FINALLY. Celebrate your successes, even the small ones! Learn from your efforts that don t turn out as you hoped or expected. If you do this, you can t fail! Set yourself up to succeed. Remember.. Most adults need to hear something new 6 times to remember or believe it, Most adults require 21 days to try out something new to develop a habit. Practice. How will you celebrate your successes? Questions? Please call Diabetes Care at 303-614-1065 or 1-866-868-7572 or go to kp.org/diabetes. Diabetes Balance & Health MY PERSONAL ROADMAP WORKBOOK 2007 Kaiser Permanente Colorado, Inc. All rights reserved. co 0037 5977 24
Diabetes Balance and Health MY PERSONAL ROADMAP WORKBOOK Planning your journey: How will you arrive at your destination? Review the sections of this Roadmap. Where can you make changes that would be easiest for you? Name: Phone: My health care team: Nurse Educator: Phone: Healthy eating: One change in my eating patterns that I know I can do today: Dietitian: Phone: My Doctor: Phone: My Pharmacist: Phone: Being active: One change in my daily activity routine that I can begin today is: Goal setting: - Be realistic - Set small goals - Plan one change at a time - Be patient and persistent - Review your Personal Roadmap often and revise as needed 2 23
Pulling it all together: Begin with the end in mind! First: Get very clear! Write it down: Why is it important for me to learn how to manage my diabetes? 1. GETTING STARTED Take a moment to answer two very important questions: What is the most important thing you want to learn? 2. 3. What will I look like in 10 years if I do this? What concerns you the most about having diabetes? What will I look like in 10 years if I choose not to do this? Next: Have you made the decision to take charge of your diabetes? If so, how will you start? Who will you ask for help? 22 3
Charting my progress Lab tests, exams Date Results Date Results Date Results A1c Total Cholesterol Triglycerides History... 21 4 Symptoms I had when my diabetes was diagnosed: Frequent urination Blurred vision Unusual thirst Slow healing Hunger Fatigue Other My blood sugar was when my diabetes was diagnosed. HDL (good) LDL (bad) Blood pressure Urine microalbumin Creatinine Weight
Staying healthy: My personal plan Exam Purpose Frequency Doctor visit Diabetes visit - Every 6 months Discuss diabetes balance if targets met Prevent complications - Every 3 months If not at targets Weight Monitor progress - Every visit toward goals Eye exam dilated Goal: healthy retina - Every year or Detect, treat problems As recommended early Foot exam Nerves and circulation - Every visit Complete foot exam - Every year Aspirin Prevent heart attack, - Ask your doctor stroke Dental exam Healthy teeth, gums - Every 6 months Why me? My diabetes risk factors: Family history History of gestational diabetes Overweight or large babies Inactive High blood pressure Low HDL (good) cholesterol Of African American, Hispanic/Latino, Native American Pacific Islander heritage Flu vaccine Prevent influenza - Every year Pneumonococcal Prevent pneumonia - Once before Vaccine age 65 - Second-ask your doctor Inspect shoes and Wound Prevention - Daily feet 20 5
Coping with diabetes My plan for dealing with stress: I will ask for support from: Risk reduction: My personal plan Smoking? Talk to your doctor about resources to help. Test Target Frequency A1c Less than 7% Every 3-6 mo. Active steps I will take to get unstuck from negative feelings: What I will do to relax when I feel stress increasing: Blood sugar Less than 120 Every day Cholesterol Less than 180 mg/dl Every year Triglycerides Less than 150 mg/dl HDL (good) - Men 40 or higher mg/dl - Women 50 or higher mg/dl LDL (bad): Less than 100 mg/dl Blood pressure Less than 130/80 Every visit Kidney tests Urine microalbumin Less than 30 Every year Blood creatinine Every year Men 0.5-1.3 Women 0.4-1.1 6 19
