TCOYD Class #1

By GabbyPA Latest Reply 2011-08-31 12:58:09 -0500
Started 2009-04-23 15:42:20 -0500

I am taking a "Take Care Of Your Diabetes" Class that will last several weeks and I wanted to share some of the points that stood out to me. This class is directed to Type 2, so the things I share may not apply to Type 1 as directly.

Today we had an overview of what diabetes is, how it works (or doesn't work). We talked about our inability to use the glucose in our bloodstream effectively and so the build up to cause high sugar levels. We spoke about diet, exercise and meds in general to just be aware. Most things we know, but it is always a good review.

The key topic was glucose testing. The ADA recommends a fasting, 2 hr after meals, bedtime and 3:00 am. She asked us what our doctors recommended and it was amazing that so many say to test once a day in the morning. Wow, I was surprised. Of course, what she really wants is for us to ask specifically from our doctors when we should test and what our fasting, before meal, after meal and bedtime goals should be. Everyone will be different, and that is something you have to work out with your doctor.

Then we talked about how even though the A1c is the "goldstandard" for glucose control. That if we have high numbers we are not aware of, that they are direct indicators of cardio vascular risks. Wow, I did not know that. How we also need to be aware of our lipids that include our LDL, HDL, Triglycerides, Blood Pressure and our kidney function.

So she wanted us to understand why we test so often is to help us react to what is happening inside our bodies. So we can get the advice that we need from our doctors.

She also spoke about getting a meter that is right for you. Some are so small now, that they are hard to handle and program. Or some may be too complicated. It is good to find the one that you will be comfortable for you.

For the best averaging that your meter can do, she also recommended that you use one meter only. So ladies, pack 'er up and carry it with you everywhere. We were all "tisk, tisked" when only one of the 20 or so attending actually had a meter with us. Ooops! I work from home and rarely carry mine, so I see I will have to change that.

I really enjoyed the class and am looking forward to learning a lot. I learn so much here, I feel like I am on target, but it is good to learn from a new voice. I will find things in each class that I am doing wrong or not doing at all. I am grateful for the help and that people want to help us manage our disease.

24 replies

GabbyPA 2011-08-31 12:58:09 -0500 Report

There are 6 other discussions that relate to these classes. Just type in TCOYD in the search bar and it will bring up the other classes I had. It was a great class that I hope to take again in a year or so for a refresher. It was well worth it.

MewElla 2011-08-29 09:11:17 -0500 Report

What a great class to take…although I went to the Diabetes Classes at the hospital when I was first diagnosed, I am watching for a refresher class in my area for me to take now that I have lived with diabetes for a while..Probably get a lot more out of the refresher classes now…Very interesting Gabby..

Type1Lou 2011-08-29 08:53:03 -0500 Report

Dear Gabby, Many of the tips provided are helpful to us Type 1's as well. I never leave home without my meter. Thanks for this post!

Edie 2009-06-09 12:05:49 -0500 Report

I started reading these posts from Class 7 and went backwards. I have finished coping all of them to my computer and I am glad that you took these classes Gabby. Keep the Info coming and I will add anything I learn from mine in the future. As soon as I have ink for the printer I will be coping all and takeing with me to my classes and see why she doesn't cover ours like this.
Your Friend Always;

GabbyPA 2009-06-09 14:49:49 -0500 Report

I have to say that my instructors were great, engaging and very updated on all the things that are going on. It was a very open class where we could ask lots of questions and share our stories. I really did learn so much and it is showing now. I have seen a resurgence in my discipline and a direction that has been getting me great results. So while the classes ended at #7 (for now) I hope I can share more as I "do" all the great things they were teaching us.

Debe Pendice
Debe Pendice 2009-04-25 06:06:57 -0500 Report

Gabby, I am so glad you got to take this. It will help you and so many others here on the site. It is interesting to me everyday in learning. I have been a diabetic as a child.(type 1) and I am learning more and more daily. No one on here can every say thay know it all because I learn something everyday for someone on this site. I am proud of you for all your learning this past year but most of all proud you are my friend…Debe

GabbyPA 2009-04-25 08:07:24 -0500 Report

You are so sweet Debe. I know you have gone thru so much these past few months and I am glad to see you still here and I love how you learn. It is my tendency after a while, to loose the spark of interest, but I am inspired by your constant search for something new. That is one of the reasons I decided to take this class. You are a rock of our community! Thanks

DJ 2009-04-25 08:27:24 -0500 Report

Gabby, Girl you are the best!! Thank-you for posting the things you do, and I agree 100% with DeDe..we can & should learn something new everyday..and you are awesome to take these classes and provide us with information, and I have learned a few new things myself thanks to you. Please keep us up-dated on what you learn,and thank-you so much!!

