TYPE 2 DIABETES A Guide for Adults Living with Diabetes
Living with Type 2 Diabetes You ve been given this booklet because you have type 2 diabetes. With this condition, the level of sugar in your blood is too high. This condition takes work to manage, and it s not always easy. But making the effort is worth it for your health and your future. This booklet will tell you more about how to get started. Risk Factors for Type 2 Diabetes Anyone can develop type 2 diabetes. But certain risk factors make a person more likely to have it. These include: Being overweight Having had diabetes during Being older than age 45 pregnancy or given birth to a baby Being physically inactive weighing more than 9 pounds Having a family member with Being African-American, type 2 diabetes Asian-American, Hispanic, Having certain other health problems, Native American, or Pacific Islander such as high blood pressure 2
You CAN Manage Diabetes Hearing that you have diabetes may come as a shock. Allow yourself time to adjust to the news. Living with a chronic (lifelong) condition can be a challenge. You don t have to know everything about diabetes all at once. For now, focus on one idea: learning strategies to control your blood sugar. This can help you live healthier. It can also lower your risk for developing health problems related to diabetes. Your healthcare providers will get you started. But it is up to you to keep learning and put what you learn into practice. You can do it! You can manage your blood sugar and your diabetes. CONTENTS 4 Adjusting to Your Diagnosis 5 Getting Support 6 Understanding Type 2 Diabetes 8 Monitoring Blood Sugar 10 Learning About Food 12 Planning Meals 14 Being More Active 16 Adding Medication 18 Taking Medication 19 High and Low Blood Sugar 20 Regular Exams and Tests 22 Changes in Routine 23 Staying Healthy 3
Adjusting to Your Diagnosis You are likely still getting used to life with a chronic condition. You might be feeling angry, sad, guilty, or even afraid. These feelings are normal, but not if they become extreme or all-consuming. Learn to watch for signs of a problem. And know that you can get help. Strong Feelings Are Normal Many people are sad or down when they first hear that they have diabetes. Other common feelings are anger, fear, frustration, and guilt. Having these feelings is sometimes called diabetes distress. Keep in mind that having diabetes is not your fault. Take things one day at a time so that you feel less overwhelmed. Talk with your healthcare team about how you re feeling. Also, if you start to feel helpless or hopeless, let your team know right away. Get a Handle on Stress In someone with diabetes, stress plays a role in raising blood sugar. So managing stress is part of your care plan. You might: Be more active. Physical activity is a natural stress reliever. Talk with a counselor about ways to cope with things that stress you. Make time to do things you enjoy. This might be a special hobby or spending time with loved ones. 4
Getting Support Controlling your blood sugar is mostly up to you, but you re not alone. Your diabetes healthcare team is there to help. These experts provide strategies on how to manage diabetes and avoid the health risks it brings. Also try reaching out to people in your life for support. Work with Your Healthcare Team Your diabetes team will work closely with you to create a management plan. The goal is to keep your blood sugar within your target range. This delays or even prevents future health problems. Your team is likely to include: A primary care provider. This might be your doctor, physician assistant, or nurse practitioner. He or she may have been the one to tell you that you have diabetes. An endocrinologist. This is a doctor who specializes in treating people with diabetes. A registered dietitian. He or she will help you learn how food and healthy eating can help manage blood sugar. A diabetes educator. This can be a nurse, dietitian, or pharmacist. He or she helps you learn how to manage diabetes. A health psychologist or social worker. He or she can help you cope with the challenges and stresses that diabetes may bring. Reach Out to Others Ask family members and friends for support. Tell them how they can be most helpful to you. Some may want to learn about diabetes along with you. Let your work supervisor know about your condition. Discuss sticking to a schedule that meets your treatment plan. 5
