Be a Diabetes Detective

Be a Detective to Manage your Diabetes

Managing your diabetes can often feel like trying to solve a mystery.  Questions that always arise up are:

How does my food effect my blood sugars?

Are my medications working? 

What does physical activity do to my blood sugars?

How come I don’t feel any different even though I am making changes?  

Diabetes is very individualized, so when it comes to figuring out how best to manage it you need to become your own detective.  The best way to do this is through Self-Monitoring your Blood Glucose (SMBG) or checking your own blood sugars!

Collect the Evidence

Checking your own blood sugars or SMBG helps you:

• -         Determine your blood sugars in that exact moment (after a meal, after activity, first thing in the morning).
• -         Determine if your blood sugars are high, low or within target.
• -         Show you in that exact moment what your food, activity and medications are doing for you.
• -         Work with your health care team to help put the puzzle pieces together with any adjustments needed for either lifestyle or medication.

I don’t like to poke my fingers so how often would I need to check?

-          As mentioned before, diabetes is very individualized, so SMBG is also individualized.  How frequent you test is dependent on your medications, your lab results, you current health status: sick, hospitalized, pregnant or even starting a new medication

What do I use to check my blood sugars?

-          You check your blood sugars through use of a portable blood glucose machine.  These devices are available through your community pharmacies or health teams.  Talk to your pharmacist or team members about what meter is right for you and coverage that is available for you

Interpreting the Evidence

Recommended blood glucose (sugar) targets for most people with diabetes*

(Your target may not be the same as the examples in this blood sugar levels chart. Yours should be specific to you.)

	A1C**	Fasting blood glucose/ blood glucose before meals (mmol/L)	Blood glucose two hours after eating (mmol/L)
Target for most people with diabetes	7.0% or less	4.0 to 7.0	5.0 to 10.0 (5.0 – 8.0 if A1C** targets not being met)

* This information is based on the Canadian Diabetes Association 2013 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada and is a guide.
** A1C is a measurement of your average blood glucose (sugar) control for the last two to three months and approximately 50 per cent of the value comes from the last 30 days.

- See more at: http://www.diabetes.ca/diabetes-and-you/healthy-living-resources/blood-glucose-insulin/managing-your-blood-glucose#sthash.JOnq46Ax.dpuf

Putting the Puzzle pieces together

Now that I have tested what do I do with the information?

-     Record your blood sugar readings in a log book or journal. This is a great way to start seeing trends and patterns.  Depending on how in-depth you want to go you can record your food, activity, medications and your blood sugar readings to get the whole picture.

-     

      Take this log book with you to your medical appointments to be able to discuss the best management options for you when it comes to managing your diabetes.

-     Look at the information you have collected. You can interpret the readings to determine whether or not it’s the food, activity or medications that needs to be reviewed.

Click on the links to see the samples of how to log your blood glucose readings:

Self-Monitoring Blood Glucose Tool

Weely Blood Glucose Log sheet (printable)

Solve the Mystery!

The more you know about diabetes and how it affects your body the better able you are to start managing it! 

If you are newly diagnosed or have question about help to manage your diabetes please ask your PCN doctor for a referral to the SMILE team, where a team of detectives can also help you out!

Please visit the CDA website for more information.

Andrea Shackel is a Registered Dietitian and Certified Diabetes Educator at the Leduc Beaumont Devon Primary Care Network.  

World Diabetes Day

World Diabetes Day is celebrated every year on November 14. It is a global event that unites millions of people around the world to raise awareness of diabetes. Blue is the colour of the diabetes circle and the global symbol of diabetes.

To recognize this important day in Edmonton, the High Level Bridge will be lit up in blue on Friday, November 14. The Canadian Diabetes Association invites everyone to join them to see the spectacular bridge lit up!

If you wish to participate, meet at the front of the Alberta Legislature Building at 6:30 PM on Friday, November 14. We will then walk the bridge together as we connect with others and reflect on the importance of recognizing World Diabetes Day.

Light refreshments will be served; please dress for the weather as the temperature is predicted to be around -16C during that time.

Diabetes and foot care

Foot Care is an essential component to your diabetes management.  Diabetes affects the circulation of your body and its immune system, which impairs the body’s ability to heal wounds. As well, over time the excess blood sugar can cause damage to the nerves in the feet, which is known as “neuropathy”. As a result of neuropathy, people are less likely to feel an injury, such as a cut or blister. If this goes unnoticed, it could become infected and lead to serious complications such as gangrene, loss of a limb, or Charcot foot, plus others. 

