The content we are going to learn today is relevant to every patient, and it covers all aspects of diabetes self-management, so you can share your good experiences and methods of managing diabetes on a daily basis with us.
Since self-management has so many benefits for controlling the disease, we should understand what self-management includes. Diabetes self-management can be divided into two major areas: life and treatment. The life section mainly involves diet and exercise, while the treatment section mainly includes monitoring and medication.
As we all know, the characteristics of diabetes are: lifelong disease, rapid changes in blood glucose levels, and large individual differences, so only short-term care by medical staff in the hospital can not achieve long-term blood glucose standards, and most of the time patients need to self-management. So, what are the benefits of self-management? First of all, it can improve the level of awareness of diabetes; it can improve the effect of treatment; effective self-management can also save medical costs and reduce physical damage; it can play a positive role in slowing down the occurrence and development of complications.
Diet management, we must first tell you the principles of diet management.
The intake of dietary calories should be appropriate, not to exceed the total daily calorie requirements, to maintain a balance between income and expenditure, not to increase weight; balanced diet, food selection should be diversified, pay attention to the ratio of nutrition, such as the current recommended carbohydrate, fat, protein intake ratio of 5:3:2; adhere to a small number of meals, can choose 3-6 meals per day, in the case of total calories remain unchanged a small number of meals can reduce blood sugar fluctuations; drink more water. 6-8 glasses of water per day, limit alcohol consumption, drinking alcohol needs to be included in the total daily calorie count, no more than 1-2 standard servings per day; the relationship between the amount of diet and labor intensity should be relatively balanced; family members participate in the daily diet management of patients to encourage and supervise, adding to the management effect.
Tips for diet management, first of all, how to control food portions. We all know that the diabetic diet requires calorie counting, and the total daily calorie requirement is converted into food exchange portions, and the total daily calorie cannot exceed the limit. You can slow down the eating speed during meals and eat more green leafy vegetables, as this is low in calories; you can also increase drinking water before and during meals and insist on a short walk after meals to distract yourself. Another trick is a balanced meal, that is, pay attention to the ratio between carbohydrates, fats and proteins with each other.
We can eat a variety of carbohydrate-based foods, but not too many servings; ensure that the daily intake of protein accounts for about 20% of total calories, eat more vegetables can increase dietary fiber, but to limit the amount of oil used in frying, generally 25 grams of oil per person per day, that is, 2 ½ spoons. Cooking methods also have many tricks, for diabetic patients, try to use steam, boil, stew, boil, mix and other cooking methods, which can reduce the amount of oil; less fried, pan-fried, burned, these methods use too much oil, the dishes made certainly exceed the calorie limit. For the three meals a day, we recommend that breakfast must be nutritious, lunch should be rich, and dinner should be light. Meals with the family need to pay attention to: the main meal can be served in a standard bowl of rice to ensure that the intake does not exceed the limit, a day of meat food should not exceed the size of a deck of cards, can eat a small amount of snacks, but to reduce the corresponding amount from the main food.
Life is exercise, life is not stopping, exercise is not stopping. What can exercise bring to you? Staying more active is one of the effective ways to control blood sugar. Exercise can help you lose weight, gain strength, and feel more energetic. No matter how old you are, you will gain if you keep exercising. Since exercise is so good, let’s choose easy-to-accept exercise to start exercising, such as daily activities like climbing stairs, mopping the floor, shopping at the mall, and running, biking, playing ball, etc . Steps to gradually increase the amount of exercise: at the beginning of the exercise, each 5-10 minutes, 2 times a week can be; after each exercise gradually increase 2-5 minutes, so that the body gradually adapt to up; when adhering to a period of time, feel that the body can adapt to more exercise, and then increase 1 day a week exercise; and so on, and finally reach at least 3-4 times a week exercise, each time adhere to the exercise 30 minutes.
What are the issues that need attention before and after exercise? Before exercise to check the physical condition, there is no discomfort, wear comfortable clothes, choose the right place to exercise, wear comfortable shoes and check the feet after exercise, before the specific exercise to do 5-10 minutes warm-up exercise activities; after the exercise to do 5-10 minutes of recovery finishing exercise, so that the body slowly adapt to down, and pay attention to timely hydration, it is best to drink a glass of warm water. In the exercise need to have safety precautions, such as as possible to find a friend to exercise together, once you feel where the pain or breathing effort, be sure to stop the exercise. You can hydrate while exercising. If you can’t carry water with you when you exercise, then you can drink a glass of water before and a large glass after exercise. Always carry emergency candy with you in case of low blood sugar. You can bring a few small packets of candy, some glucose tablets, half a bottle of sugary juice or a few cookies to take in case of hypoglycemia. Carry a card with you that says you have diabetes. Or you can ask your doctor for a first aid card, fill out the information and keep it in your bag.
