-
What Is Type 2 Diabetes?
Type 2 diabetes is a chronic (lifelong) condition. It keeps your
body from turning food into energy. That’s why you may feel tired
and run-down, especially after eating. Controlling your diabetes
means making some changes that may be hard at first. Your
healthcare team is here to help.
Managing Your DiabetesControlling the level of sugar in your
bloodstream is the key to managing your diabetes. Your healthcare
team will help you develop a program that is right for you. This
team includes your doctor, diabetes educator, and nutrition
specialist.
1. Eat HealthyEating right helps keep your blood sugar in
balance. A nutrition specialist (dietitian) will help you create a
meal plan. You don’t have to give up all the foods you like. But
you’ll need to eat on a regular schedule and follow some nutrition
guidelines.
2. Monitor Your Blood SugarChecking your blood sugar level is
essential to keeping your diabetes in control. Regular testing
helps you be sure that your treatment program is working. Make
checking your blood sugar a part of your daily routine.
3. ExerciseExercise is important to help keep your blood sugar
in balance. Daily exercise helps lower blood sugar. Your blood
sugar can continue to fall for several hours after you stop
exercising. You may need to begin slowly. Check with your
healthcare team before you start an exercise program.
4. Take Medication If PrescribedYour doctor may prescribe
medication to help manage your blood sugar. Always follow
instructions. Take your medication exactly as prescribed.
© 2005 The StayWell Company, 780 Township Line Road, Yardley, PA
19067. All rights reserved. This information is not intended as a
substitute for professional medical care. Always follow your
healthcare provider’s instructions.
1
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Ano ang Type 2 Diabetes?
What Is Type 2 Diabetes (Tagalog)
Ang Type 2 diabetes ay isang talamak (habang buhay) na
kondisyon. Hinahadlangan nito ang iyong katawan na gawing enerhiya
ang pagkain. Ito ang dahilan kung bakit maaari kang pagod at hapô,
lalo na pagkatapos kumain. Ang pagkontrol ng iyong diyabetis ay
nangangahulugang gumawa ng ilang mga pagbabago na maaaring mahirap
sa simula. Naririto ang iyong pangkat ng pangangalaga ng kalusugan
upang tumulong.
Ang Pamamahala ng Iyong DiyabetisAng pagkontrol sa antas ng
asukal sa iyong daluyan ng dugo ay ang kinakailangan upang
pamahalaan ang iyong diyabetis. Tutulungan ka ng iyong pangkat ng
pangangalaga ng kalusugan namagdibelop ng isang programa na tama
para sa iyo. Kabilang sa pangkat na ito ang iyong doktor, tagaturo
tungkol sa diyabetis, at espesyalista sa nutrisyon.
1 Kumain Nang Mabuti sa KalusuganAng kumain nang tama ay
tumutulong na panatilihing balanse ang iyong asukal sa dugo.
Tutulungan ka ng isang espesyalista sa nutrisyon (taong may
kinalaman sa pagdidiyeta) na gumawa ng plano sa pagkain. Hindi ibig
sabihing hindi mo namakakain ang lahat ng mga pagkaing gusto mo.
Ngunit kailangan mong kumain sa regular na iskedyul at sumunod sa
ilang mga patnubay sa nutrisyon.
2 Imonitor Ang Iyong Asukal sa DugoAng pagtingin sa antas ng
iyong asukal sa dugo ay mahalaga upang panatilihing kontrolado ang
iyong diyabetis. Ang regular na pagpapasuri ay makakatulong sa
iyong siguraduhin na gumagana ang iyong programa sa paggamot.
Gawing bahagi ng iyong pang-araw-araw na rutina ang pagtingin sa
iyong asukal sa dugo.
3 EhersisyoAng ehersisyo ay mahalaga upang panatilihing balanse
ang iyong asukal sa dugo. Angaraw-araw na ehersisyo ay tumutulong
sa pagpapababa ng asukal sa dugo. Ang iyong asukal sa dugo ay
maaaring magpatuloy na bumaba nang ilang oras pagkatapos mo
humintongmag-ehersisyo. Maaaring kailangan mo magsimula nang
dahan-dahan. Tanungin ang iyong pangkat ng pangangalaga ng
kalusugan bago ka magsimula ng isang programa ng ehersisyo.
