Diabetes can occur in patients of any age. Dealing with the diagnosis is manageable and does not have to be an overwhelming experience. As a diabetic, you will be faced with many challenges. Learning to manage your diabetes in situations such as illness, stress, exercise, and travel, as well as developing good eating habits, will help you live your life to the fullest.

Sick Days

When you have diabetes, being ill frequently means more than just a runny nose and sneezing. An illness such as a cold or the flu, or any gastrointestinal condition that results in nausea, vomiting, or diarrhea, may cause your blood glucose to increase. Here are some guidelines that you can follow when you are ill:

• Check your blood glucose levels every four hours.
• Make sure to test your urine for ketones. Ketones are released when your body burns stored fat for energy.
• Check your temperature on a regular basis.
• Drink plenty of liquids. Try to drink one cup of liquid every hour while you are awake. If you are unable to keep liquids down, call your physician to see if medical attention is necessary.
• Do not stop taking your insulin, even if you are unable to eat solid foods. You may need to eat or drink something with sugar to keep your blood glucose from dropping. Consult with your physician if you are unsure what to do.
• Be sure to eat at your regularly-scheduled meal times, consume the same number of carbohydrates at each meal, and snack as you would on a normal day.

Know when to contact your physician:

• Your blood glucose level is higher than 300 mg/dL
• Your blood glucose level is higher than 240 mg/dL for more than 24 hours
• Your urine ketone level is moderate to high
• Moderate equals 30 to 40 mg/dL
• High equals 80 or above mg/dL

• You feel sleepier than usual
• You’re unable to keep fluids down or you vomit for more than six hours
• You have diarrhea for more than six hours
• You feel confused and can’t think clearly

• Your lips and tongue appear dry and cracked

Stress

Stress can be damaging to anyone’s health, but as a diabetic, it can significantly affect your ability to control the disease. Stress may cause you to skip meals or forget to take your medications, either of which can affect your blood glucose levels. It is impossible to remove stress completely from your life; however, there are several ways to reduce it. By learning to cope and manage your stress, you can help keep your diabetes in control.

When a stressful situation arises, it is easy to focus on the negative instead of the positive. Try to find something positive in every aspect of your life. This can be work, family, friends, or your health. Focusing on the good things can help you get through the bad times.

Often, in stressful situations, we are our own worst enemy. When things get rough, we tend to focus on our faults and weaknesses. Try to set reasonable goals. Learn what your talents and abilities are. Don’t expect more of yourself than you have or are able to give. This will help eliminate unnecessary stressful situations.

An important aspect of any situation is to accept what you cannot change. When a situation or problem arises, ask yourself the following questions: Will this be important in two years? Do I have any control over this situation? Can I change the situation? Is there a possible learning opportunity available? If a situation cannot be changed or controlled, the best course of action is to accept it.

Lastly, it is extremely important to talk to someone about your feelings. If you are not comfortable talking to your family or friends, visit a trained professional.

Exercise

Exercise is essential to maintaining a healthy lifestyle. Participation in an exercise routine can have several positive effects on the body. Exercise is important when trying to manage both types of diabetes. By combining diet, exercise, and medicine (if prescribed), you can help control your weight, as well as your blood glucose levels. Benefits of exercise on type 2 diabetes include the following:

• Improving your body’s use of insulin
• Burning excess body fat, which will help to decrease and manage your weight
• Improving muscle strength
• Increasing bone density and strength
• Lowering blood pressure
• Improving and controlling your body’s cholesterol
• Improving blood circulation, which reduces your risk of heart disease
• Increasing energy levels
• Reducing stress, promoting relaxation, and releasing tension and anxiety
  

What counts as exercise?

Exercise is any physical activity that gets you moving, such as walking, dancing, or working in the yard. You can see benefits of exercise without going to the gym or playing sports. However, it is very important that your physical activity be comprehensive. This includes aerobic, strengthening, and flexibility exercises. In addition to formal exercises, there are many activities that you can do to stay active throughout the day. The more active you are, the more calories you will burn, and that will contribute to your overall health. Alternative activities that will help you stay healthy include:

• Walking instead of driving whenever possible
• Taking the stairs instead of the elevator
• Working in the garden, raking leaves, or doing some house cleaning every day
• Parking at the far end of the shopping center lot and walking to the store
• It is important to check with your health care provider before embarking on an exercise plan.

Travel Tips

When you have diabetes, going on vacation requires extra planning. Travel forces you to go out of your normal routine, changing your meal patterns and activity levels. All of these factors, including the change of time zones, can affect your blood glucose levels. By following a few tips, travel can be safe and fun.

Make sure to bring twice as many supplies with you. If you run out while you are out of town, obtaining more supplies can be difficult.

• Bring your physician’s name and phone number, and keep it with you at all times. This way, if something happens, you will always have access to it.
• Bring a current list of all your medications.
• Make sure to pack all of your medications in your carry-on bag.
• Always wear your medical identification bracelet to let others know that you are diabetic.
• Always carry some type of sugar source in case your blood glucose level drops.
• Test your blood glucose more often than usual. The changes that your body experiences during travel can affect your levels.

