One of the greatest joys of being a grandparent is watching your grandchildren grow and change. When you have diabetes, you may want to set a good example—since diabetes, especially type 2, tends to run in families.
With diabetes, you often have to monitor many things: your blood glucose levels, how much carbohydrate you eat, your blood pressure, your weight, and any changes to your feet and more. This information is just as valuable for your health care provider as it is for you, as any patterns or changes can show how well your diabetes management plan is working.
But this task may seem overwhelming. There is so much information to collect. What’s worth sharing? How do you organize and present it? Here are some tips for communicating your blood glucose results with your health care provider.
When you are monitoring your blood glucose levels, it is very important that you know your target ranges. If you don’t know your target blood glucose levels, this is the first thing you should discuss with your provider. The American Diabetes Association recommends that blood glucose goals be individualized, based on other conditions, especially in older people with diabetes.
Once you know your targets, you can check your blood glucose to see where you are. Although many blood glucose meters have data memories that can be downloaded in your provider’s office, it may help to write down your results in a logbook. If they are too high or too low, based on your targets, you can make a note as to the reason. Then, when you discuss your readings with your provider, you will have these notes to jog your memory as to why your blood glucose was out of target.
A major value of monitoring is that it illustrates your blood glucose patterns. These patterns can be related to the carbohydrate content of your meals and snacks, physical activities, medications and even stress. To look for patterns, it is helpful to monitor your blood glucose before each meal and at bedtime for at least three days, without changing your usual lifestyle. If you are new to monitoring, you’ll want to start recording one or two weeks before your next visit with your provider.
When you are at your appointment, first look for any lows. Hypoglycemia is often a concern in older adults with diabetes, more so than hyperglycemia. Try to figure out why they happened, so you and your provider can work to prevent them in the future. This is why it is so important to write down what happened when you have a low. For example, did you skip a meal, eat less carbohydrate or take your toddler granddaughter to the park?
If your blood glucose was too high, identifying possible reasons is also important. For example, was it your granddaughter’s first birthday party? Were you not feeling well?
The next task for your and your provider is to “fix the fasting first.” That means looking at your first blood glucose reading in the morning. If it is not at target, this may indicate that your medication from the night before, or the amount of food you eat in the evening or the timing of it, needs to be changed. Because this may involve changing your medication, it is important to have more than one morning reading to look at.
The most important thing to remember is that blood glucose monitoring is a tool for keeping your blood glucose in your target range most of the time. If you are out of range, your health care provider can help you figure out what to do; for example, change your carbohydrate intake or your activity levels, or even adjust your medication. This really helps to put you in control of your diabetes—so you can live a long and healthy life and enjoy those grandchildren!
Of course, if you notice a drastic change in your blood glucose levels or any other aspect of your health that you’re keeping an eye on, such as an infection on your foot, you should contact your provider right away and not wait for the next appointment.
Linda Haas, CDE, RN, PhC, MN, served 34 years as the endocrinology clinical nurse specialist at the VA Puget Sound Health Care System. She is a Past President, Health Care and Education, for the Association; has served as chair of the Association’s Recognition Committee; and helped author the Association’s position statement on Diabetes in Older Adults. She co-edited a book on diabetes in long term care facilities published by the Association. She currently serves on the Association’s Older Adult Subcommittee.