Diabetes Self-Management Articles

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How to Avoid Errors in Diabetes Care

by Patrick J. O'Connor, MD, MPH, JoAnn M. Sperl-Hillen, MD, and Becky Klein, RN CDE

  • When you start a new batch of test strips, do you need to enter a code in your meter? Some newer meters no longer require this step, but many still do. Those that do will not give accurate results if this step is skipped.
  • When you check your blood glucose, do you get your blood samples from approved body areas? Some meters can be used with blood samples from areas other than the fingertips (such as the palms or forearms), but some meters can only use blood from the fingertips.
  • Are you familiar with general procedure for checking your blood glucose level? Using a blood glucose meter requires that you perform numerous steps, from washing your hands to applying the blood sample to the right spot on the strip. Forgetting a step or performing steps out of order could result in an inaccurate result.
  • If you have any questions about the correct use of your meter, check your instruction manual, call the meter company’s customer service number, or speak with your diabetes educator or another member of your diabetes care team. Your pharmacist may also be able to answer questions about the correct care and use of your meter.

    How often and at what times of day you should check your blood glucose depends on many things, including what medicines you take, how much risk you have for developing hypoglycemia, and whether blood glucose information would be helpful to allow you to self-adjust your insulin doses. Many people who take multiple insulin shots (and their doctors) find that occasionally checking their blood glucose level about two hours after meals, in addition to before meals, can help them match their insulin doses to their eating habits and activity levels. Ideally, your blood glucose level two hours after a meal should be no more than 40 mg/dl higher than it was before the meal.

    Some people check far more often than is necessary, while others don’t check often enough. Discuss with your health-care provider how often to check your blood glucose, when to check, and what to do with your results.

    Avoiding errors in the hospital
    It’s not unusual to be admitted to the hospital at some point in life, so when you have diabetes it makes sense to have some knowledge ahead of time about how your treatment plan could be affected by a hospitalization. Often, oral diabetes drugs are stopped at the time of hospitalization or surgery and insulin is used instead. Insulin has many advantages when you are in the hospital because it allows for a rapid response to changing blood glucose levels.

    Typically, nurses will check your blood glucose level for you about four times a day. You can participate in your in-hospital diabetes care by knowing what your readings are and by making sure your meals are designed to accommodate your diabetes control plan. If you feel too ill to speak up on your own behalf, ask a friend or family member to speak up for you.

    If possible, talk to your doctor ahead of time about which medicines to continue taking and which to stop (and when) before you enter the hospital. If you are having surgery, it’s also a good idea to ask who will be in charge of your diabetes control while you are having surgery and recuperating from it.

    If you are in the hospital to give birth, you may be able to retain control over your diabetes management tasks. Depending on the hospital’s rules, some women are able to continue using an insulin pump during their stay and to do their own blood glucose monitoring. It’s important to find out what’s allowed ahead of time, however, so you know what’s possible and what isn’t.

    Your diabetes control plan may change after a serious illness, surgery, or childbirth. Before you leave the hospital, make sure you have in writing what your medicines and doses should be when you arrive home. If some of the medicines you were taking before hospitalization are not on the list, ask why. Also, ask your usual pharmacist to check your new combination of medicines for potential drug interactions or anything that you may be allergic to.

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    Also in this article:
    Avoiding Medication Mistakes

     

     

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    Statements and opinions expressed on this Web site are those of the authors and not necessarily those of the publishers or advertisers. The information provided on this Web site should not be construed as medical instruction. Consult appropriate health-care professionals before taking action based on this information.

     

     

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