4 Steps to Control Your Diabetes for Life

viFankar 4 yag edImIEfrkSa

CmparaWTwkenamEpyenmrbsGntildekrhUtmYyCIvit

Cambodian (Khmer)

June 2007

PasaExmicror

Ex mifuna qntildeaM 2007

Contents Step 1 Learn about diabetes 6

Step 2 Know your diabetes ABCs 12

Step 3 Manage your diabetes 16

Step 4 Get routine care 22

Notes 26

Where to get help 28

matika

viFankarTI 1 sup3 sikSaBICmparaWTwkenamEpyenm 7

viFankarTI 2 sup3 dwgBI ABCs CmparaWTwkenamEpyenmrbsGntildek 13

viFankarTI 3 sup3 EfrkSaCmparaWTwkenamEpyenmrbsGntildek 17

viFankarTI 4 sup3 TTYlkarEfTaM[eTogTat 23

esckthornIktsmAacuteal 27

kEnoslashgedImITTYlCMnYy 29

4 Steps to Control Your Diabetes For Life

This booklet presents four key steps to help you manage your diabetes and live a long and active life

Step 1 Learn about diabetes

Step 2 Know your diabetes ABCs

Step 3 Manage your diabetes

Step 4 Get routine care to avoid problems

2

viFankar 4 yag edImIEfrkSa

CmparaWTwkenamEpyenmrbsGntildek

rhUtmYyCIvit

kUnesovePAENnaMenH bgethajCUnviFankarsMxansup2 edImICYyGntildekEfrkSaC

mparaWTwkenamEpyenm

rbsGntildek nigrsranmanCivit)anyUr nigeBareBjedayfamBl

viFankarTI 1 sup3 eronBICmparaWTwkenamEpyenm

viFankarTI 2 sup3 dwgBI ABCs CmparaWTwkenamEpyenmrbsGntildek

viFankarTI 3 sup3 EfrkSaCmparaWTwkenamEpyenmrbsGntildek

viFankarTI 4 sup3 TTYlkarEfTaM[eTogTatedImIecosvagbBaetha

Diabetes is a serious disease It affects almost every part of your body That is why a health care team may help you take care of your diabetes

bull doctor bull dentist bull diabetes educator bull dietitian bull eye doctor bull foot doctor bull mental health counselor bull nurse bull nurse practitioner bull pharmacist bull social worker bull friends and family

You are the most important member of the team

The q in this booklet show actions you

can take to manage your diabetes

q Help your health care team

make a diabetes care plan that

will work for you

q Learn to make wise choices for

your diabetes care each day

CmTpara w kKCaCmW para para para Y M i Y I THORN gGseacutenragkay W kenamEpyen W FnFrmyvabHBaldlcENknmysup2esrEtTaM

rbs ntilde u U ntilde I u M u Y ntilde M W para kenam GkehtdecHehy)anCaRkmEfTasxPaBRbEhlGacCyGkEfTaCmTw

EpyenmrbsGntildek sup3

bull evCcentbNETHit

bull eBTuumleFmicroj bull GntildekGbrMBICmparaWTwkenamEpyenm bull GntildekCMnajxagGahar bull eBTuumlBuumla)alEPntildek bull eBTuumlBuumla)aleCIg bull GntildekRbwkSasuxPaBposlashUacutevcitthorn bull Kilanubdaeligayika bull eBTuumlCMnYs bull raquosfkarI bull buKAacutelikesvasgAacutem bull mitthornPkthorni nigRKYsar

GntildekKW CasmaCikdfrac34sMxanbMputsMrabRkumEfTaMsuxPaB

cMNucqenAkntildeuacutegkUnesovePAenHbgethaj

BIviFankarEdlGntildekGac

eFVIedImEfrkSaCmparaWTwkenam

EpyenmrbsGntildek

q CYyRkumEfTaMsuxPaBrbs

Gntildek

begaacuteItEpnkarEfTaM

CmparaWTwkenamEpyenm[mandMeN

IrkarsRmabGntildek

q eroneRCIserIsrkmeFuumla)ay

sRmabkarEfTaM

CmparaWTwkenamEpyenm rbsGntildekC

aerograleacutefpara

Step 1 Learn about diabetes

Diabetes means that your blood glucose (blood sugar) is too high Here are the main types of diabetes

Type 1 diabetesmdashthe body does not make insulin Insulin helps the body use glucose from food for energy People with type 1 need to take insulin every day

Type 2 diabetesmdashthe body does not make or use insulin well People with type 2 often need to take pills or insulin Type 2 is the most common form of diabetes

Gestational (jes-TAY-shon-al) diabetes mellitus (GDM)mdashoccurs when a woman is pregnant It raises her risk of getting another type of diabetes mostly type 2 for the rest of her life It also raises her childrsquos risk of being overweight and getting diabetes

CmTpara w mmannyfaKuacute oslash U aacute uacute ntilde GkmanxseBkenHKCaRbePT W kenamEpyen frac12 yksnotsrkgQambrvbarrbs ntilde lt W

FMsup2eacutenCmparaWTwkenamEpyenm

gkaymi I aacute eRbR)anbegtb I

Uvkarelb bcurrencakfntildeaMGuin

CmparaTW wkenamEpyenmRbePTTI1-ragkaymi i u i u lsquo i u i u lsquo i Y I npltGnslnGnslnCyragkayeRbR)as

Kykoslash U GaharQam[eTACafamBlmnsSEdlmanRbePTT1Rtvkarcakuacute s)anmkBI u I U

fntildeaMGuinslsquoulinCaerograleacutefpara

2-ra sGiu ulsquo nGtRtmRtv U nsli w

mnusSEdlmanRbePTTI2 Rt slsquoulin RbePTTI 2 enH

KWCaRbePTTUeTAbMput eacutenCmparaWTwkenamEpyenm

[GDM]-ekI I I thorn eBaHvabegI aacute ntilde M IteLgenAeBlEdlRsmaneacutepTHORN neRKaHfakrbsKatna[ekt

CmTpara w mRbePTepSgeToteBjmyCvtEdlPaKeRcnbptKRbePTT2ehyva W kenamEpyen Y i i I M u W I I

kfrac34 I aacute akdlknKatna[mankarelsTmnngektCmW w yenbegneRKaHfntilde U M I para i I Tpara kenamEpmpgEdr

CmparaWTwkenamEpyenmRbePTTI

CmparaWTwkenamEpyenmeBlmaneacutepTHORNeBaH (Gestational diabetes mellitus)

viFankarTI 1 sup3 eronBICmparaWTwkenamEpyenm

curren

7

Diabetes is serious

You may have heard people say they have ldquoa touch of diabetesrdquo or that their ldquosugar is a little highrdquo These words suggest that diabetes is not a serious disease That is not correct Diabetes is serious but you can manage it

All people with diabetes need to make healthy food choices stay at a healthy weight and be active every day

Taking good care of yourself and your diabetes can help you feel better and avoid health problems caused by diabetes such as

bull heart attack and stroke bull eye problems that can lead to trouble seeing or

going blind bull nerve damage that can cause your hands and feet

to hurt tingle or feel numb Some people may even lose a foot or a leg

bull kidney problems that can cause your kidneys to stop working

bull gum disease and loss of teeth

CmparaWTwkenamEpyenmFparanFpararxoslashaMgNas

Gntilde oslash curren u i Y w W para mbfaCatsrkRbEhlGacFabBmnsSnyayfaBkeKmankarTakTgngCmEpyen curren i aacute

rbs Y lt i thorn genHeFI i W para kenamEpmmnEmnCaCmW para paraBkeKmanx bn M [K T yen i para n renaHeT s cBakuumlTa V tfaCm w F F

sM I i w U I W para kenamEpmFnFrNasEtGkGacEfrkSava)aniexcl denaHmnRtmRtveLyCmTw yen para para ntilde

mnusSTaMgGsEdlmanCmparaWTwkenamEpyenm RtUvEteFVIkareRCIserIsmethUacutebGahar

EdlmansuxPaBlyen rkSaTmparan[)anlyen nighatR)aNerograleacutefpara

karEfTaM Uuml oslash knntilde gCmW para w yen G ntilde w U yGY ntilde N_Rbesmicro IxnG i TkenamEpmrbs k)anRtmRtvGacC k[manGarm r

ehIyecosputBIbBaethasuxPaBEdlbNthornalmkBICmparaWTwkenamEpyenmdUcCa sup3

bull eraKKaMgebHdUg nigCmparaWdacsreacutesQam

bull bBaethaEPntildekEdlGaceFVI[manbBaethakntildeuacutegkaremIl bcurrenkoslashayeTACaxVakcxatsreacutesRbsaTEdlGacbNal[eacutedng)ateCgrbsGkQ oacutebsup2 bullxU thorn i I ntilde W esaacute

bcurren micro w lt sSmycnnRbEhlCaGac)atbg)ateCgbeCg manGarmN_skmnu Y M Y I curren I

bull bBaethaRkelon EdlGacbNthornal[RkelonrbsGntildekQbdMeNIrkar

bull CmparaWGBacopyajeFmicroj nig)atbgeFmicroj

When your blood glucose is close to normal you are likely to

bull have more energy bull be less tired and thirsty and urinate less often bull heal better and have fewer skin or bladder

infections bull have fewer problems with your eyesight skin feet

and gums

q Ask your health care team which

type of diabetes you have

q Learn why diabetes is serious

q Learn how caring for your diabetes

helps you feel better today and in

the future

10

enAeBlKykoslash U uacute ntilde ntilde w i micro ntilde micro _ Uuacute skgQamrbsGk enAEkrngkRmtFmta GkmanGarmNdcCa sup3

bull mankmoslashaMgCagmun bull minsUvGskmoslashaMg ehIyeRskTwk nigenamkanEttic bullCasHRbesI I I U curren ireLgehymankarxcEskbkarrlakRkBHenamkanEttc

bull GntildeknwgmanbBaethatictYccMeBaHEPntildek Esk eCIg nigGBacopyajeFmicroj

q cUrsaksYrRkumEfTaMsuxPa

BrbsGntildek faetIGntildek

manCmparaWTwkenamEpyenmRbePT

mYyNa

q sikSafaetIehtuGVICmparaWTwkena

mEpyenmman

eRKaHfntildeakxoslashaMg

q sikSafaetIkarEfTaMCmparaWTwke

namEpyenmrbsGntildek

CYyGntildek[manGarmmicroN_RbesIreLIgen

AeacutefparaenH

nigeTAeacutefparaeRkayeToteday

rebobNa

11

Step 2 Know your diabetes ABCs

Talk to you health care team about how to control your A1C Blood pressure and Cholesterol This can help lower your chances of having a heart attack stroke or other diabetes problem Herersquos what the ABCs of diabetes stand for

A for the A1C test (A-one-C) It shows you how your blood glucose has been over the last three months The A1C goal for most people is below 7

High blood glucose levels can harm your heart and blood vessels kidneys feet and eyes

B for Blood pressure The goal for most people with diabetes is below 13080

High blood pressure makes your heart work too hard It can cause heart attack stroke and kidney disease

C for Cholesterol The LDL goal for most people is below 100 The HDL goal for most people is above 40

LDL or ldquobadrdquo cholesterol can build up and clog your blood vessels It can cause a heart attack or a stroke HDL or ldquogoodrdquo cholesterol helps remove cholesterol from your blood vessels