Understanding Type 2 Diabetes To get energy, your body uses a sugar in your blood called glucose. A hormone called insulin is needed to help the body use glucose. When you have type 2 diabetes, your body can t use the insulin it makes. Glucose then builds up in the bloodstream. This causes problems throughout the body. How the Body Gets Energy During digestion, the body turns food into glucose. Some of this sugar goes to the liver to be stored. The rest is sent into the bloodstream. Blood carries glucose to all the body s cells to be used as fuel. But for glucose to enter a cell, insulin is needed. Think of insulin as a key. When insulin reaches a cell, it binds to the cell wall. This signals the cell to create an opening that allows glucose to enter the cell. Insulin Normally, a healthy balance of insulin and glucose circulates in the blood. Glucose enters the bloodstream from the intestine. Cell Liver Small intestinene Insulin binds to a cell and opens it to glucose. Insulin is made in the pancreas and sent into the bloodstream. Stomach Pancreas (behind stomach and intestines) Glucose enters the cell and is used for fuel. 6
When You Have Type 2 Diabetes With type 2 diabetes, the pancreas still makes some insulin. But in many people with type 2 diabetes, cells stop responding to insulin in the right way. This is called insulin resistance. Insulin resistance means less glucose than normal moves into cells. At first, the pancreas responds by making more insulin. In time, though, even extra insulin doesn t solve the problem. As a result, less and less glucose enters cells. It builds up to a harmful level in the bloodstream. This is known as high blood sugar (also called high blood glucose or hyperglycemia). As time passes, the pancreas often makes less and less insulin. Insulin can t bind to the cell. Why High Blood Sugar Is a Problem With diabetes, glucose can t enter cells, so too much stays in the blood. Glucose can t enter the cell to be used for fuel. If high blood sugar is not controlled, it damages blood vessels, nerves, and organs throughout the body. The heart, kidneys, eyes, and limbs can be harmed. Diabetes makes other cardiovascular problems, such as high blood pressure and high cholesterol, more dangerous. Over time, uncontrolled high blood sugar makes a person more likely to have a serious, even deadly, heart attack or stroke. 7
Monitoring Blood Sugar The first step in managing diabetes is learning to check (monitor) your blood sugar. Monitoring isn t hard to do. Your diabetes team will teach you how to check and suggest how often to check. Checking Blood Sugar with a Meter You can check your blood sugar at home, at work, or anywhere you happen to be. You ll use a blood glucose meter. This meter measures the amount of sugar in a tiny drop of blood. You ll use a device called a lancet to prick your finger and take a drop of blood. The drop is placed on a small strip that goes into the meter. The meter then supplies a number (reading) that tells you the level of your blood sugar at that moment. Before a Meal: American Diabetes Association target: 80 to 130 mg/dl Your target: Between and Aim for Your Target Range The goal is for your blood sugar to be in your target range not too high or too low. Your target range is where blood sugar levels are healthiest. Staying in this range as often as possible will help reduce your risk for health problems. Your diabetes team will help you learn your ideal target range for before meals and after meals. Fill in your numbers below. After a Meal: American Diabetes Association target: lower than 180 mg/dl Your target: Between and 8
Monitoring Blood Sugar The first step in managing diabetes is learning to check (monitor) your blood sugar. Monitoring isn t hard to do. Your diabetes team will teach you how to check and suggest how often to check. Checking Blood Sugar with a Meter You can check your blood sugar at home, at work, or anywhere you happen to be. You ll use a blood glucose meter. This meter measures the amount of sugar in a tiny drop of blood. You ll use a device called a lancet to prick your finger and take a drop of blood. The drop is placed on a small strip that goes into the meter. The meter then supplies a number (reading) that tells you the level of your blood sugar at that moment. Before a Meal: American Diabetes Association target: 80 to 130 mg/dl Your target: Between and Aim for Your Target Range The goal is for your blood sugar to be in your target range not too high or too low. Your target range is where blood sugar levels are healthiest. Staying in this range as often as possible will help reduce your risk for health problems. Your diabetes team will help you learn your ideal target range for before meals and after meals. Fill in your numbers below. After a Meal: American Diabetes Association target: lower than 180 mg/dl Your target: Between and 8
