Diabetes patient education is a crucial part of management of diabetes patients because a diabetic patient has to play an active role in managing his own disease. There are a number of things that a diabetic patient should be taught by his treating physician or diabetes educator. Training a patient is not an easy job and all these self help tips can not be taught in one single session. A patient is gradually trained over number of visits during his routine follow up. Important things to be taught to a patients are –
Diabetic Diet – Diabetic diet plays a crucial role in controlling blood sugar. Though the dietary needs of every patient are different and the advice needs to be individualized there are certain basic things that every diabetic patient must follow. Simple sugar intake in any form should be completely stopped. This includes desserts made of sugar, beverages and juices with added sugar. Sugar substitutes may be advised to patients who insist. Fruits like Mango, Banana, Chiku, Grapes and custard apple are to be avoided. Other fruits may be consumed in moderation. Rice and Potato are rich in starch and are better to be avoided. Patients with hypertension should restrict their salt intake. Patients with high cholesterol levels or the ones who are at risk of heart disease should cut down on their fat intake.
Exercise – Regular exercise not just helps in controlling blood sugars but also reduced the risk of complications. The general advice that can be given to all patients is brisk walk for 45 minutes a day. Those who can not go for a walk may be advised for Yoga and Pranayam. Any kind of aerobic exercise is good for diabetic patients.
Self Monitoring of Blood Glucose – patients on insulin therapy, those with fluctuating levels of diabetes need to monitor their blood sugar frequently at home. Self monitoring may also be needed during change in doses or medication. Self monitoring is done by glucometer and every meter has a different method. Patients should better be educated and hands on training be given.
Hypoglycemia – Diabetic patients are at high risk of hypoglycemia and it can be fatal in some cases. Number of patients land up in hospital simply because they were not aware of hypoglycemia and could not manage it home. A patient should be told about common symptoms of hypoglycemia. The immediate treatment for hypoglycemia is eating. If the episode is severe glucose may be consumed. For patients who are unconscious, glucose paste should be put in their buccal cavity.
Self adjustment of Insulin doses – Doses of insulin often need to be adjusted based on glucose readings obtained on self monitoring. There are variety of insulin preparations and its better if the patient is aware of the mechanism of its action. That helps the patient in titrating doses of insulin between the visits to doctors clinic.
Insulin injection technique – a number of patients fail to achieve their glycemic targets because faulty injection technique. Patients must be aware of the storage conditions for insulin, the proper syringe to be used, the site of injection and technique of injection.
Sick day schedule for type 1 diabetic – patients with type 1 diabetes are at high risk of fluctuations in sugar levels when they are in stress which might be physical stress like fever and trauma or mental stress. They need to consume a lot of fluids during this period to avoid dehydration. They should also monitor their sugar levels more frequently and adjust the doses of insulin if needed.
Foot care – long term diabetic patients often suffer from neuropathy. They fail to feel the pain of trauma to feet. such unnoticed wound may not heal and may land up the patient into severe foot infections. Such patients need to take care of their feet regularly. The shoes should also be customized for such patients.