Hellooo Friend!
Hema Here!
Have you ever felt Diabetes like a nagging headache in CSA?
How many types of cases, scenarios, information we need to be aware in DM?
The List is endless!
httpv://youtu.be/oWNHGPLEZ-s
Yesssss, It would be tooo overwhelming many times!
It was a nightmare for me before my CSA.
I am sooooo happy to share some of my golden tips.
You can use these fantastic tips when reviewing a patient with High BMs after commencing Insulin.
Ask Questions – Non Leading Questions!
1. Ask patients what do they think about the blood sugars?
2. Have the patient felt any difference/ any new symptoms while on Insulin?
3. Educate the target BM range like – FIVE to NINE most of the time. ( nine and time rhymes)
4. Where would they like the target to be ?
5. What do they think about the current sugar levels and what to do next?
(Do not be surprised if they say – insulin should be decreased if BMs are high and vice versa )
6. Educate in an easy simple way like – ”Higher insulin for Higher BMs” and Vice versa.
7. What should we do now? ( can increase / decrease 10% or 2 units at a time)
8. How will they feel when thinking of adjusting the insulin?
9. Acknowledge that it is normal to feel scaryyyy or equivalent, even bit confusing at first. What do they think?
10. If they are afraid, Tell them that you will phone them in a week and tell them –
” I am going to ASK you ( not TELL)- WHAT YOU WOULD DO?”
THE IMPORTANT POINT IS TO EDUCATE AND EMPOWER PATIENTS TO ADJUST THEIR OWN INSULIN DOSE ACCORDING TO THE BMs.
OTHER GENERAL TIPS
1. Highlight a day in their diary ( for eg every sunday) using a yellow highlighter to encourage patients to think if they need to adjust their Insulin dose!
2. BMs Target is 6-12 for illness.
3. Sick day rules
a.Carry on same insulin dose (may even need more) and check BMs often and adjust the insulin dose.
b. Sip on milky or sugary drink to avoid ketoacidosis.
c. Can use ketone testing strips.
4. HI in Glucometer means BMs around 28-30
5. Rock & Roll ( shake) the Insulin device before use ( to mix or re suspend). ( I like it)
6. When starting Insulin, calculate the dose using 1/3 of the patient’s body weight.
For eg- 90 kg man needs 30 units daily.
7. You can go to Yorkshire Diabetes or diabetes.org.uk sites for further reading.
8. Reduce 1/3 rd of the usual morning dose if planning to have increased physical activity that day to avoid hypos!
9. Check the use of alcohol, exercise, dietary habits, occupation, DVLA rules, mental health problems etc.
10. Introduce patients to self-help groups, websites etc.
REMEMBER –
Consistent Practice brings Consistent Results.
Thats all,
To Your Success,
Hema xoxo.
Keep watching for THE BOOK – ” Diabetes Made Easy for CSA”
P.P.S
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