Tracking Your Readings Using a log to track your readings helps identify patterns, such as a sharp rise in blood sugar after eating certain foods. Write down the reading and the time. Take this log along when you see the doctor. It lets you and your team see whether changes might be needed to your treatment plan. It also helps you see how the hard work you do each day pays off. Example of a log: Date/Meal Time Before Meal Blood Sugar A1C: Glucose Control Over Time 2 Hours After Meal Time Blood Sugar 9/5 Breakfast 7am 144 9am 185 What I Was Doing Lunch 12pm 124 2:10pm 230 Ate a big lunch Dinner 5:30pm 152 7:30pm 180 Bedtime 10:30pm 129 Went for a long walk before bed The A1C blood test shows your average blood glucose level over the last 2 to 3 months. The result may be a percentage or a number (estimated Average Glucose, or eag). Unless told otherwise, aim for an A1C result less than 7% (an eag less than 154 mg/dl). If your A1C result is too high, your treatment plan will likely change. You are likely to have your A1C checked about every 3 months at first. 9
Learning About Food Knowing what, when, and how much to eat is key to managing diabetes. Start by learning which foods affect your blood sugar the most. A dietitian can help you learn more about food and help you get the skills you need. Make a Meal Plan You may work with a registered dietitian to design a meal plan. This plan will help you manage your blood sugar. It may also help you lose extra weight. The plan will be tailored for you. Tell your dietitian what foods you like. Describe your daily routine. At first, you may be asked to keep a food diary. This is a list of the foods you eat and how much you eat each day. It will help your dietitian learn your eating habits. Know About Carbohydrates Food that contains carbohydrates (carbs) gives your body the biggest boost of energy. But carbs also raise blood sugar levels higher and faster than other kinds of food. To help manage your blood sugar, your dietitian may teach you carb counting. This is a way to control the amount of carbs you eat in a day. (Or, you may learn another way to monitor the carbs you eat.) The three most important kinds of carbs are listed here. Starches are found in grain products such as bread, pasta, cereal, and tortillas. Starchy vegetables include potatoes, peas, and corn. Beans are healthy, but many are high in starch. These include kidney beans, pinto beans, and lentils. Sugars may occur naturally or be added to foods. Foods naturally high in sugar include fruits and fruit juices, dairy products, and honey. Many foods have added sugars. These include sodas and flavored drinks, desserts, candy, and ice cream. Processed and packaged foods, even ones that don t taste sweet, often have added sugar. Fiber doesn t raise blood sugar levels. Some types even slow how the body takes in sugar. You can find fiber in whole fruits and vegetables, dark leafy greens, whole grains, beans, peas, and most nuts. 10
Read Food Labels To find healthy foods that help you control blood sugar, read food labels. Look for the Nutrition Facts label on packaged foods. It will tell you how much fat, carbohydrate, sugar, and fiber is in each serving. Then, you can decide whether or not the food fits into your meal plan. This label is changing. Below shows you the newest label and the information it provides. Nutrition Facts 2 servings per container Serving size 2.0 oz Amount per serving Calories 200 %Daily Value* Total Fat 2.5g 3% Saturated Fat 0.5g 3% Trans Fat 0g Cholesterol 0mg 0% Sodium 900mg 39% Total Carbohydrate 38g 14% Dietary Fiber 2g 7% Total Sugars 12g Includes 10g Added Sugars 20% Protein 7g * The % Daily Value (DV) tells you how much a nutrient in a serving of food contributes to a daily diet. 2,000 calories a day is used for general nutrition advice. Serving Size This number tells you how much of the food makes one serving. If you eat more than one serving, all other numbers, such as calories and carbs, increase. Saturated Fat This number tells you the total amount of saturated fat in each serving. This type of fat is bad for your heart and blood vessels, so try to limit it. Trans Fat This tells you if the food includes trans fat. Trans fats are liquid fats made into a solid fat, such as shortening. Trans fats are bad for your heart. Try to avoid them. Total Carbohydrate This number tells you how many carbs are in each serving. This number can help you fit the food into your meal plan. Dietary Fiber Look for foods with a higher Dietary Fiber number under Total Carbohydrate. Sugars Total Sugars is the total amount of sugar in the food. It includes both natural sugars (these occur naturally in a food) and Added Sugars (these have been added during processing). Look for foods with low numbers for sugars, especially for Added Sugars. 11
