Just because you have diabetes, it doesn’t mean you can’t enjoy an active and fulfilling life. An essential part of controlling diabetes is getting your blood sugar under control. You can live a healthy life with fewer complications by staying in control of your blood sugar.
Some of the key elements of diabetes management include:
A healthcare team is a group of people who will help you learn about diabetes and how to take good care of yourself. The team needs to tell you how things are working and be there for you when you need help, advice and encouragement. If there is not already a team in place for you, you can build one for yourself.
Remember the most important member of the team is you. Your team members can give you all their advice, tools, and recommendations, but is up to you to follow them.
It is up to you to decide whom you want and need on your team. Look for healthcare team members at your local hospital, diabetes clinic or call the Canadian Diabetes Association (1-800-BANTING) for information. Remember, friends and family are also important team members – you don’t have to look very far to find people who are willing to help.
Your team might include:
A CERTIFIED DIABETES EDUCATOR
A Certified Diabetes Educator is a healthcare professional who can teach you about the day-to-day care of your diabetes, including:
It is a good idea to learn all you can and keep up-to-date because therapy for diabetes is improving all the time. You can ask your diabetes educator about classes you can take.
An expert in food and nutrition, a dietitian can help you understand the relationship between what you eat and how it affects blood glucose. He or she can help you develop a meal plan that works for you. Your dietitian will also teach you how to:
It is a good idea to see a dietitian every couple of years, whenever there is a change in your lifestyle, or when you have problems or questions.
PHYSICIAN / NURSE PRACTITIONER
Everyone with diabetes should have a family physician or nurse practitioner they see on a regular basis. Some people may also need to see experts in diabetes, like endocrinologists. Your family physician will refer you to any specialist you might need.
Your physician or nurse practitioner will talk to you about:
An expert in drugs and how they affect your body, a pharmacist can teach you about:
PODIATRIST / CHIROPODIST
Trained to take care of foot and lower-leg problems, your foot doctor (called a podiatrist or chiropodist) is the best person to treat any of your foot problems. The podiatrist or chiropodist will help you learn about:
Sometimes you just need to talk to someone who understands. Ask your healthcare team about local diabetes support groups.
YOUR FAMILY AND FRIENDS
Anyone who helps support you is part of your team. Let these people help you take good care of yourself. It is a good idea to have a family member or close friend attend diabetes education classes with you. This will not only give you a second set of eyes and ears, but you will have someone to help you who understands how hard diabetes management can be.
You will likely see your family and friends every day. They can give you lots of support and help you take care of yourself in many ways. You will visit the pharmacy often, and you can ask the pharmacist your questions while you are there. You will likely need an appointment to see the other members of your team.
A team approach is key to taking control of your diabetes. How often you see your physician will depend on your health and your treatment plan. With type 2 diabetes, at least 4 diabetes specific visits a year are recommended, or more if you are having problems or making changes in your treatment plan.
Here is a list of some of the most important items that you and your healthcare team should monitor, including how often they should be checked and the targets most people with diabetes should aim for. Note: these may not be your targets. It is important to work with your healthcare team to set your personal goals.
Use the chart below to keep track of your monitoring milestones and targets.
Diabetes care checklist
|Item||How often it should be checked with a healthcare professional||Target for MOST people with diabetes*||YOUR target|
|Self-monitoring of blood glucose (SMBG):
Before meals and
|Daily self-monitoring, then check in with a healthcare professional 4 times per year†||4.0-7.0 mmol/L,
5.0-10.0 mmol/L, or
|Check your meter against lab results||4 times per year†||Results should be within 15% of each other|
|Physical activity||4 times per year†||Aerobic activity: 150 minutes per week
Resistance training: 2-3 times per week
|Weight||4 times per year†||Targets vary|
|Conversation about nutrition, smoking, mood, stress, anxiety, and sexual function/pre-conception planning||4 times per year†||Targets vary|
|Assessment of risk for heart attack and stroke||4 times per year†||Targets vary|
|Review of all medications and supplements you are taking||4 times per year†||N/A|
|Foot exam||4 times per year†||Targets vary|
|Eye exam||Annually by an eye doctor||Targets vary|
|Body mass index (BMI)||4 times per year†||Most adults between 18 and 64 years of age: 18.5- 24.9|
|Waist circumference (WC)||4 times per year†||Men: <40 inches
women: <35 inches
|Blood pressure (BP)||4 times per year†||<130/80 mmHg|
|A1C lab test (every 3 months)||Every 3 months||≤7.0%|
|Low-density lipoprotein (LDL) cholesterol (“bad” cholesterol)||Every 1 to 3 years, and after a change in cholesterol treatment||≤2.0 mmol/L|
|Urine protein (albumin / creatinine ratio [ACR])||Annually||2.0|
|Kidney function (estimated glomerular filtration rate [eGFR])||Annually‡||≤7.0%|
* These are general guidelines only. Please work with your healthcare team to create your personal goals.