12

ABCs

cU i Y u M u ntilde M I i I rBPakSaCamyRkmEfTasxPaBrbsGkGBvFRKbRKg A1C smlt i U thorn U aFQam ngkeLesrl

eFVIenHGacCYykatbnszligykMu[maneraKKaMgebHdUg dacsreacutesQam

bcurrenbBaethaCmparaWTwkenamEpyenm epSgeTotrbsGntildek xageRkamenHKWCaGtszlignfrac12yrbs ABCs eacutenCmparaWTwkenamEpyenm

A sRmabetsthorntimes A1C (eG-van-suI) vabgeth ntilde I uacute oslash skuacute ntilde I I lt ajGkfaetKykU ntilde Gk manekneL skgQamrbs gx

uacutentilde LgeBlbEx cugeRkayenHedayrebobemc eKaledA gkM uacute I

A1C sRmabmnusSPaKeRcInKW eRkam 7

kRmitKoslashuacuteykUskntildeuacutegQamxlts GacbHBaldlebHdUg nigsreacutesQam

Rkelon eCIg nigEPntildekrbsGntildek

B sRmab Blood Pressure (smltaFQam) eKaledAsRmabmnusSPaKeRcInEdlmanCmparaWTwkenamEpyenkKWeR

kam 13080

smltaFQamxlts eFVI[ebHdUgrbsGntildekeFVIkarFparanNas

vaGacbNthornal[man

eraKKaMgebHdUg CmparaWdacsreacutesQam nigCmparaWRkelon

C sRmab Cholesterol (kUeLesthornrUl) eKaledA LDL sRmabmnusSPaKeRcInKWeRkam 100

eKaledA HDL sRmabmnusSPaKeRcInKWelI 40

LDL bcurren kUeLesthornrUl GaRkk GacbegaacuteIteLIgnigsTHORNHsreacutesQamrbsGntildek vaGac bNthornal[maneraKKaMgebHdUg

bcurrenCmparaWdacsreacutesQam HDL bcurrenkUeLesthornrUl lyen CYyykkUeLesthornrUlecjBIsreacutesQamrbsGntildek

1

viFankarTI 2 sup3 dwgBI CmparaWTwkenamEpyenmrbsGntildek

q Ask your health care team

q what your A1C Blood pressure

and cholesterol numbers are

q what your ABC numbers should

be

q what you need to do to reach

your targets

1

q cUrsaksYrRkumkargarE

fTaMsuxPaBrbsGntildek sup3

q faetIelx A1C smltaFQ

am

nigkUeLesthornrUlrbsGntildek

mankMritbunmicroan

q faetIelx ABC rbsGntildek

KYrEtmanbunmicroan

q faetIGntildekRtUvkareFVIG

VIedImIQaneTAdl

eKaledArbsGntildek

1

Step 3 Manage your diabetes

Many people avoid the long-term problems of diabetes by taking good care of themselves Work with your health care team to reach your ABC goals Use this self-care plan

bull Use your diabetes food plan If you do not have one ask your health care team for one

- Eat healthy foods such as fruits and vegetables fish lean meats chicken or turkey without the skin dry peas or beans whole grains and low-fat or skim milk and cheese

- Keep fish and lean meat and poultry portions to about 3 ounces (or the size of a pack of cards) Bake broil or grill it

- Eat foods that have less fat and salt

- Eat foods with more fiber such as whole-grain cereals breads crackers rice or pasta

1

EfrkSaCmparawTwkenamEpyenmrbsGntildek

mnu I u eth W para kenamEpmyrrau M Uuml oslash BkeK)anlsSCaeRcnecosptbBaaCmTw yen U eacuterM edayEfTaxnrbs Y yen

cU I V yRkmEfTasxPaBrbsGkedmQaneTAdleKaledAABCrbsGk reFkarCamY u M u ntilde I I ntilde

cUreRbIR)asEpnkarEfTaMedayxoslashUumlnEacutegenH

enHeT cUrsMuEpnkarenHBI RkumEfTaMsuxPaBrbsGntildek

- briePaKGaharmansuxPaBlyendUcCa EposlasheQI nigbEnoslash sacRtI

sac i oslash csacmanbsacman)aragedaymnmanEsk EdlmanCatxajti M i

sENthorn M thorn Uuml para FBaCatTagmlngTkedaHeKa k)aragbsENkstRKab Oslash i M U i w

nigQIsEdlmanCatixoslashajtic nigKmicroanCatiERkm

-bri I i oslash i i ePaKsacRt-sacEdlmanCatxajtc-ngsacmanRbmaN3 eGans_ notbcurrenTMhMebomYyRbGbbrvbar dut GaMg va

- briePaKGaharEdlmanCatixoslashaj nigCatieacuteRbtic

-bri oslash I i I I U Oslash i M UePaKGaharbEnEdlmanCvCateRcneRcndcCaRKabFBaCatTagml

nMbufrac12gcMNit nMeRkkxfrac12r )ay bcurren)asthorna

bulleRbIR)asEpnkarGaharsRmabCmparaWTwkenamEpyenmrbsGntildekRbsinebIGntildekminmanEpnkar

viFankarTI 3 sup3

curren

curren

17

bull Get 30 to 60 minutes of physical activity on most days of the week Brisk walking is a great way to move more

bull Stay at a healthy weight by making healthy food choices and moving more

bull Ask for help if you feel down A mental health counselor support group member of the clergy friend or family member will listen to your concerns and help you feel better

bull Learn to cope with stress Stress can raise your blood glucose While it is hard to remove stress from your life you can learn to handle it

bull Stop smoking Ask for help to quit

bull Take medicines even when you feel good Ask you doctor if you need aspirin to prevent a heart attack or stroke Tell your doctor if you cannot afford your medicine or if you have any side effects

1

bull sszligitenATmparanEdlmansuxPaBlyen edayeFVIkareRCIserIsGaharmansuxPaBlyen nigeFVIclna[kanEteRcIn

bull sMu[eKCYyRbsinebIGntildekmanGarmmicroN_TukccedilRBYy GntildekTIRbwkSasux

PaBposlashUacutevcitthorn RkumKaMRT smaCikbuBVCit mitthornPkthorni bcurrensmaCikRKYsarnwgsthornabkar)armOumlrbsGntildek ehIyCYyGntildek[manGarmmicroN_RbesIreLIg

bull eronedaHRsayPaBtantwgposlashUacutevcitthorn PaBtantwgposlashUacutevcitthorn GacbegaacuteInKoslashuacuteykUskntildeuacutegQam

rbsGntildek edaysarvaBi)akkntildeuacutegkarbM)atPaBtantwgposlashUacutevcitthornBICivit

rbsGntildek

GntildekGaceronRKbRKgva

bull QbBisa)arI cUresntildeIsMuCMnYybBaAumlbBisa)arI

bull TTYlTanfntildeaMeTaHbICaenAeBlGntildekmanGarmmicroN_lyenkfrac34eday

cUrsaksYrevCcentbNETHitrbs Gntildek faetIGntildekRtUvkarfntildeaMGasltIrIn edImITbsaacuteateraKKaMgebHdUgbcurrenCmparaWdacsreacutesQam

EdrbcurrenGt cUrR)abeTAevCcentbNETHitrbsGntildek RbsinebIGntildekminGaceacute

llkTijfntildeaMrbsGntildek

)an bcurrenRbsinebIGntildekmanplvi)akBIfntildeaMNamYy

bull hatR)aNBI 30 eTA 60 naTI[)aneRcIneacutefparakntildeuacutegmYys)athornh_ karedIrelOnsup2 KWCaviFIeFVIclna

dfrac34RbesIrmYy

1

bull Check your feet every day for cuts blisters r ed spots and swelling Call your health car e team right away about any sor es that wonrsquot go away

bull Brush your teeth and floss every day to avoid pr oblems with your mouth teeth or gums

bull Check your blood glucose Y ou may want to test it one or mor e times a day

bull Check your blood pressure If your doctor advises

bull Report any changes in your eyesight to your doctor

q Talk to your health care team

about your blood glucose targets

Ask how and when to test your

blood glucose and how to use the

results to manage your diabetes

q Use this plan as a guide to your

self-care

q Discuss how your self-care plan is

working for you each time you

visit your health care team

20

bullBinit uuml e C Ig r b s k C a e r o g r a l eacute f paraG ntilde E R k g m a n k a r m t d a c u B g E s k k n UumlTHORN l R k h m

ni I U frac12 THORN u M u ntilde oslash I W g e h m Tr s Be h A R k m k a r g a r E f T a sx P a B r b s Gk P a m R ) a b Bk a r Q c a b E d l

min)ateTAvij

U MG a t e F

mat eFmicroj nigGBacopyajeFmicrojrbsGntildek

bulldus e F microj r b s Gntildek n ig e R b IE x S k t s microj C a e r o g r a l eacute f parae d Im Ie c o s p ut b B a etha C a m Yy

bullBi i I oslashuacutent uuml e m l K y k s k ntildeuacuteg Q a m r b s U ntilde Gk R b E h l K r e F I times thorn gGk ntilde Y e t s thornV v a m

bcurreneRcIndg kntildeuacutegmYyeacutefpara

bullBinit uuml e m Il s m lta F Q a m r b s Gntildek R b s in e b Ie v C centb N ETHit r b s Gntildek E N n a M

bull raykarN_BIkarposlashasbthornUacuterkntildeuacutegEPntildekrbsGntildek eTAkanevCcentbNETHitrbsGntildek

q cUrBiPakSaCamYyRkum

kargarEfTaMsuxPaB

rbsGntildekBI eKaled

AKoslashuacuteykUs

kntildeuacutegQamrbsGntildek cUrs

aksYrfa etIeFVIets

thorntimesKoslashuacuteykUskntildeuacutegQam

rbsGntildekedayrebobN

a nigenAeBlNa nigfaet

IeRbIR)as

lTsectpledImIEfrkSa

CmparaWTwkenamEpyenmrbs

GntildekedayrebobNa

q cUrRbIR)asEpnkar

enHCaTisedAENnaMeTAkan

karEfTaM

xoslashUumlnEacutegpTHORNalrbsGntildek

q cUrBiPakSafaetIEpn

karEfTaMxoslashUumlnEacutegpTHORNal

rbsGntildek kMBugdMeN

Irkar

yagemcEdr erogr

aleBlEdlGntildekeTA

CYbRkumEfTaMsuxPaB

rbsGntildek

21

Step 4 Get routine care to avoid problems

See your health care team at least twice a year to find and treat problems early Discuss what steps you can take to reach your goals

At each visit get a bull blood pressure check bull foot check bull weight check bull review of your self-care plan shown in Step 3

Two times each year get an bull A1C testmdashIt may be checked more often if it is over 7

Once each year get a bull cholesterol test bull triglyceride (try-GLISS-er-ide) test- a type of blood fat bull complete foot exam bull dental exam to check teeth and gumsmdashtell your

dentist you have diabetes bull dilated eye exam to check for eye problems bull flu shot bull urine and a blood test to check for kidney problems

At least once get a bull pneumonia (nu-mo-nya) shot

22

CY u M xPaBrbsu Gky I uacute ntilde yqaedmrkemlngBuumla)albB ethbRkmEfTa ntilde B gm ntilde M I I I i aas agehacNas rdgk Y

[)anTan i I ntilde Y i Y I IeBlBPakSafaetGkGacTTlykvFankarNamyedmseRmc)aneKaledA

rbsGntildek

eBleTACYbmthorngsup2 cUr sup3

bull BinituumlsmltaFQam

bull BinituumleCIg bull BinituumlTmparan bullBi i M Uuml oslash alrbsGkeLgvjdc)anbgajkuacutentilde i IntuumlEpnkarEfTaxnEacutegpTHORN ntilde I i U eth gvFankarT3