Planning Meals For good blood sugar control, follow your meal plan. You are in charge of what, when, and how much you eat. The goal is to balance blood sugar and insulin. Meal planning can also help you lose weight if you need to. Know What to Eat Before you go to the store, know what you want to cook. This will help you stick to your plan while you shop. At the store, read food labels. Look for fresh vegetables and fruits. Ask for lean meats. Avoid snack food aisles. Choose 100% whole-grain breads and noodles and low-fat dairy products. Don t forget to try different types of food. Eating a variety of foods gives your body the best mix of nutrients. It will also help keep you from getting bored with your meal plan. Reduce Liquid Sugars Sugary drinks such as sodas, sports drinks, fruit drinks, sweet teas, and juices contain lots of carbohydrates. They make it harder to manage your blood sugar. Avoid them as much as you can. Instead, drink plenty of water and other sugar-free beverages. Know When to Eat For good blood sugar control, when you eat is as important as what you eat. To stay in your target range, you may need to eat several small meals spaced evenly throughout the day. Also, don t skip breakfast or wait until late in the day to get most of your calories. Doing so can cause your blood sugar to fall too low or rise too high. 12
Know How Much to Eat How much of each food should you have at a meal? Your dietitian can show you how to tell the right amounts. You may want to use measuring cups or spoons until you get used to the look of portion sizes. You can also visit the MyPlate website. This gives a visual guide to help you choose the best types and amounts of food to eat. Keep it in mind as you fill your plate. Special Occasions Devote half your plate to vegetables and fruits. Split the other half between protein and grains. Choose low-fat or fat-free milk and other dairy products. Eating out can be a challenge. Check menus online when possible. Decide what you will order before you arrive. And know that most restaurants serve extra-large portions. You might share your meal. Or eat half and take home the rest. Parties and holidays may involve special or traditional foods and drinks. You don t need to avoid them. Often, you can adjust your meal plan to allow for them. Check your blood sugar more often to see how the foods affect you. As you celebrate, do try to keep your health and weight-loss goals in mind. If you slip, don t give up. Just go back to your plan the next day. Alcoholic drinks can make it hard to stay in your target blood sugar range. Talk with your healthcare provider about how alcohol fits into your diabetes plan. Never drink on an empty stomach. Religious holidays may involve alcohol or call for fasting. Ask your healthcare provider and clergy for guidance on observing religious holidays safely. 13
Being More Active Making physical activity a part of your day can help you manage blood sugar. That s because being active makes your body better able to use insulin. In fact, regular activity can help delay or prevent health problems from diabetes. Along with healthy eating, being active can also help you lose extra weight and keep it off. Work Up to Daily Activity If activity is new to you, start slowly. Begin with 10 minutes of activity daily. Work up to getting 150 minutes of activity a week. Spread this over at least 3 days a week. If you are trying to lose weight, aim for a goal of 60 minutes of activity daily. You don t have to do a day s activity all at once. If you want, spread active periods of 10 minutes or more throughout the day. Choose an Activity Walking is a great activity to start with. Take a lap around your block or on a track at a local school. Climb the stairs. Walk around inside a mall. If walking isn t your thing, do something else. Swim. Take a dance class. Garden. Ride a bike. Choose something that you look forward to doing. Move More Every Day, and Sit Less! Planned activity is a great start. But don t stop there! Explore ways to move a little more all day long. Take the stairs instead of the elevator or escalator. Park farther away from where you re headed and walk. Get an activity tracker or an app on your phone. Count your steps or active minutes and set goals for yourself. Also, know that too much sitting has been shown to hurt your health. Limit sitting to no more than 30 minutes at a time. Take breaks to get up and stretch or walk. 14 Build Strength and Flexibility Strength exercises help build muscle. They also help lower blood sugar. Ask your healthcare provider about working with resistance bands, using weight machines, or lifting hand weights. Plan to do this at least 2 days a week Flexibility and balance exercises help make tasks of everyday life easier. They also help prevent falls that can lead to injury. Try standing on one foot while you brush your teeth. Do gentle stretches anytime. And consider yoga or tai chi classes. Aim to do these kinds of exercises 2 to 3 days a week.
