
- Four glucose tablets
- One serving of glucose gel
- One half cup of regular fruit juice
- One tablespoon of sugar or honey
After 15 minutes, check your blood glucose again. If it’s still below 70 mg/dL, repeat your treatment with another 15g of carbohydrates.
Repeat these steps until your blood glucose is at least 70 mg/dL.
To prevent your blood glucose from dropping again, eat a meal or snack every three hours. (24)
HOW CAN LOCAL PHARMACY SERVICES HELP ME WITH MY DIABETES CARE?
Whether you have questions about diabetes testing supplies, your prescriptions or your overall health, consider your pharmacist as part of your diabetes healthcare team. Look to us for trusted advice about over-the-counter (OTC) medications and supplements, potential drug interactions and more.
Healthy Living With Diabetes By Taking Control.
Take Control Of Your Diabetes By Starting With A Good Nutrition and Healthy Eating.
How To Use The Plate Method for Controlling Your Diabetes?
- Divide your plate into three sections.
- Fill the largest section with non-starchy veggies like lettuce, green beans or broccoli.
- Fill one of the smaller sections with starchy foods like noodles, rice or corn.
- Fill the last small section with lean cuts of beef or pork, skinless chicken, fish, eggs or tofu.
- Add a glass of milk and a small fruit or half a cup of fruit salad.
For more information about healthy eating, go to AMERICAN DIABETES ASSOCIATION.
Start Off Right By Taking The Right Medications.
When your doctor prescribes you diabetic medications, always ask these questions.
- How many pills do I take?
- How often should I take them and when?
- What if I forget to take my medications and remember later?
- What side effects could I have?
- What should l do if I have side effects?
- Will my diabetes medications cause a problem with any of the other medications I’m taking?
TEST LIKE A PRO…
- Test on your finger’s edges, not the tip, where more nerves are located.
- Wash hands with soap and warm water and dry thoroughly right before testing.
- Vary your fingers instead of using the same finger all the time.
- Use a fresh lancet and make sure test strips are stored in a closed container.
- When testing after eating, wait one to two hours from beginning of meal.
- Think of testing as a way to discover how your body responds to changes in medication, diet, activity and sleep. Check in with your diabetes educator, doctor or pharmacist to talk about your results and what they mean.
Having A Good Exercise Plan.
GET A LITTLE MORE ACTIVE…
- Do at least 150 minutes of moderately vigorous exercise each week.
- Get some form of aerobic exercise at least three times a week and resistance training twice a week.
- Start slowly to build up your endurance.
- If you’re a beginner, start with 15 minutes of low-impact aerobic exercise such as walking or bike riding three times per week. Gradually increase the frequency and duration to 30-45 minutes of moderate aerobic activity three to five days over the course of the week.
- Talk to your doctor if you have questions on what physical activity is right for you.
TAKE CHARGE OF YOUR HEALTH. STAY HEALTHY BY GETTING THESE IMMUNIZATIONS:
- Hepatitis B
- Tetanus/diptheria (Td)
According to the Centers for Disease Control and Prevention, immunizations can protect against illnesses that can be very serious for people with diabetes.
FOR MORE INFORMATION ABOUT IMMUNIZATIONS GO TO AMERICAN DIABETES ASSOCIATION WEBSITE.
Healthy Living With Diabetes By Taking Care of Your Feet & Shoes.
Your Feet & Shoes
WHY ARE PEOPLE WITH DIABETES AT GREATER RISK FOR FOOT COMPLICATIONS?
Even ordinary foot problems can get worse and lead to serious complications. That is why the American Diabetes Association (ADA) recommends that you examine your feet every day for signs of irritation and damage.
Foot problems most often happen when there is nerve damage, also called neuropathy, which results in a loss of feeling in your feet. This loss of “the gift of pain” makes it more likely that you will develop a non-healing wound (an ulcer). By the time you can actually “see” the wound it is often too late, and can result in amputation.
ARE ALL PEOPLE WITH DIABETES AT RISK FOR FOOT ULCERS?
Current US. statistics indicate that up to 25 percent of all people with diabetes will suffer some kind of foot problem, leading to an ulceration and possible amputation during their lifetime. Besides nerve damage, poor circulation, dry skin, change in foot or toe shape and trouble fighting infections can also make the smallest of foot problems a big issue for people with diabetes.
WHY IS DRY SKIN DANGEROUS?
Diabetes can cause changes in the skin on your feet. At times your feet may become very dry. The problem is that the nerves controlling the oil and moisture secretions in your foot are no longer functioning properly. Dry skin develops and is susceptible to cracking and once a break in the skin develops, it often leads to inflammation, infection and ultimately to foot ulcers. A moisturizer applied daily after bathing can help prevent dry skin.
