Managing diabetes mellitus

MANAGING DIABETES MELLITUS Controlling your diabetes mellitus begins by learning how to manage your blood sugar levels. In conjunction with a healthy lifestyle and regular exercise, there are many other steps you can take to regulate your blood sugar levels and reduce the risk of complications.

Learning how to manage diabetes may seem like a challenge to you at the outset. You may feel insecure about how best to control your blood sugar, or you may have trouble identifying when it is high because you do not necessarily have to feel different.

There are three important steps that can help control your glucose levels: 1. Monitor closely your blood glucose levels so that you can respond to any changes; 2. Take the medication you have been prescribed; 3. Opt for healthier eating and increase your physical activity.

This section is intended to help you keep your blood glucose within the range of normal reference values, which may prevent long-term complications. If you understand what causes your blood sugar levels to change and if you learn how to respond to those variations, you will feel confident in controlling your diabetes.

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MANAGING DIABETES MELLITUS BEGINS HERE:  Preparation of Consuta  Control glycemic changes  Collaborate with your doctor  Treating Type 2 Diabetes  Medication for Type 2 Diabetes

PREPARING THE CONSULTATION An important step for anyone with Diabetes is the preparation of the consultation. It is essential that you feel an active part in the management of Diabetes and learn more about it so you know better how to control it. Discuss with your healthcare team what you can do at the level of self-monitoring and surveillance and clarify all your questions.

POINTS YOU MAY WANT TO DISCUSS WITH YOUR PHYSICIAN   

The results of your blood and urine tests.

Problems resulting from very high or very low glycemic levels, including the symptoms you may have and what to do about them.

Your medication - when to take it and how to adjust it if necessary.

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Your food plan and what kind of food you eat, as well as the difficulties you feel about certain foods.

All situations that may interfere with your day-to-day management of Diabetes, such as school, work, travel, etc.

Questions you want to go deeper into or any point you need help with.

WHAT TO DO TO PREPARE FOR CONSULTATION 

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If you want to address specific issues, you should do so early in the consultation. Already during the consultation, whenever you have any questions do not hesitate to ask - this is the ideal time to clarify it!

If there is any aspect of your treatment plan that is not working well, try to find out the reasons for it.

Take with you all records regarding diet, exercise and glycemic levels, as well as your Diabetes Diary.

Always keep track of the medication you are currently taking, even if the doctor in question has prescribed all medication. It is important to record the name, dosage and number of tablets you take, and at what times. If you are afraid of forgetting something, take the entire boxes of the medications you are currently taking (do not just take the "caps", as you often cut the "wrong" cap, that is, the one that does not have the name of the Drug or dosage).

Take with you all the exams you have done between appointments - these may or may not be important to your doctor, but it is preferable to have more than less. If you have been hospitalized, it is very important to take the discharge you were given when you left the hospital.

CONTROLLING BLOOD SUGAR CHANGES UNDERSTAND THE REFERENCE RANGES OF BLOOD GLUCOSE (BLOOD SUGAR) According to the International Diabetes Federation, for most people with diabetes, normal blood glucose values are as follows: 3|Page

Fasting (plasma fasting glucose): less than 110 mg / dL After meals (plasma glucose postprandial): less than 145 mg / dL It should not be below 80 mg / dL at any time of the day. When the values are below 70 mg / dL, we speak of hypoglycemia or "low sugar", a situation that can be dangerous and is to be avoided.

Talk to your doctor about the range of blood glucose reference values that is most suitable for you.

HIGH BLOOD GLUCOSE LEVELS When your blood glucose is high (hyperglycemia) may experience any of these symptoms: dry mouth, thirst, frequent urination, fatigue and blurred vision . If you experience any of these symptoms, immediately confirm your blood glucose values.

Uncontrolled increases in blood glucose levels may be due to overeating, being less active than usual, not feeling well, being stressed, or needing an adjustment in diabetes medication.

LOW BLOOD GLUCOSE LEVELS Low blood glucose values are usually caused by eating less or later than usual, being more active than usual or being on medication that does not match your needs. Consult your doctor whenever you experience episodes of low blood glucose. It is also very important to recognize the symptoms of hypoglycemia and to know how to effectively control it.

When your blood sugar is low, you may experience nervousness, tremors, sweating more than usual or fatigue . Symptoms may be mild at first, but may worsen rapidly if left untreated. If you have hypoglycaemia, confirm your values immediately. If the level of blood glucose is below 70 mg / dL , or immediately ingest a carbohydrate drink such as a fruit juice cup 3 glucose tablets or lozenges 5 or 6. You may need to repeat the treatment in the next 15 to 20 minutes if the values have not increased. Waiting for values to increase spontaneously or waiting to act is not safe.

Your family and friends and colleagues should be aware that as a patient with diabetes, you are at risk for episodes of hypoglycaemia.

See the truth about diabetes that doctor never tell you.

