50 Things You Need to Know about Diabetes. Kathleen Stanley

cooking for you, they should learn what you learn. Knowing what to buy and how to prepare the food is an important part of putting together the pieces of a meal plan. Ultimately, though, the responsibility to follow the plan falls on the person who holds the fork.

       TAKE MENUS AND EMPTY BOXES WITH YOU

      If you visit a particular restaurant on a regular basis, ask for a menu and bring it with you to your RD visit. With this information, you and the RD can identify healthy choices and develop strategies for eating healthier while eating out. The same is true for some of your favorite boxed foods—take in the label. With your real-life tools (menus, labels, etc.), you will be able to individualize your plan and practice making choices.

       COMPLETE A NUTRITIONAL ASSESSMENT

      Ideally, your RD will have you to complete a nutritional assessment, which should ask for:

      

Food likes and dislikes

      

Food allergy history

      

Current weight

      

Past weight

      

Current health status and medications

      

Food intolerances

      

Swallowing abilities

      

Digestive problems

      

Food purchasing needs

      

Food preparation styles

      

Restaurant dining habits

      

Alcohol use

       ASK FOR A FOLLOW-UP

      Determine when the next visit will be, or how a follow-up will be handled after your visit. A follow-up will give you the opportunity to discuss real-life experiences you’ve encountered with your meal plan, what things work, and what may need some more planning. The RD can provide a source of support and encouragement for whatever your goals are, so use your resources and stay in touch. Once you’ve established a meal plan, it may help to touch base with your RD annually to discuss new food choices and any new information that may help you improve your plan.

       MORE RESOURCES TO EXPLORE

       WEBSITES

      American Diabetes Association Website …. WWW.DIABETES.ORG

      American Dietetic Association…… WWW.EATRIGHT.ORG

      American Association of Diabetes Educators…… www.DIABETESEDUCATOR.ORG

4 How to call your doctor for help

      There will be days with unexpected troubles, days when you need to get some advice from your health care team about your diabetes care. The doctor’s office is the place for getting accurate medical advice. It may be easier to ask friends or neighbors (or the Internet) for health advice, but they may unknowingly provide you with misinformation, or worse yet, provide dangerous suggestions, which could cause further problems. Here is some good advice for when you need some help.

       DISCUSS THE GROUND RULES

      Ideally, as part of your initial visit, you should have been given information from your health care team about when to contact them, your responsibilities when doing so, and when interventions are up to them. If you have not received this information, plan to ask these questions at your next visit:

      

At what levels do you want me to treat high or low blood glucose on my own?

      

What number should I call when my blood glucose gets really high (for example, higher than 350 mg/dl)?

      

What number should I call for help when my blood glucose gets really low (for example, lower than 50 mg/dl)?

      

When should I call other health care professionals instead of you?

      

Should I call you if I experience any hypoglycemia, or just moderate to severe episodes?

      

Should I have a glucagon emergency kit?

      

Should I check for ketones? If yes, when?

      

What steps should I take if I have positive ketones?

      

What steps should I take if I can’t take my diabetes medication (going to have a dental procedure, employment physical, having vomiting, etc.)?

      

What steps should I take if I run out of medication?

      

What steps should I take if I can’t reach your office for a diabetes problem?

      

Who will be taking my after-hour calls? What are his or her professional qualifications? Do they have access to my medical history if needed?

      

When should I go to the hospital if I can’t manage my blood glucoses on my own?

      

To which hospital should I go if I need emergency help?

       WHEN TO CALL

      Typically, you will want to notify your health care provider at once if:

      

You run out of medication

      

You are running a fever (for more than 8 hours)