Self-management -

Self-management

Why you should learn to manage your diabetes

One of the best things you can do to help your diabetes is to learn to manage it yourself. You get to keep track of your blood sugar. That means you play an active part in managing your diabetes.

Why is this important? Because so many things you do in your daily life affect your blood sugar. You are the one who takes your medication. You decide when and what to eat. You choose how much and when to exercise.

Treating your diabetes

With type 2 diabetes, your body may not make enough insulin, and may not respond to that insulin properly.

Having diabetes means you need to help your body do what it once did automatically. Before you developed diabetes, your pancreas did the work. It kept your blood sugar normal by producing the right amount of insulin at the right time.
Now it’s up to you to make sure your body works as it should. It’s not as off-putting as it sounds. For one thing, you won’t be left to cope all on your own. Your diabetes care team will help and support you.

But the fact remains you are in charge of managing your diabetes.

Set targets

Setting your own personal health targets is a very valuable thing for you to do. Together with your doctor, decide on targets for your blood glucose, blood pressure and cholesterol (see also the section on your heart).

The guidelines for adults with type 2 diabetes say you should aim to have:

Blood glucose levels between 4-6 mmol/l before meals
Blood glucose levels no higher than 7.5 mmol/l two hours after meals.

Learning self-management

It takes effort to become an expert in self management. You can’t learn just by reading about how to do it.

The best way to learn is by practising. With time and practice, and working closely with your diabetes care team, you can learn to manage your diabetes effectively and keep good control of your blood sugar.

Testing your blood sugar

Testing your blood sugar tells you how well you’re controlling your diabetes.

It helps you plan your medicine, food and exercise. It also allows you to detect patterns in your sugar levels. This in turn helps determine the best treatment for you.

Recording blood sugar measurements

Good blood sugar control

There are real benefits from good blood sugar control:

It can make you feel better in your daily life when it’s under control
It can make you feel sick, tired and uncomfortable when it’s too low or too high
It also helps prevent long-term complications when it’s under control.

Research shows that tight blood sugar control delays the start of complications, and slows them down if they have started.

Test your blood sugar

You can test your blood sugar in two ways:

One way is to apply a drop of blood, taken from your fingertip, to a test strip. After a short time, you can check the colour against the colour strip on the bottle
The second way is to use a meter, which will display the result automatically. Meter testing gives you the most accurate reading, because the meter reads the colour of the strip more accurately than your eyes.

When to test your blood sugar

Familiarising yourself with your own blood sugar patterns is extremely valuable.

It’s a good idea to start keeping a diary of your sugars at different times during the day, soon after you find out that you have diabetes.

Exactly how often and when to test varies among individuals. It depends on your particular reasons for testing. Talk with your diabetes care team about what is best for you.

HbA1c - an important number to know

Your diabetes care team are also likely to assess your blood sugar control by measuring the level of ‘HbA1c’ in your blood. Although you will not be able to measure this yourself (special equipment and techniques are required), you can use information about your HbA1c to improve your self-management. Technically, HbA1c is a measure of the amount of sugar bound to the haemoglobin in your red blood cells. What it provides in practice is an average reading of your blood sugar level over the previous 2-3 months, which means HbA1c is a useful indicator of your blood sugar control over a set period of time, as opposed to the one-off ‘spot-checks’ from blood glucose meter testing. It helps you and your doctor discuss the best treatment plan for you, and helps you keep track of how well you are doing. Current guidelines recommend keeping your HbA1c below 7.5%. Your doctor will give you individual advice on this.

Testing urine for sugar

Testing your urine for sugar tells you much less about your diabetes than testing your blood for sugar. Urine testing will only tell you if your blood sugar is above 10 mmol/l.

Urine testing can’t tell you if your blood sugar is within your target range. It can't warn you of hypoglycaemia either. Testing the urine only reflects the level of sugar in the blood at the time the urine was formed. Obviously that is not good enough, if you want to know what your blood sugar is right now.

Top tip for self management: Keep a diabetes diary

A diary can be a good way to keep track of your blood sugar readings and ketone tests. It may enable you and your diabetes care team to treat your diabetes more effectively.

How to keep a diabetes diary:

Enter your blood sugar readings in the diary, along with the date and time of testing
Write down your dose and type of medication
Make personal notes about things that may have affected your blood sugar and what you did to manage this
This is all valuable information that you can use to make decisions about your insulin dose. You can then take your diary to your appointments with the diabetes care team.

Download Novo Nordisk's home monitoring diary here.

Self-management: A summary

Managing your diabetes is ultimately down to you
The best way to learn self management is by practising
To become an expert on your own diabetes you need to know about:
   - Testing your blood sugar
   - Your HbA1c number
   - Testing your urine for sugar
   - Keeping a record of how you’re doing – for example in a diabetes diary

INS/701/0107

Last updated: May 2007