4 Inumin ang Gamot Kung IniresetaMaaaring magreseta ng gamot ang
iyong doktor upang makatulong na pamahalaan ang iyong asukal sa
dugo. Sundin lagi ang mga tagubilin. Inumin ang iyong gamot tulad
lamang nang inireseta.
© 2006 The StayWell Company, 780 Township Line Road, Yardley, PA
19067.All rights reserved. This information is not intended as a
substitute for professional medical care. Always follow your
healthcare provider’s instructions.
2
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Blood Sugar Self-Testing Healthy Ranges
Hypoglycemia (Low Blood Glucose)
Hyperglycemia (High Blood Glucose)
Below 70 mg/dl
Causes: Too little food or skipping a meal; too much insulin
or diabetes pills; more active than usual.
Symptoms: Shaky; fast heartbeat; sweating, dizziness,
anxious, hungry, blurry vision, weakness or fatigue,
headache; irritability.
If low blood glucose is left untreated, you may pass out and
need medical help.
Self-treatment:
Check your blood glucose, right away. If you can’t check,
treat anyway.
Treat by eating 3 to 4 glucose tablets, or by drinking
4-ouces of fruit juice or 1 glass of milk.
Check your blood glucose again after 15 minutes. If it is
still low, treat again. If symptoms don’t stop, call your
healthcare provider.
Above 200 mg/dl
Causes: Too much food, too little insulin or diabetes pills,
illness or stress.
Symptoms: Extreme thirst; need to urinate often, dry skin,
hungry, blurry vision, drowsy, slow healing wounds.
High blood glucose may lead to medical emergency if not
treated.
Self-treatment:
Check your blood glucose.
If your blood glucose levels are higher than your goal for 3
days and you don’t know why, call your healthcare
provider.
Drink plenty of water.
Delay eating.
Exercise (15 minutes).
Consult with Advise Nurse if you missed your medicine
64 & younger
A1C < 7
65 & older
A1C < 8
Before Meals(4-5 hours since your
last meal)
80 – 130 100 – 160
After Meals (2 hours after meal)
Less than 180 Less than 200
At Bedtime 100 – 160 100 – 200
3
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Sunday Monday Tuesday Wednesday Thursday Friday Saturday
4
-
THE
HEA
LTH
Y PL
ATE
Use
this
plat
e to
hel
p yo
u po
rtion
your
food
in
a hea
lthy w
ay an
d m
ake
mea
l plan
ning
eas
ier.
Po
rtion
s are
bas
ed o
n a s
mall
din
ner p
late
.
Fill o
ne-q
uarte
r of
your
plat
e wi
th a
healt
hy
prot
ein
sour
ce,
such
as fis
h, ch
icken
, eg
gs, c
ooke
d be
ans,
lent
ils, o
r tof
u.
For g
ood
nutri
tion
also
ch
oose
eac
h da
y:•
1 sm
all fr
uit s
ervin
g, su
chas
an o
rang
e, b
anan
a,ap
ple,
or 1
cup
of b
errie
sor
mel
on w
ith e
ach
mea
l.•
2 to
3 cu
ps o
f plai
n m
ilkor
yogu
rt.•
A sm
all am
ount
of h
ealth
yfa
ts, su
ch as
oliv
e or
cano
la oi
l, or a
small
hand
ful o
f nut
s.
Fill o
ne-q
uarte
r of
your
plat
e wi
th h
ealth
y gr
ains o
r sta
rche
s, su
ch as
bro
wn ri
ce,
whol
e-wh
eat p
asta
, qui
noa,
bulg
ur, c
orn,
pea
s, on
e sli
ce
of w
hole
-gra
in b
read
, or o
ne
corn
or w
hole
-whe
at to
rtilla
.
Fill h
alf o
f yo
ur p
late
with
non
- st
arch
y veg
etab
les,
such
as
carro
ts, b
rocc
oli, c
abba
ge,
bell p
eppe
rs, a
spar
agus
, or
leaf
y gre
ens,
like
spin
ach
or ka
le.
5
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Sample Carbohydrate Controlled Filipino Meal Plan
Day 1 Day 2 Custom Menu
Breakfast
Total CARB: 30-40g
½ C plain oatmeal (cooked) = 15g 8 walnut halves 1 whole fruit =
15g 1 egg coffee or tea
30g
1 egg (any style) 1 whole wheat English muffin OR whole wheat
pan de sal = 30g ¼ avocado
cubed coffee or
tea
30g
Snack
Total CARB: 15g
1 piece fruit = 15g 1 TB peanut butter
15g
1½ C singkamas and/or carrots = 15g 1 oz.