If you haven t been active, talk to your healthcare provider before starting an exercise program. Stick with It Some days, it can be hard to get going. If you miss a day of activity, don t give up. Get out again the next day. Ask a friend to join you for support. Being active with someone else will help you stick to a schedule. It can also be more fun! If you re finding it hard to be active, talk with your diabetes team. They can help you find a plan that better meets your needs. Set a Weight-Loss Goal If you are overweight, being active (along with healthy eating) can help you shed extra pounds. You can start with small steps. Reducing your body weight by as little as 5% can help control your blood sugar. (If you weigh 200 pounds, that means losing 10 pounds.) Weight loss can also increase your energy level and lift your mood. Work with your healthcare team to set a healthy weight-loss goal and make a plan to reach it. If You Need Extra Help Eating and exercise are great ways to get started with weight loss. Your healthcare provider may discuss other aids to help you. These may include weight-loss programs or counseling. Certain medications can help with weight loss. For very overweight people who meet certain criteria, obesity surgery may be considered. Your healthcare provider can discuss your options with you. 15
Drug Class How the Medications Work Oral Alpha-glucosidase inhibitors Biguanides DPP-4 inhibitors Glinides* Sulfonylureas* Thiazolidinediones Insulin* Slow the digestion of certain carbohydrates to help lower glucose levels in the bloodstream after meals. Decrease liver s glucose production. Also decrease insulin resistance in liver, muscle, and fat cells. May also improve blood lipid (fat) levels. Decrease liver s glucose production. Increase insulin production in the pancreas. Cause a burst of insulin to be released right after meals. They have a short time of action. Stimulate pancreas to make and release more insulin. Long-acting: may stay in the body for up to 72 hours. Help decrease insulin resistance in muscle and fat cells. Help decrease liver s glucose production. Can take 4 to 6 weeks to have full effect. Taken by shot or pump. Helps regulate blood sugar if the pancreas can t make enough insulin to keep blood sugar in the target range. Injected Injectable hormones Taken by shot. Affect insulin production in the pancreas and release of glucose into the bloodstream. * Medications in these classes can cause low blood sugar. 17
Drug Class How the Medications Work Oral Alpha-glucosidase inhibitors Biguanides DPP-4 inhibitors Glinides* Sulfonylureas* Thiazolidinediones Insulin* Slow the digestion of certain carbohydrates to help lower glucose levels in the bloodstream after meals. Decrease liver s glucose production. Also decrease insulin resistance in liver, muscle, and fat cells. May also improve blood lipid (fat) levels. Decrease liver s glucose production. Increase insulin production in the pancreas. Cause a burst of insulin to be released right after meals. They have a short time of action. Stimulate pancreas to make and release more insulin. Long-acting: may stay in the body for up to 72 hours. Help decrease insulin resistance in muscle and fat cells. Help decrease liver s glucose production. Can take 4 to 6 weeks to have full effect. Taken by shot or pump. Helps regulate blood sugar if the pancreas can t make enough insulin to keep blood sugar in the target range. Injected Injectable hormones Taken by shot. Affect insulin production in the pancreas and release of glucose into the bloodstream. * Medications in these classes can cause low blood sugar. 17
Taking Medication Medications can t cure diabetes. But, like healthy eating and activity, they can help you control blood sugar. Taking medications every day, especially shots, may seem overwhelming. But they are powerful tools you can use to stay in control of your health. Stick to Your Medication Routine Taking your medications at the same times every day gives you the best blood sugar control. Like a meal plan, have a medication routine. This can help keep your blood sugar steady. Keep track of medications with a pill organizer and a daily schedule. If you can, ask others to help you stick to this routine. Make it a priority for your health. Get Familiar with Shots Some medications, including insulin, can t be swallowed. They are usually injected through the skin. It s not hard to learn how to give yourself shots. Very small needles and new devices make it easier than ever. Ask your healthcare provider for more information. If You Take Other Medications Medications of all types can affect blood sugar. This includes those prescribed for other health problems and those you buy over the counter (OTC). It also includes herbs and vitamins. Make sure you tell your healthcare provider everything you take. When filling a new prescription or buying OTC medications, ask to talk with the pharmacist. Mention that you have diabetes. Then ask how the medication might affect your blood sugar. 18