WHY, WHEN WALKING FOR EXERCISE, IS MY SHOE FIT SO IMPORTANT?
Shoe size matters to everyone, but is even more of a concern when you suffer from diabetes. incorrectly sized shoes are a major cause of foot ulcers. Wearing shoes that do not fit cause almost 50 percent of all diabetic foot ulcers.
The loss of feeling (neuropathy) you may have experienced due to the nerve damage associated with your diabetes can affect the way you think your shoes fit. Since you can’t “feel” a proper fit, a trained shoe fitter will measure your feet to determine your appropriate shoe size
HOW DO I PREVENT A DIABETIC FOOT ULCER?
Most foot ulcers and amputations are preventable with regular care and proper footwear. Ask your local Therapeutic Shoe Fitter for diabetic shoes.
WHAT CAN I DO TO TAKE CARE OF MY FEET?
Check your feet two times a day, ideally in the morning and at night before you go to bed. Look for anything out of the ordinary, such as areas of redness, blisters, or cuts. If you discover a wound, treat it and cover it with a bandage immediately. Pay close attention to the wound during subsequent foot inspections to be certain it is healing properly.
Washing your feet every day with mild soap in tepid—not hot—water is your first line of defense against problems with your feet. After washing, dry your feet thoroughly and apply a lotion made for people with diabetes, or one that your doctor has approved. Moisturizing your feet will protect against the creation of fissures in the skin, which can serve as a breeding ground for infection.
Elevated blood glucose (blood sugars) puts people with diabetes at risk for neuropathy, or nerve damage, which can cause loss of sensation in the feet, leading to other serious complications. Good control will help you prevent these complications. You can also reduce or even prevent the risk of injury to your feet by selecting comfortable footwear.
If you are very physically active or if you have other foot problems, it is important to find a doctor to examine your feet on a regular basis to avoid any complications that may arise. All other patients with diabetes must have a foot exam at least once a year.
Diabetic Food Accessories
WHERE CAN I GET DIABETIC SHOES?
Ask shoe fitters about diabetic shoes. These shoes, which may be covered by Medicare’s Therapeutic Shoe Program, can help reduce your potential for foot-related complications.
“You can find diabetic shoes at your local custom shoe fitters and reputable diabetic shoe fitters online.”
You should always examine your feet every day for any signs of inflammation, infection, cuts or bruises. If your skin appears dry or cracked, applying skin moisturizer can help. Research suggests that 85 percent of diabetes-related amputations are preceded by foot ulcers that can be prevented with proper foot care.
WHAT IS THE MEDICARE THERAPEUTIC SHOE PROGRAM?
Medicare has established a program to help people with diabetes who are at risk of developing foot ulcerations. For those who qualify, Medicare will pay 80 percent of the allowed amount for one pair of diabetic (therapeutic) shoes and up to three pairs of inserts per year. Most secondary insurers will help with the remaining 20 percent.
HOW DO I KNOW IF I QUALIFY FOR SHOES UNDER THE MEDICARE THERAPEUTIC SHOE PROGRAM?
Not all patients with diabetes will qualify for therapeutic footwear and inserts.
If you have Part B, have diabetes, and meet certain conditions, Medicare will cover therapeutic shoes if you need them.
THE TYPES OF SHOES THAT ARE COVERED EACH YEAR INCLUDE ONE OF THESE:
One pair of depth-inlay shoes and 3 pairs of inserts
One pair of custom-molded shoes (including inserts) if you can’t wear depth-inlay shoes because of a foot deformity, and 2 additional pairs of inserts
In certain cases, Medicare may also cover separate inserts or shoe modifications instead of inserts.
HOW DO I GET THERAPEUTIC SHOES?
FOR MEDICARE TO PAY FOR YOUR THERAPEUTIC SHOES, THE DOCTOR TREATING YOUR DIABETES MUST CERTIFY THAT YOU MEET THESE 3 CONDITIONS:
1. YOU HAVE DIABETES.
2. YOU HAVE AT LEAST ONE OF THESE CONDITIONS IN ONE OR BOTH FEET:
- Partial or complete foot amputation
- Past foot ulcers
- Calluses that could lead to foot ulcers
- Nerve damage because of diabetes with signs of problems with calluses
- Poor circulation
- A deformed foot
3. YOU’RE BEING TREATED UNDER A COMPREHENSIVE DIABETES CARE PLAN AND NEED THERAPEUTIC SHOES AND/OR INSERTS BECAUSE OF DIABETES.
Medicare also requires:
- A podiatrist or other qualified doctor prescribes the shoes
- A doctor or other qualified individual like a pedorthist, orthotist, or prosthetist fits and provides the shoes