Mozzarella cheese
15g
Lunch
Total CARB: 30-60g
1 C sweet corn and shrimp* soup made with vegetable stock and
peppers = 15g
1 C sautéed eggplant & Chinese broccoli
1 C almond milk = 15g
30g
1 C Dineg-Deng (Bulanglang) with extra veggies = 10g 1 C brown
rice = 45g
55g
Snack
Total CARB: 15g
1 C mixed berries = 15g 1 oz. almonds
15g
4 high fiber crackers = 15g 1 TB peanut butter
15g
Dinner
Total CARB: 30-60g
1 C Pinakbet made with extra veggies = 5-15g
3 oz. lean pork or shrimp* 1 C brown rice (45g) OR kalabasa
(20g)
30-60g
1 C Kalderetta without potatoes, with extra carrots and bell
peppers = 17g ½ C brown rice (22g) OR ½ C
potatoes (15g) 1 C soy or lactose-free milk =
15g
50g
6
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Being Active with Diabetes:How to Get Started
As you may already know, beingactive improves your health inmany
ways.
Physical activity can help:
• control your blood sugar
• lower your blood pressure
• help you feel better and reduce stress
• lower your risk of heart disease
It helps to start with an activity that
you find to be:
• simple
• something you want to do
• easy to start slowly—and easy to
increase a little each week
For most people with diabetes, walk-
ing is an ideal activity. Using a step
counter or a pedometer can help
you keep track of your progress over
time. It’s also important to try to be
more active throughout your day.
For example, you may want to try
taking stairs instead of an elevator
as part of your daily routine—or try
parking a little further away from
where you usually park.
Be sure to check with your doctor or
diabetes care team to see if the activity
you choose is right for you. When
you begin any new physical activity
program, try to check your blood
sugars more often so that you know
your body’s response to the new
activity.
Depending upon your health and
fitness level, other aerobic options
include:
• jogging
• biking
• swimming
• low-impact or chair aerobics
• dancing
• using an elliptical or step machine
Physical activity and diabetesRemember that some people living
with
diabetes need to be more cautious
before starting a new physical activity
program.
Here are some important things to
keep in mind:
• Always carry fast-acting sugar
sources such as a tube of glucose gel
or 3-4 glucose tablets, identification,
and your Medic-Alert bracelet, if
you have one.
• Stop exercising right away if you are
dizzy, have shortness of breath, feel
sick to your stomach, or are in pain.
• Drink extra fluids before, during,
and after exercise.
• Wear shoes and socks that fit well.
Low blood sugar precautionsIf you have type 1 diabetes or if
you
have type 2 diabetes and take insulin
and/or diabetes pills, be sure to:
• Check your blood sugar before and
after physical activity. If you use
insulin to manage your diabetes,
work with your diabetes care team
to learn how you might need to
adjust the amount of insulin you
use and/or discuss how you might
want to change your meal plan to
account for the amount and type of
activity you plan to do. This is espe-
cially important to help you prevent
low blood sugars during long periods
(over 3 hours) of exercise.
• You may need to eat an extra snack
when your insulin or diabetes pills
are working the strongest or you
are doing moderate to high levels of
exercise for over 30 minutes.
• Be aware that moderate to high
activity levels can lower your blood
sugar right away or up to 24 hours
after you have stopped being active.
• If you do not take insulin, plan to
be active within an hour after eat-
ing your meals or snacks to prevent
low blood sugars. If you have type
1 diabetes and your blood sugar
is less than 120 before exercising,
eat 15-30 grams of carbohydrate
before you start exercising.
• If you have type 1 diabetes and
your blood sugar is over 250, use a
urine test strip to check your urine
for ketones before you start exercis-
ing. Do not exercise if ketones are
moderate or high. Ketones are
a certain type of chemical that
forms in your blood when your
body starts to break down fat to
use for energy instead of glucose.
This happens when you have high
blood sugar levels and not enough
insulin in your body. When the
level of ketones in your blood gets
HEALTH EDUCATION 7
-
Being Active with Diabetes:How to Get Started
too high, your kidneys help to
remove it from your blood so it
appears in your urine.
