Coronavirus: Diabetes Self-Care in a Time of Uncertainty


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Using AADE7 self-care behaviors

Life as we knew it has certainly been upended over the past month or so[1]. Social distancing, working from home — or not working at all — wearing masks and celebrating holidays with others over phone or video is not the norm for most of us. And there’s the unknown: When will it all end? When will we go back to “normal,” or will our new normal look very different? Living during a pandemic can cause a number of feelings and emotions to rise to the surface, including fear, anxiety, and depression, along with stress[2] and boredom.

On top of all the craziness that’s going on, you still have diabetes. During times of crisis and stress, your day-to-day schedule and routine can get disrupted, and that’s to be expected. Unfortunately, your diabetes management can get disrupted, as well, and that can lead to a set of other issues, such as hyperglycemia (high blood sugar)[3], hypoglycemia (low blood sugar)[4], illness, and possibly weight gain[5]. How can you use this time to your advantage?

The Association of Diabetes Care & Education Specialists (ADCES; formerly AADE) has identified seven key areas of diabetes self-management[6] for successful and effective diabetes self-management. These are behaviors that you’ve likely been practicing. But if you’ve been thrown off a bit (and who hasn’t?), here are some suggestions for helping you get back on track.

To get cutting-edge diabetes news, strategies for blood glucose management, nutrition tips, healthy recipes, and more delivered straight to your inbox, sign up for our free newsletter[7]!

1. Healthy eating

If finding and/or affording your usual foods has been a challenge, or if food preparation has been a struggle, try these tips:

· Come up with a plan for meals and snacks[8] to help ensure that you and your family are eating healthfully and regularly. If you need inspiration, check out quick meal ideas on our website[9] or www.diabetesfoodhub.org[10].

· If finding adequate fresh fruits and vegetables is a challenge, it’s okay to turn to canned and frozen produce. Choose vegetables that are “no salt added” and that aren’t packed in butter or cheese sauce. Good fruit choices are those packed in fruit juice or water, not syrup.

· Stay with a regular eating schedule to help with your blood sugars and your weight.

· Tracking your food with a food app or even pencil and paper can help you stick with your goals to eat healthfully and manage your blood sugars[11] and your weight.

2. Being active

You can still be active[12], even if you’re not able to get to the gym or to your usual exercise class. Doing just 10 minutes of physical activity can lower stress and anxiety, give your mood a boost, and make it easier to manage your blood sugars.

· Set a timer to get up every 30 minutes to march in place, climb stairs, dance[13] or do some stretching.

· Go out for a walk[14]. If you walk with others, be sure to stay at least six feet apart.

· Check out exercise videos on sites such as You Tube. Some gyms are offering free streaming classes[15].

· Gardening and yard work can help you burn calories and tone muscles.

3. Blood glucose monitoring

Keeping up with your blood sugar checking[16] is important, especially when there’s a change in your routine. But monitoring can also mean keeping tabs on other aspects of your health, such as your blood pressure[17], weight, sleep[18], medications and mood.

· If you like doing puzzles, try tracking your glucose levels using a logbook or a spreadsheet, or download your glucose values from your meter or CGM[19]. Look for patterns of high or low glucose levels. Then, think about what may have caused them and what you could try to do differently next time.

· Step on the scale. Weighing yourself at regular intervals is a way to increase your awareness; doing so can keep you on track to reach your weight goal or to help you maintain your current weight. If weighing yourself daily makes you feel anxious or stressed, check your weight once or twice a week — whatever works best for you.

· Use a sleep tracking device or app if you’re having trouble sleeping or feeling tired all the time. These devices and apps can give you insight into your sleep habits. For suggestions, visit the website of the National Sleep Foundation[20].

4. Taking medication

One of the biggest concerns that people have during this time is being able to afford medications and diabetes supplies.

· If you’re having difficulty affording medications and/or diabetes supplies, read “Resources & Financial Assistance Programs to Help with the Cost of Managing Diabetes”[21] on the AgaMatrix website for resources.

