UNIT FOUR LESSON 10 OUTLINE

Transcription

1 UNIT FOUR LESSON 10 OUTLINE Welcome participants to the final unit in the series Taking Ownership of Your Diabetes Ask participants how they are doing in terms of the Diabetes Checklist and goal setting. Managing your diabetes helps you feel better and stay healthy. Blood glucose monitoring is an important part of diabetes care. Keeping your blood glucose within the target range set by your doctor prevents long-term complications such as eye, kidney and heart disease, and amputations. Read and briefly describe objectives to participants. Distribute Factsheet

2 Ask participants how many of them monitor their blood glucose. Ask those who monitor their blood glucose to share their experiences (how long they have been monitoring, benefits of the practice, barriers they had to overcome, etc.) Ask participants who do not monitor their blood glucose to share their reasons for not monitoring. Ask: What are some of the barriers that keep you from monitoring? What would make it easier for you to monitor? Ask participants to share other benefits they have experienced from monitoring blood glucose. Say: This is one of the most recommended checks. It provides information on the overall treatment plan. Tell Participants: Checking after meals is most useful if you check before meals. You can compare before and after meal blood glucose values. The after meal value may also help you and your doctor determine how the amount and types of foods you eat affect your blood glucose levels.

3 Testing at bedtime is important if blood glucose was lower than usual or if you exercised more than usual during the day. Some individuals who use insulin may also check their blood glucose level in the middle of the night or around 2 or 3 a.m. When someone is sick, hormones are released to fight the sickness. These hormones cause blood glucose to go up mainly because they counteract the effect of insulin. Stress produces hormones that cause blood glucose to rise. Other stressors include infection, surgery, and pregnancy. Read information on the slide. Changes could be in the intensity or type of physical activity. Physical activity makes muscles and tissues more sensitive to insulin. Some people with type 2 diabetes who exercise regularly find that they may no longer need to take insulin or diabetes medication. It is important to speak with your doctor when you begin any exercise program or before you make any change in the regimen prescribed by your doctor.

4 If you had a larger-than-usual meal or more carbohydrate-containing foods. People with diabetes should work with their doctor to set their target blood glucose range. This range depends on a person s health, lifestyle and diabetes management goals. If your blood glucose level is consistently out of range, you might want to check more often and record the results of the tests. Take your record with you when you visit your doctor. Signs of extreme hyperglycemia (high blood glucose) include very dry mouth or fruity odor to the breath.

5

6 The American Diabetes Association suggests that the ranges on the slide be used as a guide for people with diabetes. It is important to remind participants that many factors affect blood glucose; therefore, their blood glucose may not always be in the target range set by them and their doctor. Factors that affect blood glucose include stress, exercise, food and drink (including alcohol), medication, and the time of day the test is performed. Note: These factors were mentioned previously as reasons for testing more often. At this time, have the health care professional you invited demonstrate how to take a blood glucose reading. Make sure your blood glucose meter is working well and strips are not expired. Ask your doctor, pharmacist, certified diabetes educator, or other health care team member to show you the right way to use your meter.

7 If you have problems getting the drop of blood, you should wash your hands in warm water and shake hands at your side for about 30 seconds. Then prick the side of your fingertip instead of the middle part. You may want to try your thumb or fourth finger, because they have a rich supply of blood. Questions to ask your doctor about your blood glucose level: What should be the target range for my blood glucose level? What should I do if my numbers are higher or lower than the range set for me? What factors affect my test results?

8 At this time, show the Diabetes Education Series CD and select the section on Monitoring Blood Glucose, or have participants share their experiences monitoring blood glucose. Allow time for participants to share their feelings and experiences. 1. Ask participants how they did in accomplishing their goal from last week. For those who accomplished their goals, ask what actions were taken to be successful. Provide incentives for those who met their goals. For those who did not accomplish their goals, ask if they took steps to meet their goals. If they did, acknowledge that they are moving in the right direction. 2. Move onto setting a new goal for this week. Talk with your participants about how goal-setting can help them with diabetes management. 3. Tell participants to set a goal that they can accomplish in the upcoming week. 4. This week, the goal should be related to monitoring blood glucose. 5. The participants can record their goals on the Goal Setting Worksheet (found in the Appendix for this lesson). 6. Discuss SMART goals. Is your goal Specific, Measurable, Action-oriented, Realistic, and Time framed? 7. Select goals from some of the participants to share with the group.

9 The answers to the PowerPoint questions can be found in the appendix for this lesson. Show the next slide as you read the story. Annabelle is 66-year-old woman with type 2 diabetes in a senior living facility. She is active, as most days she walks with a friend for at least 20 minutes and on other days she takes part in line-dancing or swimming. She mentioned that she does not check her blood glucose level because she is afraid of needles. She notices that she sometimes has the following symptoms after she exercises: rapid heart rate, nervousness, sweating, and headache. She does not need insulin, so she thinks she has no reason to check her blood glucose. In addition to having a fear of needles, Annabelle has no idea how she can go about checking her blood glucose.

10 What is Annabelle s problem? Annabelle seems to have symptoms of low blood glucose. She should check with her doctor to see if she needs to change her diet so that she gets more even amounts of glucose throughout the day. Note: Severe hypoglycemia is a serious condition that needs immediate treatment to prevent serious complications or even death. What can Annabelle do if her doctor tells her that her problem is not severe hypoglycemia? Annabelle can: (a) begin monitoring her blood glucose to see if it is low (below 70 mg/dl); (b) take two glucose tablets or drink ½ cup of juice or regular soda, eat 2 tablespoons raisins or 4 saltine crackers, or take 1 tablespoon of sugar or honey if her blood glucose level is low; (c) check blood glucose after 15 minutes and have another serving of the foods or items mentioned above if it s still too low; (e) repeat the steps mentioned above until her blood glucose level is 70 mg/dl or higher; (f) have a snack if it is an hour or more before her next meal; (g) check her blood glucose level before and 15 minutes after physical activity and follow the steps listed above if it is low; and (h) check her blood glucose if she is sick, stressed, or if there are changes in the amount of carbohydrates she eats each day. What other information would you pass on to Annabelle about checking her blood glucose number? Annabelle should know: (a) the importance of talking to a certified diabetes educator about blood glucose monitoring benefits; (b) when to monitor blood glucose levels; (c) her blood glucose goals; (d) how to test her blood glucose; (e) the importance of recording results; and (f) things that cause high and low blood glucose. The handout with completed answers can be found in the Appendix for this lesson. The handout for participants to complete will be in their folders. The questions can be completed as group work or take-home work.

11 Tell participants to find Recipe: Two-Cheese Pizza and Recipe: Spinach Dip with Vegetables in their folders. Information about the menu: Aim for no more than 100-calories for your snack. Commercially there are a lot of 100-calorie portion packages available. Be sure to look at the carbohydrate count on the nutrition label. Aim for no more than 15 grams. Take some time to allow participants to share what they learned this week. Allow the group to discuss ways in which they can support each other.