.

Exercise Reminders from your Diabetes Physician and the Diabetes Management Team

• Some activity is better than none.• Check your blood glucose before and after

you exercise if you use insulin. • Let us check on your heart health and your

eyes before you start moderate to inten.se exercise.

• Warm up before exercise, slow down after exercise.

• Let us know if you have joint pain which keeps you from being able to exercise.

• Let us check your feet for neuropathy before you start your exercise routine.

Exercise:• improves blood glucose and

insulin sensitivity, • reduces cardiovascular risk,

causes weight loss, • reduces stress • improves emotional well being. • Use appropriate footwear when

you exercise. • Drink water when you exercise. • Speak with our personal trainer

about your exercise plan.

Diet Reminders from your Diabetes Physician

and the Diabetes Management team • Eat breakfast.• Have 3 meals a day at regular times. • Opt for low sugar or sugar-free snacks

and drinks/juice.• Choose lean meats, and reduce dairy

foods.• Choose foods with low salt, low

saturated fat, and avoid trans fatty acids.

• Eat more fish, whole grains, fruits, legumes and vegetables.

• Opt for foods with low glycaemic index.• Read food labels.• Drink more water.• Avoid excessive alcohol. • Speak to our nutritionist about portion

sizes and meal plans.

Medication Reminders From your Diabetes Physician

and the Diabetes Management team • Please take your medications as

prescribed.• See us for a review before your

medications run out.• Be aware of the number of repeats on

your prescription.• Use a pillbox if you have difficulty

keeping track of your medications.• Tell us about your over-the-counter

medications and vitamin supplements.

• Tell us about any side effects of your medications.

• Please do not change your medications without advice.

• Share your blood glucose logs with us.• Avoid sharing medications with others.• Avoid taking your medications if they are past

the expiration date.• Tell us if you are allergic to any medications.• Tell us if you are breastfeeding.• Let us know if you can no longer afford your

medications.• Discuss the use of insulin with us.

Foot care reminders from your Diabetes Physician

and the Diabetes Management Team

• Let us examine your feet at least once a year.

• Let us manage your diabetes since good blood sugar control is important for healthy feet.

• Get advice from our podiatrist.• Let us evaluate whether you have high risk

feet:• Do you have normal feeling in your feet?• Have you had a foot ulcer before?• Do you have abnormally shaped feet?

• Do you have poor circulation to your feet?• Check your feet daily for blisters and bruises • Wash your feet daily, drying between your

toes. • Avoid soaking your feet. • Wear shoes indoors and outdoors.• Wear shoes that support the feet and are

not too tight.• Slippers are not recommended for outdoor

use.• Cut your nails straight across.• Do not cut calluses by yourself.• Choose not to get a pedicure if your blood

sugar is not well controlled.

• Glycaemic index/load: The Glycaemic Index (GI) is a ranking of carbohydrate

containing foods based on their overall effect on blood glucose levels. Higher glycaemic index foods raise blood glucose more quickly but you must also consider portion size carbohydrate content and cooking methods.

• Glycaemic Index of local foods:

• Greenfig ----------------------------------65• Sweet potato ----------------------------70• Yam ----------------------------------------54• Breadfruit --------------------------------68• Dasheen ----------------------------------53• Plantain ----------------------------------66 • Irish potato ------------------------------87

The symptoms of hypoglycaemia:

• sweating, palpitations, weakness/dizziness, confusion, shakiness, difficulty speaking or slurred speech and anxiety.

• These symptoms may occur

below 70mg/dl but this may vary between persons with diabetes depending on duration of diabetes.

• If you experience these symptoms check your blood glucose, but if unable to, drink 4oz juice or chew 4 glucose tablets (4g x 4). • Wait 15 minutes and then check your

blood glucose again. If your blood glucose is still less than 70mg/dl (3.9mmol/l) please repeat the above measures. • When your blood glucose is above

70mg/dl, have a snack or your next meal.

How to administer insulin

• Start by administering insulin in the subcutaneous tissue of the abdomen at least 2 inches from the navel.

• Keep your insulin between 2˚C and 30˚C for best results

• Use open insulin bottle within 28 days

• Wash your hands and skin of the abdomen with soap and water

• Gently roll the insulin solution • Draw up the required insulin

volume of air into the syringe. For example if you are taking 10 units pull the plunger on the syringe to 10 (1cc syringe) so that there is air in the syringe.

• Clean surface of insulin bottle with alcohol. Inject the volume of air into the insulin bottle.

• Turn the insulin bottle upside down

• Draw into the syringe the required insulin dosage

• Tap on the syringe to remove air bubbles

• If the skin of the abdomen is not clean, clean with alcohol swab and allow to dry

• Pinch a fold of skin in between thumb and index finger

• Inject the insulin by placing the syringe at a 90 degree angle to the skin (right angle) straight down

• Push the needle in completely, push down on the plunger and wait about ten seconds before withdrawing the syringe

• Dispose of insulin syringe into a medical sharps container. Single use of an insulin syringe is advised

• For advice on alternate sites, talk to your diabetes physician