High and Low Blood Sugar Many things, including medication, can cause your blood sugar to go too high or too low. Both can be a problem. You cannot always feel when your blood sugar is too high or too low. So check it regularly. And take action right away when you have a high or a low. High Blood Sugar Hyperglycemia is high blood sugar. It is blood sugar around 200 or higher. You might have: Increased thirst Increased need to urinate Increased tiredness Blurred vision When You Have Symptoms Check your blood sugar right away! If it s too high: 1. Drink water or other sugar-free liquid. 2. If you take insulin, you may be able to take an extra dose. Follow your healthcare provider s instructions. 3. Check your blood sugar every 4 hours to see whether it is going down. Low Blood Sugar Hypoglycemia is low blood sugar. It usually needs to be treated if it is lower than 70. A drop in blood sugar can happen very quickly. You might have: Heavy sweating or cold, clammy skin Dizziness, shakiness, or tingling skin Hard, fast heartbeat or headache Confusion or irritability When You Have Symptoms Check your blood sugar right away! If it s too low: 1. Eat or drink at least 15 to 20 grams of fast-acting sugar. Examples include: 4 glucose tablets, ½ cup (4 oz) of fruit juice or nondiet soda, 1 to 2 sugar packets, or 2 tablespoons of raisins. 2. Check your blood sugar again after 15 minutes. If it s still low, repeat step 1. Check again after 15 more minutes. If it s still too low, call your doctor right away. 3. Once your blood sugar is back over 70, eat a snack to keep it in a safe range (unless your next meal is within 15 minutes). Call your doctor right away if your blood sugar stays over 300 or if symptoms get worse. Call your doctor right away if your blood sugar stays low for more than 30 minutes. 19
Regular Exams and Tests Taking care of your diabetes every day will help lower your risk of complications. But you also need regular checkups with your healthcare provider. Keep up-to-date on tests and vaccinations. The test results show if your management plan is keeping you healthy. Tests Blood pressure check When: Every doctor visit Why: Managing blood pressure helps prevent heart attack, stroke, eye problems, and kidney damage. A1C When: At first, every 2 to 3 months, then at least twice a year Why: This test helps monitor blood sugar control over time. Cholesterol and blood lipids When: At least once a year Why: Lowering cholesterol and blood lipids helps fight blood vessel disease. Blood and urine tests (such as urine albumin) When: At least once a year Why: These tests help check kidney function. Thinking of Pregnancy? Immunizations Influenza vaccination (flu shot) When: Once a year Why: Having the flu can be serious for people with diabetes. Pneumonia vaccination When: At least once, then as needed Why: Having pneumonia can be serious for people with diabetes. Hepatitis B vaccination When: As soon as possible if you re younger than 60, or as recommended by your doctor if you re older than 60 Why: Having diabetes makes you more likely to get hepatitis B, a chronic liver disease. If you re thinking of getting pregnant, talk with your healthcare provider right away. Having blood sugar under tight control before you get pregnant increases your chances of having a healthy baby. 20
Diabetes increases the dangers of smoking. Ask your doctor for help quitting. Eye Care Diabetes can cause long-term damage to the blood vessels in the eyes. This is called retinopathy. It can lead to blindness. Your Role See an eye doctor at least once a year for an eye exam. Do this even if your eyes feel fine and you aren t having any trouble seeing. Call your healthcare provider if you have new dark spots in front of your eyes, poor vision in dim light, or eye pain or pressure. Gum Care People with diabetes can suffer periodontal (gum) disease. This is an infection that destroys the gums and the bone that holds the teeth. Your Role See your dentist at least twice a year. Tell anyone who works on your teeth that you have diabetes. Call your dentist if you