Are you one of the many diabetics who has trouble getting your blood sugar under control? Is your doctor unhappy with your A1C readings no matter what you do?

Odds are, the situation isn’t as hopeless as it seems. Given sufficient information and motivation, every Type II diabetic can bring their results in line with current recommendations.The question, then, is: do you have sufficient information and motivation?

Here are 5 practical tips to get your sugar under control.

1. Adjust to reality. Patients often tell their physicians that they are taking their medication as prescribed when, in fact, they are not. None of us likes to be scolded by a parent figure. But who are you fooling, your doctor or yourself? Rather than view your physician as an authority figure, think of him as a partner or advisor in your health care. If your doctor has prescribed a medication that you have no intention of taking, speak up, so the two of you can come up with a better solution. If you can never remember your evening dose of insulin, discuss a realistic dosing schedule with your doctor, who may switch you to a different kind of insulin, or combine it with an oral medication. If it’s too difficult to give yourself an injection, find a way to have someone else administer it. If your pills are giving you side-effects, have your doctor switch you to another rather than simply not take them. If you can’t pay for your medication, ask your doctor to change you to something more affordable, or check into a patient assistance program.

2. Educate yourself about the glycemic index. Many diabetics believe that sugar is the only food the must avoid. This is far from the truth. Other carbohydrates raise the blood glucose level as quickly and as high as sugar itself. Even the glycemic index is not the final answer – educate yourself about the glycemic load as well. Whereas cantaloupe and croissants may have similar glycemic index listings, it’s much easier to gorge on croissants than cantaloupe. Total calories consumed is at least as important as the glycemic index of a particular food.

3. Just eat less. If educating yourself about the glycemic index and glycemic load is too difficult, just eat less. Eat less of everything and your sugar is sure to improve. If you have a Big Mac and large fries for lunch, cut down to a cheeseburger and small fries – not the healthiest diet, but still an improvement. If you normally have seconds for dinner, stop after your first serving. Most diabetics became that way through a long-established pattern of overeating. Cut out a third of your calories and watch your levels improve. Discuss this approach with your doctor first, in case your medicine needs to be adjusted. You don’t want to run the risk of a low blood sugar either.

4. Switch to insulin. Most diabetics are afraid of the needle. But nowadays the needles are so small you barely feel them. With so many oral medications available, patients are often taking 2 or 3 different kinds in order to put off starting insulin. This becomes costly and the dosing schedule may be complicated. Often it’s easier to bite the bullet and switch to insulin. There are so many different types available that your doctor should be able to find one suitable for your needs. Enroll in a diabetic class to learn everything you’ll need to know about insulin injections and blood sugar monitoring.

5. Figure out why your blood sugar is too high. Does it run high only in the morning? Only after breakfast? Before dinner? Although it’s a pain to check your blood sugar several times a day, doing it for short periods should reveal what pattern of hyperglycemia is troubling you the most. Another approach is to check your fasting blood sugar daily and again later in the day, but at different times. If you record the information in a chart or flowsheet, your doctor can examine it for patterns and adjust your medicine time or dosage accordingly.

It’s really up to you how well your sugar is controlled. Don’t fool yourself by avoiding the need to take action. Partner with your doctor and take charge of your health care today.

Copyright 2010 Cynthia J. Koelker, M.D.


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