Mental health care. The day-to-day necessity of dealing with a chronic illness can add stress and strain to one’s life, and your diabetes care team should address these issues with you. If you’re having trouble coping, they may recommend that you see a psychologist (or other mental health care professional) to talk about issues such as your attitude toward having diabetes, your expectations for managing the condition, your general and health-related quality of life, and the financial, social, and emotional resources at your disposal. If needed, including a mental health professional in your diabetes care team is recommended, because emotional well-being is an important part of your personal diabetes management.
Sick-day plan. Physical stressors, such as illness, trauma, or surgery, can disrupt your blood glucose control, leading to very high blood glucose levels. This, in turn, can trigger serious conditions such as diabetic ketoacidosis (in which poisonous acids called ketones build up in the blood) or nonketotic hyperosmolar state (in which high blood glucose levels cause severe dehydration). You and your diabetes care team should determine a sick-day plan in advance that spells out what to do if one of these stressors occurs. Your sick-day plan may call for more frequent blood glucose monitoring, monitoring of ketones in the blood or urine, and ongoing communication with your physician to help you manage your diabetes during an illness. Should you need to be admitted to the hospital for any reason, ask that a member of your diabetes care team be consulted regarding your treatment to ensure that you maintain the best possible blood glucose control. Keeping your blood glucose levels as close as possible to their target ranges while you are in the hospital can reduce your chance of developing further illness or infection during your stay.
Hypoglycemia plan. Knowing how to deal with hypoglycemia (low blood glucose) is important for people for people whose diabetes treatment plans include insulin or diabetes drugs that increase the body’s own production of insulin, such as glyburide, glipizide, or glimepiride. Learn to identify your particular signs and symptoms of hypoglycemia, which may include weakness, shakiness, a sweaty or clammy feeling, fast heart rate, confusion, dizziness, changes in vision and lack of coordination. Treatment to raise blood glucose is usually called for in adults with diabetes if blood glucose levels fall below 70 mg/dl. Usually, 15–20 grams of pure glucose (the amount found in 3–5 glucose tablets) is the recommended treatment, although any form of carbohydrate in the appropriate amount is acceptable. Using a food with added fat (such as a chocolate bar) however, is not recommended to treat hypoglycemia because fat may slow the body’s absorption of the carbohydrate.
Your diabetes care team will recommend that you check your blood glucose 15 minutes after treatment to assure that your blood glucose level has returned to the recommended range. If it hasn’t, treating again is generally recommended. Your physician may also prescribe a glucagon emergency kit if you are at risk for severe hypoglycemia. When a person develops severe hypoglycemia, he may lose consciousness and be unable to treat himself. Glucagon is a hormone that causes the liver to release glucose into the bloodstream, raising blood glucose levels. It must be injected and should be given by someone, such as a family member, friend, or coworker, who has been trained to administer it.
Immunizations. Influenza and pneumonia are especially dangerous in people with chronic medical conditions such as diabetes. Therefore, all people with diabetes who are at least six months old should receive a yearly influenza vaccine (flu shot). Your physician may ask you some questions to confirm that the vaccine will be safe for you. For example, the vaccine is usually not given to people who are allergic to eggs or egg products.