BIrdgCaerogralqntildeaM cUr sup3

bull eFVIetsthorntimes A1C - GaceFVIjwkjabCagenH)an RbsinebIvaelIsBI 7

mthorngCaerogralqntildeaM cUr sup3

bull BinituumlkUeLesthornrUlI times K t) Y i aj gQamuacutebulleFetsV thorn triglyceride (RTI esrIoslash I -CaRbePTmyeacutenCatxoslash kntilde

bull karBinituumleCIgTaMgmUl bullkarBi i micro I I I micro i copy micro U micro ntildentuumleFjedmemleFjngGBaajeFj-crR)abeBTuumleFjrbsGkfa

GntildekmanCmparaWTwkenamEpyenm

bull BinituumlEPntildek edImIemIlbBaethaEPntildek bull cakfntildeaMkarBarRKunpthornasay bull eFVIetsthorntimesTwkenam nigQam edImIemIlbBaethaRkelon

yagehacNasmthorngmYyqntildeaM cUr sup3

bull cakfntildeaMkarBareraKrlaksYt notnUmUnIyabrvbar

viFankarTI 4 sup3 TTYlkarEfTaMCaRbcaM[eTogTatedImIecosputbBaetha

2

q Ask your health care team about

these and other tests you may

need Ask what your results

mean

qWrite down the date and time of

your next visit

q If you have Medicare ask your

health care team if Medicare

will cover some of the costs for

q learning about healthy eating

and diabetes self

care special shoes if you

need them

qmedical supplies

q diabetes medicines

2

qcUrsYrRkumEfT

aMsuxPaBrbs

GntildekGMBIkareFVIe

tsthorntimes TaMgenH

nigepSgeTot

EdlGntildekGacR

tUvkar cUrs

YrfaetI

lTsectplrbsG

ntildekmannfrac12yyag

dUcemthornc

q cUrktRtakal

briecaumlT nigeB

levlaeacutenkar

eTACYb

elIkeRkayrb

sGntildek

q RbsinebIGntildekm

an Medicare cUrsYrRkum

EfTaM

suxPaBrbsG

ntildekfa etI Medicare nwg

rabrg

cMNaymYycMnYns

Rmab

q sikSaGMBIkarb

riePaKEdlma

nsuxPaBlyen

nigEskeCIgB

iessEfTaMCmparaWT

wkenamEpyenm

xoslashUumlnEacuteg Rbs

inebIGntildekRtUvkar

q smOumlarsup3pAacutetpAacuteg

Buumla)al

q fntildeaMCmparaWTwkenam

Epyenm

2

__________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________

Notes

NATIONAL DIABETES EDUCATION PROGRAM wwwndepnihgov

2

Contents Step 1 Learn about diabetes 6

Step 2 Know your diabetes ABCs 12

Step 3 Manage your diabetes 16

Step 4 Get routine care 22

Notes 26

Where to get help 28

matika

viFankarTI 1 sup3 sikSaBICmparaWTwkenamEpyenm 7

viFankarTI 2 sup3 dwgBI ABCs CmparaWTwkenamEpyenmrbsGntildek 13

viFankarTI 3 sup3 EfrkSaCmparaWTwkenamEpyenmrbsGntildek 17

viFankarTI 4 sup3 TTYlkarEfTaM[eTogTat 23

esckthornIktsmAacuteal 27

kEnoslashgedImITTYlCMnYy 29

4 Steps to Control Your Diabetes For Life

This booklet presents four key steps to help you manage your diabetes and live a long and active life

Step 1 Learn about diabetes

Step 2 Know your diabetes ABCs

Step 3 Manage your diabetes

Step 4 Get routine care to avoid problems

2

viFankar 4 yag edImIEfrkSa

CmparaWTwkenamEpyenmrbsGntildek

rhUtmYyCIvit

kUnesovePAENnaMenH bgethajCUnviFankarsMxansup2 edImICYyGntildekEfrkSaC

mparaWTwkenamEpyenm

rbsGntildek nigrsranmanCivit)anyUr nigeBareBjedayfamBl

viFankarTI 1 sup3 eronBICmparaWTwkenamEpyenm

viFankarTI 2 sup3 dwgBI ABCs CmparaWTwkenamEpyenmrbsGntildek

viFankarTI 3 sup3 EfrkSaCmparaWTwkenamEpyenmrbsGntildek

viFankarTI 4 sup3 TTYlkarEfTaM[eTogTatedImIecosvagbBaetha

Diabetes is a serious disease It affects almost every part of your body That is why a health care team may help you take care of your diabetes

bull doctor bull dentist bull diabetes educator bull dietitian bull eye doctor bull foot doctor bull mental health counselor bull nurse bull nurse practitioner bull pharmacist bull social worker bull friends and family

You are the most important member of the team

The q in this booklet show actions you

can take to manage your diabetes

q Help your health care team

make a diabetes care plan that

will work for you

q Learn to make wise choices for

your diabetes care each day

CmTpara w kKCaCmW para para para Y M i Y I THORN gGseacutenragkay W kenamEpyen W FnFrmyvabHBaldlcENknmysup2esrEtTaM

rbs ntilde u U ntilde I u M u Y ntilde M W para kenam GkehtdecHehy)anCaRkmEfTasxPaBRbEhlGacCyGkEfTaCmTw

EpyenmrbsGntildek sup3

bull evCcentbNETHit

bull eBTuumleFmicroj bull GntildekGbrMBICmparaWTwkenamEpyenm bull GntildekCMnajxagGahar bull eBTuumlBuumla)alEPntildek bull eBTuumlBuumla)aleCIg bull GntildekRbwkSasuxPaBposlashUacutevcitthorn bull Kilanubdaeligayika bull eBTuumlCMnYs bull raquosfkarI bull buKAacutelikesvasgAacutem bull mitthornPkthorni nigRKYsar

GntildekKW CasmaCikdfrac34sMxanbMputsMrabRkumEfTaMsuxPaB

cMNucqenAkntildeuacutegkUnesovePAenHbgethaj

BIviFankarEdlGntildekGac

eFVIedImEfrkSaCmparaWTwkenam

EpyenmrbsGntildek

q CYyRkumEfTaMsuxPaBrbs

Gntildek

begaacuteItEpnkarEfTaM

CmparaWTwkenamEpyenm[mandMeN

IrkarsRmabGntildek

q eroneRCIserIsrkmeFuumla)ay

sRmabkarEfTaM

CmparaWTwkenamEpyenm rbsGntildekC

aerograleacutefpara

Step 1 Learn about diabetes

Diabetes means that your blood glucose (blood sugar) is too high Here are the main types of diabetes

Type 1 diabetesmdashthe body does not make insulin Insulin helps the body use glucose from food for energy People with type 1 need to take insulin every day

Type 2 diabetesmdashthe body does not make or use insulin well People with type 2 often need to take pills or insulin Type 2 is the most common form of diabetes

Gestational (jes-TAY-shon-al) diabetes mellitus (GDM)mdashoccurs when a woman is pregnant It raises her risk of getting another type of diabetes mostly type 2 for the rest of her life It also raises her childrsquos risk of being overweight and getting diabetes

CmTpara w mmannyfaKuacute oslash U aacute uacute ntilde GkmanxseBkenHKCaRbePT W kenamEpyen frac12 yksnotsrkgQambrvbarrbs ntilde lt W

FMsup2eacutenCmparaWTwkenamEpyenm

gkaymi I aacute eRbR)anbegtb I

Uvkarelb bcurrencakfntildeaMGuin

CmparaTW wkenamEpyenmRbePTTI1-ragkaymi i u i u lsquo i u i u lsquo i Y I npltGnslnGnslnCyragkayeRbR)as

Kykoslash U GaharQam[eTACafamBlmnsSEdlmanRbePTT1Rtvkarcakuacute s)anmkBI u I U

fntildeaMGuinslsquoulinCaerograleacutefpara

2-ra sGiu ulsquo nGtRtmRtv U nsli w

mnusSEdlmanRbePTTI2 Rt slsquoulin RbePTTI 2 enH

KWCaRbePTTUeTAbMput eacutenCmparaWTwkenamEpyenm

[GDM]-ekI I I thorn eBaHvabegI aacute ntilde M IteLgenAeBlEdlRsmaneacutepTHORN neRKaHfakrbsKatna[ekt

CmTpara w mRbePTepSgeToteBjmyCvtEdlPaKeRcnbptKRbePTT2ehyva W kenamEpyen Y i i I M u W I I

kfrac34 I aacute akdlknKatna[mankarelsTmnngektCmW w yenbegneRKaHfntilde U M I para i I Tpara kenamEpmpgEdr

CmparaWTwkenamEpyenmRbePTTI

CmparaWTwkenamEpyenmeBlmaneacutepTHORNeBaH (Gestational diabetes mellitus)

viFankarTI 1 sup3 eronBICmparaWTwkenamEpyenm

curren

7

Diabetes is serious

You may have heard people say they have ldquoa touch of diabetesrdquo or that their ldquosugar is a little highrdquo These words suggest that diabetes is not a serious disease That is not correct Diabetes is serious but you can manage it

All people with diabetes need to make healthy food choices stay at a healthy weight and be active every day

Taking good care of yourself and your diabetes can help you feel better and avoid health problems caused by diabetes such as

bull heart attack and stroke bull eye problems that can lead to trouble seeing or

going blind bull nerve damage that can cause your hands and feet

to hurt tingle or feel numb Some people may even lose a foot or a leg

bull kidney problems that can cause your kidneys to stop working

bull gum disease and loss of teeth

CmparaWTwkenamEpyenmFparanFpararxoslashaMgNas

Gntilde oslash curren u i Y w W para mbfaCatsrkRbEhlGacFabBmnsSnyayfaBkeKmankarTakTgngCmEpyen curren i aacute

rbs Y lt i thorn genHeFI i W para kenamEpmmnEmnCaCmW para paraBkeKmanx bn M [K T yen i para n renaHeT s cBakuumlTa V tfaCm w F F

sM I i w U I W para kenamEpmFnFrNasEtGkGacEfrkSava)aniexcl denaHmnRtmRtveLyCmTw yen para para ntilde

mnusSTaMgGsEdlmanCmparaWTwkenamEpyenm RtUvEteFVIkareRCIserIsmethUacutebGahar

EdlmansuxPaBlyen rkSaTmparan[)anlyen nighatR)aNerograleacutefpara

karEfTaM Uuml oslash knntilde gCmW para w yen G ntilde w U yGY ntilde N_Rbesmicro IxnG i TkenamEpmrbs k)anRtmRtvGacC k[manGarm r

ehIyecosputBIbBaethasuxPaBEdlbNthornalmkBICmparaWTwkenamEpyenmdUcCa sup3

bull eraKKaMgebHdUg nigCmparaWdacsreacutesQam

bull bBaethaEPntildekEdlGaceFVI[manbBaethakntildeuacutegkaremIl bcurrenkoslashayeTACaxVakcxatsreacutesRbsaTEdlGacbNal[eacutedng)ateCgrbsGkQ oacutebsup2 bullxU thorn i I ntilde W esaacute

bcurren micro w lt sSmycnnRbEhlCaGac)atbg)ateCgbeCg manGarmN_skmnu Y M Y I curren I