What can you do to reduce complications from neuropathy?  Start by visually inspecting your feet daily, including the bottom and in between your toes. Use a mirror if you have to.  Check to make sure there is no cuts, cracks, ingrown toenails, blisters, etc. Wash your feet in warm (not hot) water, using a mild soap.  Don’t soak your feet as that could cause dryness. Dry your feet carefully, especially between your toes.   If there are cuts, cracks, etc., cover them with a dry dressing suitable for sensitive skin.  Trim your toenails straight across and file and sharp edges. Don’t cut them too short.  Put unperfumed lotion on your heels and soles, and thoroughly rub it in. Do not put lotion in between your toes as this excess moisture will may promote infection. While putting on lotion, notice the temperature of your feet, it should be warm, not cold or hot. Exercise regularly to improve circulation. Wear proper footwear that is supportive and do not rub or pinch. 

If you do have neuropathy, follow the above instructions but also wear white socks instead of black or dark brown. White socks allow you to see if there is any discharge from a crack or cut. Do not put a heater or hot water bottle on your feet as you may not feel any pain it may be causing. 

It’s best for everyone to have their feet checked by a healthcare professional yearly, if not more often.  However, if you have any swelling, warmth, redness, numbness, tingling or pain in your legs or feet, contact your healthcare professional right away.  

Cherie deBoer is a Registered Nurse at the Leduc Beaumont Devon Primary Care Network.

For more information on when to see your Doctor, click this link: http://www.diabetes.ca/diabetes-and-you/healthy-living-resources/foot-care/signs-of-foot-problems

References:

Foot Care: a step toward good health. (2009). Canadian Diabetes Association. 

Family Doctor Week

November 10 - 15 marks the College of Family Physicians of Canada’s 10th Annual Family Doctor Week.

The College of Family Physicians of Canada proudly acknowledges the outstanding contributions of Canadian family doctors for their dedication to their patients and the delivery of high-quality health care.

Family Doctor Week in Canada will be celebrated during the week of the annual Family Medicine Forum from November 13 to 15 in Quebec City, QC.  

Watch the the Family Doctor Week video, here.

November is Diabetes Awareness Month - Exercise

Diabetes and the Effectiveness of Regular Physical Activity 

The short-term benefits of increasing physical activity for a person with diabetes:

• Lowers your blood glucose within one hour.
• Increases your energy and strength during the day
• Decreases stress, anxiety and fatigue
• Improves relaxation and sleep
• Improves overall well being  

The long-term benefits if activity is sustained:

• Improved blood glucose (sugar) control.
• Helps to maintain or lose weight.
• Lowered blood pressure.
• Stronger bones and muscles.
• Lower risk of diabetes complications such as eye, heart, and kidney disease.
• Improved quality of life.

One of the most effective aerobic activities with the lowest dropout rate is walking.  It can be as simple as going for a brisk walk in your neighborhood.  Click here for an example of a walking plan if you are just starting out. Feel free to print it for your own use or share it with others.  

Both aerobic and resistance exercises are important when it comes to decreasing the risk of developing or advancing Type 2 Diabetes as both help to improve the bodies insulin sensitivity.      

The following facts were taken from the Canadian Diabetes Association website:

• Low physical fitness is as strong a risk factor for mortality as smoking.
• Fitness level is one of the strongest predictors of all-cause mortality in people with diabetes.
• Physical activity can be as powerful as glucose-lowering medication… with fewer side effects.
• Regular physical activity, in conjunction with healthy eating and weight control, can reduce type 2 diabetes incidence by 60 per cent.

If you require help with getting started on an exercise or activity plan, ask your PCN family doctor for a referral to the Exercise Specialist on the SMILE team.      

Corinne Cutler is an Exercise Specialist at the Leduc Beaumont Devon Primary Care Network.                                                                                                                                                                                                                                                                                                                                                                

Diabetes Educator Day

Happy Diabetes Educator Day!

On November 5^th,2014 the Canadian Diabetes Association will recognize this date as the first annual Diabetes Educator Day.

A Certified Diabetes Educator is a health professional committed to excellence in diabetes education who has expertise knowledge in providing guidance and assistance for day to day management for people living with diabetes.  A Diabetes Educator has a sound knowledge base in diabetes care/management and education processes, as well as good communication skills and who has passed the Canadian Diabetes Educator's Certification Board (CDECB) exam.

Many health care professionals take on the role of being a CDE including pharmacists, dietitians and nurses making them an essential part of the health care team. Whether they are working directly with patients or advising health-care providers, diabetes educators play an integral role in the education, care and support of those with diabetes. Their specialized training makes them an invaluable resource.

