Living well with Diabetes

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Introduction

More than 9 million Canadians are living with diabetes or pre-diabetes. Many people with diabetes do not understand diabetes and how it affects their body. The more you learn about diabetes, the better you will understand how it affects you.

Understanding Type 2 Diabetes

Type 2 diabetes affects the way your body turns food into energy. Usually…

  • Food you eat is turned into a type of sugar (called glucose) that enters your bloodstream.
  • Your pancreas (an organ near your stomach) produces insulin.
  • Insulin plays an important role in how your body uses glucose for energy.

When you have diabetes…

  1. Your pancreas is not producing as much insulin as needed
  2. Your cells are not responding properly to insulin, so they do not take in the glucose to be converted into energy.

The result…

Too much glucose stays in your bloodstream. This is known as hyperglycemia (hyper= too much, glycemia= glucose in the blood).

Is hyperglycemia dangerous?

Over a period of time, hyperglycemia caused by diabetes can cause damage to your body resulting in a number of serious complications.

But there is Good news…

The GOOD news is you can manage your diabetes and keep your blood glucose under control

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How?

  1. Eat right.
  2. Keep active.
  3. Take medications as directed by your healthcare provider.
  4. Monitor the results.

 

Nutrition and Diabetes

Healthy eating is an important part of your diabetes management. This is because the foods you choose and how much of them you eat affects your blood glucose levels. Controlling your blood glucose levels can help reduce the complications associated with hyperglycemia. Healthy eating is one way for you to take charge of your diabetes management.

How can I use food to manage my blood glucose?

  • Consult with a dietitian or your health care provider.
  • Create a meal plan using “Eating Well with Canada’s Food Guide”.
  • Eat at regular times.
  • Eat high fibre foods like whole grain cereals and breads, fruits, vegetables.
  • Choose low fat dairy products, lean meats, foods prepared with little or no fat.
  • Limit sodium, alcohol and caffeine.

Healthy eating does not mean that you can’t eat the foods you enjoy. It just means that you have to plan your meals to include a balance of health foods.

A healthy meal should include all 4 food groups. The “Eating well with Canada’s Food Guide” recommends for adults:

  • 6-8 servings of grain products every day.
  • 7-10 servings of vegetables and fruit every day.
  • 2-3 servings of milk and alternative products every day.
  • 2-3 servings of meat and alternatives every day.

Talk to your healthcare provider about how much food is in a serving.

Planning a healthy meal:

 cda-balanced-meal

 

Physical Activity and Diabetes

Regular activity should be a key part of your diabetes management plan. This is because physical activity can help to control your blood glucose levels by helping your body respond better to insulin. Like healthy eating, regular exercise is good for everyone, so you can include your family and friends in your plans!

Chances are, there is an activity that you already LOVE to do that involves moderate exercise.

 

 

How much exercise should I be getting?

  • The Canadian Diabetes Association recommends a minimum of 150 minutes of moderate to vigorous-intensity aerobic exercise each week, spread out over at least 3 days of the week, with no more than 2 consecutive days without exercise.
  • Resistance exercise (weight lifting, exercise with weight machines) 3 times per week can also be good for you because it increases your strength, energy and metabolism.

Before you start, talk to your healthcare provider about which activities are best for you.

Medications and Diabetes

  • Medications can play an important role in your diabetes management plan.
  • Take medications only as directed by your healthcare provider.
  • Tell your healthcare provider about changes in your diet, weight or activity level, as these can change your medication needs.

Monitoring Your Results – Checking Blood Glucose Levels

How can checking my blood glucose levels help me?

Blood glucose levels change during the day depending on what you eat, your level of activity, stress and other factors. By checking your blood glucose at home, you can see how these factors increase or decrease your blood glucose.

How do I check my blood glucose level?

The better you manage your blood glucose levels, the better chance you have of avoiding complications.

  • Obtain a blood glucose meter and the corresponding test strips.
  • With structured testing you can get a better picture of what is going on with your blood glucose levels.
  • Talk to your healthcare provider about the testing pattern that might be best for you.