bull bBaethaRkelon EdlGacbNthornal[RkelonrbsGntildekQbdMeNIrkar

bull CmparaWGBacopyajeFmicroj nig)atbgeFmicroj

When your blood glucose is close to normal you are likely to

bull have more energy bull be less tired and thirsty and urinate less often bull heal better and have fewer skin or bladder

infections bull have fewer problems with your eyesight skin feet

and gums

q Ask your health care team which

type of diabetes you have

q Learn why diabetes is serious

q Learn how caring for your diabetes

helps you feel better today and in

the future

10

enAeBlKykoslash U uacute ntilde ntilde w i micro ntilde micro _ Uuacute skgQamrbsGk enAEkrngkRmtFmta GkmanGarmNdcCa sup3

bull mankmoslashaMgCagmun bull minsUvGskmoslashaMg ehIyeRskTwk nigenamkanEttic bullCasHRbesI I I U curren ireLgehymankarxcEskbkarrlakRkBHenamkanEttc

bull GntildeknwgmanbBaethatictYccMeBaHEPntildek Esk eCIg nigGBacopyajeFmicroj

q cUrsaksYrRkumEfTaMsuxPa

BrbsGntildek faetIGntildek

manCmparaWTwkenamEpyenmRbePT

mYyNa

q sikSafaetIehtuGVICmparaWTwkena

mEpyenmman

eRKaHfntildeakxoslashaMg

q sikSafaetIkarEfTaMCmparaWTwke

namEpyenmrbsGntildek

CYyGntildek[manGarmmicroN_RbesIreLIgen

AeacutefparaenH

nigeTAeacutefparaeRkayeToteday

rebobNa

11

Step 2 Know your diabetes ABCs

Talk to you health care team about how to control your A1C Blood pressure and Cholesterol This can help lower your chances of having a heart attack stroke or other diabetes problem Herersquos what the ABCs of diabetes stand for

A for the A1C test (A-one-C) It shows you how your blood glucose has been over the last three months The A1C goal for most people is below 7

High blood glucose levels can harm your heart and blood vessels kidneys feet and eyes

B for Blood pressure The goal for most people with diabetes is below 13080

High blood pressure makes your heart work too hard It can cause heart attack stroke and kidney disease

C for Cholesterol The LDL goal for most people is below 100 The HDL goal for most people is above 40

LDL or ldquobadrdquo cholesterol can build up and clog your blood vessels It can cause a heart attack or a stroke HDL or ldquogoodrdquo cholesterol helps remove cholesterol from your blood vessels

12

ABCs

cU i Y u M u ntilde M I i I rBPakSaCamyRkmEfTasxPaBrbsGkGBvFRKbRKg A1C smlt i U thorn U aFQam ngkeLesrl

eFVIenHGacCYykatbnszligykMu[maneraKKaMgebHdUg dacsreacutesQam

bcurrenbBaethaCmparaWTwkenamEpyenm epSgeTotrbsGntildek xageRkamenHKWCaGtszlignfrac12yrbs ABCs eacutenCmparaWTwkenamEpyenm

A sRmabetsthorntimes A1C (eG-van-suI) vabgeth ntilde I uacute oslash skuacute ntilde I I lt ajGkfaetKykU ntilde Gk manekneL skgQamrbs gx

uacutentilde LgeBlbEx cugeRkayenHedayrebobemc eKaledA gkM uacute I

A1C sRmabmnusSPaKeRcInKW eRkam 7

kRmitKoslashuacuteykUskntildeuacutegQamxlts GacbHBaldlebHdUg nigsreacutesQam

Rkelon eCIg nigEPntildekrbsGntildek

B sRmab Blood Pressure (smltaFQam) eKaledAsRmabmnusSPaKeRcInEdlmanCmparaWTwkenamEpyenkKWeR

kam 13080

smltaFQamxlts eFVI[ebHdUgrbsGntildekeFVIkarFparanNas

vaGacbNthornal[man

eraKKaMgebHdUg CmparaWdacsreacutesQam nigCmparaWRkelon

C sRmab Cholesterol (kUeLesthornrUl) eKaledA LDL sRmabmnusSPaKeRcInKWeRkam 100

eKaledA HDL sRmabmnusSPaKeRcInKWelI 40

LDL bcurren kUeLesthornrUl GaRkk GacbegaacuteIteLIgnigsTHORNHsreacutesQamrbsGntildek vaGac bNthornal[maneraKKaMgebHdUg

bcurrenCmparaWdacsreacutesQam HDL bcurrenkUeLesthornrUl lyen CYyykkUeLesthornrUlecjBIsreacutesQamrbsGntildek

1

viFankarTI 2 sup3 dwgBI CmparaWTwkenamEpyenmrbsGntildek

q Ask your health care team

q what your A1C Blood pressure

and cholesterol numbers are

q what your ABC numbers should

be

q what you need to do to reach

your targets

1

q cUrsaksYrRkumkargarE

fTaMsuxPaBrbsGntildek sup3

q faetIelx A1C smltaFQ

am

nigkUeLesthornrUlrbsGntildek

mankMritbunmicroan

q faetIelx ABC rbsGntildek

KYrEtmanbunmicroan

q faetIGntildekRtUvkareFVIG

VIedImIQaneTAdl

eKaledArbsGntildek

1

Step 3 Manage your diabetes

Many people avoid the long-term problems of diabetes by taking good care of themselves Work with your health care team to reach your ABC goals Use this self-care plan

bull Use your diabetes food plan If you do not have one ask your health care team for one

- Eat healthy foods such as fruits and vegetables fish lean meats chicken or turkey without the skin dry peas or beans whole grains and low-fat or skim milk and cheese

- Keep fish and lean meat and poultry portions to about 3 ounces (or the size of a pack of cards) Bake broil or grill it

- Eat foods that have less fat and salt

- Eat foods with more fiber such as whole-grain cereals breads crackers rice or pasta

1

EfrkSaCmparawTwkenamEpyenmrbsGntildek

mnu I u eth W para kenamEpmyrrau M Uuml oslash BkeK)anlsSCaeRcnecosptbBaaCmTw yen U eacuterM edayEfTaxnrbs Y yen

cU I V yRkmEfTasxPaBrbsGkedmQaneTAdleKaledAABCrbsGk reFkarCamY u M u ntilde I I ntilde

cUreRbIR)asEpnkarEfTaMedayxoslashUumlnEacutegenH

enHeT cUrsMuEpnkarenHBI RkumEfTaMsuxPaBrbsGntildek

- briePaKGaharmansuxPaBlyendUcCa EposlasheQI nigbEnoslash sacRtI

sac i oslash csacmanbsacman)aragedaymnmanEsk EdlmanCatxajti M i

sENthorn M thorn Uuml para FBaCatTagmlngTkedaHeKa k)aragbsENkstRKab Oslash i M U i w

nigQIsEdlmanCatixoslashajtic nigKmicroanCatiERkm

-bri I i oslash i i ePaKsacRt-sacEdlmanCatxajtc-ngsacmanRbmaN3 eGans_ notbcurrenTMhMebomYyRbGbbrvbar dut GaMg va

- briePaKGaharEdlmanCatixoslashaj nigCatieacuteRbtic

-bri oslash I i I I U Oslash i M UePaKGaharbEnEdlmanCvCateRcneRcndcCaRKabFBaCatTagml

nMbufrac12gcMNit nMeRkkxfrac12r )ay bcurren)asthorna

bulleRbIR)asEpnkarGaharsRmabCmparaWTwkenamEpyenmrbsGntildekRbsinebIGntildekminmanEpnkar

viFankarTI 3 sup3

curren

curren

17

bull Get 30 to 60 minutes of physical activity on most days of the week Brisk walking is a great way to move more

bull Stay at a healthy weight by making healthy food choices and moving more

bull Ask for help if you feel down A mental health counselor support group member of the clergy friend or family member will listen to your concerns and help you feel better

bull Learn to cope with stress Stress can raise your blood glucose While it is hard to remove stress from your life you can learn to handle it

bull Stop smoking Ask for help to quit

bull Take medicines even when you feel good Ask you doctor if you need aspirin to prevent a heart attack or stroke Tell your doctor if you cannot afford your medicine or if you have any side effects

1

bull sszligitenATmparanEdlmansuxPaBlyen edayeFVIkareRCIserIsGaharmansuxPaBlyen nigeFVIclna[kanEteRcIn

bull sMu[eKCYyRbsinebIGntildekmanGarmmicroN_TukccedilRBYy GntildekTIRbwkSasux

PaBposlashUacutevcitthorn RkumKaMRT smaCikbuBVCit mitthornPkthorni bcurrensmaCikRKYsarnwgsthornabkar)armOumlrbsGntildek ehIyCYyGntildek[manGarmmicroN_RbesIreLIg

bull eronedaHRsayPaBtantwgposlashUacutevcitthorn PaBtantwgposlashUacutevcitthorn GacbegaacuteInKoslashuacuteykUskntildeuacutegQam

rbsGntildek edaysarvaBi)akkntildeuacutegkarbM)atPaBtantwgposlashUacutevcitthornBICivit

rbsGntildek

GntildekGaceronRKbRKgva

bull QbBisa)arI cUresntildeIsMuCMnYybBaAumlbBisa)arI

bull TTYlTanfntildeaMeTaHbICaenAeBlGntildekmanGarmmicroN_lyenkfrac34eday

cUrsaksYrevCcentbNETHitrbs Gntildek faetIGntildekRtUvkarfntildeaMGasltIrIn edImITbsaacuteateraKKaMgebHdUgbcurrenCmparaWdacsreacutesQam

EdrbcurrenGt cUrR)abeTAevCcentbNETHitrbsGntildek RbsinebIGntildekminGaceacute

llkTijfntildeaMrbsGntildek

)an bcurrenRbsinebIGntildekmanplvi)akBIfntildeaMNamYy

bull hatR)aNBI 30 eTA 60 naTI[)aneRcIneacutefparakntildeuacutegmYys)athornh_ karedIrelOnsup2 KWCaviFIeFVIclna

dfrac34RbesIrmYy

1

bull Check your feet every day for cuts blisters r ed spots and swelling Call your health car e team right away about any sor es that wonrsquot go away

bull Brush your teeth and floss every day to avoid pr oblems with your mouth teeth or gums

bull Check your blood glucose Y ou may want to test it one or mor e times a day

bull Check your blood pressure If your doctor advises

bull Report any changes in your eyesight to your doctor

q Talk to your health care team

about your blood glucose targets

Ask how and when to test your

blood glucose and how to use the

results to manage your diabetes

q Use this plan as a guide to your

self-care

q Discuss how your self-care plan is

working for you each time you

visit your health care team

20

bullBinit uuml e C Ig r b s k C a e r o g r a l eacute f paraG ntilde E R k g m a n k a r m t d a c u B g E s k k n UumlTHORN l R k h m

ni I U frac12 THORN u M u ntilde oslash I W g e h m Tr s Be h A R k m k a r g a r E f T a sx P a B r b s Gk P a m R ) a b Bk a r Q c a b E d l

min)ateTAvij

U MG a t e F

mat eFmicroj nigGBacopyajeFmicrojrbsGntildek

bulldus e F microj r b s Gntildek n ig e R b IE x S k t s microj C a e r o g r a l eacute f parae d Im Ie c o s p ut b B a etha C a m Yy

bullBi i I oslashuacutent uuml e m l K y k s k ntildeuacuteg Q a m r b s U ntilde Gk R b E h l K r e F I times thorn gGk ntilde Y e t s thornV v a m

bcurreneRcIndg kntildeuacutegmYyeacutefpara

bullBinit uuml e m Il s m lta F Q a m r b s Gntildek R b s in e b Ie v C centb N ETHit r b s Gntildek E N n a M

bull raykarN_BIkarposlashasbthornUacuterkntildeuacutegEPntildekrbsGntildek eTAkanevCcentbNETHitrbsGntildek

q cUrBiPakSaCamYyRkum

kargarEfTaMsuxPaB

rbsGntildekBI eKaled

AKoslashuacuteykUs

kntildeuacutegQamrbsGntildek cUrs

aksYrfa etIeFVIets

thorntimesKoslashuacuteykUskntildeuacutegQam

rbsGntildekedayrebobN

a nigenAeBlNa nigfaet

IeRbIR)as

lTsectpledImIEfrkSa

CmparaWTwkenamEpyenmrbs

GntildekedayrebobNa

q cUrRbIR)asEpnkar

enHCaTisedAENnaMeTAkan

karEfTaM

xoslashUumlnEacutegpTHORNalrbsGntildek

q cUrBiPakSafaetIEpn

karEfTaMxoslashUumlnEacutegpTHORNal

rbsGntildek kMBugdMeN

Irkar

yagemcEdr erogr

aleBlEdlGntildekeTA

CYbRkumEfTaMsuxPaB

rbsGntildek

21

Step 4 Get routine care to avoid problems

See your health care team at least twice a year to find and treat problems early Discuss what steps you can take to reach your goals

