Not Reproduce. Living with Diabetes

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2 Living with Diabetes Living with diabetes can be a challenge, but you can stay healthy and live a long life. The key is to have and follow a written action plan that keeps your blood sugar under control. Develop a written plan for your needs with your health care team. As your treatment guidelines change, make changes on your Do written plan. Not Reproduce Use this calendar to: Remind you to follow your treatment guidelines. Schedule and keep track of appointments with members of your health care team for health care visits, tests, and exams. Note when it is time to re-order your medications and supplies. Keep track of your weight American Institute for Preventive Medicine. All rights reserved.

3 Telephone Numbers Emergency Contact Name: Number: Health Care Team Primary Care Physician: Endocrinologist: Dentist: Certified Diabetes Educator: Opthalmologist / Eye Doctor:_ Podiatrist / Foot Doctor: Pharmacist: Registered Dietitian: Care Specialist: Things I Need to Keep Track of:

4 This is the last month of the year and the beginning of the rest of your life. Use your written action plan and this planner to help you reach goals for controlling your diabetes. These include: Checking your blood glucose and keeping track of results. Being physically active. Following your eating plan for meals and snacks. Taking your diabetes medications every day. Keeping track of your weight, physical activities, etc. Following your sick day guidelines. Having tests and exams to diagnose and monitor other problems that affect your diabetes. Write your weekly weight on the lines given. Do this for every month. December 2008 Do you have a written action plan? 19 Winter Begins Chanukah 25 Christmas Day 26 Kwanzaa Begins

5 Controlling your weight helps keep your blood sugar under control. If you are overweight, losing 5-10 percent of your weight helps lower your risk for heart disease, stroke, arthritis and other health problems. Set a goal weight with your health care provider. Write it here: pounds. Follow your health care provider s advice for physical activity, diet, and behavior changes to achieve and maintain a healthy weight. For children, meal and activity plans may be needed to reduce or prevent overweight, but ensure proper nutrition for growth. Record your weekly weight in this pocket planner. Follow your eating plan s portion sizes for meals and snacks. January 2009 Do you know your healthy weight? 1 New Year s Day Martin Luther King, Jr. Day

6 Having diabetes puts you at an increased risk for heart disease and stroke. To help lower the risk, control the ABCs of Diabetes. *A1C (blood glucose average over 3 month s time). Target numbers for A1C for persons with diabetes are: < 7 for adults (non-pregnant). < 7.5 for ages years. < 8 for children ages 6-12 years. < 8.5 (but > 7.5) for children age 6 years and under. *Blood pressure. Target blood pressure (BP) goal is < 130 / 80 for most adults with diabetes. Get your BP tested at every office visit. Test it at home, as advised. *Cholesterol. (See Target Blood Fats (Lipids) at the end of this calendar.) * Follow ABC target goals as advised by your physician. February 2009 Have you had your ABC tests? Groundhog Day 6 Wear Red Day 14 Valentine s Day 16 President s Day 25 Ash Wednesday American Heart Month

7 What you eat and drink plays a major role in controlling your blood sugar. Follow the meal plan for breakfast, lunch, dinner, and snacks as advised by your registered dietitian or health care provider. Review your meal plan often. Get more information and help from your registered dietitian, certified diabetes educator, and Eat meals and snacks at regular times. Read food labels to guide your choices. Strictly limit saturated fats. Eliminate trans fats. These may be labeled as hydrogenated fats or oils in some cookies, chips, etc. Limit alcohol as advised by your physician. March 2009 Have you checked your portion sizes lately? Daylight Saving Time Begins 17 St. Patrick s Day 20 Spring Begins

8 Regular exercise helps control your blood sugar and weight. It improves blood cholesterol, blood pressure, and heart disease risk, too. In general, adults should do at least 150 minutes a week of moderateintensity aerobic physical activity.* Children and teens should be physically active, as advised by their physicians. Adults should do resistance exercise 3 times a week.* When you exercise, have a carbohydrate source with you. Examples are: 4 oz. fruit juice, 6 hard candies, 1 tube Glucose gel, or 3 or 4 Glucose tablets. Always talk to your physician before beginning or changing an exercise program. * Source: Standards of Medical Care in Diabetes 2008; American Diabetes Association. April 2009 Remember to track your daily exercise. 1 April Fool s Day Passover 10 Good Friday Easter 22 Earth Day

