Managing Diabetes and Improving Your Health " Rachael a 62-year-old retired teacher "

Case study ( 8525 views as of May 20, 2024 )

Rachael, a 62-year-old retired teacher, has gone in to talk to an endocrinologist about her diabetes. She has had increasing blood sugar levels on testing for the last four years and finally this year she is now considered to be a diabetic.

She is very serious about her overall health and therefore would like to discuss any suggestions on how to improve her health. She is so engaged and ready to take action that she has several questions for the doctor regarding how to self-manage her diabetes and create a long term management plan.

The endocrinologist makes several suggestions for Rachael to start her management plan. To begin, an optometrist can check her eyes for any signs of diabetic retinopathy. A dietitian can teach her about foods that have a low glycemic index to help regulate blood sugars. A dietitian can also give her tips on weight loss and dieting. Her family physician can help her manage and maintain a diabetes plan over the long term. Lastly, she should see a pedorthist to ensure good foot health.


Conversation based on: Managing Diabetes and Improving Your Health " Rachael a 62-year-old retired teacher "

Managing Diabetes and Improving Your Health " Rachael a 62-year-old retired teacher "

  • The former term for type 2 diabetes. Although type 2 diabetes usually occurs in people over 40, this term is no longer used because the disease is being increasingly diagnosed in younger people, even adolescents and children.
  • For diabetes control…know our ABCs :A achieve A1C targets of =7%B: acheive BP targets of <130/80 mmHgC: achieve Cholesterol targets LDL-C <2.0 mmol/LD: consider Drugs for cardiovascular risk reductionE: achieve Exercise goals S: see your primary care provider to screen for diabetes complicationsS: Smoking cessationS: optimize diabetes self-management, be mindful to manage stress
  • For diabetes control…know our ABCs \nA: achieve A1C targets of =7%\nB: acheive BP targets of <130/80 mmHg\nC: achieve Cholesterol targets LDL-C <2.0 mmol/L\nD: consider Drugs for cardiovascular risk reduction\t\nE: achieve Exercise goals \nS: see your primary care provider to screen for diabetes complications\t\nS: Smoking cessation\t\nS: optimize diabetes self-management, be mindful to manage stress
  • The case study recommends that she see a pedorthist regularly. Is that to keep an eye out for circulation issues that diabetics are prone to ? Or would there be other reasons ?
    • @K.Michael - absolutely. Foot care is so important to people with diabetes. Over time, diabetics can lose sensation in their extremities from nerve damage and if they don't notice a small nick or cut on their feet, it can lead to infection which can easily cause more severe damage because of the circulation challenges. Having someone else check your feet regularly is a good preventative practice since we don't always look at our own feet, especially the soles and around each toe.
  • There are generally three main ways to take insulin. The first would be premixed insulin, where the product has already been mixed, perhaps short- and intermediate-acting insulins in the same vial; inject twice a day, usually breakfast and supper.
    • My understanding is that there are various medications used in Type 2 diabetes to stimulate insulin production before insulin is administered externally on a regular basis. This would result in the blood sugar stabilization you're referring to. Although, the term 'insulin pill' may be a bit misleading since the pill wouldn't contain insulin itself. I'm fairly certain this type of treatment would only really be relevant in Type 2 diabetes that has progressed significantly, not in Type 1 Diabetes since the ability to actually produce insulin is lacking in Type 1.
    • Before my father began taking insulin daily he took what he referred to as an insulin pill. Is there a medicine normally given to help stabilize blood sugar prior to needing insulin?
    • As you gain weight, your life expectancy decreases. And there are also other issues, such as effects on fertility; obesity decreases your fertility, and also effects on joints, particularly lower limbs, knees, hips, lower spine.
  • With circulation, and decrease of circulation specifically with diabetes, comes many problems, including nerve damage and peripheral vascular problems at the bottom of the feet and fingertips. A lot of diabetics, if the damage gets severe enough, can’t actually feel the bottom of their feet, and if they happen to step on something that could hurt them, they might not actually feel it. And the damage could be done without them even knowing it.
    • My father finds that the circulation issues caused by his diabetes are helped by wearing the diabetic socks. The offer support but aren't so tight they create more issues.