What do the blood glucose results mean?

  • Canadian Diabetes Association (CDA) recommends that your blood glucose target be in the following range:
    • Before meals – 4.0 – 7.0mmol/L
    • 2 hours after meals – 5.0 – 10.0mmol/L
    • Discuss your specific targets with your healthcare provider to find a range that is suitable for you.

How often do I need to check my blood glucose level?

Testing frequency should be tailored to that type of diabetes (type 1, type 2, gestational) and your diabetes management goals.

  • Speak to your healthcare provider about the ideal frequency of blood glucose testing to meet your needs.
  • Keep a record in your logbook along with any specific notes or activities that may have impacted your readings. Remember to bring it with you when visiting your healthcare provider to give them more information on how your overall diabetes management plan is working.
  • More focused testing may help you makes choices and changes that can lead to improvement in your diabetes management.
  • In some situations more frequent testing should be undertaken to provide information necessary to make treatment adjustments required to achieve desired glycemic targets and avoid risk of hypoglycemia (low blood glucose).
  • Using meter features, such as meal markers and alarm reminders, may help you better understand your results.

What should I do if my blood glucose levels are high:

  • Consult your healthcare provider or go to the emergency room if your blood glucose id higher than 20mmol/L.
  • People with Type 1 diabetes should test for the presence of ketones in blood or urine if blood glucose is equal or greater than 14.0mmol/L.
  • If blood glucose levels remain above target, contact your healthcare provider to discuss the need for changes to your current diabetes treatment.

What should I do if your blood glucose levels are low – below 4mmol/L:

  • Eat or drink fast-acting glucose such as:
    • 15g sugar tablets
    • 6 life savers
    • 15ml (3 teaspoons) of sugar or honey
    • 175ml (3/4 cup) of juice or regular soft drink
    • Wait 15 minutes, then check your levels again. If they are still below 4mmol/L, repeat the treatment.
    • Once your level is above 4mmol/L, if your next meal is more than one hour away, have something to eat that includes 15g of carbohydrate and some protein.

Monitoring Your Results – Testing Your A1C

What is the A1C test?

The A1C test will give you what your average blood glucose level has been over the past 3 months.

How does this test work?

  • Hemoglobin is a part of your red blood cells.
  • Glucose in your blood attaches to hemoglobin (part of your red blood cell) and stays there for the life of the red blood cell (about 3 months).
  • The A1C test measures how much glucose is attached to your hemoglobin.
  • By measuring how much glucose is attached to your hemoglobin, it gives you an average of your blood glucose control over the last 3 months.

How do I get my A1C level tested?

  • CDA guidelines recommends that your A1C be measured every 3-6 months to ensure that glycemic goals are being met or maintained.
  • Usually this test will be done through your healthcare provider as part of your regular bloodwork.

How should I use the A1C results?

  • The target A1C value for most people is less than 7%.
  • If your A1C value is above target, talk to your healthcare provider about making changes to your diet, activity levels or blood glucose monitoring schedule to help reduce your A1C levels.
  • Using your blood glucose monitor to check your glucose levels at various times during the day will help you to understand what you need to do to lower your A1C.

What do my blood glucose results mean?

glucose-meter

  • Hyperglycemia Symptoms – fatigue, thirst, blurred vision, increased urination.
  • Corrective measure for hyperglycemia – drink water.
  • Hypoglycemia Symptoms – shaky, nervous, hungry, sweating, headache, dizzyness.
  • Corrective measure of hypoglycemia – consume 15g of sugar.
  • If you are above your target, speak to your doctor or diabetes educator. High blood glucose is associated with diabetes complications, such as eye or kidney problems and heart disease.
  • When your blood glucose is within the target range set by your doctor, you are at lower risk of diabetes complications.
  • Blood glucose below 4mmol/L indicated low blood glucose which may lead to coma and seizures.

 

 

Why lower my A1C level?

It’s been shown that a 1% reduction in A1C lowers risk of complications, such as eye, kidney and nerve disease, by 40%.

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