The tasks involved in self-management are relatively easy, once you have learned how to do it. There is more and more help available as the concern about increasing prevalence and cost of DB2 increases.  The American Diabetes Association published revised Standards of Care for diabetes   emphasizing that high-quality diabetes care must be individualized to reflect the needs, interests, and abilities of each patient. The primary goal is to reduce blood glucose levels to normal. You self-monitor blood glucose levels at home and have HbA1c monitored very 3 months. The secondary goal is to monitor for and, if detected, promptly treat any developing complications.

The Cardinal Rules of DB2

Eat less, exercise more.

You adjust the food you eat and your activity level to bring glucose utilization into balance with intake.

You monitor blood glucose frequently at first until you understand what different foods do in your body.

You use exercise to lower blood glucose if the levels go too high.

If your blood glucose is too high, you can skip meals, take Alpha DMX twice a day and snack on low calorie foods such as celery, lettuce, apples and carrot sticks.

The basic problem with proposing diet revision, as therapy is that eating behaviors are deeply rooted in a psychosocial matrix and are not rationally determined.  Diabetic food management requires rational determination of eating behaviors and food selection. The social basis of eating patterns often conflicts with individual needs and opposes the attempts made by an individual to modify diet as a means of restoring or maintaining health.

The idea of "a diabetic diet" as a fixed set of instructions and a restricted food list is stubborn and fits with a passive-dependent attitude  - "fix me" A new attitude of approach to diet revision is required especially when you have  a chronic illness. The new attitude is based on self-responsible, self-monitored and self-directed change. The Alpha Nutrition Program assumes that you are in charge and you make your own decisions. The professional role is to support your effort to self-manage and assist you in trouble-shooting when symptoms recur or when irrational eating behavior is dominant and you need help complying with the healthy path.

Blood Glucose Monitoring

Home testing of blood glucose levels is useful for the self-managing diabetic. You have to remember that the reason for doing a test is to provide you with information that influences the decisions you make. An insulin dependent diabetic will make  decisions about the dose and timing of insulin injections based on blood glucose levels. Frequent measurements are essential for good decisions. A person with early type 2 diabetes will need less frequent blood glucose measurements to guide food choices and adjust activity levels.

Blood glucose values in medical publications are measured from venous blood drawn from your arm. Test results vary depending on the age of the blood sample and the calibration of lab instruments. There are no measurements without error. A properly calibrated machine will have a known error range.  See Glucose Monitoring

Three glucose measurements are useful for different reasons:

1. Fasting blood glucose levels, taken in the morning before eating, should fall in a normal range. The goal is to keep this value under 7 mmol/L or 120 mg/dL (venous blood sample). For long term monitoring of stable DB2, daily fasting glucose is the most useful measurement. Morning blood pressure and body weight can be added to a daily record to provide good information about stability or change.

2. Two hours after eating; blood glucose rises and then falls to a baseline level. By sampling blood glucose levels one and two hours after eating, you determine if glucose is being removed from your blood in a reasonable time. The goal is to show values less than 7 mmol or 120 mg/dL at two hours. Higher values tell you that you must do three things:  (i) Reduce the amount of food. (ii) Change the food choices that caused high glucose level. (iii) You need to exercise after the meal to increase glucose utilization.

3. Checking symptomatic episodes: you measure blood glucose when you are not feeling well to find out how your symptoms correlate with the blood glucose level. High levels are associated with an intoxicated feeling - drowsy, hard to concentrate, and judgment is impaired. Levels above 15 mmol are much too high. You are drowsy and want to sleep at this level but the most effective way to reduce the glucose levels is to exercise as vigorously as you can. Levels below 4.0 capillary (60 mg.) cause hypoglycemic symptoms - you feel strange, anxious, irritable; your heart rate increases and a tremor develops if the blood glucose value falls lower and you become desperate to eat something. If you take a quick glucose hit - a glass of orange juice will do - your blood glucose level should rise within minutes; as you feel better, do another blood glucose check in 20 minutes will determine the blood glucose value that feels more normal.

Managing Diabetes 2

Alpha Nutrition Program

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Alpha Nutrition is a trademark and a division of  Environmed Research Inc. Environmed was founded in 1984 at Vancouver, BC, Canada. Online Since 1995. Experts in Self-Managed Care. Experts in Elemental Nutrient Formulas.  All Alpha Nutrition formulas, printed books and Starter packs are ordered online. We ship through the Post Office to all destinations in Canada, Continental USA, Alaska, Hawaii. Prices are listed as Canadian dollars. US $ prices depend on the daily dollar exchange rate. Persona Digital is a separate online site dedicated to downloading eBooks, music, tutorials and other digital documents. All Alpha Education Books are available as inexpensive downloads from Persona Digital.