Preventing hypoglycemia during exercise: Avoid exercising alone; recommend starting exercise one hour after meals; if you are going to do moderate intensity exercise for a long time, such as long-distance running, mountain climbing, you need to take some precautions, such as taking a proper meal before and during exercise, and monitoring blood sugar at any time; patients who are in a position to do so can monitor blood sugar after exercise; after doing larger exercise, eat more appropriately.
Monitoring in a broad sense should be condition monitoring, including general monitoring, such as diabetes symptoms, signs, blood pressure, weight, waist circumference, hip circumference, etc.; there is also the monitoring of metabolic control indicators, such as blood glucose, urine sugar, glycosylated hemoglobin, blood lipids, etc.; in addition, the monitoring of chronic complications and daily care are also involved in the condition monitoring of diabetes. Because of the limited time for monitoring in hospital, most of the time patients need to do it at home, and the monitoring at home is based on blood glucose monitoring, and the change of blood glucose can reflect the good or bad disease control, which directly provides guidance for the daily self-management of patients.
Self-monitoring of blood glucose (SMBG) is the most basic means to evaluate the level of blood glucose control. It can reflect real-time blood glucose level, evaluate the impact of pre- and post-meal hyperglycemia as well as life events (exercise, meals, sports and emotional stress, etc.) and hypoglycemic drugs on blood glucose, evaluate the effect of diabetes treatment, detect hypoglycemia in time, help to formulate individualized lifestyle interventions and optimize drug intervention programs for patients, and improve the effectiveness and safety of treatment; on the other hand, SMBG, as part of diabetes self-management On the other hand, SMBG, as part of diabetes self-management, can help diabetic patients better understand their disease status and guide them to self-management more effectively; the guidelines issued by the International Diabetes Federation (IDF), the American Diabetes Association (ADA) and the National Institute for Health and Clinical Care (NICE) in the UK all emphasize that self-monitoring of blood glucose plays an active role in the comprehensive management and control of diabetes. Since we cannot live without monitoring, we should keep a good monitoring diary. Patients can prepare a blood glucose monitoring record book, record the corresponding monitoring results when measuring blood glucose at each time point, and record the meal and bedtime and the dose and medication time of insulin or oral medication, and explain the non-daily situation in the notes. It is more beneficial to monitor the condition if the patient’s family members can assist in helping to monitor blood sugar.
Glucose-lowering drugs are an important weapon in the treatment of hyperglycemia. On the basis of the general principles of medication, we need to pay attention to the following: As the function of beta cells decreases, we need to constantly adjust the drug treatment plan; 2. Medical advice, scientific use of drugs, individualized use of drugs.
In the principle of medication, it is necessary to adjust the medication with the decreasing function of β-cells: type 2 diabetes is a progressive disease, and the function of β-cells will gradually decline with the prolongation of the disease, and when the function of β-cells is still available, we can control the disease through diet and exercise and other lifestyle interventions to make the blood glucose reach the standard; when only lifestyle interventions cannot make the blood glucose reach the standard, it is necessary to add an oral hypoglycemic drug for treatment. If one oral hypoglycemic drug treatment can hardly make blood glucose reach the standard, another oral hypoglycemic drug can be added, and if the treatment with a large dose of multiple oral hypoglycemic drugs cannot make blood glucose reach the standard, insulin treatment needs to be started, and insulin treatment can be added with basal insulin or premixed insulin on top of oral hypoglycemic drugs; when blood glucose control is not satisfactory with basal insulin treatment, basal-meal insulin can be administered. When the glycemic control with basal insulin is not satisfactory, intensive basal-mealtime insulin therapy or intensive pre-mixed insulin therapy three times a day when twice daily pre-mixed insulin therapy is not up to the standard can be carried out, and insulin pump therapy can be added if necessary.
Another principle of medication is about balancing benefits and risks. The choice of glucose-lowering drugs should be to control blood glucose to achieve the standard, and the benefit point of achieving the standard is firstly glycated hemoglobin <7%, and secondly to avoid or minimize the side effects brought by drugs, such as no weight gain and no mild and severe hypoglycemia. We should know that patients will worry about hypoglycemia and weight gain in drug therapy, and frequent occurrence of hypoglycemia is not good for disease control, so we should choose drugs with low risk of hypoglycemia, such as 3rd generation insulin insulin analogs and GLP-1 receptor agonists. On the other hand, weight gain increases insulin resistance, which in turn aggravates the disease, so insulins with weight advantage should be selected. So that most patients in the treatment of type 2 diabetes will end up on insulin therapy. We need to dispel the worries of using insulin therapy, and we should have a correct understanding of insulin, that is, insulin is the most effective weapon to lower blood sugar, and insulin analogues can make sugar reduction more effective and make the treatment of patients more convenient and safe.