· A shake-up in your daily routine can mean that you get off track with taking your medications as prescribed. Use a pill organizer or set a reminder on your calendar or phone to prompt you to take your medication.

· If you think you need more or less of your diabetes medicines, or have questions about them, make a virtual appointment with your doctor, diabetes educator[22] or pharmacist — either by phone or telemedicine visit.

5. Problem solving

Problem solving has never been more important during this time. If things aren’t working out for you as they should around managing your diabetes, take some time to figure out what needs changing.

· Enlist the help of others in your household to help with chores, meal preparation or food shopping, for example, or even to encourage or remind you to stick with your self-care routine.

· If you’re feeling stuck on how to figure out a tricky situation, try this worksheet to get you going[23].

· Reach out to a diabetes educator if you feel like you’re struggling to discuss your concerns. Your doctor may be able to refer you to one in your community or you can visit ADCES’s website[24].

6. Reducing risks

Managing diabetes is more than simply taking your medication and checking your blood sugar. It also involves behaviors that can help you prevent or delay problems down the road. Fortunately, there are steps that you can take now to minimize the risk of complications[25].

· Make a point to give your feet some attention[26]. This means washing, drying and moisturizing your feet (except between your toes), looking for cuts, sores or redness, and trimming your toenails straight across. If you usually have a podiatrist do this for you, reach out to their office for guidance.

· Keep tabs on your dental health[27]. Brush your teeth at least twice a day and floss every day. Let your dentist know if you have bleeding gums or loose or painful teeth.

· Be nice to your heart[28]. Eating healthy foods and being active will help, as will getting enough sleep, doing something (healthy) that you enjoy, and if you smoke, working on stopping smoking. Find help for quitting smoking here[29].

7. Healthy coping

Finding ways to boost your mental and emotional health is especially important at a time like this. If you are struggling with feelings of depression, stress and/or anxiety[30], it can take a toll on your health in many ways, including affecting your ability to take care of your diabetes. There’s a lot that you can do to cope with stress.

· Go easy on yourself. Try not to set your expectation too high right now — you don’t need to clean your entire house or learn a new language. Do the best you can and think about what is working and what isn’t, and then move on. Plus, make time in your day to do something just for you: take a nap, read a book, or work on a hobby, for example.

· Stay in contact with others. This is especially important if you live alone. Try meeting a friend or neighbor for a walk outside (staying, as noted above, at least six feet apart), call someone on the phone, and, if you have the technology, use apps like FaceTime, Zoom or Skype to talk and catch up with family and friends.

· If you’re feeling alone as a result of having diabetes, you’re not alone! There are a number of online diabetes peer support communities. Check them out here[31].

· Visit the CDC’s website[32] for other ways to cope with stress.

Want to learn more about coronavirus and diabetes? Read “Coronavirus and Diabetes: What You Need to Know,”[33] “Healthy Eating During Hard Times”[34] and “Avoiding Coronavirus With Diabetes: Stock Up and Stay Home, CDC Says.”[35]