At each visit get a bull blood pressure check bull foot check bull weight check bull review of your self-care plan shown in Step 3

Two times each year get an bull A1C testmdashIt may be checked more often if it is over 7

Once each year get a bull cholesterol test bull triglyceride (try-GLISS-er-ide) test- a type of blood fat bull complete foot exam bull dental exam to check teeth and gumsmdashtell your

dentist you have diabetes bull dilated eye exam to check for eye problems bull flu shot bull urine and a blood test to check for kidney problems

At least once get a bull pneumonia (nu-mo-nya) shot

22

CY u M xPaBrbsu Gky I uacute ntilde yqaedmrkemlngBuumla)albB ethbRkmEfTa ntilde B gm ntilde M I I I i aas agehacNas rdgk Y

[)anTan i I ntilde Y i Y I IeBlBPakSafaetGkGacTTlykvFankarNamyedmseRmc)aneKaledA

rbsGntildek

eBleTACYbmthorngsup2 cUr sup3

bull BinituumlsmltaFQam

bull BinituumleCIg bull BinituumlTmparan bullBi i M Uuml oslash alrbsGkeLgvjdc)anbgajkuacutentilde i IntuumlEpnkarEfTaxnEacutegpTHORN ntilde I i U eth gvFankarT3

BIrdgCaerogralqntildeaM cUr sup3

bull eFVIetsthorntimes A1C - GaceFVIjwkjabCagenH)an RbsinebIvaelIsBI 7

mthorngCaerogralqntildeaM cUr sup3

bull BinituumlkUeLesthornrUlI times K t) Y i aj gQamuacutebulleFetsV thorn triglyceride (RTI esrIoslash I -CaRbePTmyeacutenCatxoslash kntilde

bull karBinituumleCIgTaMgmUl bullkarBi i micro I I I micro i copy micro U micro ntildentuumleFjedmemleFjngGBaajeFj-crR)abeBTuumleFjrbsGkfa

GntildekmanCmparaWTwkenamEpyenm

bull BinituumlEPntildek edImIemIlbBaethaEPntildek bull cakfntildeaMkarBarRKunpthornasay bull eFVIetsthorntimesTwkenam nigQam edImIemIlbBaethaRkelon

yagehacNasmthorngmYyqntildeaM cUr sup3

bull cakfntildeaMkarBareraKrlaksYt notnUmUnIyabrvbar

viFankarTI 4 sup3 TTYlkarEfTaMCaRbcaM[eTogTatedImIecosputbBaetha

2

q Ask your health care team about

these and other tests you may

need Ask what your results

mean

qWrite down the date and time of

your next visit

q If you have Medicare ask your

health care team if Medicare

will cover some of the costs for

q learning about healthy eating

and diabetes self

care special shoes if you

need them

qmedical supplies

q diabetes medicines

2

qcUrsYrRkumEfT

aMsuxPaBrbs

GntildekGMBIkareFVIe

tsthorntimes TaMgenH

nigepSgeTot

EdlGntildekGacR

tUvkar cUrs

YrfaetI

lTsectplrbsG

ntildekmannfrac12yyag

dUcemthornc

q cUrktRtakal

briecaumlT nigeB

levlaeacutenkar

eTACYb

elIkeRkayrb

sGntildek

q RbsinebIGntildekm

an Medicare cUrsYrRkum

EfTaM

suxPaBrbsG

ntildekfa etI Medicare nwg

rabrg

cMNaymYycMnYns

Rmab

q sikSaGMBIkarb

riePaKEdlma

nsuxPaBlyen

nigEskeCIgB

iessEfTaMCmparaWT

wkenamEpyenm

xoslashUumlnEacuteg Rbs

inebIGntildekRtUvkar

q smOumlarsup3pAacutetpAacuteg

Buumla)al

q fntildeaMCmparaWTwkenam

Epyenm

2

__________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________

Notes

NATIONAL DIABETES EDUCATION PROGRAM wwwndepnihgov

2

matika

viFankarTI 1 sup3 sikSaBICmparaWTwkenamEpyenm 7

viFankarTI 2 sup3 dwgBI ABCs CmparaWTwkenamEpyenmrbsGntildek 13

viFankarTI 3 sup3 EfrkSaCmparaWTwkenamEpyenmrbsGntildek 17

viFankarTI 4 sup3 TTYlkarEfTaM[eTogTat 23

esckthornIktsmAacuteal 27

kEnoslashgedImITTYlCMnYy 29

4 Steps to Control Your Diabetes For Life

This booklet presents four key steps to help you manage your diabetes and live a long and active life

Step 1 Learn about diabetes

Step 2 Know your diabetes ABCs

Step 3 Manage your diabetes

Step 4 Get routine care to avoid problems

2

viFankar 4 yag edImIEfrkSa

CmparaWTwkenamEpyenmrbsGntildek

rhUtmYyCIvit

kUnesovePAENnaMenH bgethajCUnviFankarsMxansup2 edImICYyGntildekEfrkSaC

mparaWTwkenamEpyenm

rbsGntildek nigrsranmanCivit)anyUr nigeBareBjedayfamBl

viFankarTI 1 sup3 eronBICmparaWTwkenamEpyenm

viFankarTI 2 sup3 dwgBI ABCs CmparaWTwkenamEpyenmrbsGntildek

viFankarTI 3 sup3 EfrkSaCmparaWTwkenamEpyenmrbsGntildek

viFankarTI 4 sup3 TTYlkarEfTaM[eTogTatedImIecosvagbBaetha

Diabetes is a serious disease It affects almost every part of your body That is why a health care team may help you take care of your diabetes

bull doctor bull dentist bull diabetes educator bull dietitian bull eye doctor bull foot doctor bull mental health counselor bull nurse bull nurse practitioner bull pharmacist bull social worker bull friends and family

You are the most important member of the team

The q in this booklet show actions you

can take to manage your diabetes

q Help your health care team

make a diabetes care plan that

will work for you

q Learn to make wise choices for

your diabetes care each day

CmTpara w kKCaCmW para para para Y M i Y I THORN gGseacutenragkay W kenamEpyen W FnFrmyvabHBaldlcENknmysup2esrEtTaM

rbs ntilde u U ntilde I u M u Y ntilde M W para kenam GkehtdecHehy)anCaRkmEfTasxPaBRbEhlGacCyGkEfTaCmTw

EpyenmrbsGntildek sup3

bull evCcentbNETHit

bull eBTuumleFmicroj bull GntildekGbrMBICmparaWTwkenamEpyenm bull GntildekCMnajxagGahar bull eBTuumlBuumla)alEPntildek bull eBTuumlBuumla)aleCIg bull GntildekRbwkSasuxPaBposlashUacutevcitthorn bull Kilanubdaeligayika bull eBTuumlCMnYs bull raquosfkarI bull buKAacutelikesvasgAacutem bull mitthornPkthorni nigRKYsar

GntildekKW CasmaCikdfrac34sMxanbMputsMrabRkumEfTaMsuxPaB

cMNucqenAkntildeuacutegkUnesovePAenHbgethaj

BIviFankarEdlGntildekGac

eFVIedImEfrkSaCmparaWTwkenam

EpyenmrbsGntildek

q CYyRkumEfTaMsuxPaBrbs

Gntildek

begaacuteItEpnkarEfTaM

CmparaWTwkenamEpyenm[mandMeN

IrkarsRmabGntildek

q eroneRCIserIsrkmeFuumla)ay

sRmabkarEfTaM

CmparaWTwkenamEpyenm rbsGntildekC

aerograleacutefpara

Step 1 Learn about diabetes

Diabetes means that your blood glucose (blood sugar) is too high Here are the main types of diabetes

Type 1 diabetesmdashthe body does not make insulin Insulin helps the body use glucose from food for energy People with type 1 need to take insulin every day

Type 2 diabetesmdashthe body does not make or use insulin well People with type 2 often need to take pills or insulin Type 2 is the most common form of diabetes

Gestational (jes-TAY-shon-al) diabetes mellitus (GDM)mdashoccurs when a woman is pregnant It raises her risk of getting another type of diabetes mostly type 2 for the rest of her life It also raises her childrsquos risk of being overweight and getting diabetes

CmTpara w mmannyfaKuacute oslash U aacute uacute ntilde GkmanxseBkenHKCaRbePT W kenamEpyen frac12 yksnotsrkgQambrvbarrbs ntilde lt W

FMsup2eacutenCmparaWTwkenamEpyenm

gkaymi I aacute eRbR)anbegtb I

Uvkarelb bcurrencakfntildeaMGuin

CmparaTW wkenamEpyenmRbePTTI1-ragkaymi i u i u lsquo i u i u lsquo i Y I npltGnslnGnslnCyragkayeRbR)as

Kykoslash U GaharQam[eTACafamBlmnsSEdlmanRbePTT1Rtvkarcakuacute s)anmkBI u I U

fntildeaMGuinslsquoulinCaerograleacutefpara

2-ra sGiu ulsquo nGtRtmRtv U nsli w

mnusSEdlmanRbePTTI2 Rt slsquoulin RbePTTI 2 enH

KWCaRbePTTUeTAbMput eacutenCmparaWTwkenamEpyenm

[GDM]-ekI I I thorn eBaHvabegI aacute ntilde M IteLgenAeBlEdlRsmaneacutepTHORN neRKaHfakrbsKatna[ekt

CmTpara w mRbePTepSgeToteBjmyCvtEdlPaKeRcnbptKRbePTT2ehyva W kenamEpyen Y i i I M u W I I

kfrac34 I aacute akdlknKatna[mankarelsTmnngektCmW w yenbegneRKaHfntilde U M I para i I Tpara kenamEpmpgEdr

CmparaWTwkenamEpyenmRbePTTI

CmparaWTwkenamEpyenmeBlmaneacutepTHORNeBaH (Gestational diabetes mellitus)

viFankarTI 1 sup3 eronBICmparaWTwkenamEpyenm

curren

7

Diabetes is serious

You may have heard people say they have ldquoa touch of diabetesrdquo or that their ldquosugar is a little highrdquo These words suggest that diabetes is not a serious disease That is not correct Diabetes is serious but you can manage it

