Self-monitoring of blood glucose is an important component to achieve and maintain glycemic goals, allowing for better management of diabetes. It allows for the appropriate action to be taken regarding food intake, activity, medication dosage, and identification of complications such as hyperglycemia or hypoglycemia. The frequency of monitoring depends on factors such as the patient’s glycemic goals, type of diabetes, or the patient’s willingness to test.
Because insulin is given subcutaneously, it is important to know proper injection technique. SubQ injections are given at a 45-90 degree angle into the fatty layer of tissue such as in the arms, legs, or abdomen. Be sure to rotate sites, apply pressure over the site following administration, and remember that aspiration is not necessary with SubQ injections.
Lifestyle changes may include weight loss using diet and exercise. This includes cutting out high fat and high sugar foods and replacing them with fruits and vegetables. Maintaining a healthy body weight not only improves one’s overall health, but will help lower blood glucose levels while lowering the risk of developing a heart attack or stroke. The triangle is a quick way to remember 3 points on the triangle - MED - medication, exercise, and diet.
Complications of diabetes often arise from events associated with hyperglycemia and hypoglycemia; therefore, it is important to recognize symptoms of each and know prevention and management techniques.
Acute illness, injury, and surgery are situations that can cause a counterregulatory hormone response, resulting in hyperglycemia. Patients should be educated to plan ahead, continue taking their insulin as prescribed, and check blood glucose at least every 4 hours.
Proper foot care is critical for those with diabetes as individuals are prone to nerve damage and circulation issues. Skin care includes daily inspection of the feet for redness, swelling, or a break in skin integrity; and, washing, patting drying, and moisturizing the area. Anything that could hinder circulation should be avoided, so shoes should fit properly.
Exercise decreases insulin resistance and can have a direct effect on lowering blood glucose levels; therefore, the patient should be educated on the importance of incorporating a regular and consistent exercise program as part of their diabetes management.
The patient should be educated on proper medication use, which may include the use of insulin or oral hypoglycemics. Proper storage, techniques for administration, and recognizing adverse effects should be taught. This may include explaining proper carbohydrate counting and portion sizes.
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