† It is generally recommended that you visit your primary healthcare professional at least 4 times per year specifically for diabetes care and concerns.
‡ If you have kidney disease, you may need this test done more often.
CONTOUR®NEXT meters go above the industry standard by providing blood glucose readings that are within ±10%¶ of the lab reading. This means that the reading you get from CONTOUR®NEXT meters will be closer to the lab results.
Careful meal planning is an important part of diabetes management. Your healthcare team will help you put together a meal plan just for you that will include a variety of foods from all four groups of the Eating Well with Canada's Food Guide. The plan will also include recommendations for portion sizes and suggest how frequently you should be eating to maintain blood sugar control.
Eating at regular times helps control blood sugar levels.
The more sugar you eat, the higher your blood sugar will be.
Carbohydrates (“carbs”) raise blood sugar quickly. The amount, timing and type of carbohydrate consumed will all have an effect on overall blood glucose control.
High-fat foods may cause you to gain weight. A healthy weight helps with blood glucose (sugar) control and is healthier for your heart.
Foods high in fibre may help you feel full and may lower blood glucose and cholesterol levels.
Drinking regular pop and fruit juice will raise your blood glucose
Carbohydrates are an important source of energy. However, because your body breaks down carbohydrates into glucose, carbohydrates also raise overall blood glucose levels. Therefore, it is particularly important for people with diabetes to monitor carbohydrate consumption and the effect that it has on your blood sugar levels. This can be done by testing blood sugar regularly with your CONTOUR® meter. Some meters even allow for carb logging for a more complete picture and control. For example, the CONTOUR®NEXT USB lets you enter carbohydrate and insulin information in addition to testing and logging blood glucose. It also allows you to review your logbook and trends on your meter or download results to your computer so you can share them with your healthcare professional.
Carb counting is a system of meal planning that focuses on the total amount of carbohydrates eaten at each meal and snack. Carb counting helps maintain consistent amounts of blood sugar while giving you flexibility in the carbohydrate foods you can choose.
The amount of carbohydrates you should eat throughout the day varies for each person. Your dietitian can help you decide how much total carbohydrate you need and when you should eat it.
In general, high carbohydrate foods include:
It’s a good idea to have a few high-sugar items on hand for quick sugar boosts when your blood glucose gets too low. Juice, regular pop, candies and glucose tablets are some examples. While they shouldn’t be part of your regular diet, these can be helpful when you are experiencing symptoms of hypoglycemia.
Lower carbohydrate foods include:
A balanced diet will include both high- and low-carb foods.
The Glycemic Index (GI) is a scale that ranks carbohydrate-rich foods based on how quickly they raise blood glucose compared to a standard food (the “standard food” used is glucose or white bread). This method of monitoring carbs is different from simple carb counting in that it focuses on the type of carb rather than the overall amount of carb. Eating foods with a low GI (e.g., 100% stone ground whole wheat, barley or oat bran) may benefit people with diabetes. The slow digestion and slow absorption of these foods can cause a more gradual rise in blood sugar. The GI values of foods are based on many factors, including the food form, food processing and cooking methods. Consult a registered dietitian to help you incorporate low-GI foods into your meal plan.
If you know how different foods affect your blood glucose, you can make diet changes to better manage your blood glucose levels. Keep a food record of what you eat, how much you eat, the carbohydrate amount (or GI value) and your blood glucose level, and it will help you learn about the effect different foods have on you. If you are a ContourCare member and have registered your CONTOUR® meter, download GLUCOFACTS®DELUXE to help you track your carbs and insulin, and monitor blood sugar trends.
Not a ContourCare member? Join today!
The Nutrition Facts label found on packaged foods in Canada contains valuable information that can help you make wise food choices. Below is a label found on a package of gingerbread cookies.
Being physically active is one of the most important things you can do to help manage your diabetes and improve your health. Both aerobic and resistance activity are important for people with diabetes. Always talk to your physician before you begin any exercise program.