9 Controlling your blood sugar and blood pressure lowers your risk for stroke. Follow your diabetes written action plan for diet, exercise, and medications. Take your medications, as advised. Keep a current list of your diabetes and other medications. List over-thecounter medicines, vitamins, minerals, and other supplements, too. When you have a change in medications, update the list. To help remind you to take your medications, use pill containers, a daily checklist, or this planner. Let your health care provider know if and why you don t take your medications. May 2009 Always carry a list of all your medications. 5 Cinco de Mayo 25 Memorial Day Mother s Day High Blood Pressure 16 Armed Forces Day Awareness Month

10 Take good care of your feet. Do not go barefoot indoors or outdoors, even when you walk in the sand. Wear shoes and slippers that fit well. Wear cotton or wool socks. Wash your feet daily with soap and warm water. Dry them well, especially between the toes. If your skin is dry, apply lotion, but not between the toes. Keep toenails trimmed. If it s hard for you to do this, have a foot specialist trim them. See a podiatrist (foot physician) regularly. Inspect your feet daily for cracks, cuts, redness, sores, or swelling. Use a mirror to look at the bottom of your feet. Ask for help, if you need it. Let your health care provider know about any foot problems. At every health visit, remove your shoes and socks and get your feet examined. June 2009 Remember to check your feet daily Men s Health Week 14 Flag Day 21 Father s Day; Summer Begins

11 Protect your vision. Keep your blood sugar and blood pressure under control to help prevent damage to tiny blood vessels in the retinas of your eyes. Blindness can occur if the damage is left untreated. Finding eye problems early and getting treatment right away helps prevent more serious problems. See an eye physician at least once a year to have a dilated retinal eye exam.* He or she will put drops in your eyes to dilate your pupils to help see the backs of your eyes and look for signs of problems. Call your eye physician right away if you have any vision problems. * Check your plan documents or call Customer Service for your specific plan s coverage. July 2009 Do you need to schedule an eye exam? 4 Independence Day

12 Manage stress to help keep your blood glucose under control. Ways to DE-STRESS: Develop a personal exercise plan with your physician. Express your creative side. Write. Paint. Join a book club. Stretch muscles to relieve tension. Take deep breaths. Meditate. Relax with soothing music, a warm (not hot) bath or shower, and relaxation exercises, such as deep breathing. Enjoy a massage. Sip a cup of warm, herbal tea. Share your feelings with others. August 2009 Schedule time to relax. 22 Ramadan Begins

13 Back-to-School Checklist: q Give updated, written diabetes care plan copies to your child, the school nurse, teachers, coaches, and the school office. q Discuss how your child s needs will be met for glucose testing; insulin; storage of medication, supplies, and snacks; physical activity; special events; and after-school activities. q Decide how to meet your child s meal plan needs with cafeteria foods and ones brought from home. q Prepare kits of supplies, as needed, to be kept in classrooms, the nurse s and principal s offices, and available to the coach. q Plan how to communicate about emergencies and day-to-day concerns. September 2009 Get more information from 1 Labor Day Ramadan Ends 21 Autumn Begins Yom Kippur

14 Protect yourself from the flu and pneumonia. People who have diabetes are more likely to be sicker longer and have more serious health problems when they get the flu or pneumonia. Get a yearly flu vaccine* (if not contraindicated). Get information from the CDC at or CDC.INFO ( ). Wash your hands often. Keep them away from your nose, eyes, and mouth. Use alcohol-based hand rubs when you can t wash your hands. Avoid contact with persons and their things when they have the flu. Get a pneumonia vaccine* as advised by your physician. * Check your plan documents or call Customer Service for your specific plan s coverage. October 2009 Have you gotten your flu shot? 12 Columbus Day National Breast Cancer Halloween Awareness Month Healthy Lung Month

15 It s not too late for screenings and exams. You still have time left this year. Check off, below, if you have had all your screenings.* q A1C test. q Dilated retinal eye exam. q Urinary protein / microalbumin test. q Blood pressure screening. q Cholesterol screening. q Serum creatinine test. q Regular dental checkup. * Check your plan documents or call Customer Service for your specific plan s coverage. November 2009 Schedule screenings you have not yet had Daylight Saving Time Ends 3 Election Day 26 Thanksgiving Day American Diabetes Month