Daily Eating Habits

Having diabetes changes what and when you eat. By learning to make smart, healthy choices, you will be able to manage and control your condition while maintaining an enjoyable quality of life. “Diabetes is a chronic condition; thus maintaining a healthy lifestyle is absolutely key in managing it. Taking baby steps is a great way to get started. After all, it’s those small baby steps that become giant strides in the future,” said Rosalyn S. Padiyara, Pharm.D., CDE, Clinical Pharmacist in the Health Management Department. The following tips will help you take small steps toward developing healthy daily eating habits.

• Eat lots of vegetables and fruits. Try picking from a rainbow of colors available to maximize variety. Eat non-starchy vegetables such as spinach, carrots,broccoli, or green beans with meals.
• Choose whole grain foods over processed grain products. Try brown rice with your stir fry or whole wheat spaghetti with your favorite pasta sauce.
• Include dried beans (like kidney or pinto beans) and lentils into your meals.
• Include fish in your meals two to three times a week.
• Choose lean meats like cuts of beef and pork that end in "loin" such as pork loin and sirloin.
• Remove the skin from chicken and turkey.
• Choose non-fat dairy such as skim milk, non-fat yogurt, and non-fat cheese.
• Choose water or calorie-free "diet" drinks instead of regular soda, fruit punch, sweet tea, and other sugar-sweetened drinks.
• Choose liquid oils for cooking instead of solid fats that can be high in saturated and trans fats. Remember that fats are high in calories. If you're trying to lose weight, watch your portion sizes of added fats.
• Cut back on high-calorie snack foods and desserts like chips, cookies, cakes, and full-fat ice cream.
• Eating too much of even healthful foods can lead to weight gain. Watch your portion sizes.
  

It can be easier to maintain a healthy lifestyle when you prepare your own food. However, many times situations arise when that is not always an option. It is important to maintain healthy food choices when dining out or attending a party. Here are some tips to follow in such situations.

Appetizers

• Select fresh fruit or vegetables.
• Avoid cream-based soups.
• Stay away from white bread and rolls with salty, buttery crusts.

Salads

• Select fresh fruits and vegetables.
• Avoid pickles, olives, canned or marinated vegetables, cured meats, seasoned croutons, cheeses, and salted seeds.
• Order salad dressings on the side and use small amounts of them.

Main courses

• Select plain foods including broiled, grilled, or roasted meat, poultry, fish, or shellfish. Select plain vegetables, potatoes, and noodles.
• Ask the server about the low-sodium menu choices and ask how the food is prepared.
• Request food to be cooked without salt or monosodium glutamate (MSG).
• Avoid restaurants that do not allow for special food preparation (such as buffet-style restaurants or diners).
• Avoid casseroles, mixed dishes, gravies, and sauces.

Desserts

• Select fresh fruits, ices, sherbet, and gelatin.

Diabetes Management Clinic

Dreyer offers a Diabetes Management Clinic that is staffed with trained pharmacists, nurses, and dietitians to help manage your diabetes. Diabetes requires time and intensive effort on the part of the health care team and the patient. This program is designed to help patients understand all of their personal responsibilities, as well as provide the necessary time and attention from the health care team. In the Diabetes Management Clinic, patients receive specialized diabetes care from a number of clinicians working in collaboration with your primary care physician.

Who is Involved?

Clinical pharmacists, who are specially-trained in managing diabetes as well as high blood pressure and high cholesterol, provide expert assessment of your medication regimen including the need for adjustments in therapy. They also order any lab work that is necessary and make sure that you receive appropriate follow-up care.

Nurse educators, who are certified in diabetes education and have extensive training, provide instruction on vital information needed for diabetes self-care. Educators meet with patients individually, assess their needs, and help them to set realistic goals for diabetes care. During group sessions, patients learn what diabetes is, how to prevent complications, use of diabetic medications, how to monitor their blood sugar, foot care, and healthy eating with diabetes. Patients receive a follow-up telephone call in three months to answer any questions they may have. Patients also have a comprehensive diabetic foot examination that should be done annually.

Dietitians develop flexible and realistic food plans tailored to the patient’s everyday needs to manage their diabetes successfully. They offer a wide range of nutrition counseling, including carbohydrate counting, weight management, dining out, cooking, heart health, and much more diabetes-specific topics.

All clinicians involved ensure that the patient’s diabetes care meets the standards established by the American Diabetes Association. Our program is accredited by the American Diabetes Association and has received Best Practice awards from both the American Medical Group Association and the Association of Health-System Pharmacists.

How Do I Sign Up?

Please call 630-859-6898 or 630-859-6739 to make appointments with the Diabetes team. “Having diabetes can affect many parts of a person’s life and can sometimes be overwhelming. At Dreyer, we have a team of health professionals trained to focus on different areas of diabetes care, from everyday glucose management to preventing long-term complications. Our team empowers patients to manage their diabetes and encourages them to be an active participant in their care,” said Jennifer J. D’Souza, Pharm.D., CDE, Clinical Pharmacist in the Health Management Department.