Aerobic exercise is anything that increases breathing and heart rate. This includes activities like walking, running, swimming, and biking for example. The Canadian Diabetes Association (CDA) recommends getting 150 minutes of aerobic activity each week. Taking a brisk 20-minute walk at lunch every day, walking the dog for 20 minutes at night, or joining friends 3 times per week for an hour of cardio classes are all examples of ways you might meet this weekly goal.
Resistance exercise is brief repetitive exercise to build muscle strength. This includes activities such as weights, weight machines, and resistance bands. The CDA recommends three sessions of resistance activity each week.
There are many benefits to making physical activity a regular part of your diabetes management plan. Regular physical activity helps:
It is important that you check your blood glucose before, during and after exercise to see how exercise affects your blood glucose levels, particularly if you are starting a new activity or have recently made changes to your medication or insulin. Accurate blood glucose readings are important, as they can help you make better decisions with respect to food, activity and changes in treatment.
Physical activity is important, but it shouldn’t come at the cost of safety. Talk to your physician before you start any activity that’s more strenuous than a brisk walk. Remember, depending on how active you are and how much carbohydrates you have consumed, hypoglycemia (low blood sugar) might also be a risk. It’s a good idea to carry some form of fast-acting carbohydrate with you (e.g., glucose tablet, hard candy) when you are exercising in case you need to treat hypoglycemia. More information on the signs and symptoms of hypoglycemia and how to treat it.
Your healthcare team will create a diabetes treatment plan for you that may include lifestyle modifications or medication – or both.
In general, treatment may look something like this:
Type 1 diabetes:
Type 2 diabetes:
Together, you and your physician can put together a customized treatment plan to suit your specific needs.
If you require medication to help control your diabetes, testing your blood sugar becomes even more important. You will need to have accurate blood glucose test results to know exactly how much medication you should be taking and when. CONTOUR®NEXT meters provide test results that go beyond industry standards, bringing you closer to lab results, helping you make the right decisions when they matter most. Learn more about CONTOUR® meters.
There are many things to consider when it comes to choosing a meter: comfort, style, ease of use, level of accuracy, etc. Many people with diabetes don’t know that Canadian industry standards have an acceptable error range of ±15%* between the meter reading and the lab reading on the same blood sample.† This means that your blood glucose meter reading could actually be 15% higher or 15% lower than the true value of the glucose in your blood.
CONTOUR®NEXT meters go above the industry standard by providing blood glucose readings that are within ±10%† of the lab reading. This means that the reading you get from CONTOUR®NEXT meters will be closer to the lab results. This is important because accurate readings can help you make the right decisions when they matter most.
* Current regulation based on Health Canada recognized ISO 15197:2013 standard requires results within ±15% range, specifically: ≥95% of results must fall within ±0.83 mmol/L for blood glucose concentrations.
Sometimes people with diabetes will need to take one or more medication(s) to help control their blood sugar. Your healthcare team will help you decide which medications are right for you, should you require any.
Oral medications are those that are taken by mouth. For people with type 2 diabetes who are unable to manage their blood glucose levels through diet and exercise, oral medications are usually the first type of therapy prescribed. There are many kinds of oral medications available and they all work differently. Your physician will determine which type or types are best for you.
When oral medications aren’t enough to help control blood glucose, insulin is often prescribed. You may need only one or you may need different types, either mixed together in a syringe or pen, or given as two separate injections. You and your physician will decide on an insulin plan that’s right for you.
You will need to keep in mind how your insulin works. Some types of insulin act quickly, some work over longer periods of time. Timing meals and injections properly and testing your blood glucose regularly are important when you are taking insulin. You may need to adjust your dose, your next meal, or your physical activity schedule depending on what your blood glucose reading is.
While insulin is most commonly given by injection with a pen or syringe, it may also be delivered by an insulin pump. Insulin pumps provide insulin 24 hours a day through a catheter placed under the skin and a pump (about the size of a pager) worn outside the body. When you eat or when you need to treat high blood glucose levels, you use buttons on the pump to give additional insulin. Insulin pumps are becoming more common, particularly among people with type 1 diabetes who would otherwise have to take multiple injections of insulin per day.
Accurate blood glucose readings are important in helping you decide when and how much insulin should be delivered by your pump. CONTOUR®NEXT LINK meter is designed to work with your Medtronic pump to deliver accurate blood glucose readings when they matter most. CONTOUR®NEXT LINK wirelessly sends blood glucose results directly to the Bolus Wizard™ calculator on your Medtronic MiniMed pump‡ to help save you time and effort. This eliminates the need to manually enter your blood glucose result into your insulin pump. Learn more about how your Medtronic pump and CONTOUR®NEXT LINK meter can work together.
