Managing Your Diabetes

Your diabetes team at Virginia Mason Franciscan Health is here to work with you as a partner in your good health. Our goal is to help you live a full and productive life. We work with you to create a meal plan that best suits your needs, counsel you on an appropriate exercise program, and educate you about medications and insulin.

Diabetes is managed through diet, exercise and medications (if these are recommended). Those with Type 1 diabetes must take insulin every day to replace the insulin no longer being made naturally in the body. Learn more about our diabetes education program designed to help you manage all aspects of diabetes.

If you’re diagnosed with diabetes, you’ll be asked to monitor your blood glucose levels daily to determine the amount of glucose in your blood. Your diabetes health care team will work with you to determine the best times during the day to test your blood glucose and to find the monitoring device that best suits your needs. There are many accurate blood glucose meters available, and they’re simple to operate. You prick your finger with a lancet and apply a drop of blood to a treated strip. A glucose meter then reads the strip and displays the value. 

Monitoring blood glucose and making appropriate changes offers a more independent, self-sufficient approach to diabetes management. Research indicates that complications associated with diabetes may be reduced if blood glucose levels are kept near normal. Blood glucose monitoring can help you:

• Make changes in your daily diet, medications, or activity
• Identify low blood glucose levels
• Control blood glucose during illness

Continuous glucose monitoring (CGM) technology uses a wearable or  implantable sensor to monitor blood sugar levels and communicate data via a phone app or receiver-style device. Personal CGM devices are considered the standard of care for patients with Type 1 diabetes and are increasingly common for those with Type 2 diabetes. CGM technology allows patients to view their results in real time and for those results to be shared with their doctor.

Your diabetes care team can provide more information about these products. To make the most of glucose monitoring, however, Virginia Mason Franciscan Health strongly recommends receiving instruction from a qualified diabetes specialist.

Good nutrition is an important component of managing your diabetes. A registered dietitian will work with you to create a meal plan that best fits your needs. If you’re newly diagnosed with diabetes, the following information will help answer questions you may have until you can meet with a dietitian or attend a diabetes class.

Eating a meal or snack every three to four hours can help manage blood sugars and help prevent overeating later in the day.

If you want to lose weight, cut down on your portion sizes. Fill your plate at your main meal with a half-plate full of vegetables and a quarter-plate of each protein and starch.

Until you see your dietitian, avoid desserts, regular soft drinks, fruit juice, fruit-flavored drinks, jelly, honey, sugar, syrups, and alcohol.

The American Diabetes Association recommends 150 minutes per week.

You can expect to be scheduled for checkups every three to six months, depending on your overall health, the types of medications you take and your personal needs.  

You should use self-blood glucose monitoring. We’ll also instruct you on when to report poor control or complications to your health care providers.

When you come in for follow-up visits, your health care provider will review the medications you’re taking and the results of self-blood glucose monitoring. We’ll then evaluate occurrences of unusually high or low blood glucose levels, any changes you’ve made in medications, and diabetes complications or adherence problems you may have experienced. Additionally, we’ll talk with you about psychological and social factors and other medical illnesses influencing your health.

Follow-up physical exams will include weight, height (until maturity), blood pressure and foot checks. Lab tests that produced abnormal findings in previous visits will be repeated. We’ll run tests for glycosylated hemoglobin (A1C—an estimate of your average blood sugar level for the past three months) and, if appropriate, blood glucose. Lipid studies (blood tests for cholesterol) are checked annually in adults and every two years in children. A urine test is performed annually. If urine contains protein, we’ll do further tests to assess kidney function.

Acute illnesses such as infections can affect your ability to control diabetes and can lead to serious diabetic complications, such as ketoacidosis, hyperosmolar coma and severe dehydration. Your health care provider will give you instructions about how to care for diabetes during acute illnesses, and you can learn to avoid acute complications through patient education.

If you have concerns about managing your diabetes, schedule an appointment with a diabetes specialist.