have gums that bleed or are red, swollen, or tender; gums that pull away from the teeth; or teeth that are loose or have shifted position. Foot Care Y Over time, high blood sugar affects nerves and blood vessels. Wounds may be slow to heal and may infect easily. Nerve damage means you may not always feel if you have a cut or infection. Because of this, you need to pay special attention to the health of your feet. Your Role Inspect your feet daily for cuts, cracks, sores, redness, or swelling. If you can t see your feet, ask a family member to help. Visit a foot doctor (podiatrist) for help to cut and file toenails safely. Take off your shoes and socks every time you see the doctor. Be sure your feet are examined. Ask your doctor about special footwear that can help protect your feet. Contact your healthcare provider if you see cuts, sores, or other problems. Also call if cuts and scrapes are slow to heal, or if a cut itches, feels warm, oozes fluid, or has a bad odor. 21
Changes in Routine Having diabetes doesn t mean you can t go out and explore. It does mean that you need to plan ahead. Think about how you will handle things that disrupt your medication, meal, and activity routines. Special Situations Being ill or traveling can disrupt your schedule and treatment plan. And having low blood sugar can make driving dangerous. Below are tips to help keep you safe during these special situations. Illness. Being sick is likely to raise blood sugar. When you re sick, try to follow your meal plan. Drink plenty of sugar-free fluids. If you can t eat solid foods, have soup, applesauce, or yogurt. Check your blood sugar often. Don t stop taking your medication unless told to by your doctor. Also get plenty of rest. Travel. Always be prepared to manage blood sugar. Carry a diabetes toolkit (see below). Have water with you at all times. Check your blood sugar often. If you plan to travel across time zones, ask your diabetes team for advice about timing meals and medication use. Driving. When you drive, always be prepared for low blood sugar. Check your blood sugar before you drive. If it is low, eat or drink fastacting sugar (see page 19). Keep diabetes supplies where you can reach them from the driver s seat, not in the backseat or trunk. A Toolkit for Supplies Keep track of your medications and diabetes supplies by creating a diabetes toolkit. Use a small makeup or travel bag. Include supplies listed below and any other medications you take. Fast-acting sugar Blood sugar ID card meter ID bracelet Lancet Syringes Test strips Diabetes Extra batteries medications for your meter 22
Staying Healthy Learn your target numbers for blood sugar control, cholesterol, blood pressure, and weight management. These and other numbers tell you and your diabetes team if your treatment plan is keeping you healthy. Copy this chart to help track your numbers. Tests Blood Sugar A1C or eag Premeal blood sugar Postmeal blood sugar Blood Pressure Blood Lipids LDL ( bad ) cholesterol HDL ( good ) cholesterol Triglycerides Urine Albumin Weight American Diabetes Association Targets <7.0% or <154 mg/dl 80 130 mg/dl <180 mg/dl <140/90 mmhg You and your healthcare provider will determine what cholesterol levels are right for you. <30 mg My Numbers Now Note: > means higher than < means lower than My Target Numbers My Next Check Up Data supported by: Standards of Medical Care in Diabetes. Diabetes Care. January 2017;40(20):142. 23
Also available in Spanish Changes to Last a Lifetime Having type 2 diabetes means living with it for the rest of your life. So it s best to make changes that will work for you for the long term. To help ensure your needs are met, be an active member of your healthcare team. Talk with your team about goals and any challenges. If you have questions, be sure to get answers. By doing this, you re taking charge of your life and your health. For More Information For more information about living with diabetes, see these websites: American Diabetes Association www.diabetes.org American Heart Association www.heart.org Academy of Nutrition and Dietetics www.eatright.org National Diabetes Education Program www.ndep.nih.gov TAKE OUR PATIENT SURVEY. Help us help other patients. Please visit www.kramesurvey.com to provide your feedback on this booklet. This booklet is not intended as a substitute for professional medical care. Only your doctor can diagnose and treat a medical problem. 2013, 2014, 2015, 2016, 2017 The StayWell Company, LLC. www.kramesstore.com 800.333.3032 All rights reserved. Made in the USA. 12017 1702