Diabetes and Sick Days

Recently, I came across some excellent information from the Channing Bete Company of South Deerfield, MA in their "Living Your Life With Diabetes Self-care Handbook". Personally, I don't get sick much, however, occasionally a flu bug does catch up me. I thought they provided good information on how to manage if the situation arises. Here are commonly recommended tip: 


1. Call your health-care provider if:

• you've been sick or had a fever for 2 or more days and you aren't getting better
• you're vomiting or have had diarrhea for more than 6 hours
• you're showing moderate to large amounts of keytones in your urine
• you take insulin and your blood sugar level is 240 mg/dl even though you've taken the extra insulin your sick day plan calls for
• you take other diabetes medications and your blood sugar level is 240 mg/dl or higher before meals and stays high for 24 hours
• you have symptoms that may be signs of ketoacidosis, dehydration, or another serious condition
• you're not sure what to do to take care of yourself

2. Take good care of yourself

• Stick with your regular meal plan if possible
• If you're on your regular meal plan, drink plenty of calorie-free, caffeine-free liquids to stay hydrated (unless otherwise advised by your health-care provider)
• If you're having stomach problems, try a soft foods/liquids diet
• Take your normal dose of insulin
• Take your normal dose of other diabetes medications. If you're unable to keep pills down, call your health-care provider right away
• Test your blood sugar and ketones every 3-4 hours and record the results
• Report high blood sugar levels to your health-care provider. They may want you to take extra insulin
•  Ask someone to check on you from time to time

3. You may need a soft foods/liquid diet

• Each of the servings of these foods will allow you to get enough carbohydrates: 1/2 cup fruit juice
• 3/4 cup ginger ale (nondiet)
• 1/2 cup gelatin (with sugar)
• 6 saltines
• 1 cup soup/broth
• 1/2 cup hot cereal
• 1/2 cup ice cream
• 3 tsp honey
• 1 slice toast

2 Great Tips From Penny - A Lutheran Hospital Diabetes Educator

When Going To The Doctor For a Diabetic Checkup, Here Are 2 Things You Should Do Automatically:
1. Start a list between visits and be sure to review each question on the list with your doctor at your appointment.
2. Take your shoes and socks off so your doctor can examine your feet and perform a sensitivity check.


Here's One For No Charge ;-)
The longer you work out and the more intense you work out, the longer the period of control you'll experience. (Let's work out guys!!)


Thank you Penny!  :-)

I Love My Spouse...But

Just a note to all those diabetics out there who are waiting for their spouses to take care them...
If I waited for my spouse to take care of me and manage all my dietary needs, count my carbs, remind me to test myself, or to take my insulin - I'd be in a pine box right now. The facts are, if you are diabetic, YOU have to be the most responsible for taking care of YOU. I mean - if you haven't become mentally or physically challenged. My spouse is great! I love her very much - but she'll go out and buy two cakes for a small dinner party, and I have to be the one that says to myself, "You can not go through that cake like a human buzz saw." and for the remainder of the days that the cake is in existence (talking to me) I must be the mature person and simply walk in the other direction. She'll offer to do dinner at Casa D's and order the garlic cheese bread, a heavy pasta dish, another loaf of bread when the 1st one is gone, dessert and coffee, then look at me when I only eat a minute part of the pasta dish, a portion of one slice of garlic cheese bread, and less then 1/2 of the dessert and say, "I guess you weren't hungry :-("
At that point, I usually remind her (after 10 years) - I'm trying to keep my carbs to less than 130 grams for one meal :-[  (they should be 180g per day)
You see, I had to realize that she is not going to - and neither should I expect her to, adjust her food intake to a lifestyle that is my burden. Regardless of how she decides to eat, I must still stick to the requirements that make good diabetic sense. Keeping myself healthy is primarily my responsibility. When we food shop together, I can pick the foods that are more diabetic friendly. If she food shops, she usually asks me for things that I like so she can be sure to purchase them. If I food shop, she lets me know what she may have a taste for and I make it a point to purchase those items. 
I also learned that my kids absolutely hate diet soda. It doesn't matter what sugar substitute is in it - they hate the taste. Do I think they're crazy, YES - but it's irrelevant. They don't have to drink it, I do.
I guess, I had to look at being diabetic as being part of some sort of secret society. No one, including my spouse knows I'm a member of this elite group because I blend in so well - almost eating the same things they eat, but just adjusting my portion sizes. Testing myself so quickly before and after meals that no one even notices (except other elite members ;-). Empowering myself with knowledge so I can tell when any non-members are doing things that cause me to be cautious. 
It's YOUR life, YOU take charge. I'm sure all your relationships will remain intact. :-)

Food for thought...

Often, when I'm talking to other diabetics about diabetes, and in particular monitoring, treatment, and therapies - people often drop their jaw when I say that I test on the average about six times a day. Six times a day, they say! How can you prick yourself that much? Doesn't it hurt?
To this, I simply respond, "The real question is - does it hurt less than a heart attack?"
Monitoring yourself using a blood glucose monitor of some type is the single most effective way to care for yourself. You must know where you're at in order to know how to treat yourself. Please, continue to monitor, no matter what the pain factor.

Fact: A1C Aces the Test (Diabetes Forecast, June 2010)

This is information we truly need to hear, as the A1C is what most of our doctors use to determine how our therapy is going. "The New England Journal of Medicine, March 4, 2010" published an article stating: Diabetes raises the risk of heart attacks and strokes, which is one reason it's so important to screen for the disease and start treatment early. In a study, the A1C test - which shows average blood glucose over two to three months - did a better job of predicting a patient's risk of heart disease and premature death than did the fasting plasma glucose test, which is taken after at least an eight-hour fast. The results suggest that the recent addition of the A1C test as a way to diagnose diabetes may identify more people at risk for fatal heart attacks and strokes. Diabetes is diagnosed at A1Cs of 6.5 percent and above.

Tidbit: Money Makes a Difference

This interesting tidbit came from "The American Journal of Managed Care, January 2010".
Doctors in a voluntary program called pay-for-performance, P4P, who received financial incentives to provide good care were found to have healthier patients than doctors not in the program. P4P doctors were paid to do tests, like those for A1C and cholesterol, that assess their patients' health, and they received bonuses if they improved these measures year by year. Over three years, people with diabetes who saw doctors in the P4P program required fewer hospitalizations than those who saw physicians outside the program.
On the one side, I feel why should doctors have to be compensated more financially to provide good care. Isn't this what they're supposed to do, Hippocratic Oath and all. Or could I be wrong by creating an association between medical ethics and level of care? Either way, if it's going to work for diabetics maybe we should embrace changing our current system.

Good Advice

I love this. Diabetes Forecast Magazine posed the question, "What is the best advice you ever got about diabetes?"
Rita Franks of Ruston, LA said, "When I asked my doctor, how many days a week should I exercise?" her doctor replied: "How many days are you diabetic?" She said, "I exercise everyday now."
Even if it's a walk in your neighborhood after dinner, please do something.
Kudos to Rita and her doctor for inspiring us to healthier living.