Self management means
Self management means that YOU keep track of YOUR blood sugar and take an active part in the treatment of YOUR diabetes. This is important because so many things you do in your daily life affect your blood sugar. You are the one who takes the daily insulin injections. You decide when and what to eat. You choose how much and when to exercise.
Treating your diabetes
Before you got diabetes your pancreas kept your blood sugar within the normal range by producing the right amount of insulin at the right time. Now, YOU must do what your body once did automatically. You will not be alone. Your diabetes care team will help and support you. But YOU are the main person to treat YOUR diabetes.
Learning self management
It takes effort to learn about and use the tools of self management. You cannot learn this just by reading about it. Learning by doing is a must. It takes time and practice and requires that you work closely with your doctor and other members of your diabetes care team. They’ll guide you to maintain the best possible blood sugar control.
Testing your blood sugar
Testing your blood sugar tells you how well you are doing with the factors that affect your blood sugar — insulin, food, exercise and illness. A single blood sugar test at the clinic is usually of little value. It takes much more to keep good control of your diabetes. It requires that you test your blood sugar regularly during the course of the day, keep track of the readings in a diary and adjust your treatment accordingly.
Good blood sugar control
You benefit from good blood sugar control, because it can make you feel better in your daily life. When your blood sugar is either too low or too high, you’ll feel sick, tired and uncomfortable. Good blood sugar control also helps to prevent long-term complications from diabetes.
When to test blood sugar
Exactly how often and when to test varies among individuals. It depends on your particular reasons for testing. If you use each blood sugar reading to adjust your next insulin and diet, then you need to test before each insulin injection and each meal. Talk with your diabetes care team about what is best for you. To make good decisions about your treatment, it is also helpful to test before and after exercise, whenever you suspect that your blood sugar is low or high and when you are ill.
Your diabetes care team are also likely to assess your blood sugar control by measuring the level of ‘A1c’ 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 A1c to improve your self-management.
Ketones in urine
If you find ketones in your blood or urine, it shows that your diabetes is not in control. High levels of ketones may lead to a serious condition called ketoacidosis. Ketones in the blood or urine are a danger signal, a sign that you must take action right away to prevent problems.
Test urine for ketones
Ketones are acid waste products that are formed in large amounts if you lack insulin and your blood sugar is rising. When ketones reach your kidneys, some flow out in the urine together with sugar. You should test your urine for ketones if you are ill with a fever or if your blood sugar is higher than 15 mmol/l.
Fill in your diary
A diary is 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. Enter your blood sugar readings in the diary, along with the date and time of testing. Be sure to note the dose and type of insulin and presence of ketones. It’s a good idea to make personal notes about things that may have affected your blood sugar, how you felt about it and what you did to keep your blood sugar under control. This is all valuable information that you can use to make decisions about your insulin dose. Always take your diary to appointments with your diabetes care team.