Treating your diabetes can be a slow, long-term process. It might be hard to see the positive effects of limiting your diet while everyone else around you is indulging in sweets. The best way to feel that you are making positive progress on a day-to-day basis is to track your progress. Once you see the results in front of you, you'll know your treatment plan is working.
Look for Patterns Learning to identify diabetes patterns is a valuable tool. It takes practice and it takes diligence, but the results are well worth it. Your doctor and diabetes educator will want to see your daily medication, blood glucose, and food records, and they'll help you learn to evaluate them yourself. If you control diabetes by means of diet and exercise, watching for patterns is less critical but still useful. It allows you to see how your blood glucose responds to certain foods and different types of exercise.To detect patterns of control, you must first have a good understanding of your medication. If you require an oral agent or insulin, know the name of the medication, when it begins to work, when it works the hardest (when the action peaks), and how long it works. Record periods of activity, exercise, or stress as well as foods and eating patterns. If you had extra food one day or a special treat, write it down. Likewise, it's important to know if you missed a meal, ate lightly, or were sick. Here are some other ideas to help you study your patterns.
- Recognize that two heads are better than one. Study your records with a family member or friend. He or she can help you remember that a particular entry coincides with the night you went to the mall or went bike riding.
- Use color to help you keep track. Purchase two different-colored highlighter markers. Highlight low numbers (less than your target range) in, say, yellow and high numbers (greater than your target range) in pink. After a couple of weeks, study the pattern. When are the highs and lows occurring? Why do you think they occur when they do? If your page looks very "pink" at supper, can you determine why you consistently run over your target range then? Have you been snacking too much in the afternoon? Are certain foods to blame? Are you eating a large midday meal? Or are you eating appropriately, which means you may need an adjustment in your medications or exercise schedule?
- Compare bedtime readings with your dinner menu. Can you track high bedtime readings to certain foods? For example, do you notice that blood glucose levels are particularly high when you eat pizza, Mexican food, or mashed potatoes? If you take pills, you might want to experiment by eating less of the foods you suspect cause glucose levels to rise, or exercise longer before or after that meal. If you take insulin, ask your doctor or educator if he or she suggests you take extra insulin on nights you eat these foods.
- Recognize that all foods are not created equal. Some are more refined and as a result more easily absorbed than others. Some have more fat, resulting in a slower rate of absorption. (The effects of a particular food may even vary greatly from one person to the next.) Figure these facts into your control. If you notice a raisin bran cereal causes a greater rise than oatmeal, choose the raisin bran cereal on an active morning and choose the oatmeal on a less hectic morning.
- Look for a pattern of low blood glucose after exercise. If such a pattern occurs, how long after exercise does it occur? Are blood glucose levels too low in the morning when you exercise the evening before? If so, consider eating a little extra at bedtime, or talk to your educator or doctor about changing your diet, medication dose, or medication timing.
- Look for a pattern of high blood glucose after low results. This effect is commonly called a rebound, and it occurs when hormones kick in to raise blood glucose when it is too low. Because the hormones continue to work for a while after blood glucose returns to normal, a high blood glucose level often follows. On the other hand, high blood glucose levels that occur after low ones may also be due to overeating or anxiety eating. Evaluating patterns helps you identify the difference.
- Keep a record of where you inject insulin. Some people notice differences in their glucose levels when they inject insulin in their arm compared with days they use their leg or abdomen.
- Look for bumps or lumps of thickened tissue at your injection sites. These raised areas may appear if you give your injections in the same places for a long time. They are fat and scar tissue, which prevent good absorption of insulin.
One of the ways you and your doctor will evaluate the success of your diabetes control is to review the results you obtain when you test your blood on your meter. Discuss with your doctor your target range for blood glucose levels. If your results generally run outside this target range, your doctor, diabetes educator, or registered dietitian can help you adjust your food, exercise, or medication. Another way to assess diabetes control is with a blood test called hemoglobin A1C (HbA1C). Hemoglobin is a part of your red blood cells. Researchers discovered that glucose sticks to hemoglobin. The HbA1C test measures the amount of glucose that stuck to the hemoglobin; this is an excellent reflection of average blood glucose control over the past two to three months. Most people with diabetes undergo an HbA1C test every three months. In general, the closer the result is to normal -- so long as you don't also experience hypoglycemia -- the better. Every little bit you can decrease HbA1C levels helps reduce complications of diabetes. Keep track of your HbA1C results just as you do your other tests:
- Ask your doctor what your goal is for HbA1C results.
- Don't be too upset if your HbA1C result doesn't improve very quickly. It takes at least two months to see significant changes.
- Evaluate your HbA1C results in conjunction with your meter test results. If the HbA1C value is high, indicating a high average blood glucose, and your meter numbers are normal, something is amiss. It could be a problem with your meter accuracy, or you may be testing blood glucose only at times your blood glucose is within normal range.
Another major concern when planning your diabetes strategy should be what role your insurance company can play in your treatment. We'll examine this question in the next section. This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.