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Our Diabetes Educator answers your questions

 by angela blair rn cde on 23 Feb 2017 |
1 Comment(s)
My blood glucose levels are playing up at night.

Max called me the other day because his blood glucose levels when he wakes up had become very unpredictable. Some mornings they were under 6 and other days around 12 to 14. Max treats his diabetes with tablets at breakfast and Lantus once a day usually in the evenings. We explored what had recently changed in Max’s life.  Sadly, Max had become a widower and his life also unpredictable especially at night. He found, because he wasn’t sleeping well he often feel asleep on the lounge after dinner. He used to have his Lantus at around 8:30 to 9:00pm at night but recently this had changed to anywhere form 8:30pm to midnight depending on when he woke up.
Lantus is a once a day insulin that works for 24 hours and should be taken at roughly the same time every 24 hours. Max didn’t know this. We chatted about the best time for him to take his Lantus and Max decided that 7:00pm would work because that’s when he watched the news. I am happy to report Max is again finding his levels on rising are now under 7. 


 
Disposing of used sharps

Question: I have a new meter and “finger-pricker” that is very different to my old one. This new one has a head with 6 lancets that I can use one at a time but don’t need to take out. Do I still need to throw this out in a sharps container or just the general trash?

Answer: The lancet drum should be disposed of in a sharps container. If the lancing device head or drum is dropped on a hard surface, the lancets may stick out slightly from the drum and could cause injury, so it is still considered a “sharp”. If you drop it, always pick it up at the red-striped end and dispose in a sharps container.
Sharps include finger prickers or blood glucose lancets, syringes, pen needles and needles used to insert insulin pump tubing.
There are many Australian Standard Sharps collection containers available from Diabetes NSW shop or your local pharmacy. Alternatively, you could you use puncture-resistant plastic container with a screw top such as a liquid detergent bottle. 




 
Eating healthy isn't easy when I'm being tempted by friends and family

Question: I'm having terrible trouble getting motivated to exercise & eat well. My husband sabotages my efforts with cakes & dinners & it's so hard to resist. My blood glucose levels are ok but my stomach fat is atrocious I feel bloated & horrible & my clothes are all too tight. I'm type 2 on 1 x metformin daily.

Answer: As an educator I have been asked this many times. Type 2 diabetes is a progressive condition and over time you have the opportunity improve your diabetes journey with some simple changes. Sit down together and talk about what is happening and ask for his support. Here are some suggestions that I know have worked for many people.

Diabetes Support Tip No. 1: Talk Diabetes

Have a chat about what you need and what he thinks about your diabetes. I encourage people to work together. He may still be able to provide some treats, but may need help in how to make them healthier for you. Ring and speak to one of our dietitians for suggestions and advice. There are some great diabetes friendly cookbooks that he can use that won’t bust your waist line.  As much as your spouse loves you, ultimately, your diabetes belongs to you.

To view our range of e
ndorsed cookbooks, all reviewed by one of our Accredited Practicing Dietiticans (APD), against the Diabetes Australia nutritional guidelines, click the link below.


Diabetes Support Tip No. 2: Adopt Healthy Habits for the Whole Household

I have found in most households everybody wants cookbooks, but in reality, most people cook the same seven meals over and over again. A dietitian can give advice on how to adapt familiar recipes into healthier versions or advise on serving sizes. Shop together for your groceries and make a list before you go.

If you need more information on filling your shopping cart with healthy meal options, check out the Diabetes Australia Healthy Shopping Guide 2016, by clicking the link below.


Diabetes Support Tip No. 3: Help Make Time to Move More

Make exercise a priority but if possible do it together. Goin for a walk together is a great time to catch up and talk about the world around you. Maybe investigate local gyms or personal trainers.

For an easy at home work out check out our Resistance Training Pack by clicking the link below.


Diabetes Support Tip No. 4: Educate Him

Give your husband some simple information to read so that he understands your diabetes journey. There are some great fact sheets about managing your diabetes on our website; diabetesnsw.com.au.
 
I would suggest to start by setting some realistic goals such as working with him to set out a week’s menu plan that has healthier options, shop together so you both select the foods for the pantry or an exercise plan for the week.  
The choice of what you will or won’t eat is yours. As long as you balance what you are eating with how much you are moving, your waist line should benefit. I often suggest documenting for a week, how much food you eat and when, physical activity in minutes over the day, including any barriers such as weather or illness and how you feel. This will help you look for patterns over the day for times you may indulge such as after dinner when watching TV. This will help you make some changes.
Sometimes it is as simple as starting with one change such as moving more. Good luck.


Click the link below to read the latest fact sheets from Diabetes Australia.




If you have any questions about diabetes related products please email me at angelab@diabetesnsw.com.au.

For more information about living with diabetes or any of the on our website products please call 1300 136 588 to speak to one of our diabetes educators or visit our online shop at www.diabetesshop.com.

 
About the Author
Angela Blair
 
I am a credentialled diabetes educator through the Australian Diabetes Educators Association and have worked in diabetes care and management since 1979 in a number of clinical and management roles.

My professional qualifications are NSW registered nurse/midwife with a Bachelor of Nursing from the University of Newcastle (1993), and a Masters in Applied Management (Health) through the University of Newcastle.

Comment(s)1

rennai - Comment
rennai05 Mar 2017Reply
My 7 year old type 1 sons levels shoot up from 4 to 12 after taking lantis. He hasnt eaten inbetween and he has insulin at 5pm for dinner and lantis at 7pm for bed. Whats going on?
rennai - Comment
rennai05 Mar 2017Reply
Thank you for your reply, we upped his meal time dose and fingers crossed this has helped.
angela blair rn cde - Comment
angela blair rn cde05 Mar 2017Reply
The first step is take some extra finger prick test for three or four days, if that’s OK with your son. Test before dinner when he takes his insulin, 2 hours after at 7pm and again at 9pm. Compare how much carbohydrate he eats at dinner, with the amount of fasting insulin he takes. I would suggest taking these results to his diabetes team to discuss as it is more likely that the fasting acting insulin is not enough for the food he is eating at dinner, or it may be the type of carbohydrate, some types have a faster impact on the glucose levels and others are quite slow such as dairy.
The usual rule is to look at pre-meal levels to see if the long acting insulin is the correct dose and before and after meals to see if the fasting acting insulin (Novorapid, Humalog or Apidra) is the correct amount for the blood glucose levels and carbohydrate eaten. If your son’s pre-meal levels are stable and in the target range, then his dose of Lantus would seem to be suitable for now. If he his level is going up after the meal within the 2 hours, then he probably need a review of his fast acting insulin dose.
Look for patterns and take 3 – 4 days of results with the amount of carbohydrate eaten, activity times and any changes to health along with you when you next see your diabetes team.
For more information, call 1300 136 588 and speak to one of our diabetes educator.

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