At the same time, do not forget that insulin needs to pay attention to the following points in use: unopened insulin is stored at 2-8oC, such as by the refrigerator freezer door, do not freeze; premixed insulin needs to be fully shaken before injection; according to the onset of action of different insulins on time for meals, such as premixed human insulin needs to be injected 30 minutes before meals, while premixed insulin analogues can be injected adjacent to meals, without waiting, rapid-acting insulin The analogue can be injected immediately before mealtime, and there is no need to wait for mealtime; pay attention to the rotation of the injection site to prevent subcutaneous hard nodes at the injection site; reuse of needles is strictly prohibited to avoid infection and bleeding; strengthen blood glucose monitoring during the initial insulin treatment and adjustment of the treatment plan, and reduce monitoring as appropriate after the condition is stable.
Regular follow-up at the hospital is also an important part of self-management. Diabetes is a lifelong disease, and glucose patients should have regular follow-ups: regular follow-ups are good for better adjustment of medication dosage so that blood glucose can reach the standard, and regular follow-ups are good for prevention and timely detection of complications.
Each part of self-management is important, and only by actively learning about diabetes can one effectively self-manage, so diabetes education is the core and foundation of self-management. The importance of diabetes education: receiving diabetes education can acquire health knowledge, correctly understand the disease and treatment, and change the bad lifestyle; it can also improve the ability of self-management of diabetes, including learning scientific diet and exercise, correctly monitoring blood sugar, and standardizing insulin injection; it is conducive to scientific understanding and treatment of diabetes and delaying the development of complications, so it is an indispensable means in diabetes treatment and complication prevention. Therefore, it is an indispensable tool in diabetes treatment and complication prevention.
Diabetes autumn health some general knowledge, health considerations: control diet: fall listed fruit, eat fruit, pay attention to the corresponding calories from the main food deductions; limit fat intake, strict control of weight, do not blindly paste autumn fat; tonic can not be indiscriminate tonic, diet should not be too cold, eat less stimulating food; pay attention to the cold to keep warm, prevent colds: cold stimulation may induce blood sugar and blood pressure rise, leading to diabetes The weather changes in autumn, you need to pay attention to the cold to keep warm, add clothing in time to prevent colds; early to bed and early to rise; happy mood; appropriate exercise.
The feet of diabetic patients need the following care in autumn.
1.Check the feet daily for any abnormalities;
2.Wash your feet with warm water and non-irritating soap, soak for 5 minutes, and dry them with a white towel, which is mainly used to find out if there is any damage to the feet in time;
3, wearing clean and comfortable cotton socks, socks too tight will affect the blood circulation of the foot;
4, shoes should be wide some, better breathability;
5, foot cracking do not stick tape, foot fungal infection to timely treatment.
Eyes are the window of our communication with the outside world, autumn climate change leads to blood sugar fluctuations, patients are prone to eye disease, so autumn eye care should pay attention to.
1.Try to keep blood sugar close to normal or normal;
2. Try to control blood pressure in the normal range;
3.Treat high blood pressure to keep it normal;
4, quit smoking;
5, if the retinal blood vessels have been lesions, should avoid strenuous exercise;
6.Go to the hospital for regular eye examination.
The dry weather in autumn, sugar lovers are prone to constipation, active prevention and control of constipation has a protective effect on blood sugar control, vision and cardiovascular system, treatment should pay attention to.
1, careful use of stimulating laxatives;
2, eat more high fiber diet, such as vegetables, fruits, etc.;
3, do more abdominal rubbing, abdominal and anal exercises;
4, honey contains fructose, sucrose, easily lead to high blood sugar, is not recommended to use honey to treat constipation.
After entering autumn, the night is long and the day is short, if the dinner can not maintain the energy and sugar needed for a long night, it is easy to happen night hypoglycemia. How can patients prevent hypoglycemia in autumn?
1.Take insulin or oral hypoglycemic drugs regularly and quantitatively;
2.Eat meals on time, if you cannot eat on time, you should eat some fruit, juice or cookies at meal time;
3.When you go out, make sure you have some cookies and candies to eat in time when the aura of low blood sugar appears;
4, carry a diabetic information card with you, and indicate that in case of unconsciousness, please put the candy in your pocket into your mouth or immediately send it to the hospital emergency room for resuscitation;
5, diabetic patients should regularly review the hospital and follow medical advice to prevent the occurrence of hypoglycemia, especially to avoid repeated hypoglycemia;
6, to develop good habits, quit smoking, such as drinking alcohol should be a small amount, avoid drinking alcohol on an empty stomach;
7, should not exercise on an empty stomach, eat some snacks before exercise, and keep the amount of exercise appropriate and constant.