Control and Management Plan

Diabetes is a lifelong disorder. Understanding diabetes better and planning your day accordingly can help you lead a healthy and longer life. Hence, in this article, we will learn how to effectively plan a routine, monitor progress and improvise on it.

Get started!

Before we discuss how to effectively control and manage diabetes, let us just develop a quick idea on what to do as we begin our journey on diabetic planning.

  • Always speak to your doctor before starting any diet or exercise plan

  • As a patient, you need to be aware by trying to learn everything about diabetes mellitus from various sources such as newspapers, scientific journals and organisational websites such as CDC and WHO

  • Check your blood glucose regularly; keep a track of your sugar levels in urine samples by getting them monitored

  • Eat healthy food, exercise regularly, manage your weight and avoid smoking

  • Know the complications of diabetes and how to face them in the long run

What next?

Let us now develop an overview of the management plan for diabetes.

Act

  • Get an overall diagnosis done

  • Every year, go for a medical review that includes HbA1c test and complications check after consulting your physician

  • Ensure that your blood glucose and blood pressure levels are under control

Review

  • Monitor and evaluate your progress regularly with your physician

  • Monitor blood sugar levels regularly for spikes or falls

  • Consult your physician and find if any more urine or blood sample tests should be done

How to monitor and check?

Self-management

  • Keep a regular check on your blood glucose levels

  • Get your fasting plasma glucose and 2-hour postprandial glucose tests done

  • Try monitoring these glucose levels at home

  • Measure your body weight regularly

Laboratory tests

  • Get your urine glucose levels measured

  • Get a lipid test done with the advice of your physician

  • Check your injection sites, if you are being treated with insulin

What is self-monitoring of blood glucose used for?

Self-monitoring of blood glucose can be used if

  • You have diabetes and want to keep yourself updated about the sugar levels

  • You use insulin for glucose control

  • You have regular falls in blood sugar levels

  • You are pregnant and have diabetes

Annual check-up

Get an annual check-up done after consulting with your physician. Some of the parameters tested include

  • Lipids

  • Eyes

  • Blood urea nitrogen

  • Urine

  • Electrocardiography

Numbers!

Diabetes control has a lot of numbers involved.

Let us identify the values of tests that you need to see on your reports, as indicated in the table.

Table. Foods with different glycaemic indices

Parameters

Expected Values

Fasting plasma glucose (mg/dL)

80-110

2-hour postprandial glucose (mg/dL)

120-140

Blood pressure (mm Hg)

<130/80

BMI (kg/m2)

20-23

Waist-hip ratio

Men <0.90 
Women <0.85

HbA1c (%)

<7

Total cholesterol (mg/dL)

<180

HDL cholesterol (mg/dL)

>45

LDL cholesterol (mg/dL)

<100

Serum triglyceride (mg/dL)

<150

BMI Body mass index

HbA1c Glycylated haemoglobin

HDL High density Lipoproteins

LDL Low density Lipoproteins

Insulin

  • If you have type 1 diabetes, you need to take 3 to 4 injections per day. Ask your physician on how to match your insulin therapy with your carbohydrate intake

  • To avoid the risk of low sugar levels, ask your doctor for insulin analogues instead of insulin

  • A clinical study has proven that regular insulin therapy improves sugar control and helps to avoid complications; hence, do not panic if your physician prescribes insulin

Diet management and nutrition

  • Adjust your intake of carbohydrate, protein and fat to meet your dietary needs and taste preferences

  • Monitor carbohydrate levels by choosing wisely or counting your intake or on experience

  • Reduce the intake of saturated and trans fats

Exercise

  • Try aerobic exercise for at least 150 min/wk and spread over at least 3 d/wk

  • Try resistance training under supervision at least twice a week if you have type 2 diabetes

  • Regular exercise helps in keeping glucose levels in check, reduces cardiovascular risk, sustains weight loss and improves overall wellness

Weight management

  • Effective weight control and maintenance of body mass index levels help plan an effective drug therapy with control on glucose levels

  • To reduce weight effectively, instead of trying low-calorie diets, you should go for a balanced diet, regular exercise and good lifestyle habits

Avoid smoking!

  • Diabetic patients who smoke are 4 times more susceptible to death from a cardiovascular illness than those who do not

  • Smoking also affects insulin therapy by reducing its absorption

  • Ask your physician if you can use nicotine patches and bupropion to control smoking

Disclaimer

  • Issued in public interest by Novartis

  • “Always consult your doctor for any medical advice”

  • “The information contained here is not to be used for treatment purpose or for diagnosis of health problems or as a substitute to expert medical advice. Please consult your doctor for any health related problems or queries that you may have. Although great care has been taken in computing and checking the information, Novartis is not responsible or liable in any way for any errors, omissions or inaccuracies in or otherwise howsoever for any consequences arising there from"

References

  • Living with the diabetes. 2014. http://www.diabetescareindia.org/lwtd.php. Accessed September 29, 2014.

  • Fox C, MacKinnon M. Vital diabetes. 3rd ed. London: Class Pub; 2005:38-42.

  • Monitoring and follow up of people with diabetes. ICMR Guidelines for Management of Type 2 Diabetes. 2005:9-10.

  • Targets for control of diabetes. ICMR Guidelines for Management of Type 2 Diabetes. 2005:8.

  • Standards of Medical Care in Diabetes--2013. Diabetes Care. 2012;36(Suppl 1):S11-S66. doi:10.2337/dc13-s011.

  • Hillson R. Practical Diabetes Care. 2nd ed. Oxford, UK: Oxford University Press; 2005:28, 31

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