MY ABC TARGETS: Usual target My last result My target A: A1c: less than 7% % % B: Blood Pressure 130/80 / / Reducing my risk for complications of diabetes Do you know someone who has experienced complications of diabetes? Who? Check the risk factors that affect you: 7 Can t change Can change Family history of Inactive heart disease Smoking Age High blood pressure Diagnosis of diabetes Controlled diabetes High cholesterol Overweight 18 C: Cholesterol Below 180 mg/dl Triglycerides Below 150 mg/dl LDL (bad) Below 100 mg/dl HDL (good) Women Over 50 Men Over 40
My current lifestyle patterns: Healthy patterns Patterns to Improve (examples) Eat lots of vegetables Watch too much TV Walk almost every day Eat at fast food restaurants Portion Control Eat large servings My plan for taking my medications Medication Dose Time(s) For blood sugar For blood pressure Setting goals: For cholesterol Step 1: The area in my lifestyle I would like to improve is: (Example: I eat too much at each meal.) Step 2: My goal is: (Example: I will eat one serving of the foods at my meals, no seconds) Step 3: What are the steps I will take to reach my goal? a. b. c. 8 17
What medications are you taking now for your diabetes? Medication Doses Time (s) MY FOOD What are some carbohydrate foods that I eat on a regular basis? (Examples: fruit and juices, pasta, bread, rice, sweets, milk, etc) 1) 2) 3) 4) 5) Think of a high fat food you eat often and a healthier substitute: (Example: regular cheese, substitute with low fat cheese) 1) How often do you miss a dose? Why? Have you stopped taking a prescribed medication? Why? I feel better, don t think I need it It made me feel worse Cost, I can t afford it Other: 2) 3) 4) 5) 16 9
My food targets: General carb targets to get started could be: 45-60 grams/meal for women, 60-75 grams/per meal for men, 15-30 grams for snacks Breakfast Time: Carbohydrate target: My monitoring plan I plan to check my blood sugar times each day. Before breakfast Hours after breakfast Before lunch Hours after lunch Before dinner Hours after dinner At bedtime Snack Time: Carbohydrate target: Lunch Time: Carbohydrate target: Snack Time: Carbohydrate target: Dinner Time: Carbohydrate target: Snack Time: Carbohydrate target: For several foods you have on hand, practice checking labels: (see page 9) Serving size Total carb grams/serving Before meals: After meals: Bedtime: My target blood sugars 10 15
14 Physical activity What are my current activities and how would I describe my current activity level? At work? At home? For fun? Planned exercise? What are the barriers that keep me from being more active? (check all that apply) Weather Time Too Tired Low motivation Illness Boredom No Equipment No Facilities Joint Problems Out of Breath Pain/Discomfort Hate Exercise Other: Which benefits of exercise would motivate me to become more active? (check all that apply) Improved strength, flexibility Improved endurance Heart and Lung Health Promote Weight Loss Prevent Osteoporosis Improve Blood Sugars Look Better Improve Well-being Decrease Anxiety, Depression Reduce Heart Risk (BP, cholesterol) Improve my insulin sensitivity (Get more mileage out of the insulin I make, possibly reducing need for medications) 11 Example log book: Recording medications, carbs, and blood sugars DATE BREAKFAST LUNCH DINNER BEDTIME May 20 146 / 175 112 / Sun Carbs 3 servings 1 serv. Snack, 3 serv. Lun 4 servings Meds Glyb 10 mg, Met 500 Glyb 10 mg, met 500 May 21 122 / 210 184 Mon (ate out-spaghetti) Carbs 3 servings 1 serv. Snack, 3 serv. Lun 6 servings Meds Glyb 10 mg, Met 500 Glyb 10 mg, met 500 May 22 155 / 132 125 Tues Carbs 3 servings 1 serv. Snack, 3 serv. Lun 4 servings Meds Glyb 10 mg, Met 500 Glyb 10 mg, met 500 Comments:
My activity plan I will exercise times a week. I will do the following activities: Monitoring my blood sugar How often do I check your blood sugar? Times each day Number of days each week What results are you getting? How high? How low? Do you know what these numbers mean? I plan to exercise minutes each session. Other ways I will increase my daily activity: What are your blood sugar targets? Before meals? After meals? At bedtime? 12 13