Guest post by Joe Fraser, author of Joe’s Rough Guide to Diabetes and the website www.joes-diabetes.com
1. Take responsibility for your diabetes
As a diabetic, this is the first and biggest step to achieving good control. Other people won’t always be around to look after you if things go wrong, and the sooner you take ownership of it the sooner control should improve.
2. Talk about it
The best way to make diabetes yours is to understand it, and a good way of getting to know what’s going on is to talk about it. Obviously tell your child’s school teacher for safety reasons, but encourage your child to talk to their friends about it too.
3. Always carry something sweet
Even if your child’s really well controlled, hypos can happen. Having a high Glycaemic Index food or drink will quickly bring the levels back to normal: make sure you’ve always got something to hand.
The following raise blood sugars quickly and are ‘user-friendly’: GlucoGel, Lucozade Sport gel, dextrose tablets, sweets, Boosts.
4. Check the back of packets
If it’s possible, always check the back of food packets to see what your child’s eating. The balance between the insulin dose and the amount of carbohydrate is very delicate and can be changed by lots of factors.
A great way to know this relationship is carbohydrate counting. Note the insulin dosage, the amount of carbohydrates, and other factors may affect the levels (such as exercise). Measure the blood sugar just before and about an hour afterwards. If it’s too high, take slightly more insulin the next time or vice versa. This should provide the foundations for excellent control.
5. Record your blood sugar levels and what you eat
Recording what and when your child eats, how much they’ve injected, and whatever activity they’ve done or will do is tedious. There’s no getting around that, and it can be really frustrating when the blood sugars aren’t going the right way. However, recording is the best way to learn how to manage diabetes and means you can start to notice patterns in your readings.
6. Vary injection sites
Injecting can be quite weird at first – not many people enjoy it (!); hitting a nerve can be really painful. The best places to inject are where there’s the most fat, usually the stomach and legs. Most people find it easier on the stomach, but you shouldn’t inject too much in one spot as insulin can make fatty ‘lumps’ grow! These can slow up the absorption of the insulin. To get rid of them, just stop injecting into that area for a week or so.
I inject in my right thigh for breakfast, the left side of my stomach for lunch, the right side for dinner, and into my left thigh for the night time dose.
7. Exercise
Exercise lowers the blood sugar level, which makes managing diabetes more complicated but can really improve control. One of the complications of long-term high blood sugar is getting smaller, stickier blood vessels which cause lower blood flow and problems in the extremities. Keeping fit helps to stop these complications from taking place by increasing the heart’s strength and the size of the blood vessels.
8. Alternate Site Testing
This won’t save a diabetic’s life, but it should improve control and make diabetes a lot less painful! Some glucose meters can only measure blood taken from the ends of the fingers. This isn’t much fun and can stop people measuring as frequently.
Alternate Site Testing allows a diabetic to measure their glucose using blood taken from less sensitive areas like the forearm. Not only is it less painful but since the extremities go wrong first with diabetes, damaging your fingers is not good in the long-run.
9. Always carry your equipment
Carrying all the equipment needed to stay in control can be a real hassle. For just going out in the day you’ll need the glucose meter, test-strips, lancer, insulin pen, spare lancets, needles, and a glucose supply to stay well-controlled. If your child’s staying the night somewhere they’ll need to add more needles and another insulin pen.
Only taking some of what’s needed is not a good idea. It unwittingly puts the people they’re with under a lot of pressure: not having the right equipment means they’re probably going to be in worse control.
10. When you travel take double your supplies
Travelling is brilliant fun: a chance to relax, explore, and get a tan. It’s no different for diabetics, but you need to think a little ahead, especially about supplies. How many needles/lancets/insulin cartridges will your child need? Whenever I travel I take twice as many supplies as I think I’ll need. You never know what will happen, and you don’t want to be stuck without supplies.
Also, take spare insulin pens and divide up the supplies between two bags, otherwise a lost or stolen case could mean the end of your holiday.