Diabetes and Self Monitoring

1. Diabetes and Self Monitoring Write Presentation Title • Date in Footer

2. What is Diabetes? • Diabetes is a condition in which there is too much sugar (glucose) in the blood. Although sugar is needed to provide energy for the body, when in excess, it causes problem. • Persons with diabetes have excess sugar because they lack or have deficient supply of insulin.

3. Diabetes “Mild Disease” Serious consequences

4. Diabetes Mellitus A Serious Disease Leading cause of new cases of blindness 25 times more prone to eye problems 6 times higher risk for Paralysis (stroke) 2-3 times higher risk for heart attack 5 times more prone to Kidney failure 20 times more prone to lower limb amputation Nerve damage causes loss of sensation

5. What Are Common Symptoms of Diabetes ? • Frequent Urination • Hunger • Weight loss • Excessive thirst • Other Symptoms like: • Fatigue • Unusual Infections • Blurred vision • Dry and itchy skin etc

6. How do you Manage Your Diabetes? Follow a Healthy Meal Plan Regular Exercise Take your Medication Test blood sugar Regularly

7. Diabetes Self-management • Understanding diabetes, its management and the problems associated with it • Participation in decision making and taking an active part in day to day management • Monitoring and keeping track of your blood sugar • It requires determination, effort and time • It requires willingness for self-care • It requires close co-ordination with your doctor and the diabetes care team

8. Benefits of Normal Blood Sugar • Normal blood sugar • Improves your sense of well being • Restores energy • Makes you symptom free • Helps prevent long term complications of diabetes

9. Self Management What Is Required? • Test and record blood and /or urine sugar regularly as advised • Record your medication, food and activity pattern • Identify blood sugar pattern in relation to the above and learn how your blood sugar reacts to changes • Use the learning and your blood sugar results to adjust your food, activity and medication

10. Self Management What is Required? • Learn to recognize and manage hypoglycemia and sick day problems • Visit your doctor and diabetes care team regularly and carry out other tests and examinations as advised • Make all efforts to control your diabetes with help of your diabetes care team to prevent long term complications

11. Methods of Self-monitoring • Home monitoring and recording of • blood sugar using glucose meters, or color strips • urine sugar and ketones using strips or reagents

12. Self Monitoring of Blood Sugar Your Tool to Good Control ! • It allows you to determine pattern of blood sugar level and make necessary changes in your food and activity program or insulin / OHA dose • Allows you to respond quickly to a rise or fall in blood sugar • Useful in preventing long term complications

13. Home Monitoring of Blood Sugar • Check when and how often to monitor - suggested times include • Fasting, before lunch and dinner • 2 hrs after breakfast, lunch and dinner • 3 AM • Test more often • When not well • Suspect hypoglycemia • During pregnancy • When changing treatment or not in control

14. Home Monitoring of Blood Sugar • What is needed • Lancet • Test strips • Cotton swab • Glucose meter or color chart • Steps • Clean and dry hands • Puncture skin of finger (side), squeeze out large drop of blood • Apply blood to test strip, and do as per instructions • Apply cotton swab to puncture • Note and record result

15. Home Monitoring of Urine Sugar and Ketones • Urine Testing • Positive only when blood sugar is high > 180 mg/dl. • Messy, not accurate but non invasive and less expensive • Not useful to detect and document hypoglycemia • Very useful in testing for ketones • What is needed • Test tube to collect urine • Test strips • Steps • Collect urine in test tube (second void preferable for urine sugar) • Dip test strip in urine and do as per instructions • Note and record result

16. Why Test for Ketones in the Urine? • Ketones are acid waste products formed when the liver burns fat for energy • Produced when level of insulin is very low and blood sugar is rising • Accumulate in the bloodstream and spill into the urine • Can be detected by special test strips • Provide warning that blood sugar is out of control • High levels can lead to life threatening Ketoacidosis requiring prompt treatment and frequent monitoring

17. When to Test for Ketones? • Sick, high fever or a stressful medical, physical or emotional condition • Blood sugar >250 mg/dl • Nausea, vomiting, or abdominal pain accompanied by severe thirst and confusion • Peculiar fruity smell in breath

18. What Is Glycosylated Hemoglobin ? • HbA1c is a test that reflects the average of your blood sugar levels over the past 2-3 months • Optimal value of the HbA1c is 7% • Higher value means, you had higher blood sugar levels for last 2 – 3 months • HbA1c maybe high despite one or two near normal blood sugar values in between

19. Your Daily Diabetes Diary! • An important tool to learn and manage your diabetes • Helps keep record of • Food, activity and medications • Blood sugar and other tests • Weight changes • Hypos • It will help you to understand how your body responds to different foods, to different situations, and to your medications

20. Your Daily Diabetes Diary! • It will also help your diabetes care team to discuss and plan your treatment effectively

21. Set Your Goals and Achieve Them • Goal must be realistic and based on your need, lifestyle, health and age • You and your diabetes care team must be equally involved in setting the goal • Once set, you and your diabetes care team must make all efforts to achieve it by appropriate monitoring and adjustments to your food, activity and medication

22. Set Your Goals and Achieve Them Keep your blood sugar as close to good as possible to prevent long term complications. Take insulin, if advised.

23. Write Presentation Title • Date in Footer