What can help you stickwith your activity plan?
It may be hard to add activity into
your life, especially if you haven’t
been active lately. Once you have
chosen a simple, easy activity which
appeals to you and which can be
increased gradually, try to:
• Make your activity as regular as
sleeping and eating. Mark it on your
calendar like any other appoint-
ment. You may also want to write it
down on an activity goal sheet. (See
the “Weekly Plan” below.)
• Connect with someone else to keep
you motivated and to make it more
enjoyable. Invite a friend to be
your exercise partner.
• When you reach your goal, give
yourself a reward. Treat yourself to
movie tickets, a book, a magazine,
a song or album.
• If you get bored doing one activity
over and over, try a different activity.
Or do different types of activities
on different days of the week.
• When it is raining or too cold out-
side, try doing aerobics or stretching
exercises inside where it’s warm
instead of not doing any activity.
You can try walking in an indoor
mall, using an exercise video or fitness
video game, or dancing.
Other resources
• Visit kp.org/mydoctor to try an
Online Health Coach video coaching
program. Start today to improve your
eating habits and get more active.
• Visit our Web site at kp.org/diabetes.
Here you’ll find more information about
diabetes and other topics.
•Tryourpersonalizedonlineprogramsat
kp.org/healthyliving to get
support for your weight loss and
activity goals.
• Contact your facility’s Health Education
CenterorDepartmentforbooks,videos,
classes, and additional resources.
To help you get started—and keep you going—you may want to use
the “Weekly Plan” to
set activity goals that you can easily reach.
Weekly Plan
This week, I will (what?)
(how much?)
(when?)
(how many?)
How confident am I that I can follow my plan?
1 2 3 4 5 6 7 8 9
Not at all confident
10
Very confident
How I plan to reward myself:
This information is not intended to diagnose health problems or
to take the place of medical advice or care you receive from your
physician or other health care professional. If you have persistent
health problems, or if you have additional questions, please
consult with your doctor.
© 2005, The Permanente Medical Group, Inc. All rights reserved.
Regional Health Education.
90351 (Revised 9-10) RL78
-
Diabetes Medications How They Work
There are many types of diabetes medications which work in
different ways to help control blood sugars. It is important to
learn about these medications and how they work so you are prepared
to discuss your options with your diabetes care team.
Blood sugar goals To lower the risk of complications, the goal
for most people with diabetes is to get to an A1C test result of
less than 7 percent or an estimated average glucose (eAG) result of
below 150 mg/dL. If you are over age 65, or have certain
conditions, such as heart disease, your doctor or health care
professional may recommend an A1C goal of less than 8 percent. Both
the A1C and eAG measure your average blood sugar over the past 2–3
months.
Medications explained
•
••
Medication type: biguanides Main site of action: liver How it
controls blood sugar:
keeps the liver from releasing too much glucose
Names: metformin (Glucophage) metformin ER (extended
release)
Medication type: insulin Names: • Longacting: NPH insulin,
insulin detemir (Levemir), insulin glargine (Lantus)
• Rapidacting: regular insulin,insulin aspart (Novolog),insulin
lispro (Humalog)
Most patients will choose to add insulin to achieve or maintain
their blood sugar goals. Insulin can be injected and helps the
cells in the body get the blood sugar or glucose out of the
bloodstream and into the cells where it can be used to provide
energy for the body.
Medication type: DPP4 analogs and DPP4 enzyme inhibitors
How it controls blood sugar: blocks an enzyme (DPP4) that
increases blood sugar
Names: DPP4 analogs: exanetide (Byetta); DPP4 enzyme inhibitors:
sitagliptin (Januvia), saxagliptin (Onglyza), and linogliptin
(Tradjenta)
Medication type: sulfonylureas and glinides
Main site of action: pancreas How it controls blood sugar:
helps pancreas to make more insulin
Names: sulfonylureas: glipizide (Glucotrol), glyburide
(Micronase, DiaBeta) glinides: glimepiride (Amaryl), repaglinide
(Prandin), nateglinide (Starlix)
Medication type: thiazolidinediones Main site of action: muscle
cells How it controls blood sugar:
makes muscle cells more sensitive to insulin
Names: pioglitazone (Actos)
9
-
Information to remember about diabetes medicines • Diabetes
medicines help to lower high blood sugar levels. They do not take
the place of healthy
eating and exercise. • Know when and how to take the medicines.