GabbyPA 2009-04-24 10:12:12 -0500 Report

Something I forgot, but with testing so often, many of us cannot afford the strips. What was suggested was to do your 2 hours after a meal in this manner.
Week1: fast, pre-breakfast, 2 hours after, bedtime, 3:00
Week 2: fast, pre-lunch, 2 hours after, bedtime, 3:00
Week 3: fast, pre-dinner, 2 hours after, bedtime, 3:00

Of course, never limit it if you are feeling ill or need to see what is going on. Talk to your doctor to see what they suggest. And of course, this doesn't apply to Type 1 on insulin dependent Type 2.

gma 2009-04-24 18:48:36 -0500 Report

Gabby thank you for sharing. I hope you will share after all the classes I have learned a few things from this which I needed thanks again Iam type 2 on no meds so I need all the help I could get

alwaystryin 2009-04-23 16:09:24 -0500 Report

Three A.M.? If taken at bedtime, and no eating until Three A.M., what's the logic?


John Crowley
John Crowley 2009-04-23 16:55:18 -0500 Report

Actually much of the trouble with morning highs and/or lows can be solved by testing around 3:00 a.m. to see what your bs is doing.

Our doc doesn't recommend 3:00 a.m. testing EVERY night. He hopes for 4 or 5 middle of the night tests in a month.

Sarguillo 2009-04-23 17:08:09 -0500 Report

I never thought of testing at 3 am. But that is the time when you body strats to rev up and get ready for the day so that would be a perfect time to test. There are times I am up at 3 am. Wonder if there is a difference between waking up from a sleep at 3 am to test and already being up, not haveing gone to bed to test at 3 am?

John Crowley
John Crowley 2009-04-23 17:37:39 -0500 Report

There is definitely a difference between testing in the middle of the night when you've been asleep versus after you've been up all night. But I'd say, if you're up, you might as well test and learn what you can from it.

alwaystryin 2009-04-23 17:41:39 -0500 Report

Made me saw WOW! That is such a great thing to know. But then what does that result actually tell you, or me? Because those am/pm swings are baffling to me.

2009-04-23 18:02:40 -0500 Report

Gabby, great information and thank you much!

A few months ago I was having terrible nightmares and started a discussion about it. Amy T suggested I test at 3:00 am and it's a very good thing I did it. My reading were 30 to 40 for a solid week. I took this information to my doctor and my insulin dosage was cut in half. I was about to OD on insulin. I've had to check again at 3:00 am since the first time and I was going hypo again. My insulin was changed and the dosage lowered yet again. It REALLY will tell you what's going on inside that body! (I think Debe P was testing at 3:00 am at the same time I was.) Good luck to you, it's well worth waking up for! Hugs friends! Angie

John Crowley
John Crowley 2009-04-24 10:11:46 -0500 Report

So in the middle of the night, you may be either dropping too low or running too high. When you drop low at night, your liver will release stored sugars as protection for the body. This will often result in being too high in the morning.

Or you may simply be experiencing high blood sugars all night.

To oversimplify the explanation: In the first case, you usually need to cut back on your insulin or meds so that you're not dropping too low. In the second case, you need more insulin or meds.

It's definitely a question to take to your doc. But having some middle of the night testing will really help him/her figure out what change needs to be made.

skayc1 2009-04-23 16:04:19 -0500 Report

I remember taking a 6 week class at the hospital, and most of this is familiar, although I dont think my class went into the detail of testing at set times of the day including 3 am! who is awake at 3 am? (well besides my boyfriend, and he's not diabetic) not sure I would want to wake up just to test my blood suagr, testing it with a fasting and at meals and after meals I allready do. I do know that I need to have a set schedule for when I eat my meals, which I do not allways do.

John Crowley
John Crowley 2009-04-23 16:02:18 -0500 Report

Gabby, you are so awesome. Thanks for taking the time to share this with everyone else.

And we certainly have a long way to go in educating many doctors out there about appropriate levels of testing. Although, I suppose for a Type 2 with an A1c below 6 who is doing a great job with diet and exercise, testing 5 or 6 times a day might really be overkill.

Certainly for anyone who has poor control, testing once a day is almost pointless. There is so much information missing if you only test once a day.

GabbyPA 2009-04-24 10:05:03 -0500 Report

Yeah, I had noticed that as the class was coming, I got really lazy about testing and did it once a day. What a joke. It really doesn't tell you anything useful. I was doing the 3:00 am testing a while back to see how to get my morning levels down, so I started doing that again to see what is going on.
I am kind of approaching it like it is brand new, to get any of my pre-disposed notions out so I can learn as much as I can.
The instructors are all trained in their specialty, so the classes on management are by a diabetic, the nutrition classes are by a trained diabetes nutritionist, and the cardiovascular classes will be taught by a nurse that specializes in diabetes and cardio. So I know the things I learn will help me get to my next level of control. And give me a bunch of questions to ask my doctor on my next visit.

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