1. SHARED MEDICAL APPOINTMENTS FOR DIABETES: LESSON 3 Created by Rebecca Bates, DNP(c), RN, CFNP July 2014

2. Objectives Participants will understand the basics of blood glucose. Participants will understand blood glucose targets and A1C. Participants will articulate reasons for blood sugar fluctuation. Participants will be able to manage highs and lows. Participants will use their blood glucose results to change behaviors. 3. What are blood glucose and insulin? Blood glucose = sugar in the blood. Insulin = a hormone that moves glucose from your blood stream into your cells. Activity: 1. What are two ways glucose gets into your blood? 2. Why is blood glucose so important for managing diabetes? 3. What are your blood glucose goals and how did you choose this goal? 4. The Role of Insulin Please play video. 5. Blood glucose targets Pre-prandial (before meals) Post-prandial (2 hours after a meal) Activity: 1. What are your blood glucose targets? 2. Why is it important to have a target? 6. Challenges and Barriers Activity: What challenges or barriers do you have to keeping your blood sugar under control? 7. How do you feel? How do you feel when your blood sugar is out of range? How do you feel when your blood sugar is in range? 8. Blood glucose & A1C Why monitor? How can this information be used? When to monitor? 9. Monitoring Activity: 1. What do you learn by monitoring? 2. What is your target A1C and when did you last have this checked? 10. Glucose Variations Hyperglycemia = high blood sugar What makes the blood glucose go up? What are symptoms of high blood glucose? Hypoglycemia = low blood sugar What makes the blood glucose go 11. Active Self-Management Using your results Treating highs Treating lows 12. Dangers of Uncontrolled Blood Sugar Activity: Discuss the short-term and long- term dangers of high and low blood glucose. Click for Web link to ADA: Complications 13. The Plan Plan to Improve your blood glucose self- management Plan to Engage your support network Plan to Engage your health care team Plan realistic changes you can make Activity: How can you better manage your diabetes? 14. References American Diabetes Association. (2014). Complications. Retrieved from http://www.diabetes.org/living-with- diabetes/complications/ Clearly Health. (October 15, 2009). Diabetes: How insulin works. Retrieved from https://www.youtube.com/watch?v=VgGHSddJrU Q Novo Nordisk. (2014). Fact sheet library. Retrieved from http://www.cornerstones4care.com/ToolsResourc es/FactSheetLibrary.aspx