Managing Diabetes

 

The goals of treatment for diabetes are to prevent or delay complications and optimize quality of life. However, it is difficult, if not impossible, to manage your diabetes without monitoring it at home. It often said that “trying to manage your diabetes without home monitoring is like driving a car without a milometer, fuel gauge or temperature gauge”. Therefore, undoubtedly/ without doubt “Everyone is like a child when starting something new.”

Diabetes self-management education and support, medical nutrition therapy, routine physical activity, smoking cessation counselling when needed, and psychosocial care are essential to achieving treatment goals for people with diabetes as suggested by (ADA, 2020). There are two major self-management tasks to keep in mind. The first is to maintain a safe blood glucose level (this means balancing all the treatment methods, which include healthy eating, exercise, managing stress and emotions, and medication) and to detect early any problems caused by diabetes.

Recommendations for managing Diabetes as proposed by International Diabetes Center; Joslin Diabetes Foundation; American Diabetes Association (ADA):

·       In accordance with the American Diabetes Association standards for diabetes self-management education and support, all people with diabetes should participate in diabetes self-management education and receive the support needed to facilitate the knowledge, decision-making, and skills mastery necessary for diabetes self-care.

1.          Exercise is an important part of your self-management program because it helps to lower your blood sugar. However, sometimes it can lower your blood sugar too much, which can cause hypoglycaemia and other problems. Therefore, it is important to find the best time during the day to exercise and to know how to treat hypoglycaemia should it occur.
2.          Have your eyes (including the retina at the back of your eyeball) examined every 1 to 2 years (or as recommended by your doctor) and report any changes in vision to your doctor.
3.          Check your blood pressure yearly (or as recommended by your doctor).
4.          Have your cholesterol and lipids checked yearly (or as recommended by your doctor).
5.          Have your kidney function checked yearly (or as recommended by your doctor) with a urine test for micro-albumin.
6.          When a person with diabetes is sick with an infection, a cold, or the flu, the blood sugar tends to go up, and food and medicines can have different effects during those days. For this reason, it is especially important to have a plan for sick days and know what to do and when to seek additional help.
7.          Have your haemoglobin A1c (HbA1c) level checked several times a year (or as recommended by your doctor). The HgA1c or glycosylated haemoglobin test is a blood test that measures the average control of blood glucose over the past 2–3 months. A target level for HbA1c is below 7.0.
8.          Monitoring your blood glucose helps you know if the strategies you are using to control your diabetes are working. Only through monitoring and recording the results can you judge the success of your program and make appropriate adjustments (under the guidance of your doctor).

Regular physical activity is one of the best things one can do to control diabetes and improve health. This keeps the joints flexible, strengthens the heart, lungs, and blood vessels to help prevent heart problems; reduces stress; and helps to deal with sad or unhappy feelings. Exercise also helps with weight control in three ways: First, we burn calories or energy while we are exercising. Second, exercise helps build and maintain muscle. Therefore, a steady supply of energy in the form of glucose needs to be supplied because the muscles are burning calories (using energy) 24 hours a day. This helps manage weight. Third, sustained aerobic exercise, which is exercise that raises the heart rate, makes one breathe harder or perspire and also increases the rate at which the body burns calories. When you stop exercising, your metabolism does not return immediately to normal. It remains somewhat elevated for up to 6 hours after. Exercise changes the metabolism in the muscles and helps normalize blood glucose levels. Thus, you continue burning calories at an increased rate long after you finish exercising, helping your body use the glucose in the blood as energy, as postulated by (Kate Lorig, RN.; DrPH, Halsted Holman, MD; David Sobel, MD; Diana Laurent, MPH; Virginia González, MPH, and Marian Minor, RPT, PhD, 2006).

Living well with diabetes requires both good medical care and effective self-management. Although there is much that health care providers can do, you must take responsibility for learning about diabetes and managing the daily decisions and actions necessary to deal with the disease. To understand and monitor the effects of food, exercise, illnesses, and medications, it is helpful to learn how to test your blood sugar at home. Most importantly, ongoing diabetes self-management education and support are critical to preventing acute complications and reducing the risk of long term complications.

References

1. care.diabetesjournals.org/content/43/Supplement_1 
2. https://doi.org/10.2337/dc20-SINT
3. www.classhealth.co.uk 
4. www.diaTribe.org