16 Plan for the hectic holidays. Plan for changes in meals, exercise, daily activities, etc. Choose foods wisely. Bring your own snacks and foods, as needed. You may need to monitor your blood sugar more often. If traveling by plane, carry your insulin and other medications; syringes; glucagon emergency kit; and self-testing equipment with you at all times. If traveling by car, check your blood sugar before you begin. If it is lower than 100 mg/dl, have something to eat or drink to raise your blood sugar. Have a quick sugar source within easy reach at all times. If you do not feel well, contact your health care provider. Don t put it off until next year because you are too busy. December 2009 Call your Care Specialist for healthy tips. 12 Chanukah Winter Begins Christmas Day 26 Kwanzaa Begins 31 New Year s Eve

17 Symptoms of Hypoglycemia (Low Blood Glucose)* Hunger. Sweating. Confusion. Irritability. Anxiousness. Dizziness. Blurred vision. Extreme fatigue. Slurred speech. Slow reaction time. Rapid heartbeat. Assistance is needed. Options for consuming 10 to 20 grams of carbohydrates or sugar to treat hypoglycemia (low blood glucose) include: Four ounces of regular sweetened fruit juice, such as orange, apple or grape juice. Avoid grapefruit juice, if possible. Six ounces of regular soda. Six Life Savers candies. One tube of glucose (Glutose) = 15 grams per tube. Three to four glucose tablets = 4 or 5 grams per tablet. Two to three teaspoons of sugar or honey. * For symptoms of hypoglycemia, follow your diabetes action plan Do and consult Not your physician Reproduce as directed. Symptoms of Hyperglycemia (High Blood Glucose)* Headache. Increased thirst. Increased urination. Fruity breath. Blurred vision. Weakness. Increased appetite. Rapid heartbeat. Stomach pain. Dry mouth. Hiccups. Weight loss. To avoid or address hyperglycemia (high blood glucose): Identify your target blood glucose levels and maintain them. Monitor your blood glucose regularly. For example: Before meals, after meals, at bedtime. Exercise, follow your meal plan and take your medication as prescribed. Increase insulin dose or take extra doses as needed, per your physician s direction. If symptoms persist, call your physician. * For symptoms of hyperglycemia, follow your diabetes action plan and consult your physician as directed.

18 Health Tests & Exams These are general guidelines for adults.* Follow your physician s advice for tests and exams. For your child, follow his/her physician s advice for tests and exams. Exam or Test Checkup Blood pressure and weight Dental exam Cholesterol blood test (fasting lipids) Foot exam Blood test for A1C Urine test for protein (microalbumin) Blood test (serum creatinine) How Often** At least 2 times a year. Every office visit. Test at home as advised. 2 times a year. 1-2 times a year as advised. Every 2-3 months. 2 times a year; more often if not at target goal or you have a change in medication therapy. Yearly. Yearly. Flu vaccine Every year during flu season. Pneumonia vaccine 1 or 2 lifetime doses as advised. Dilated retinal eye exam Yearly. Breast exam by physician or nurse W Every 3 years (ages 18-40); yearly (age 40 +). Pap test O Every 1-3 years to age 65; as advised age 65+. Chlamydia screening Mammogram Osteoporosis screening Colorectal cancer screening Prostate cancer screening Abdominal aortic aneurysm screening M E N M E N Discuss with your physician. Every 1-2 years age 40+ as advised. Starting at age 65 (60 if at increased risk for fractures) as often as advised. Starting at age 50 or as advised. As advised by your physician. Once for men age who have ever smoked. * Sources: 1 The Guide to Clinical Preventive Services, 2008, Recommendation of the U.S. Preventive Service Task Force. 2 Standards of Medical Care in Diabetes 2008; American Diabetes Association ** Check your plan documents or call Customer Service for your specific plan s coverage.

19 Helpful Web Sites American Diabetes Association American Dietetic Association American Heart Association Children with Diabetes Online Community Juvenile Diabetes Research Foundation International National Council on Alcohol and Drug Dependence National Institute of Diabetes & Digestive & Kidney Diseases National Institutes of Health National Kidney Foundation National Safety Council Smokefree.gov

20 Medicine Log. (Record in pencil to keep this list current.) Medicine Name Dose Frequency Reason to Take