The SMILE Healthcare Team at the Leduc Beaumont Devon Primary Care Network (LBD PCN) is proud to have three Certified Diabetes Educators on staff:

Nandini Desai, Pharmacist and Certified Diabetes Educator, has worked at the LBD PCN for nearly 6 years. Her specialties include diabetes management including insulin start, optimizing insulin management and smoking cessation. She attends the Canadian Diabetes Association annual conference on a regular basis as well as takes part in many learning opportunities with diabetes specialists. 

Andrea Shackel is a Registered Dietitian and Certified Diabetes Educator with the LBD PCN.  She has been working in the field of Chronic Disease Management with the SMILE team at the PCN for 6 years. 

Andrea received her Bachelor of Sciences in Human Nutritional Sciences from the University of Manitoba.  Her specialties of interest are obesity, diabetes and heart disease and emotional eating. Andrea is dedicated to educating patients about the health benefits of proper nutrition as well as identifying the many reasons “why” we eat which will help people become more mindful eaters.  She helps patients implement evidence-based nutrition recommendations to help manage their blood sugars, cholesterol, blood pressure and weight.

Sally Ho is a Registered Dietitian and Certified Diabetes Educator with the LBD PCN.  She joined our S.M.I.L.E. Healthcare Program (Self Manage to Improve Life Everyday) team last year, coming to us from the South Calgary Primary Care Network, where she worked in a similar setting.  Sally also works with our PCN patients in the Leduc Cardiac Rehabilitation Program, providing nutrition support to patients managing chronic disease such as hypertension, dyslipidemia, diabetes, obesity and nutrition concerns. She facilitates several education classes at the PCN, including the Weight Wise workshops Craving Changes workshops, and the Cardiac Rehabilitation’s nutrition classes.

If you are newly diagnosed, have had diabetes for a long time or having any difficulties with your diabetes management, please ask your LBD PCN family physician for a referral to the SMILE team.

Senior's Falls Prevention Month - Virtual Trek Across Alberta

This November’s Seniors’ Falls Prevention month focuses on the ‘Keep Active’ message. In partnership with UWALK, Finding Balance is hosting a virtual TREK across Alberta. Seniors across the province can join the TREK challenge by counting and recording the number of steps they take from November 1 to 30. The virtual TREK challenge begins in Coutts, Alberta and finishes in Fitzgerald, Alberta. The goal is 3,263,500 steps.

Let's take steps together to prevent falls.

You can pick up your free Finding Balance pedometer and passport (while supplies last) at the Leduc Beaumont Devon Primary Care Network office.The passport provides information on how to join, count steps, convert minutes of other activities like biking or shoveling into steps and where to log all steps. Group leaders can log steps for their group or individuals can log their own steps.

#301, 4710 - 50 Street, Leduc AB.

www.lbdpcn.com

For more information on Finding Balance and preventing falls, please visit:

http://www.findingbalancealberta.ca

National Senior Safety Week

National Senior Safety Week

November 6-12, 2014

As the Canadian population ages, injury and death from falls are on the rise. This National Senior Safety Week, November 6 to 12, the Canada Safety Council challenges all Canadians to commit to “take five to prevent falls.” With these easy steps, we can all reduce the likelihood and severity of a fall:

1. Using this infographic, check your home for tripping and slipping hazards. Click the picture to view it larger.

2. Include calcium and vitamin D in your diet with milk and nuts. Check out the Osteoporosis of Canada Calcium Calculator to find out if you’re getting enough. Osteoporosis and weakening bones increase your chances falls and fractures.

3. Check your medications. If you are on more than three medications a day, or take pills that could impair your balance such as sleeping pills, anti-depressants or blood pressure medications, have a discussion with your doctor about how to best reduce your chance of falling. 

4. Get your eyes checked. Even if you’re not experiencing symptoms, the Doctors of Optometry of Canada recommend that you have your vision checked at least once a year if you are over the age of 65, or every two years if you’re younger. Vision impairments are a leading cause of falls.

5. Exercise to keep strong.  Try a gentle strength-building exercise like yoga or Tai Chi to work your core balance and reduce the risk of falling.

We can all take steps to protect ourselves and our loved ones from preventable falls. Check the Canadian Safety Council website for more activities and resources on falls prevention during National Senior Safety Week, November 6 to 12. 

Also visit the Finding Balance website for tips on falls prevention, use their falls risk calculator and join the Virtual Trek Across Canada. You can pick up a Virtual Trek passport and pedometer for free at the Leduc Beaumont Devon Primary Care Network office.