It may take you a while to digest the news after you see your doctor and get home: You have diabetes , and now you need to control your blood sugar levels. As you adjust to this new lifestyle, let's take a look at the tools and other things that can help you manage your condition and prevent future complications. All of these play a different role in managing your diabetes .
Insulin and its methods of administration
Your doctor may recommend that you take insulin to control your high blood sugar levels. Simply put, insulin is a hormone produced by an organ in our body called the pancreas. It helps the sugar in the food we eat be used for energy or stored.
If you have Type 1 Diabetes , your pancreas has stopped making insulin altogether. But if you have Type 2 Diabetes, your pancreas still makes insulin, but your body doesn't use it properly.
Depending on your condition, your doctor may prescribe different types of insulin. Some work quickly, while others work slowly and stay in the blood for a longer time.
Typically, you may need to inject insulin from one to four times a day. This will be determined by your doctor. There are several ways to do this:
- Syringe: A syringe can be used to draw up the correct dose of insulin from a bottle and inject it.
- Insulin Pen: This is very easy to use. Some pens come pre-filled with insulin, while others require us to insert a cartridge.
What is an Insulin Pump?
Sometimes, instead of taking injections several times a day, your doctor may suggest that you use an insulin pump. This delivers insulin to your body gradually throughout the day. You still need to check your blood sugar, but some people find that it helps control their blood sugar levels.
This pump is very small. You can easily keep it on a waistband, in a sock, or in your underwear. It is connected to a thin tube called a ``catheter''. This tube is placed under your skin with the help of a needle.
This pump releases insulin in small doses throughout the day, as programmed according to your needs. Also, when you eat a meal, you can press a button on the pump to get an extra dose of insulin needed to burn the carbohydrates in that meal.
Blood Sugar Meters
A blood glucose meter (or glucometer) is a small electronic device used to check whether your blood sugar level is too high or too low.
How to use this is very simple:
1. First, prick your fingertip with a small needle called a ``Lancet'' and collect a small drop of blood.
2. Place the drop of blood on the designated spot on a test strip (Diabetic Test Strip).
3. Then insert the strip into the meter, and within a few seconds your blood sugar level will appear on the screen.
It is very important to write down these results in a book. This will help your doctor make sure your treatment plan is working. Your doctor will tell you how often you need to check your blood sugar. Especially if you feel shaky, anxious, dizzy, have a pounding chest, sweat, feel very hungry, or sleepy, these may be signs of low blood sugar (hypoglycemia). Be sure to check your blood sugar at such times.
Continuous Glucose Monitor (CGM)
This is another advanced device. It automatically measures your blood sugar levels every few minutes, 24 hours a day. This allows you to know in advance if your blood sugar levels are too high or too low.
A small sensor implanted under the skin sends data to a device on your wrist or to your phone. This data can be used to track patterns and trends in your blood sugar levels. This information can help you and your doctor develop the best treatment plan.
But remember, even with a CGM, you still need to take blood from your finger with a regular glucometer several times a day to ensure its accuracy. You also need to change the sensor under the skin every 3-7 days.
Ketone Test Strips
When your body doesn't have enough insulin to use sugar, it starts burning fat for energy. This process produces substances called ketones . Elevated levels of ketones in your urine are a dangerous sign that your diabetes is out of control .
Your doctor may recommend a ketone test if you have the following symptoms:
- If your blood sugar level is 240 mg/dL or higher
- If you feel sick or tired all the time
- If you have a dry mouth and feel thirsty all the time
- If you feel confused
- If you have difficulty breathing
To do this test at home, collect some urine in a clean cup and dip the test strip in it. Shake off any excess urine and wait for the strip to change color according to the instructions. Then, compare the color of the strip with the color chart on the kit. If your ketone levels are moderate or high, see your doctor immediately. If necessary, go to the nearest hospital Emergency Department (ETU).
Other essentials and emergency preparedness
When managing diabetes, it's important to keep a few other things with you. Let's look at what those things are in this table.
| Need | Things to keep close by |
|---|---|
| Hypoglycemia | Something to quickly raise your blood sugar, such as glucose tablets, sugar cubes, toffee, a bottle of fruit juice. A glucagon injection (on medical advice) to give if you lose consciousness. Keep these in several places, such as in your bag, car, and office drawer. |
| To protect skin and feet | A mild soap, a moisturizer for the skin, items to clean the wound (sterile gauze, paper tape), nail clippers, and a mirror to check the feet daily for wounds and blisters. If there is nerve damage, seamless, padded socks. |
| For oral health | A soft-bristled toothbrush, toothpaste containing fluoride, and dental floss to clean between teeth. |
| For an emergency | A bracelet or card that says you have diabetes (Medical Alert ID). A phone number for someone to call in case of an emergency. An emergency kit that includes at least 7 days' worth of diabetes medication, insulin, test strips, batteries, etc. |
Is it easy for us to get all these devices in Sri Lanka?
Some of the advanced devices we've talked about, for example, insulin pumps and CGM devices, are not very common in Sri Lanka. And they're also very expensive.
Glucometers, test strips, lancets, and various types of insulin are generally readily available from pharmacies in our country. However, there may be some difficulties in obtaining advanced technological equipment.
So, don't be discouraged by what others are using. The most important thing is to talk to your doctor and decide which treatment method and equipment is most suitable and appropriate for you, based on your financial situation, lifestyle, and the nature of your illness.
Take-Home Message
- Managing diabetes is a journey, and having the right tools and supplies is essential to make that journey easier.
- Check your blood sugar levels regularly as advised by your doctor. Record the results.
- Be aware of the symptoms of low blood sugar (hypoglycemia). Always keep something that can quickly raise your blood sugar (glucose tablets, sugar cubes) nearby in case of such a situation.
- Always be prepared for an emergency. Carry a diabetes ID card and an emergency supply kit.
- Talk openly with your doctor about what treatment options are most appropriate and affordable for you.
Diabetes, diabetes equipment, insulin, glucometer, blood sugar, hypoglycemia, diabetes management
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