All people with diabetes need to make healthy food choices stay at a healthy weight and be active every day

Taking good care of yourself and your diabetes can help you feel better and avoid health problems caused by diabetes such as

bull heart attack and stroke bull eye problems that can lead to trouble seeing or

going blind bull nerve damage that can cause your hands and feet

to hurt tingle or feel numb Some people may even lose a foot or a leg

bull kidney problems that can cause your kidneys to stop working

bull gum disease and loss of teeth

CmparaWTwkenamEpyenmFparanFpararxoslashaMgNas

Gntilde oslash curren u i Y w W para mbfaCatsrkRbEhlGacFabBmnsSnyayfaBkeKmankarTakTgngCmEpyen curren i aacute

rbs Y lt i thorn genHeFI i W para kenamEpmmnEmnCaCmW para paraBkeKmanx bn M [K T yen i para n renaHeT s cBakuumlTa V tfaCm w F F

sM I i w U I W para kenamEpmFnFrNasEtGkGacEfrkSava)aniexcl denaHmnRtmRtveLyCmTw yen para para ntilde

mnusSTaMgGsEdlmanCmparaWTwkenamEpyenm RtUvEteFVIkareRCIserIsmethUacutebGahar

EdlmansuxPaBlyen rkSaTmparan[)anlyen nighatR)aNerograleacutefpara

karEfTaM Uuml oslash knntilde gCmW para w yen G ntilde w U yGY ntilde N_Rbesmicro IxnG i TkenamEpmrbs k)anRtmRtvGacC k[manGarm r

ehIyecosputBIbBaethasuxPaBEdlbNthornalmkBICmparaWTwkenamEpyenmdUcCa sup3

bull eraKKaMgebHdUg nigCmparaWdacsreacutesQam

bull bBaethaEPntildekEdlGaceFVI[manbBaethakntildeuacutegkaremIl bcurrenkoslashayeTACaxVakcxatsreacutesRbsaTEdlGacbNal[eacutedng)ateCgrbsGkQ oacutebsup2 bullxU thorn i I ntilde W esaacute

bcurren micro w lt sSmycnnRbEhlCaGac)atbg)ateCgbeCg manGarmN_skmnu Y M Y I curren I

bull bBaethaRkelon EdlGacbNthornal[RkelonrbsGntildekQbdMeNIrkar

bull CmparaWGBacopyajeFmicroj nig)atbgeFmicroj

When your blood glucose is close to normal you are likely to

bull have more energy bull be less tired and thirsty and urinate less often bull heal better and have fewer skin or bladder

infections bull have fewer problems with your eyesight skin feet

and gums

q Ask your health care team which

type of diabetes you have

q Learn why diabetes is serious

q Learn how caring for your diabetes

helps you feel better today and in

the future

10

enAeBlKykoslash U uacute ntilde ntilde w i micro ntilde micro _ Uuacute skgQamrbsGk enAEkrngkRmtFmta GkmanGarmNdcCa sup3

bull mankmoslashaMgCagmun bull minsUvGskmoslashaMg ehIyeRskTwk nigenamkanEttic bullCasHRbesI I I U curren ireLgehymankarxcEskbkarrlakRkBHenamkanEttc

bull GntildeknwgmanbBaethatictYccMeBaHEPntildek Esk eCIg nigGBacopyajeFmicroj

q cUrsaksYrRkumEfTaMsuxPa

BrbsGntildek faetIGntildek

manCmparaWTwkenamEpyenmRbePT

mYyNa

q sikSafaetIehtuGVICmparaWTwkena

mEpyenmman

eRKaHfntildeakxoslashaMg

q sikSafaetIkarEfTaMCmparaWTwke

namEpyenmrbsGntildek

CYyGntildek[manGarmmicroN_RbesIreLIgen

AeacutefparaenH

nigeTAeacutefparaeRkayeToteday

rebobNa

11

Step 2 Know your diabetes ABCs

Talk to you health care team about how to control your A1C Blood pressure and Cholesterol This can help lower your chances of having a heart attack stroke or other diabetes problem Herersquos what the ABCs of diabetes stand for

A for the A1C test (A-one-C) It shows you how your blood glucose has been over the last three months The A1C goal for most people is below 7

High blood glucose levels can harm your heart and blood vessels kidneys feet and eyes

B for Blood pressure The goal for most people with diabetes is below 13080

High blood pressure makes your heart work too hard It can cause heart attack stroke and kidney disease

C for Cholesterol The LDL goal for most people is below 100 The HDL goal for most people is above 40

LDL or ldquobadrdquo cholesterol can build up and clog your blood vessels It can cause a heart attack or a stroke HDL or ldquogoodrdquo cholesterol helps remove cholesterol from your blood vessels

12

ABCs

cU i Y u M u ntilde M I i I rBPakSaCamyRkmEfTasxPaBrbsGkGBvFRKbRKg A1C smlt i U thorn U aFQam ngkeLesrl

eFVIenHGacCYykatbnszligykMu[maneraKKaMgebHdUg dacsreacutesQam

bcurrenbBaethaCmparaWTwkenamEpyenm epSgeTotrbsGntildek xageRkamenHKWCaGtszlignfrac12yrbs ABCs eacutenCmparaWTwkenamEpyenm

A sRmabetsthorntimes A1C (eG-van-suI) vabgeth ntilde I uacute oslash skuacute ntilde I I lt ajGkfaetKykU ntilde Gk manekneL skgQamrbs gx

uacutentilde LgeBlbEx cugeRkayenHedayrebobemc eKaledA gkM uacute I

A1C sRmabmnusSPaKeRcInKW eRkam 7

kRmitKoslashuacuteykUskntildeuacutegQamxlts GacbHBaldlebHdUg nigsreacutesQam

Rkelon eCIg nigEPntildekrbsGntildek

B sRmab Blood Pressure (smltaFQam) eKaledAsRmabmnusSPaKeRcInEdlmanCmparaWTwkenamEpyenkKWeR

kam 13080

smltaFQamxlts eFVI[ebHdUgrbsGntildekeFVIkarFparanNas

vaGacbNthornal[man

eraKKaMgebHdUg CmparaWdacsreacutesQam nigCmparaWRkelon

C sRmab Cholesterol (kUeLesthornrUl) eKaledA LDL sRmabmnusSPaKeRcInKWeRkam 100

eKaledA HDL sRmabmnusSPaKeRcInKWelI 40

LDL bcurren kUeLesthornrUl GaRkk GacbegaacuteIteLIgnigsTHORNHsreacutesQamrbsGntildek vaGac bNthornal[maneraKKaMgebHdUg

bcurrenCmparaWdacsreacutesQam HDL bcurrenkUeLesthornrUl lyen CYyykkUeLesthornrUlecjBIsreacutesQamrbsGntildek

1

viFankarTI 2 sup3 dwgBI CmparaWTwkenamEpyenmrbsGntildek

q Ask your health care team

q what your A1C Blood pressure

and cholesterol numbers are

q what your ABC numbers should

be

q what you need to do to reach

your targets

1

q cUrsaksYrRkumkargarE

fTaMsuxPaBrbsGntildek sup3

q faetIelx A1C smltaFQ

am

nigkUeLesthornrUlrbsGntildek

mankMritbunmicroan

q faetIelx ABC rbsGntildek

KYrEtmanbunmicroan

q faetIGntildekRtUvkareFVIG

VIedImIQaneTAdl

eKaledArbsGntildek

1

Step 3 Manage your diabetes

Many people avoid the long-term problems of diabetes by taking good care of themselves Work with your health care team to reach your ABC goals Use this self-care plan

bull Use your diabetes food plan If you do not have one ask your health care team for one

- Eat healthy foods such as fruits and vegetables fish lean meats chicken or turkey without the skin dry peas or beans whole grains and low-fat or skim milk and cheese

- Keep fish and lean meat and poultry portions to about 3 ounces (or the size of a pack of cards) Bake broil or grill it

- Eat foods that have less fat and salt

- Eat foods with more fiber such as whole-grain cereals breads crackers rice or pasta

1

EfrkSaCmparawTwkenamEpyenmrbsGntildek

mnu I u eth W para kenamEpmyrrau M Uuml oslash BkeK)anlsSCaeRcnecosptbBaaCmTw yen U eacuterM edayEfTaxnrbs Y yen

cU I V yRkmEfTasxPaBrbsGkedmQaneTAdleKaledAABCrbsGk reFkarCamY u M u ntilde I I ntilde

cUreRbIR)asEpnkarEfTaMedayxoslashUumlnEacutegenH

enHeT cUrsMuEpnkarenHBI RkumEfTaMsuxPaBrbsGntildek

- briePaKGaharmansuxPaBlyendUcCa EposlasheQI nigbEnoslash sacRtI

sac i oslash csacmanbsacman)aragedaymnmanEsk EdlmanCatxajti M i

sENthorn M thorn Uuml para FBaCatTagmlngTkedaHeKa k)aragbsENkstRKab Oslash i M U i w

nigQIsEdlmanCatixoslashajtic nigKmicroanCatiERkm

-bri I i oslash i i ePaKsacRt-sacEdlmanCatxajtc-ngsacmanRbmaN3 eGans_ notbcurrenTMhMebomYyRbGbbrvbar dut GaMg va

- briePaKGaharEdlmanCatixoslashaj nigCatieacuteRbtic

-bri oslash I i I I U Oslash i M UePaKGaharbEnEdlmanCvCateRcneRcndcCaRKabFBaCatTagml

nMbufrac12gcMNit nMeRkkxfrac12r )ay bcurren)asthorna

bulleRbIR)asEpnkarGaharsRmabCmparaWTwkenamEpyenmrbsGntildekRbsinebIGntildekminmanEpnkar

viFankarTI 3 sup3

curren

curren

17

bull Get 30 to 60 minutes of physical activity on most days of the week Brisk walking is a great way to move more

bull Stay at a healthy weight by making healthy food choices and moving more

bull Ask for help if you feel down A mental health counselor support group member of the clergy friend or family member will listen to your concerns and help you feel better

bull Learn to cope with stress Stress can raise your blood glucose While it is hard to remove stress from your life you can learn to handle it

bull Stop smoking Ask for help to quit

bull Take medicines even when you feel good Ask you doctor if you need aspirin to prevent a heart attack or stroke Tell your doctor if you cannot afford your medicine or if you have any side effects

1

bull sszligitenATmparanEdlmansuxPaBlyen edayeFVIkareRCIserIsGaharmansuxPaBlyen nigeFVIclna[kanEteRcIn

bull sMu[eKCYyRbsinebIGntildekmanGarmmicroN_TukccedilRBYy GntildekTIRbwkSasux

PaBposlashUacutevcitthorn RkumKaMRT smaCikbuBVCit mitthornPkthorni bcurrensmaCikRKYsarnwgsthornabkar)armOumlrbsGntildek ehIyCYyGntildek[manGarmmicroN_RbesIreLIg

bull eronedaHRsayPaBtantwgposlashUacutevcitthorn PaBtantwgposlashUacutevcitthorn GacbegaacuteInKoslashuacuteykUskntildeuacutegQam

rbsGntildek edaysarvaBi)akkntildeuacutegkarbM)atPaBtantwgposlashUacutevcitthornBICivit

rbsGntildek

GntildekGaceronRKbRKgva

bull QbBisa)arI cUresntildeIsMuCMnYybBaAumlbBisa)arI

bull TTYlTanfntildeaMeTaHbICaenAeBlGntildekmanGarmmicroN_lyenkfrac34eday

cUrsaksYrevCcentbNETHitrbs Gntildek faetIGntildekRtUvkarfntildeaMGasltIrIn edImITbsaacuteateraKKaMgebHdUgbcurrenCmparaWdacsreacutesQam