Endnotes:
  1. upended over the past month or so: https://www.diabetesselfmanagement.com/healthy-living/general-health/coronavirus-and-diabetes-what-you-need-to-know/
  2. stress: https://www.diabetesselfmanagement.com/healthy-living/emotional-effects/coronavirus-stress-dealing-with-anxiety/
  3. hyperglycemia (high blood sugar): https://www.diabetesselfmanagement.com/managing-diabetes/blood-glucose-management/managing-hyperglycemia/
  4. hypoglycemia (low blood sugar): https://www.diabetesselfmanagement.com/managing-diabetes/blood-glucose-management/understanding-hypoglycemia/
  5. weight gain: https://www.diabetesselfmanagement.com/nutrition-exercise/weight-loss-management/tried-and-true-weight-loss-techniques/
  6. seven key areas of diabetes self-management: https://www.diabeteseducator.org/living-with-diabetes/aade7-self-care-behaviors
  7. sign up for our free newsletter: https://www.diabetesselfmanagement.com/newsletter/
  8. plan for meals and snacks: https://www.diabetesselfmanagement.com/healthy-living/nutrition-exercise/coronavirus-healthy-eating-during-hard-times/
  9. on our website: https://www.diabetesselfmanagement.com/cooking-style/quick-meals/
  10. www.diabetesfoodhub.org: http://www.diabetesfoodhub.org
  11. blood sugars: https://www.diabetesselfmanagement.com/managing-diabetes/blood-glucose-management/blood-sugar-chart/
  12. You can still be active: https://www.diabetesselfmanagement.com/nutrition-exercise/exercise/choosing-right-fitness-program/
  13. dance: https://www.diabetesselfmanagement.com/nutrition-exercise/exercise/the-health-benefits-of-dance/
  14. Go out for a walk: https://www.diabetesselfmanagement.com/nutrition-exercise/exercise/health-benefits-of-walking/
  15. ome gyms are offering free streaming classes: https://www.goodhousekeeping.com/health/fitness/a31792038/coronavirus-live-stream-workout-classes/
  16. blood sugar checking: https://www.diabetesselfmanagement.com/managing-diabetes/blood-glucose-management/blood-glucose-monitoring-when-to-check-and-why/
  17. blood pressure: https://www.diabetesselfmanagement.com/managing-diabetes/complications-prevention/the-pressure-is-on/
  18. sleep: https://www.diabetesselfmanagement.com/managing-diabetes/general-health-issues/getting-the-sleep-you-need/
  19. CGM: https://www.diabetesselfmanagement.com/managing-diabetes/blood-glucose-management/cgm-diabetes-management/
  20. National Sleep Foundation: https://www.sleep.org/articles/best-sleep-trackers/
  21. “Resources & Financial Assistance Programs to Help with the Cost of Managing Diabetes”: https://agamatrix.com/blog/diabetes-financial-assistance/
  22. diabetes educator: https://www.diabetesselfmanagement.com/about-diabetes/diabetes-basics/certified-diabetes-educator/
  23. try this worksheet to get you going: https://www.diabeteseducator.org/docs/default-source/living-with-diabetes/tip-sheets/aade7/aade7_problem_solving.pdf?sfvrsn=10
  24. ADCES’s website: https://www.diabeteseducator.org/living-with-diabetes/find-an-education-program
  25. risk of complications: https://www.diabetesselfmanagement.com/education/diabetes-complications/
  26. give your feet some attention: https://www.diabetesselfmanagement.com/managing-diabetes/complications-prevention/caring-for-your-feet/
  27. dental health: https://www.diabetesselfmanagement.com/managing-diabetes/complications-prevention/practice-good-oral-health-diabetes/
  28. Be nice to your heart: https://www.diabetesselfmanagement.com/education/tips-for-a-healthy-heart/
  29. Find help for quitting smoking here: https://smokefree.gov/everytrycounts/?gclid=EAIaIQobChMIl4nW2uj06AIVhZ-fCh2LkwASEAAYAiAAEgK1d_D_BwE&gclsrc=aw.ds
  30. stress and/or anxiety: https://www.diabetesselfmanagement.com/healthy-living/emotional-effects/coronavirus-stress-dealing-with-anxiety/
  31. Check them out here: https://www.diabeteseducator.org/docs/default-source/living-with-diabetes/tip-sheets/peer-support/peer-support-tip-sheet---color-version.pdf?sfvrsn=4
  32. CDC’s website: https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fprepare%2Fmanaging-stress-anxiety.html
  33. “Coronavirus and Diabetes: What You Need to Know,”: https://www.diabetesselfmanagement.com/healthy-living/general-health/coronavirus-and-diabetes-what-you-need-to-know/
  34. “Healthy Eating During Hard Times”: https://www.diabetesselfmanagement.com/healthy-living/nutrition-exercise/coronavirus-healthy-eating-during-hard-times/
  35. “Avoiding Coronavirus With Diabetes: Stock Up and Stay Home, CDC Says.”: https://www.diabetesselfmanagement.com/news-research/2020/03/18/avoiding-coronavirus-with-diabetes-stock-up-and-stay-at-home-cdc-says/

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