1. Diabetes and Self Monitoring
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2. What is Diabetes?
Diabetes is a condition in which there is too much sugar (glucose) in the blood. Although sugar is needed to provide energy for the body, when in excess, it causes problem.
Persons with diabetes have excess sugar because they lack or have deficient supply of insulin.

3. Diabetes
“Mild Disease”
Serious consequences

4. Diabetes Mellitus A Serious Disease
Leading cause of new
cases of blindness
25 times more prone to
eye problems
6 times higher risk for
Paralysis (stroke)
2-3 times higher risk for
heart attack
5 times more prone to
Kidney failure
20 times more prone to
lower limb amputation
Nerve damage causes
loss of sensation

5. What Are Common Symptoms of Diabetes ?
Frequent Urination
Hunger
Weight loss
Excessive thirst
Other Symptoms like:
Fatigue
Unusual Infections
Blurred vision
Dry and itchy skin etc

6. How do you Manage Your Diabetes?
Follow a Healthy
Meal Plan
Regular Exercise
Take your
Medication
Test blood sugar
Regularly

7. Diabetes Self-management
Understanding diabetes, its management and the problems
associated with it
Participation in decision making and taking an active part in day
to day management
Monitoring and keeping track of your blood sugar
It requires determination, effort and time
It requires willingness for self-care
It requires close co-ordination with your doctor and the diabetes care team

8. Benefits of Normal Blood Sugar
Improves your sense of well being
Restores energy
Makes you symptom free
Helps prevent long term complications of diabetes

9. Self Management What Is Required?
Test and record blood and /or urine sugar regularly as advised
Record your medication, food and activity pattern
Identify blood sugar pattern in relation to the above and learn how your blood sugar reacts to changes
Use the learning and your blood sugar results to adjust your food, activity and medication

10. Self Management What is Required?
Learn to recognize and manage hypoglycemia and sick day problems
Visit your doctor and diabetes care team regularly and carry out other tests and examinations as advised
Make all efforts to control your diabetes with help of your diabetes care team to prevent long term complications

11. Methods of Self-monitoring
Home monitoring and recording of
blood sugar using glucose meters, or color strips
urine sugar and ketones using strips or reagents

12. Self Monitoring of Blood Sugar Your Tool to Good Control !
It allows you to determine pattern of blood sugar level and make necessary changes in your food and activity program or insulin / OHA dose
Allows you to respond quickly to a rise or fall in blood sugar
Useful in preventing long term complications

13. Home Monitoring of Blood Sugar
Check when and how often to monitor - suggested times include
Fasting, before lunch and dinner
2 hrs after breakfast, lunch and dinner
3 AM
Test more often
When not well
Suspect hypoglycemia
During pregnancy
When changing treatment or not in control

14. Home Monitoring of Blood Sugar
What is needed
Lancet
Test strips
Cotton swab
Glucose meter or color chart
Steps
Clean and dry hands
Puncture skin of finger (side), squeeze out large drop of blood
Apply blood to test strip, and do as per instructions
Apply cotton swab to puncture
Note and record result

15. Home Monitoring of Urine Sugar and Ketones
Urine Testing
Positive only when blood sugar is high > 180 mg/dl.
Messy, not accurate but non invasive and less expensive
Not useful to detect and document hypoglycemia
Very useful in testing for ketones
What is needed
Test tube to collect urine
Test strips
Steps
Collect urine in test tube (second void preferable for urine sugar)
Dip test strip in urine and do as per instructions
Note and record result

16. Why Test for Ketones in the Urine?
Ketones are acid waste products formed when the liver burns fat for energy
Produced when level of insulin is very low and blood sugar is rising
Accumulate in the bloodstream and spill into the urine
Can be detected by special test strips
Provide warning that blood sugar is out of control
High levels can lead to life threatening Ketoacidosis requiring prompt treatment and frequent monitoring

17. When to Test for Ketones?
Sick, high fever or a stressful medical, physical or emotional
condition
Blood sugar >250 mg/dl
Nausea, vomiting, or abdominal pain accompanied by severe
thirst and confusion
Peculiar fruity smell in breath

18. What Is Glycosylated Hemoglobin ?
HbA1c is a test that reflects the average of your blood sugar levels over the past 2-3 months
Optimal value of the HbA1c is 7%
Higher value means, you had higher blood sugar levels for last 2 – 3 months
HbA1c maybe high despite one or two near normal blood sugar values in between

19. Your Daily Diabetes Diary!
An important tool to learn and manage your diabetes
Helps keep record of
Food, activity and medications
Blood sugar and other tests
Weight changes
Hypos
It will help you to understand how your body responds to different foods, to different situations, and to your medications

20. Your Daily Diabetes Diary!
It will also help your diabetes care team to discuss and plan your treatment effectively

21. Set Your Goals and Achieve Them
Goal must be realistic and based on your need, lifestyle, health and age
You and your diabetes care team must be equally involved in setting the goal
Once set, you and your diabetes care team must make all efforts to achieve it by appropriate monitoring and adjustments to your food, activity and medication
Blood Sugar
mg/dl
Good
Borderline
Poor
Fasting
80-110
> 140
Post Prandial
80-144
> 180

22. Set Your Goals and Achieve Them
Keep your blood sugar as close to good as possible to prevent long term complications. Take insulin, if advised.

23. Outro
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