Do not skip a dose.• Wear a medical alert bracelet and/or carry
your My Diabetes Care Plan sheet for emergencies.• Bring an updated
list of your medications to visits with your doctor or other health
care professional.
To learn more about your diabetes medications, find information
at our website: kp.org/medications or consult with a
pharmacist.
Questions to ask your diabetes care team about your diabetes
medications
• When do I need to take the medicine–before ameal, with a meal,
or after a meal?
• How often should I take the medicine?
• Should I take the medicine at the same timeevery day?
• What should I do if I forget to take my medicine?
• What kind of side effects could I have and what symptoms
should I look for?
• How should I manage my medications when Iam sick and can’t
keep my food or drinksdown as usual?
Tips to help you remember to take your medications Everyone
struggles with remembering to do things regularly. There are a
number of ways that can help you remember. Below, check off things
you might try:
q Make a simple chart and post it in an obvious place where you
will see it every day, like on the mirror in the bathroom.
q Set an alarm clock or watch as a reminder. q Establish a daily
routine for taking your medications,
such as at bedtime, mealtime, or the beginning of a daily TV
show, such as the evening news.
q Use a pillbox that has sections, representing the days of the
week.
q Record taking your medications on a wallet card or
calendar.
q Can you think of others?
It’s easy to get prescription refills at Kaiser Permanente
pharmacies. • Please reorder your medications at least one to two
weeks before you run out.
• Use EasyFill, our automated phone prescription refill system.
Find the number to call in the upper righthand corner of your
prescription label, or call the pharmacy near you.
• Refill prescriptions at our website: Visit kp.org. and click
on “Pharmacy Center” under the “My HealthManager” tab. You can also
arrange to have many medications sent to you by mail.
Other resources For other healthy living resources, please visit
kp.org/healthyliving to get ideas to manage your condition.
Some conditions, including diabetes, can be seriously affected
by violence or abuse. If you are hit, hurt, or threatened by a
partner or spouse, there is help. Call the National Domestic
Violence Hotline at 18007997233 or connect to ndvh.org.
This information is not intended to diagnose health problems or
to take the place of medical advice or care you receive from your
physician or other medical professional. If you have persistent
health problems, or if you have further questions, please consult
your doctor. If you have questions or need additional information
about your medication, please speak to your pharmacist. Kaiser
Permanente does not endorse the medications or products mentioned.
Any trade names listed are for easy identification only. © 2003,
The Permanente Medical Group, Inc. All rights reserved. Regional
Health Education. 011061212 (Revised 112) 10
http:ndvh.org
-
Coping with Stress
Stress is an emotional and physical reaction to change.
Stress
can be positive and give you energy or it can be unhealthy
and cause health problems. Stress for short periods may not
affect you but stress over time can cause or make some
illnesses worse, such as heart disease, stroke, high blood
pressure, diabetes, irritable bowel syndrome, asthma or
arthritis.
Signs: Some common signs of unhealthy stress:
Tips for Coping with StressWatch for signs of stress. When they
occur, try to avoid the cause or change how you react.
Other helpful tips:
• Do something that relaxes you such as: deep and
slow breathing, stretching exercises, yoga, a
massage, meditation, listening to music, reading, a
hot bath or shower.
• Get a hobby or do something you enjoy.
• Learn to accept things that you cannot change.
• Think positive.
• Set limits. Learn to say no. Take one thing at a time.
• Get 8 hours of sleep each night.
• Eat a healthy diet that includes fruits, vegetables,
protein and whole grains. Limit caffeine and sugar.
• Exercise regularly. Exercise will help relax tense
muscles, improve your mood and help you sleep
better.
• Talk to your family and friends about your problems.
• Do not deal with stress in unhealthy ways such as
eating too much, not eating enough, using tobacco
products, drinking alcohol or using drugs.
• Get help from a professional if you need it. A
counselor can help you cope with stress and deal
with problems. Your doctor may prescribe
medicines to help with sad feelings, nervousness or
trouble sleeping.
Talk to your doctor or nurse if you have signs of stress.
