If you can only educate your patient on one thing to control their diabetes, what would it be?
Understanding their disease and their goals, and making those goals achievable within their cultural and economic context. This has been my biggest key to success with previously noncompliant patients. Not everyone has access to a wide variety of fresh foods, or can afford them. Handing a patient a booklet on diet that divorces them from their culture is virtually a guarantee of noncompliance. We desperately need dietitians, diabetes educators, physicians, and nurses who can translate optimal diabetic diets into AAPI and BIPOC cultural cuisines--as well as dispel myths about diabetes and diabetes management in each culture. We need to take time to understand the patient's economic situation and present solutions within their budget.
As RNs, we need to understand the difference between Type 1 and Type 2 diabetes, and learn to recognize our inherent bias and stop fat shaming or BG shaming our patients. Sometimes, people do everything right and still have difficulty controlling blood glucose levels due to factors beyond their control (site absorption, hormone fluctuations, stress, other health issues...). We need to work with the patient and encourage them, not develop an adversarial relationship.
Controlling blood sugars! Checking with finger sticks one hour and half after meal. Watch carb intake most important.
Teaching is patient centered. What does your patient want to know today? And consider starting each appointment by thanking them for coming in.
be mindful of the consumption of carbs!!! and exercise is essential
what they want to learn.
No regular soda, no regular sugared drinks, no sweets. Drink plenty of water.
Decreasing and eliminating stress in their lives.
The relationship of a healthy diet and any form of exercise more than the person is doing currently. I have patients with diabetes ,as well as myself, and to control my blood sugars required exercise much more than the walking I was trying to do, sometimes my blood glucose then would bottom out and I would have to eat carbs to bring it back to a normal level. There is a balance which when people understand that, they feel better.
Meal/food choices! Structure your meals like this: The majority of your plate should be non starchy veggies. Eat them first. You can dress them up with a little healthy fat such as olive oil, avocados, etc. Then eat your lean protein. Then a very small portion of starchy veggies OR grains. Snacks are similar and should contain protein and fat.
BE-SAFE
If you can do one thing that really helps, take at least 1 flight of stairs before you get on the elevator. Park just a little further away from the grocery store, WalMart, Target, your doctor's office, church or temple, etc. Walk around your block every day and try to increase the number of times you do this- up to 3 times/day. Get a dog if you can, and you don't want to walk alone. Buy 5 or 10 lb weights and use them every day, by following You Tube videos on increasing upper arm strength. More muscle equals a higher metabolism, and more calories burned, even at rest. Good Luck!
Susie, BSN, RN
Type 1 or 2?
Control your glycemia twice a week and tale note.!
Diet, Diet and diet. I use the Lilly diabetic education booklet and review how to follow a diabetic diet. I know the ADA doesn’t use that anymore but I found that it is easier for patients to understand and follow. The patient is given a copy to take home.
Checking the blood sugars AND knowing the abnormals. You’d be surprised how many think 200 is fine.
Meal planning, their food intake will drive their BG and A1C.
Low glycemic index foods