EdrbcurrenGt cUrR)abeTAevCcentbNETHitrbsGntildek RbsinebIGntildekminGaceacute

llkTijfntildeaMrbsGntildek

)an bcurrenRbsinebIGntildekmanplvi)akBIfntildeaMNamYy

bull hatR)aNBI 30 eTA 60 naTI[)aneRcIneacutefparakntildeuacutegmYys)athornh_ karedIrelOnsup2 KWCaviFIeFVIclna

dfrac34RbesIrmYy

1

bull Check your feet every day for cuts blisters r ed spots and swelling Call your health car e team right away about any sor es that wonrsquot go away

bull Brush your teeth and floss every day to avoid pr oblems with your mouth teeth or gums

bull Check your blood glucose Y ou may want to test it one or mor e times a day

bull Check your blood pressure If your doctor advises

bull Report any changes in your eyesight to your doctor

q Talk to your health care team

about your blood glucose targets

Ask how and when to test your

blood glucose and how to use the

results to manage your diabetes

q Use this plan as a guide to your

self-care

q Discuss how your self-care plan is

working for you each time you

visit your health care team

20

bullBinit uuml e C Ig r b s k C a e r o g r a l eacute f paraG ntilde E R k g m a n k a r m t d a c u B g E s k k n UumlTHORN l R k h m

ni I U frac12 THORN u M u ntilde oslash I W g e h m Tr s Be h A R k m k a r g a r E f T a sx P a B r b s Gk P a m R ) a b Bk a r Q c a b E d l

min)ateTAvij

U MG a t e F

mat eFmicroj nigGBacopyajeFmicrojrbsGntildek

bulldus e F microj r b s Gntildek n ig e R b IE x S k t s microj C a e r o g r a l eacute f parae d Im Ie c o s p ut b B a etha C a m Yy

bullBi i I oslashuacutent uuml e m l K y k s k ntildeuacuteg Q a m r b s U ntilde Gk R b E h l K r e F I times thorn gGk ntilde Y e t s thornV v a m

bcurreneRcIndg kntildeuacutegmYyeacutefpara

bullBinit uuml e m Il s m lta F Q a m r b s Gntildek R b s in e b Ie v C centb N ETHit r b s Gntildek E N n a M

bull raykarN_BIkarposlashasbthornUacuterkntildeuacutegEPntildekrbsGntildek eTAkanevCcentbNETHitrbsGntildek

q cUrBiPakSaCamYyRkum

kargarEfTaMsuxPaB

rbsGntildekBI eKaled

AKoslashuacuteykUs

kntildeuacutegQamrbsGntildek cUrs

aksYrfa etIeFVIets

thorntimesKoslashuacuteykUskntildeuacutegQam

rbsGntildekedayrebobN

a nigenAeBlNa nigfaet

IeRbIR)as

lTsectpledImIEfrkSa

CmparaWTwkenamEpyenmrbs

GntildekedayrebobNa

q cUrRbIR)asEpnkar

enHCaTisedAENnaMeTAkan

karEfTaM

xoslashUumlnEacutegpTHORNalrbsGntildek

q cUrBiPakSafaetIEpn

karEfTaMxoslashUumlnEacutegpTHORNal

rbsGntildek kMBugdMeN

Irkar

yagemcEdr erogr

aleBlEdlGntildekeTA

CYbRkumEfTaMsuxPaB

rbsGntildek

21

Step 4 Get routine care to avoid problems

See your health care team at least twice a year to find and treat problems early Discuss what steps you can take to reach your goals

At each visit get a bull blood pressure check bull foot check bull weight check bull review of your self-care plan shown in Step 3

Two times each year get an bull A1C testmdashIt may be checked more often if it is over 7

Once each year get a bull cholesterol test bull triglyceride (try-GLISS-er-ide) test- a type of blood fat bull complete foot exam bull dental exam to check teeth and gumsmdashtell your

dentist you have diabetes bull dilated eye exam to check for eye problems bull flu shot bull urine and a blood test to check for kidney problems

At least once get a bull pneumonia (nu-mo-nya) shot

22

CY u M xPaBrbsu Gky I uacute ntilde yqaedmrkemlngBuumla)albB ethbRkmEfTa ntilde B gm ntilde M I I I i aas agehacNas rdgk Y

[)anTan i I ntilde Y i Y I IeBlBPakSafaetGkGacTTlykvFankarNamyedmseRmc)aneKaledA

rbsGntildek

eBleTACYbmthorngsup2 cUr sup3

bull BinituumlsmltaFQam

bull BinituumleCIg bull BinituumlTmparan bullBi i M Uuml oslash alrbsGkeLgvjdc)anbgajkuacutentilde i IntuumlEpnkarEfTaxnEacutegpTHORN ntilde I i U eth gvFankarT3

BIrdgCaerogralqntildeaM cUr sup3

bull eFVIetsthorntimes A1C - GaceFVIjwkjabCagenH)an RbsinebIvaelIsBI 7

mthorngCaerogralqntildeaM cUr sup3

bull BinituumlkUeLesthornrUlI times K t) Y i aj gQamuacutebulleFetsV thorn triglyceride (RTI esrIoslash I -CaRbePTmyeacutenCatxoslash kntilde

bull karBinituumleCIgTaMgmUl bullkarBi i micro I I I micro i copy micro U micro ntildentuumleFjedmemleFjngGBaajeFj-crR)abeBTuumleFjrbsGkfa

GntildekmanCmparaWTwkenamEpyenm

bull BinituumlEPntildek edImIemIlbBaethaEPntildek bull cakfntildeaMkarBarRKunpthornasay bull eFVIetsthorntimesTwkenam nigQam edImIemIlbBaethaRkelon

yagehacNasmthorngmYyqntildeaM cUr sup3

bull cakfntildeaMkarBareraKrlaksYt notnUmUnIyabrvbar

viFankarTI 4 sup3 TTYlkarEfTaMCaRbcaM[eTogTatedImIecosputbBaetha

2

q Ask your health care team about

these and other tests you may

need Ask what your results

mean

qWrite down the date and time of

your next visit

q If you have Medicare ask your

health care team if Medicare

will cover some of the costs for

q learning about healthy eating

and diabetes self

care special shoes if you

need them

qmedical supplies

q diabetes medicines

2

qcUrsYrRkumEfT

aMsuxPaBrbs

GntildekGMBIkareFVIe

tsthorntimes TaMgenH

nigepSgeTot

EdlGntildekGacR

tUvkar cUrs

YrfaetI

lTsectplrbsG

ntildekmannfrac12yyag

dUcemthornc

q cUrktRtakal

briecaumlT nigeB

levlaeacutenkar

eTACYb

elIkeRkayrb

sGntildek

q RbsinebIGntildekm

an Medicare cUrsYrRkum

EfTaM

suxPaBrbsG

ntildekfa etI Medicare nwg

rabrg

cMNaymYycMnYns

Rmab

q sikSaGMBIkarb

riePaKEdlma

nsuxPaBlyen

nigEskeCIgB

iessEfTaMCmparaWT

wkenamEpyenm

xoslashUumlnEacuteg Rbs

inebIGntildekRtUvkar

q smOumlarsup3pAacutetpAacuteg

Buumla)al

q fntildeaMCmparaWTwkenam

Epyenm

2

__________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________

Notes

NATIONAL DIABETES EDUCATION PROGRAM wwwndepnihgov

2

4 Steps to Control Your Diabetes For Life

This booklet presents four key steps to help you manage your diabetes and live a long and active life

Step 1 Learn about diabetes

Step 2 Know your diabetes ABCs

Step 3 Manage your diabetes

Step 4 Get routine care to avoid problems

2

viFankar 4 yag edImIEfrkSa

CmparaWTwkenamEpyenmrbsGntildek

rhUtmYyCIvit

kUnesovePAENnaMenH bgethajCUnviFankarsMxansup2 edImICYyGntildekEfrkSaC

mparaWTwkenamEpyenm

rbsGntildek nigrsranmanCivit)anyUr nigeBareBjedayfamBl

viFankarTI 1 sup3 eronBICmparaWTwkenamEpyenm

viFankarTI 2 sup3 dwgBI ABCs CmparaWTwkenamEpyenmrbsGntildek

viFankarTI 3 sup3 EfrkSaCmparaWTwkenamEpyenmrbsGntildek

viFankarTI 4 sup3 TTYlkarEfTaM[eTogTatedImIecosvagbBaetha

Diabetes is a serious disease It affects almost every part of your body That is why a health care team may help you take care of your diabetes

bull doctor bull dentist bull diabetes educator bull dietitian bull eye doctor bull foot doctor bull mental health counselor bull nurse bull nurse practitioner bull pharmacist bull social worker bull friends and family

You are the most important member of the team

The q in this booklet show actions you

can take to manage your diabetes

q Help your health care team

make a diabetes care plan that

will work for you

q Learn to make wise choices for

your diabetes care each day

CmTpara w kKCaCmW para para para Y M i Y I THORN gGseacutenragkay W kenamEpyen W FnFrmyvabHBaldlcENknmysup2esrEtTaM

rbs ntilde u U ntilde I u M u Y ntilde M W para kenam GkehtdecHehy)anCaRkmEfTasxPaBRbEhlGacCyGkEfTaCmTw

EpyenmrbsGntildek sup3

bull evCcentbNETHit

bull eBTuumleFmicroj bull GntildekGbrMBICmparaWTwkenamEpyenm bull GntildekCMnajxagGahar bull eBTuumlBuumla)alEPntildek bull eBTuumlBuumla)aleCIg bull GntildekRbwkSasuxPaBposlashUacutevcitthorn bull Kilanubdaeligayika bull eBTuumlCMnYs bull raquosfkarI bull buKAacutelikesvasgAacutem bull mitthornPkthorni nigRKYsar

GntildekKW CasmaCikdfrac34sMxanbMputsMrabRkumEfTaMsuxPaB

cMNucqenAkntildeuacutegkUnesovePAenHbgethaj

BIviFankarEdlGntildekGac

eFVIedImEfrkSaCmparaWTwkenam

EpyenmrbsGntildek

q CYyRkumEfTaMsuxPaBrbs

Gntildek

begaacuteItEpnkarEfTaM

CmparaWTwkenamEpyenm[mandMeN

IrkarsRmabGntildek

q eroneRCIserIsrkmeFuumla)ay

sRmabkarEfTaM

CmparaWTwkenamEpyenm rbsGntildekC

aerograleacutefpara

Step 1 Learn about diabetes

Diabetes means that your blood glucose (blood sugar) is too high Here are the main types of diabetes

Type 1 diabetesmdashthe body does not make insulin Insulin helps the body use glucose from food for energy People with type 1 need to take insulin every day

Type 2 diabetesmdashthe body does not make or use insulin well People with type 2 often need to take pills or insulin Type 2 is the most common form of diabetes

Gestational (jes-TAY-shon-al) diabetes mellitus (GDM)mdashoccurs when a woman is pregnant It raises her risk of getting another type of diabetes mostly type 2 for the rest of her life It also raises her childrsquos risk of being overweight and getting diabetes

CmTpara w mmannyfaKuacute oslash U aacute uacute ntilde GkmanxseBkenHKCaRbePT W kenamEpyen frac12 yksnotsrkgQambrvbarrbs ntilde lt W