• Feeling nervous, sad or
angry
• Fast pounding heartbeat
• Hard time breathing
• Sweating
• Pain or tense muscles in
the neck, shoulders, back,
jaw or face
• Headaches
• Feeling tired or having
trouble sleeping
• Constipation or diarrhea
• Upset stomach, lack of
appetite or weight loss
National Institute of Health. (2011, November). Coping with
Stress - Tagalog. www.healthinfotranslations.org
11
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Paano Kakayanin ang Tensiyon
(Stress)
Ang tensiyon (stress) ay isang emosyonal at pisikal na
reaksiyon
sa pagbabago. Ang tensiyon (stress) na nagtatagal sa
maikling
panahon ay maaaring hindi makaapekto sa inyo ngunit ang
tensiyon (stress) na nagtatagal ay maaaring maging sanhi o
magpalala ng ilang mga karamdaman, kagaya ng sakit sa puso,
atake sa utak, mataas na presyon ng dugo, diyabetis, sakit
sa
pagdumi (irritable bowel syndrome), hika o pamamaga ng mga
pinaghuhugpungan (arthritis).
Mga Paraan para Makayanan ang Tensiyon (Stress)Tingnan kung
mayroon kayong mga palatandaan ng tensiyon (stress). Kapag nangyari
ang mga ito, subukang umiwas
sa sanhi o baguhin ang inyong reaksiyon. Iba pang makakatulong
na paraan:
• Gumawa ng isang bagay na nakakapagpahingalay
sa inyo kagaya ng: malalim at mabagal na
paghinga, pag-uunat na ehersisyo, yoga, masahe,
pagninilay-nilay, pakikinig sa musika, pagbabasa,
paliligo ng mainit na tubig.
• Magkaroon ng libangang-gawain o gumawa ng
isang bagay na ikinalilibang ninyo.
• Pag-aralang tanggapin ang mga bagay na hindi
ninyo mababago.
• Mag-isip nang positibo.
• Magtakda ng mga limitasyon. Pag-aralang
tumanggi. Gawin ang mga bagay nang paisa-isa
lamang.
• Matulog ng 8 oras gabi-gabi.
• Kumain ng malusog na diyeta na may kasamang
prutas, gulay, protina at mga buong butil. Limitahan
ang kape at asukal.
• Palaging mag-ehersisyo. Makakatulong ang
ehersisyo upang makapagpahingalay ang matigas
na mga kalamnan, mapabuti ang inyong
disposisyon at matulungan kayong matulog nang
mahimbing.
• Kausapin ang inyong pamilya at mga kaibigan
tungkol sa inyong mga problema.
• Huwag harapin ang tensiyon (stress) sa mga
paraang hindimakabubuti kagaya ng pagkain ng
masyadong marami, hindi pagkain nang mabuti,
paggamit ng mga produktong tabako, pag-inom ng
alak o paggamit ng droga.
• Humingi ng tulong mula sa isang propesyunal kung
kailangan ninyo ito. Makakatulong ang isang
tagapagpayo upang kayanin ninyo ang tensiyon
(stress) at harapin ang mga problema. Maaaring
magreseta ang inyong doktor ng mga gamot upang
makatulong sa mga malulungkot na pakiramdam,
pagkanerbiyos o kahirapan sa pagtulog.
Kausapin ang inyong doktor o nars kung mayroon kayong mga
palatandaan ng tensiyon.
Mga PalatandaanIlang karaniwang palatandaan ng masamang tensiyon
(stress):
• Pakiramdam na
ninenerbiyos, nalulungkot
o nagagalit
• Mabilis na tibok ng puso
• Nahihirapang huminga
• Pananakit ng ulo
• Pakiramdam na pagod o
nahihirapang matulog
• Pananakit o paninigas ng
mga kalamnan sa leeg,
balikat, likod, panga o
mukha
• Pagpapawis
• Kahirapan sa pagdumi/tibi
o pagtatae
• Masakit na tiyan, kawalan
ng gana sa pagkain o
pagbaba ng timbang
National Institute of Health. (2011, November). Coping with
Stress – Tagalog. www.healthinfotranslations.org12
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Blood Sugar Testing - Hyper and HypoDiabetes Sugar
LogsCarbohydrate Counting with Filipino Foods SJSUFilipino DM Meal
PlansBeing Active with Diabetes (English)DM medsManaging
StressFilipino DM Resources_Final
