Managing Your Blood Glucose Ups and Downs

Your overall diabetes plan should include an individualized meal plan that helps you choose the types and amounts of food to eat to prevent your blood glucose level from rising too high after meals. If you have other health problems such as high blood pressure, high cholesterol, or overweight, your meal plan should be designed to help improve those conditions, as well.

Your diabetes plan should also include a plan for regular physical activity to keep your heart and blood vessels healthy and to lower or prevent insulin resistance, which contributes to high blood glucose in people with diabetes. Cells that are insulin resistant require more insulin than normal to take in glucose from the bloodstream. Most people with Type 2 diabetes and some with Type 1 have some degree of insulin resistance.

Your plan may include taking oral or injected medicines on a particular schedule. Learning to inject insulin or other medicines requires training and practice, and sticking to any drug regimen takes effort and discipline. A certified diabetes educator can help you master both the techniques and planning necessary to maintain a medication plan.

Your plan may also include visits to a mental health-care provider, such as a psychologist or social worker, to talk about the social, emotional, and practical effects of diabetes on your life. While you might not think that talk therapy could directly affect your diabetes control, in fact, having the opportunity to express your feelings, and feeling supported in your efforts, can have a big effect on your willingness to carry out your diabetes care tasks at all.

Given how many components there are to a diabetes care plan and how much there is to learn, many people find it useful to attend diabetes education classes, particularly when first diagnosed. Diabetes education classes are commonly given at hospitals, clinics that provide diabetes care, and, sometimes, medical offices. Most classes meet for several sessions, covering different topics at each session, and ideally providing time for questions and discussion among class attendees. Many insurance plans, including Medicare, cover a certain number of hours of diabetes education when a person is first diagnosed and each year thereafter.

Monitoring
Once you and your health-care provider have worked out a diabetes control plan for you and have settled on a target blood glucose range, you need to monitor your blood glucose periodically to see whether you’re in that range. That means you’ll need a blood glucose meter, which your physician or diabetes educator can help you choose and teach you to use. Most insurance plans cover only selected meters and test strips. However, if you are likely to have trouble using the meter your insurance normally covers because of visual impairment, shaky hands, or something else, you or your health-care provider can petition your insurance company for a meter that better fits your needs. Some people who want very frequent information about their glucose level have started using continuous glucose monitoring devices in addition to blood glucose meters. To read more about continuous monitors, see “Continuous Glucose Monitoring.”