24 ©2007 Kaiser Permanente Colorado, Inc. All rights reserved. co 0037 5977

FINALLY…. Celebrate your successes, even the small ones! Learn from your efforts that don’t turn out as you hoped or expected. If you do this, you can’t fail! Set yourself up to succeed. Remember…..

• Most adults need to hear something new 6 times to remember or believe it,

• Most adults require 21 days to try out something new to develop a habit.

Practice. How will you celebrate your successes? Questions? Please call Diabetes Care at 303-614-1065

or 1-866-868-7572 or go to kp.org/diabetes.

MY PERSONAL ROADMAP WORKBOOK Diabetes Balance & Health

2

Diabetes Balance and Health MY PERSONAL ROADMAP WORKBOOK

Name: Phone: ________________ My health care team:

Nurse Educator: Phone:

Dietitian: Phone: ________________

My Doctor: Phone:

My Pharmacist: Phone:

23

Planning your journey: How will you arrive at your destination? Review the sections of this Roadmap. Where can you make changes that would be easiest for you? Healthy eating: One change in my eating patterns that I know I can do today: Being active: One change in my daily activity routine that I can begin today is: Goal setting:

- Be realistic - Set small goals - Plan one change at a time - Be patient and persistent - Review your Personal Roadmap often and revise as needed

22

Pulling it all together: Begin with the end in mind! First: Get very clear! Write it down: Why is it important for me to learn how to manage my diabetes? 1. 2. 3. What will I look like in 10 years if I do this? What will I look like in 10 years if I choose not to do this? Next: Have you made the decision to take charge of your diabetes? If so, how will you start? Who will you ask for help?

3

GETTING STARTED

Take a moment to answer two very important questions:

What is the most important thing you want to learn?

What concerns you the most about having diabetes?

4

Symptoms I had when my diabetes was diagnosed: ___ Frequent urination ___ Blurred vision ___ Unusual thirst ___ Slow healing ___ Hunger ___ Fatigue ___ Other

My blood sugar was ___________ when my diabetes was diagnosed.

History...

21

Charting m

y progress

Lab

tests, e

xam

s D

ate

Resu

lts D

ate

Resu

lts D

ate

Resu

lts

A1c

Total Cholesterol

Triglycerides

HD

L (good)

LDL (bad)

Blood pressure

Urine m

icroalbumin

Creatinine

Weight

20

Staying healthy: My personal plan

Exam Purpose Frequency Doctor visit Diabetes visit - Every 6 months Discuss diabetes balance if targets met Prevent complications - Every 3 months If not at targets Weight Monitor progress - Every visit toward goals Eye exam dilated Goal: healthy retina - Every year or Detect, treat problems As recommended early Foot exam Nerves and circulation - Every visit Complete foot exam - Every year Aspirin Prevent heart attack, - Ask your doctor stroke Dental exam Healthy teeth, gums - Every 6 months Flu vaccine Prevent influenza - Every year Pneumonococcal Prevent pneumonia - Once before Vaccine age 65 - Second-ask your doctor

Inspect shoes and Wound Prevention - Daily feet

5

Why me? My diabetes risk factors: ___ Family history ___ History of gestational diabetes ___ Overweight or large babies ___ Inactive ___ High blood pressure ___ Low HDL (good) cholesterol ___ Of African American, Hispanic/Latino, Native American Pacific Islander heritage

6

Coping with diabetes My plan for dealing with stress: I will ask for support from: Active steps I will take to get “unstuck” from negative feelings: What I will do to relax when I feel stress increasing:

19

Risk reduction: My personal plan Smoking? Talk to your doctor about resources to help. Test Target Frequency A1c Less than 7% Every 3-6 mo. Blood sugar Less than 120 Every day Cholesterol Less than 180 mg/dL Every year Triglycerides Less than 150 mg/dL HDL (good) - Men 40 or higher mg/dL - Women 50 or higher mg/dL LDL (bad): Less than 100 mg/dL Blood pressure Less than 130/80 Every visit Kidney tests Urine microalbumin Less than 30 Every year Blood creatinine Every year Men 0.5-1.3 Women 0.4-1.1

18

Reducing my risk for complications of diabetes

Do you know someone who has experienced complications of diabetes? Who? Check the risk factors that affect you: Can’t change Can change ___ Family history of ___ Inactive heart disease ___ Smoking ___ Age ___ High blood pressure ___ Diagnosis of diabetes ___ Controlled diabetes ___ High cholesterol ___ Overweight

7

MY A

BC

TAR

GETS:

Usual target

M

y last result

My target

A:

A1c:

less than 7%

_________%

________%

B:

Blood Pressure

130/80

____/____

___/___

C:

Cholesterol

B

elow 180 m

g/dL

Triglycerides B

elow 150 m

g/dL ________

________

LDL (bad)

Below

100 mg/dL

________

________

H

DL (good)

W

omen

O

ver 50

________

—

——

—

M

en

Over 40

________

________

8

My current lifestyle patterns: Healthy patterns Patterns to Improve (examples) Eat lots of vegetables Watch too much TV Walk almost every day Eat at fast food restaurants Portion Control Eat large servings Setting goals: Step 1: The area in my lifestyle I would like to improve is: (Example: I eat too much at each meal.) Step 2: My goal is: (Example: I will eat one serving of the foods at my meals, no seconds) Step 3: What are the steps I will take to reach my goal? a. b. c.

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My plan for taking my medications Medication Dose Time(s) For blood sugar For blood pressure For cholesterol

16

What medications are you taking now for your diabetes?

How often do you miss a dose? Why? Have you stopped taking a prescribed medication? Why? ___ I feel better, don’t think I need it ___ It made me feel worse ___ Cost, I can’t afford it ___ Other:

Medication Doses Time (s)

9

MY FOOD What are some carbohydrate foods that I eat on a regular basis? (Examples: fruit and juices, pasta, bread, rice, sweets, milk, etc) 1) 2) 3) 4) 5) Think of a high fat food you eat often and a healthier substitute: (Example: regular cheese, substitute with low fat cheese)

1) 2) 3) 4) 5)

10

My food targets:

Breakfast Time: Carbohydrate target: ______ Snack Time: Carbohydrate target: ______ Lunch Time: Carbohydrate target: ______ Snack Time: Carbohydrate target: ______ Dinner Time: Carbohydrate target: ______ Snack Time: Carbohydrate target: ______ For several foods you have on hand, practice checking labels: (see page 9) Serving size_________ Total carb grams/serving___________

General carb targets to get started could be: 45- 60 grams/meal for women, 60-75 grams/per meal for men, 15-30 grams for snacks

15

My monitoring plan

I plan to check my blood sugar _________ times each day. ___ Before breakfast ___ Hours after breakfast ___ Before lunch ___ Hours after lunch ___ Before dinner ___ Hours after dinner ___ At bedtime

My target blood sugars

Before meals: After meals: Bedtime:

14

E

xample log book: R

ecording medications, carbs, and blood sugars

C

omm

ents:

D

ATE

B

REAK

FAST

LUN

CH

D

INN

ER

BED

TIME

May 20 Sun

146 / 175

112 /

Carbs

Meds

3 servings G

lyb 10 mg, M

et 500 1 serv. Snack, 3 serv. Lun

4 servings G

lyb 10 mg, m

et 500

May 21 M

on 122

/ 210 (ate out-spaghetti)

184

Carbs

Meds

3 servings G

lyb 10 mg, M

et 500 1 serv. Snack, 3 serv. Lun

6 servings G

lyb 10 mg, m

et 500

May 22

Tues 155 /

132

125

Carbs

Meds

3 servings G

lyb 10 mg, M

et 500 1 serv. Snack, 3 serv. Lun

4 servings G

lyb 10 mg, m

et 500

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Physical activity

What are my current activities and how would I describe my current activity level? At work?

At home?

For fun?

Planned exercise?

What are the barriers that keep me from being more active? (check all that apply) ___ Time ___ Too Tired ___ Low motivation ___ Weather ___ Illness ___ Boredom ___ No Equipment ___ No Facilities ___ Joint Problems ___ Out of Breath ___ Pain/Discomfort ___ Hate Exercise ___ Other: Which benefits of exercise would motivate me to become more active? (check all that apply) ___ Improved strength, flexibility ___ Improved endurance

___ Heart and Lung Health ___ Promote Weight Loss

___ Prevent Osteoporosis ___ Improve Blood Sugars

___ Look Better ___ Improve Well-being

___ Decrease Anxiety, Depression

___ Reduce Heart Risk (BP, cholesterol)

___ Improve my insulin sensitivity (Get more mileage out of the insulin I make, possibly reducing need for medications)

12

My activity plan

I will exercise ____________ times a week. I will do the following activities: I plan to exercise _______ minutes each session. Other ways I will increase my daily activity:

13

Monitoring my blood sugar How often do I check your blood sugar? Times each day ____________ Number of days each week ____________ What results are you getting? How high? __________________ How low? __________________ Do you know what these numbers mean? What are your blood sugar targets? Before meals? ___________________ After meals? ___________________ At bedtime? ___________________