    • Very true - and this can lead to infection which can be much harder to manage for those with diabetes, especially for those with poor blood glucose control.
  • We have several family members who have Type 2 diabetes. The main way their doctors have them controlling it is through diet and exercise. This is a big part of their health and well being, therefore they take it very serious. Watching what they eat helps to maintain good glucose levels when testing their blood.
    • In my experience, people struggle with the dietary changes required by a diabetes diagnosis. They often feel they have to give up all their favorite foods when really, they just need to learn a new way to enjoy them. A dietitian's guidance is crucial at this time.
  • My MIL has type 2 diabetes and has been able to control it with diet and exercise. I encourage Rachael to do whatever she can to help control her diabetes. Her hard work and persistence will pay off.
  • Rachael should consider consulting an exercise specialist to get a baseline fitness assessment completed. This can help her understand where her current fitness level is. Also, she is starting with a good level of motivation, and having a baseline in order to compare her progress to as she works towards her goals can really help her stick with her exercise efforts.
    • My Aunt was sent to a doctor and was told to keep a 7 day log of any exercise / movement that was occur in her day to day life. In addition to this, she was also asked to keep a food diary for the 7 days. When she returned to the doctor they discussed both and it helped to pinpoint where she needs to change things. By doing this she has been able to become more active and her diabetes is more controlled.
  • Was this patient diagnosed with type 1 or 2 diabetes ?
    • @kimberley, Rachel most likely has Type 2 diabetes.
  • Family physicians are taking a greater role in the care of diabetes patients. Pharmacists are also full of information for people with diabetes. London Drugs has many useful pamphlets that patients can take home and learn more about the disease. Can anyone comment on what information a dietician/nutritionist can provide for diabetes?
    • @ Bernadette diet plays a huge role in diabetes management, for both type 1 and type 2. Registered Dietitians and those specialized as certified diabetes educators (CDE) can help individuals adjust their diet so that the food they eat does not cause huge spikes in blood sugar levels. For example, this could include eating less carbohydrates or more protein at meals.
    • I would think it would depend on whether you have type 1 or type 2 diabetes ? Some nutritional recommendations would be the same but they are two separate diseases and need to be treated as such
  • My father had borderline blood sugar issues for a number of years without making any dietary changes. Now he has type 1 diabetes
  • A person with diabetes must be extremely careful to eat a healthy diabetes diet, in order to balance carbohydrate intake and keep blood sugar levels within the target range. Diabetes is a lifelong disease that affects how your body makes or uses insulin. In people who don;t have diabetes, insulin is released after eating to regulate blood sugar levels, and allows glucose from the blood to enter the cells. However, in someone with diabetes, this process doesn;t work properly and glucose begins to build up in the blood
    • If someone comes in with a diabetic sore, we always make sure that we refer to a specialist because their wounds heal quite a bit slower because of the circulation problems that can arise from diabetes.
    • @ Kimberley this is true. For some people with Type 1 diabetes they may produce a tiny amount of insulin but not enough to maintain healthy blood sugar levels. Those with Type 2 may make enough insulin but their body is resistant to using it, to move sugar out of the blood and into the cells.
    • @Mr. Jackson Sayers - I thought people with Type I diabetes don't produce insulin on their own ?
  • There are so many options out there now for the treatment and management of diabetes. It is important to do your part in the self management of diabetes to help eliminate or reduced future issues resulting from a diabetes diagnosis.
  • Also, a good exercise routine will assist in weight loss and overall diabetes management.
    • Exercise and watching their diet closely is what helps several family members stay within a good range when dealing with Type 2 diabetes.
  • Diabetes is a condition that effects many and should be taken seriously. Consult your entire team for good advise and treatment options.
    • @John Smith Diabetes is a situation that needs a lot more education in the media / public. Especially involving childhood diabetes and schools
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