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HOW IT CAN HELP PREVENT SUDDEN CHANGES IN BLOOD SUGAR:     

Keep your routine and daily meal and exercise times as much as possible, and be sure to take your medication.

Check your blood glucose levels as you have been taught and share the records with your doctor.

Set goals for weight, physical activity, blood glucose and HbA1C with your doctor.

Use an object that tells other people who are suffering from diabetes, in case of an emergency, such as a wire or a bracelet.

Always have carbohydrates (such as sweets or sugar packets) to treat hypoglycaemia at any time ("low sugar").

Consult your doctor if you frequently experience high or low blood glucose levels. You may need to review and make some changes to your diet, physical activity, or diabetes medication.

COLLABORATE WITH YOUR DOCTOR It is important to establish a good relationship with your doctor and other healthcare team as this will be a crucial source of support and guidance in managing your diabetes. Working with your doctor can help you determine if your blood sugar levels are under control and together can identify areas for better diabetes management.

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At each visit, your doctor will do routine blood tests or evaluate your blood glucose measurements ("finger prick") between appointments to help monitor your blood glucose levels.  

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Plasma fasting glucose (also called FPG) is the level of blood glucose after at least 8 hours without eating. This test is usually done early in the morning upon waking.

Postprandial plasma glucose (also called postprandial glucose) is the level of blood glucose after a meal. You can tell this value by doing the capillary glycemia ("finger prick") an hour and a half to two hours after the start of the meal.

Hemoglobin A1c (HbA1c) is a measurement that indicates your average blood glucose level over the previous 2 to 3 months.

To help reduce the risk of complications, your doctor will also monitor your blood pressure, your cholesterol level, and your weight.

GET THE MOST OUT OF EVERY MEDICAL APPOINTMENT It is important to be prepared with your daily blood glucose records so that you can review the values with your doctor. Each consultation should be an opportunity to:      

Review how often your blood glucose was higher or lower than the reference value Discuss whether you have taken your medication correctly and whether it is producing the intended effects Get advice on healthy eating Get advice on the proper ways to exercise Talk about how you feel and the challenges you face Ask questions about immunizations (for example, about the flu vaccine) Additionally, write down any questions you may have in advance and make sure you have obtained the necessary clarification for each of the following areas:

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HbA1c analyzes and blood glucose monitoring Blood pressure Cholesterol Complications (eg, kidney damage, heart disease) Nutrition Physical activity Family, friends and feelings Where can you find more information about your diabetes

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TREATING TYPE 2 DIABETES Many people need treatment to help manage their diabetes, and with so many options available, it's important that you feel comfortable and confident about the medications that are prescribed for you.

Along with a healthy lifestyle, diabetes treatment can be an important component in controlling your diabetes.

A wide variety of treatment options are available to help control type 2 diabetes. It is important to know how these different medications help regulate blood sugar levels so that you can discuss with your doctor what the Most appropriate for you.

FINDING THE RIGHT TREATMENT STARTS HERE:

MEDICATION FOR TYPE 2 DIABETES Some people can keep their blood sugar controlled by simply adopting a healthier lifestyle. However, if you need the additional help of diabetes medications, this section will help you understand what treatment options are right for you.

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DIABETES MANAGEMENT OPTIONS The first step in the treatment of type 2 diabetes is often a calorically restricted diet, abstaining from simple sugars, weight loss and increased physical activity. However, these measures are not always sufficient to lower your blood sugar levels to the reference values.

ADVANTAGES OF TREATMENT There are several treatment options available for people with type 2 diabetes. These medicines work differently to lower blood glucose levels. Your doctor will tell you what type of medicine is right for you.

Several treatment options available for the treatment of type 2 diabetes: 

Biguanides: Essentially, reduce the amount of glucose produced by the liver  Inhibitors of DPP-4 and GLP 1: Induce glucose lowering, increasing the amount of insulin produced by the pancreas and reducing the amount of sugar produced in the liver  Insulin: An injectable hormone that replaces the insulin normally produced by the body to help control blood glucose levels  Alpha glucosidase inhibitors: After meals, slow down decomposition and absorption of carbohydrates  Sulfonylureas and meglitinides: directly stimulate the pancreas to release insulin  Glitazones (also known as TZDs or Thiazolidinediones): Essentially help the body to use the insulin and glucose transport to the interior of cells This diagram shows where each of the mentioned medicines acts in the body:

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Adjuvant oral therapy as treatment options mentioned above act differently to lower blood glucose levels, are often prescribed together. If a single medication does not produce the desired effects, your doctor may combine two or more medications to help improve glycemic control.

Weight Gain The weight increase may be a side effect of taking some of the drugs mentioned above. If this is of concern to you, you should discuss the matter with your doctor so that he or she can adjust your medication accordingly. And remember that you do not have to settle for weight gain as part of your diabetes treatment. There are measures that can help to counteract the weight gain

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