Caring for yourself when routine diabetes care is suspended?

During this unprecedented time, with routine out-patient services being postponed until further notice you may have some questions about how to best “self “manage your diabetes. Support services such as routine nurse, GP, Diabetes clinic, group education sessions have all being postponed in order to restrict movement of members of the public. Some hospitals are doing virtual outpatient clinics which involves a consultation over the telephone or video call between the healthcare professional and the patient in the place of a face to face appointment.

 

 

However, if you have concerns about your diabetes care or you need medical attention for any reason you DO STILL NEED to contact your GP by phone to avoid a situation where you become more unwell

 

Such situations may include:

  • if your glucose levels are consistently not with in the ranges set for you by your doctor and you cannot get them under control.
  • if you have questions about your medication.
  • if you develop an infection or become ill.
  • If you require any attention for problems that may relate to your diabetes e.g Foot infection/ cuts bruising or changes in colour.
  • Changes in Eyesight.
  • Blood pressure concerns.

 

For general information call the Diabetes Ireland information line on 01 8428118, or email [email protected] if we can help with your query.

 

Continue to take medication as prescribed:

Do continue to take your medication as prescribed. It is important though to inform your doctor/pharmacist by phone if you are experiencing any difficulty with it with respect to prescription update and supply, side effects, effectiveness of the medication or questions about when or how much to take. https://www.diabetes.ie/will-i-be-able-to-continue-to-get-my-medications-supplies/

 

Managing Glucose levels:

 

High Blood glucose levels:

If your glucose levels are higher the recommended range for you may need to discuss this with your doctor, or it may be that you –

 

Sick Day Management

  • If you have diabetes and are feeling unwell, your blood glucose levels will tend to rise which makes it more difficult to fight illness.
  • Remember never stop your diabetes medications/insulin unless instructed as part of your Sick Day Regime. Do check with your doctor or pharmacist as some oral medications may need to be altered. For further information, see https://www.diabetes.ie/what-if-i-get-a-mild-illness/
  • If you do Home blood glucose testing, check your glucose level more frequently.
  • Eat normally if possible and drink plenty water and sugar free fluids to keep hydrated.
  • If unable to eat you may need to sip on non-diet drinks and try light foods frequently e.g. toast, yogurt /custard.

For people with diabetes on insulin therapy – Sick Day Leaflet – Type 1 for more information. This information is a general guide only. Each person should have their own individual Sick Day Regime. If you don’t have one, contact your own diabetes team today.

 

With Type 2 diabetes, you need to know which medications to alter if not eating – check with your pharmacist if any of the tablets or injections you are taking should be altered if you are unable to eat.

Your Sick Day Regime should help you stay in control. Sick Day Leaflet – Type 2 for more information. This information is a general guide only. Each person should have their own individual Sick Day Regime. If you don’t have one, contact your own diabetes team today.

 

Low blood glucose levels (Hypo)

Those on insulin injections will be at risk of low blood glucose levels. Certain tablets for Type 2 diabetes may also increase the risk of hypos occurring, check with your pharmacist to see if the medication you take puts you at risk of a hypo

If you are experiencing hypos (Low blood glucose levels) ie < 4mol

It may be that you:

Ate less Carbohydrates than usual.

Took more diabetes medication / insulin than usual.

Missed or delayed a meal.

Are more active than usual / started a new activity.

We’re drinking alcohol.

 

Low blood glucose symptoms include:

Shaky, nervous, sweaty, clammy, weak or dizzy or a combination of feelings.

 

*You need to be very mindful of the symptoms and causes of low blood glucose. particularly if you are self-isolating, STAYING AT HOME and spending more time on your own than you usually would.

 

*Make sure you continue to eat regularly and do not leave too long between meals.

 

*Have some fast-acting carbohydrate to hand in case you need to treat a hypo.

 

HYPOs (Low blood glucose) NEED TO BE TREATED IMMEDIATELY

 

What to do

If possible, check your blood glucose and if it is <4. Otherwise if you think it is a hypo, but are unable to test your glucose – you are best to treat it as such.

 

Step 1

  • Take some fast acting carbohydrate immediatelyg.glass (150mls) of non-diet mineral or sugary drink or 150mls fruit juice OR 3-4 glucose or dextrose tablets or LIFT glucose drink
  • Recheck your glucose levels after 15 minutes
  • Repeat step 1 if you still don’t feel well or your glucose level is still<4

Step 2

  • Follow this with a snack eg plain biscuits, or a sandwich or next meal if it is due
  • Try figure why the hypo happened so you can try avoiding it happening again

Keep your phone charged and close by.

Save the details of contact persons and your doctor in case of emergency

Ask relatives and friends to keep in contact by phone

 

Eyecare & Eye Screening

The HSE Retina Screen programme is currently paused in line with the HSE measure to stop the spread of COVID 19

You may have questions about what to do in the event of your screening being cancelled or were if you were due a follow up see https://www.diabeticretinascreen.ie/covid-19.2714.html for further information regarding these questions, and more, see

Or freephone 1800 45 45 55

Global vision 1800 30 36 33

 

If you are worried about any symptoms or have any difficulty with your sight, please phone your GP.

 

NEVER IGNORE SYMPTOMS

 

 

Footcare

An essential part of Diabetes care and preventing potential problems from your diabetes is looking after your feet. To prevent foot problems daily footcare is vital:

Some essential daily footcare tips include

  • Exam your feet daily including in between your toes checking for any broken skin, hard skin. If you cannot reach your feet or see your feet use a mirror or take a photo of the sole of your foot using the camera on your phone so you can examine them more closely.

 

  • Wash your feet daily and dry thoroughly especially in between your toes.

 

  • If the skin on your feet is dry, moisturise but avoid moisturising in between your toes.

 

  • Change your socks daily and ensure they are not too tight.

 

  • Always avoid walking barefoot.

 

  • Examine footwear before putting them on to ensure there is nothing in your shoe that may cause injury.

 

  • Any callous, corns, problem toenails do not attempt to treat at home but make an appointment with a podiatrist.

 

See booklet for more information

https://www.diabetes.ie/wp-content/uploads/2014/11/Footcare-New-Feb-15.pdf