A TeachingResourceGuide

Diabetes: What it is and why it happens

• Diabetes is a condition that causes sugar levels in your blood to be high

• When you have diabetes:• Your pancreas does not make insulin, or• It does not make enough insulin, or• Your body prevents the insulin you do make from working right• As a result, sugar can’t get into your cells, so it stays in your

blood• That’s why your blood sugar

gets too high

Taking care of your diabetes

• Diabetes can cause problems. But diabetes-related problems don’t have to happen

• Millions of people live long, full lives with diabetes

• You can be one of them

• Taking care of yourself and managing your blood sugar is the key

Your diabetes care: it’s a team effort

• You are not alone when it comes to managing your diabetes• You may have a team of healthcare professionals working

with you• You may also have family members or friends for help and

support• But the most important member of the team is you• As the captain of your team, you need to:

• Learn as much as you can about diabetes in general• Know as much as possible

about your diabetes and your health

Your diabetes care plan should include:

• A meal plan• A physical activity plan• A plan for how often you should check

your blood sugar• Your personal blood sugar goals• When to take your diabetes medicines• A schedule for regular checkups• Other health goals

“The key to diabetes management is getting educated about diabetes and realizing that this disease is controllable.”

–Karen R., South Carolina

Diabetes care schedule

• Daily:• Check blood sugar as recommended

by your diabetes care team • Every 3 months:

• Regular office visit• A1C test (if blood sugar is

not stable)• Blood pressure check• Weight check• Foot check

• Every 6 months:• A1C test (if blood

sugar is stable)• Dental exam

Diabetes care schedule

• Every year:• Physical exam• Comprehensive foot exam• Blood fats and cholesterol

tests (more often if not at goal)• Kidney tests• Dilated eye exam• Flu shot

“I’ve learned to be proactive in my own care and to educate myself. It is never too late and might just give you more years to enjoy with life.”

–Cheryl K., Maryland

Checking your blood sugar

• Why:• Checking your blood sugar yourself

is often the best way to be sure your diabetes is under control. It tells you:

• If your insulin or other diabetes medicine is working

• How physical activity and the foods you eat affect your blood sugar

• Based on your care plan, you may want to test when:

• You wake up• Before meals or large snacks• 1 or 2 hours after meals or large snacks• Before and 15 minutes after physical activity

Keeping a blood sugar diary

Target blood sugar levels for people with diabetes

Goals for People With Diabetes

A1C Less than 7%

Before meals 70 – 130 mg/dL

2 hours after meals Less than 180 mg/dL

Adapted from the American Diabetes Association. Standards of medical care in diabetes—2009. Diabetes Care. 2009;32(suppl 1):S13-S61.

Insulin: a medical breakthrough

• People with type 1 diabetes must take insulin to control blood sugar

• People with type 2 diabetes who take insulin may find that they have more flexible eating and activity schedules

What are the different types of insulin?

• Rapid-acting:• Controls blood sugar surges

at mealtime

• Long-acting:• Controls blood sugar between

meals and during sleep

• Premixed:• Combines rapid-acting and intermediate-acting insulin• Controls blood sugar at mealtime and all day and night

What is an insulin plan?

• Your plan will help you take insulin the way your body would make it if you did not have diabetes

• Your plan tells you:• What type of insulin to take• How much insulin to take• When to take insulin

• Your plan is based on:• When and how much you eat• Your current blood sugar level• Your level of physical activity• Your lifestyle

Injecting insulin

• How:• Insulin pen• Syringe filled from a bottle of insulin• Insulin pump

• Where:• Abdomen • Thighs• Backs of the upper arms

“With the insulin pen, it’s as easy as 1, 2, 3…The pen technique has brought me more freedom to take care of my diabetes.”

