Diabetes Control Notes By Rain V. Lazala

CEBU, Philippines - “DiabetEase Magazine,” which releases tips on how to effectively control diabetes, issues this advisory on the “dos and don’ts” in self-monitoring of blood glucose (SMBG), as well as in getting into an exercise regimen:

• Be educated about structured self-monitoring. Remember that your target range may differ, especially if you’re pregnant or have diabetes complications. It may be affected as you get older, too. As changes occur, it’s critical to know how your self-monitoring frequency may also be affected. Make sure that you ask questions the firs time your doctor prescribes you a glucose meter. Request special training sessions if need be to ensure you have an adequate understanding of techniques, interpretation of results, and appropriate action when required.

• Know the relationship with your insulin doses. Although not all people with diabetes take insulin, for those who do, knowing how to act appropriately with regard to insulin dosage is important. Typically, if levels are high, this could mean that you need additional insulin. Those using twice-daily insulin therapy, for example, may need to be educated to undertake SMBG at least twice daily, varying the time between fasting, pre-meal and post-meal, sugar control throughout the day. Ideally, patients who alter insulin doses at mealtimes should be encouraged to monitor at least four times a day.

• Understand what the results mean. When you finish the blood glucose check, write down your results and review them to see how food, activity and stress affect your blood glucose. Take a close look at your blood glucose record to see if your level is too high or too low several days in a row at about the same time. If the same thing keeps happening, it might be time to change your plan. Work with your doctor or diabetes educator to learn what your results mean for you.

• Do not ignore your schedule. While several studies are trying to determine the true impact of SMBG on blood sugar control, its efficacy as a tool for the diabetic patient is unquestioned. Simply being responsible will help you be in control over your condition. Record your progress, and note areas where improvements can be made.

• Do not neglect your device. Technology has made this process a quicker, less painful one, but care and attention are still needed on your part. Check the test strips and monitor. Throw out damaged or outdated strips and make sure the monitor is at room temperature, the strip guide and test window are clean. If you’re still not sure what’s wrong, do a quality control test according to the manufacturer’s manual. You can bring the monitor to your next door appointment as well.

• Do not reuse or share needles, syringes, or lancets. For some, the cost of using blood glucose meters can be a heavy load. But when your safety is at risk, you shouldn’t be cutting corners. Glucose meters are assigned or designated for use by individual patients, and their sharing can lead to misreading, not to mention, contamination.

Diabetes and Exercise

• Consult your doctor or health care provider before beginning an exercise plan. The last thing you want to do is injure yourself unnecessarily.

• Test blood glucose levels before and after exercise. Once you’ve given the go signal, make sure you know and are able to maintain your target levels throughout the time you’re exercising.

·Start slowly and increase activity gradually. Approval from your doctor doesn’t mean that you should start dead-lifting your weight in dumbbells. Refrain from overstraining yourself and only do what feels comfortable to you.

• Choose an activity you enjoy. Try a water exercise program, walking, riding a stationary bicycle, swimming or muscle stretching. Doing what you enjoy will mean you’ll stick to in the long run.

• Make exercise a lifetime commitment. Make it a part of your New Year’s resolutions. And since you’re enjoying the workout you’ve chosen think of continuing it in the long-term. Exercising once a month does you no good.

• Wear good shoes and take care of your feet. Diabetic neuropathy complications may develop if you don’t remain aware of the condition your feet are in.

• Eat and drink accordingly. Bring a carbohydrate-based food along if you are taking insulin or an oral glucose-lowering medication. These will help you maintain those target levels while your body is experiencing the beneficial effects of working out.

• Bring a friend. Exercise with someone who knows you have diabetes and knows what to do if you have a low blood glucose reaction. Just like someone on the bench press needs a spotter, it is important to have someone aware of your condition informed, and better yet, along with you as you go about your exercise regimen. Remember that it is better to be prepared for worst case scenarios.

• Do not get dehydrated. Drink water before, during and after exercise. This not only applies to diabetics but to anyone going through exercises that cause a great deal of sweating.

• Do not risk hypoglycemia. Follow a regular exercise, food and medication routine each day. Don’t push yourself to stick to your exercise regimen if you’ve missed a meal or scheduled medication. It’s better to be aware of your internal state rather than forcing the physical aspect.

• Do not overexert yourself. Do not participate in prolonged or strenuous exercise without first consulting your physician. During strenuous exercise, the body produces adrenaline and other hormones that can counteract the effects of insulin and cause blood glucose to rise. Again, it is important for you to have the approval of your doctor who knows the causes and effects of both the medication and the workout you hope to have.

• Do not ignore pain. You may cause stress or damage to joints. The saying “no pain, no gain” does not apply here. It is critical to listen to the signals your body is sending you. Stop the activity immediately and if pain persists, consult your doctor to be able to properly assess the situation.

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