‡ Compatible with Medtronic MiniMed® Paradigm® pump models: MMT-554, MMT-754, MMT-522 and MMT-722.
Diet, exercise, and medication are all important to help you better manage diabetes. But there are other things you should be doing every day – things you might not think about – that can also help you better manage your condition.
Your teeth, skin and feet need special attention every day. Caring for them properly plays a big part in helping prevent diabetes complications.
Good oral care is important to help prevent gum disease. This includes:
You can do several things to help prevent skin problems:
Proper foot care is important, particularly if you have nerve damage. Here are some tips to help you:
Check your feet daily
Keep feet clean and moisturized
Choose proper footwear
As a person with diabetes, you know how important it is to take good care of yourself. It may be harder to do when you're sick, but that's precisely when you need to pay special attention to nutrition, medication and testing your blood and urine.
Whether it's a sore throat, the flu or surgery, illness puts your body under extra stress. To help fight illness, your body releases hormones that cause your liver to release glucose. As a result, your blood glucose rises, sometimes to dangerously high levels. This can lead to Diabetic Ketoacidosis (DKA) or Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS) in people with type 2 diabetes, especially seniors.
Avoid a risky situation by making a sick-day plan and talking about it with your physician before you become ill. Your plan should cover eating and drinking, taking medication and testing both blood glucose and ketones.
Continue testing your blood and urine as long as:
If your ketones are moderate to high, contact your physician or diabetes educator right away.
Drinking enough fluids is extremely important, since dehydration can make your illness worse. You are at risk of becoming dehydrated if you are:
Your choice of liquids should be guided by your blood glucose. If your blood glucose is over 14 mmol/L, drink calorie-free liquids, such as:
If you have low blood glucose, drink:
You may not be able to eat according to your usual meal plan while you're ill, but it's important to eat carbohydrates regularly to keep your blood glucose from getting too low. If you are unable to eat solid foods, you should try to consume 10-15 g of carbohydrates in liquid form every hour.
When to call your healthcare professional
Call your healthcare professional when:
Create a special emergency kit that contains the items listed below. Keep it somewhere handy and out of the reach of children and pets. Make a note of any expiry dates on your household calendar so you can replace items when they become outdated.
When you are ill, tell a family member or friend, so that someone can check on you every four to six hours.
When you have diabetes, you probably visit the pharmacy often. Take advantage of all your pharmacy has to offer. It’s more than just medicine!
NONPRESCRIPTION (OVER-THE-COUNTER) MEDICATION
Nonprescription medicines are those that can be purchased off the shelf or over-the-counter. Check with your pharmacist before you buy any nonprescription medication as many can affect blood glucose.
Your pharmacist will ask about:
When you first start to take a nonprescription medicine, it is a good idea to check your blood glucose to see if the medicine affects your blood glucose levels.
HOW CAN NONPRESCRIPTION MEDICINES AFFECT BLOOD GLUCOSE?
Some nonprescription medicines contain alcohol. Different people react differently to alcohol and alcohol can interact with other medications you may be taking. Alcohol also raises blood sugar. Products containing alcohol should be used with caution – and perhaps not at all if your pharmacist advises against it.
Many over-the-counter products are made with sugar, so it’s a good idea to ask the pharmacist for sugar-free products. These are better choices because sugar can raise your blood glucose.
Remember that just being sick can cause a rise in blood glucose, so test more often when you're sick and follow your sick-day plan, and use your CONTOUR®NEXT meter to test your blood glucose.
HOW DO YOU CHOOSE NONPRESCRIPTION MEDICINES?
Here are some tips to help you choose products that might be right for you. Ask your pharmacist to be sure:
OTHER USEFUL PRODUCTS YOU CAN FIND AT YOUR PHARMACY
Your pharmacy carries many other products made specifically for people with diabetes. Many larger pharmacies have entire sections devoted to diabetes care. Ask your pharmacist if you need help locating a product. Here are some products you might find useful:
Your pharmacist is an important member of your healthcare team. Make a point of talking to them regularly about your diabetes care plan.
CONTOUR®NEXT meter meets ±10% accuracy vs. laboratory method, specifically: 98.1% of results within ±10% for blood glucose concentrations ≥5.55 mmol/L, and 99.4% of results within ±0.56 mmol/L accuracy vs. laboratory method for blood glucose concentrations <5.55 mmol/L.