–Mayra A., New Jersey

Storing insulin

• Follow the instructions on the insulin label• Keep unopened insulin containers in

the refrigerator• It’s usually okay to store insulin at

room temperature once it’s been opened, but check the label to make sure

• Don’t let insulin become too hot or too cold• Keep insulin out of bright light and sunlight• Do not use insulin after the expiration date on the label

Getting rid of used diabetes supplies

• Use needles and syringes only once. Then throw them away in a safe container

• Find out if your state has laws about how to dispose of used diabetes supplies

• Unless your state says otherwise, get a “sharps” container at your local pharmacy

• Ask your diabetes care team how to get rid of the container after it’s full

3 steps to starting your activity program

• Talk with your doctor before you start• Choose your activity:

• Walking • Jogging• Bicycling• Swimming • Dancing

• Set a goal:• At least 30 minutes,

at least 5 days a week

Planning healthy meals

• For teenagers and adults, a day’s worth of healthy meals includes at least:

• 2-3 servings of nonstarchy vegetables• 2 servings of fruits• 6 servings of grains, beans, or starchy vegetables• 2 servings of low-fat or fat-free milk• About 6 oz of meat or meat substitutes

Carb counting and diabetes

• Carbs raise blood sugar more than other nutrients• Carb counting can help you:

• Manage your blood sugar• Be flexible in your choice of foods and mealtimes• Eat more foods that you enjoy

• The only foods that generally don’t contain carbs are:• Meats and meat substitutes, such as eggs and cheese• Fats and oils

How many carbs are in your favorite foods?

Using exchange lists for meal planning

• Each list has foods that have about the same amount of carbs, calories, protein, and fat

• The lists come in these groups:• Starch• Fruits• Milk• Sweets, desserts, and other carbohydrates• Nonstarchy vegetables• Meat and meat substitutes• Fats

“There will be a cure one day; until that time, diligence in watching your diet and testing your blood sugar will play a huge part in combating the disease.”

–Russell S., Illinois

Portion sizes count

• It’s important to eat not only the right types of foods, but also the right amounts

• Weigh and measure your foods when you first start carb counting and once in a while after that

• Use your hand to estimate portion sizes:• Your fist = 1 cup• Your palm = 3 ounces• Your thumb = 2 tablespoons or 1 ounce• Your thumb tip = 1 teaspoon• A handful = 2 ounces (¼ cup) of a

snack food

Short-term diabetes problems: managing low blood sugar

• Recognize the symptoms:• Weakness, tiredness• Hunger• Dizziness or shakiness• Nervousness, sweating• Fast heartbeat• Blurry vision

• Eat or drink something high in sugar right away, such as:

• 4 oz of regular fruit juice or soda pop• 3 to 4 glucose (sugar) tablets• 3 to 5 hard candies that you can chew quickly

Short-term diabetes problems: managing high blood sugar

• If your blood sugar is too high, you may:• Feel very thirsty or hungry• Need to pass urine more than usual• Feel like your mouth and skin are dry• Have blurry vision• Feel sleepy

• Manage high blood sugar by:• Checking your blood sugar• Following your meal plan• Doing some exercise (follow your plan)• Taking your medicine as prescribed

Diabetes care plan checkup

• Make sure you know:• When and how to take your insulin or diabetes medicine• When and how to check your blood sugar and what the

numbers mean• Your target blood sugar goals

(before meals, after meals, and A1C)

• What you can do if your blood sugars are out of goal range

• How to follow your meal and exercise plans

• When and how to call your diabetes care team

Long-term diabetes problems

•Over time, high blood sugar can cause problems with your:

• Heart and blood vessels• Kidneys• Teeth and gums• Feet• Eyes• Nerves• Skin

To help prevent these problems, keep your blood sugar as close to normal as possible. That means following your diabetes care plan.

Coping with changes in your diabetes care plan

• Don’t blame yourself• Learn as much as you can• Think about joining a diabetes

support group• Focus on the positive parts of

the change

“Don’t give up. It’s your life we are talking about and your body, and you can be in control…Decide you will do what it takes.”

– Sally W., Washington

Time to take charge!

• You are not alone• Diabetes cannot be cured,

but it can be managed• You can live a full and active

life with diabetes:• Learn as much as you can• Work with your team• Get support to

stay strong!

For more information, visit the Changing Life With Diabetes Tip Line at 1-800-260-3730 or visit us online at ChangingDiabetes-us.com.

For more information about Novo Nordisk products for diabetes care call 1-800-727-6500.

The photographs used in the booklets are for illustration only. The models in the photographs do not necessarily have diabetes or other ailments or use or endorse any products mentioned.

©2009 Novo Nordisk Inc. 137521 February 2009 ChangingDiabetes-us.com