FMsup2eacutenCmparaWTwkenamEpyenm

gkaymi I aacute eRbR)anbegtb I

Uvkarelb bcurrencakfntildeaMGuin

CmparaTW wkenamEpyenmRbePTTI1-ragkaymi i u i u lsquo i u i u lsquo i Y I npltGnslnGnslnCyragkayeRbR)as

Kykoslash U GaharQam[eTACafamBlmnsSEdlmanRbePTT1Rtvkarcakuacute s)anmkBI u I U

fntildeaMGuinslsquoulinCaerograleacutefpara

2-ra sGiu ulsquo nGtRtmRtv U nsli w

mnusSEdlmanRbePTTI2 Rt slsquoulin RbePTTI 2 enH

KWCaRbePTTUeTAbMput eacutenCmparaWTwkenamEpyenm

[GDM]-ekI I I thorn eBaHvabegI aacute ntilde M IteLgenAeBlEdlRsmaneacutepTHORN neRKaHfakrbsKatna[ekt

CmTpara w mRbePTepSgeToteBjmyCvtEdlPaKeRcnbptKRbePTT2ehyva W kenamEpyen Y i i I M u W I I

kfrac34 I aacute akdlknKatna[mankarelsTmnngektCmW w yenbegneRKaHfntilde U M I para i I Tpara kenamEpmpgEdr

CmparaWTwkenamEpyenmRbePTTI

CmparaWTwkenamEpyenmeBlmaneacutepTHORNeBaH (Gestational diabetes mellitus)

viFankarTI 1 sup3 eronBICmparaWTwkenamEpyenm

curren

7

Diabetes is serious

You may have heard people say they have ldquoa touch of diabetesrdquo or that their ldquosugar is a little highrdquo These words suggest that diabetes is not a serious disease That is not correct Diabetes is serious but you can manage it

All people with diabetes need to make healthy food choices stay at a healthy weight and be active every day

Taking good care of yourself and your diabetes can help you feel better and avoid health problems caused by diabetes such as

bull heart attack and stroke bull eye problems that can lead to trouble seeing or

going blind bull nerve damage that can cause your hands and feet

to hurt tingle or feel numb Some people may even lose a foot or a leg

bull kidney problems that can cause your kidneys to stop working

bull gum disease and loss of teeth

CmparaWTwkenamEpyenmFparanFpararxoslashaMgNas

Gntilde oslash curren u i Y w W para mbfaCatsrkRbEhlGacFabBmnsSnyayfaBkeKmankarTakTgngCmEpyen curren i aacute

rbs Y lt i thorn genHeFI i W para kenamEpmmnEmnCaCmW para paraBkeKmanx bn M [K T yen i para n renaHeT s cBakuumlTa V tfaCm w F F

sM I i w U I W para kenamEpmFnFrNasEtGkGacEfrkSava)aniexcl denaHmnRtmRtveLyCmTw yen para para ntilde

mnusSTaMgGsEdlmanCmparaWTwkenamEpyenm RtUvEteFVIkareRCIserIsmethUacutebGahar

EdlmansuxPaBlyen rkSaTmparan[)anlyen nighatR)aNerograleacutefpara

karEfTaM Uuml oslash knntilde gCmW para w yen G ntilde w U yGY ntilde N_Rbesmicro IxnG i TkenamEpmrbs k)anRtmRtvGacC k[manGarm r

ehIyecosputBIbBaethasuxPaBEdlbNthornalmkBICmparaWTwkenamEpyenmdUcCa sup3

bull eraKKaMgebHdUg nigCmparaWdacsreacutesQam

bull bBaethaEPntildekEdlGaceFVI[manbBaethakntildeuacutegkaremIl bcurrenkoslashayeTACaxVakcxatsreacutesRbsaTEdlGacbNal[eacutedng)ateCgrbsGkQ oacutebsup2 bullxU thorn i I ntilde W esaacute

bcurren micro w lt sSmycnnRbEhlCaGac)atbg)ateCgbeCg manGarmN_skmnu Y M Y I curren I

bull bBaethaRkelon EdlGacbNthornal[RkelonrbsGntildekQbdMeNIrkar

bull CmparaWGBacopyajeFmicroj nig)atbgeFmicroj

When your blood glucose is close to normal you are likely to

bull have more energy bull be less tired and thirsty and urinate less often bull heal better and have fewer skin or bladder

infections bull have fewer problems with your eyesight skin feet

and gums

q Ask your health care team which

type of diabetes you have

q Learn why diabetes is serious

q Learn how caring for your diabetes

helps you feel better today and in

the future

10

enAeBlKykoslash U uacute ntilde ntilde w i micro ntilde micro _ Uuacute skgQamrbsGk enAEkrngkRmtFmta GkmanGarmNdcCa sup3

bull mankmoslashaMgCagmun bull minsUvGskmoslashaMg ehIyeRskTwk nigenamkanEttic bullCasHRbesI I I U curren ireLgehymankarxcEskbkarrlakRkBHenamkanEttc

bull GntildeknwgmanbBaethatictYccMeBaHEPntildek Esk eCIg nigGBacopyajeFmicroj

q cUrsaksYrRkumEfTaMsuxPa

BrbsGntildek faetIGntildek

manCmparaWTwkenamEpyenmRbePT

mYyNa

q sikSafaetIehtuGVICmparaWTwkena

mEpyenmman

eRKaHfntildeakxoslashaMg

q sikSafaetIkarEfTaMCmparaWTwke

namEpyenmrbsGntildek

CYyGntildek[manGarmmicroN_RbesIreLIgen

AeacutefparaenH

nigeTAeacutefparaeRkayeToteday

rebobNa

11

Step 2 Know your diabetes ABCs

Talk to you health care team about how to control your A1C Blood pressure and Cholesterol This can help lower your chances of having a heart attack stroke or other diabetes problem Herersquos what the ABCs of diabetes stand for

A for the A1C test (A-one-C) It shows you how your blood glucose has been over the last three months The A1C goal for most people is below 7

High blood glucose levels can harm your heart and blood vessels kidneys feet and eyes

B for Blood pressure The goal for most people with diabetes is below 13080

High blood pressure makes your heart work too hard It can cause heart attack stroke and kidney disease

C for Cholesterol The LDL goal for most people is below 100 The HDL goal for most people is above 40

LDL or ldquobadrdquo cholesterol can build up and clog your blood vessels It can cause a heart attack or a stroke HDL or ldquogoodrdquo cholesterol helps remove cholesterol from your blood vessels

12

ABCs

cU i Y u M u ntilde M I i I rBPakSaCamyRkmEfTasxPaBrbsGkGBvFRKbRKg A1C smlt i U thorn U aFQam ngkeLesrl

eFVIenHGacCYykatbnszligykMu[maneraKKaMgebHdUg dacsreacutesQam

bcurrenbBaethaCmparaWTwkenamEpyenm epSgeTotrbsGntildek xageRkamenHKWCaGtszlignfrac12yrbs ABCs eacutenCmparaWTwkenamEpyenm

A sRmabetsthorntimes A1C (eG-van-suI) vabgeth ntilde I uacute oslash skuacute ntilde I I lt ajGkfaetKykU ntilde Gk manekneL skgQamrbs gx

uacutentilde LgeBlbEx cugeRkayenHedayrebobemc eKaledA gkM uacute I

A1C sRmabmnusSPaKeRcInKW eRkam 7

kRmitKoslashuacuteykUskntildeuacutegQamxlts GacbHBaldlebHdUg nigsreacutesQam

Rkelon eCIg nigEPntildekrbsGntildek

B sRmab Blood Pressure (smltaFQam) eKaledAsRmabmnusSPaKeRcInEdlmanCmparaWTwkenamEpyenkKWeR

kam 13080

smltaFQamxlts eFVI[ebHdUgrbsGntildekeFVIkarFparanNas

vaGacbNthornal[man

eraKKaMgebHdUg CmparaWdacsreacutesQam nigCmparaWRkelon

C sRmab Cholesterol (kUeLesthornrUl) eKaledA LDL sRmabmnusSPaKeRcInKWeRkam 100

eKaledA HDL sRmabmnusSPaKeRcInKWelI 40

LDL bcurren kUeLesthornrUl GaRkk GacbegaacuteIteLIgnigsTHORNHsreacutesQamrbsGntildek vaGac bNthornal[maneraKKaMgebHdUg

bcurrenCmparaWdacsreacutesQam HDL bcurrenkUeLesthornrUl lyen CYyykkUeLesthornrUlecjBIsreacutesQamrbsGntildek

1

viFankarTI 2 sup3 dwgBI CmparaWTwkenamEpyenmrbsGntildek

q Ask your health care team

q what your A1C Blood pressure

and cholesterol numbers are

q what your ABC numbers should

be

q what you need to do to reach

your targets

1

q cUrsaksYrRkumkargarE

fTaMsuxPaBrbsGntildek sup3

q faetIelx A1C smltaFQ

am

nigkUeLesthornrUlrbsGntildek

mankMritbunmicroan

q faetIelx ABC rbsGntildek

KYrEtmanbunmicroan

q faetIGntildekRtUvkareFVIG

VIedImIQaneTAdl

eKaledArbsGntildek

1

Step 3 Manage your diabetes

Many people avoid the long-term problems of diabetes by taking good care of themselves Work with your health care team to reach your ABC goals Use this self-care plan

bull Use your diabetes food plan If you do not have one ask your health care team for one

- Eat healthy foods such as fruits and vegetables fish lean meats chicken or turkey without the skin dry peas or beans whole grains and low-fat or skim milk and cheese

- Keep fish and lean meat and poultry portions to about 3 ounces (or the size of a pack of cards) Bake broil or grill it

- Eat foods that have less fat and salt

- Eat foods with more fiber such as whole-grain cereals breads crackers rice or pasta

1

EfrkSaCmparawTwkenamEpyenmrbsGntildek

mnu I u eth W para kenamEpmyrrau M Uuml oslash BkeK)anlsSCaeRcnecosptbBaaCmTw yen U eacuterM edayEfTaxnrbs Y yen

cU I V yRkmEfTasxPaBrbsGkedmQaneTAdleKaledAABCrbsGk reFkarCamY u M u ntilde I I ntilde

cUreRbIR)asEpnkarEfTaMedayxoslashUumlnEacutegenH

enHeT cUrsMuEpnkarenHBI RkumEfTaMsuxPaBrbsGntildek

- briePaKGaharmansuxPaBlyendUcCa EposlasheQI nigbEnoslash sacRtI

sac i oslash csacmanbsacman)aragedaymnmanEsk EdlmanCatxajti M i

sENthorn M thorn Uuml para FBaCatTagmlngTkedaHeKa k)aragbsENkstRKab Oslash i M U i w

nigQIsEdlmanCatixoslashajtic nigKmicroanCatiERkm

-bri I i oslash i i ePaKsacRt-sacEdlmanCatxajtc-ngsacmanRbmaN3 eGans_ notbcurrenTMhMebomYyRbGbbrvbar dut GaMg va

- briePaKGaharEdlmanCatixoslashaj nigCatieacuteRbtic

-bri oslash I i I I U Oslash i M UePaKGaharbEnEdlmanCvCateRcneRcndcCaRKabFBaCatTagml

nMbufrac12gcMNit nMeRkkxfrac12r )ay bcurren)asthorna

bulleRbIR)asEpnkarGaharsRmabCmparaWTwkenamEpyenmrbsGntildekRbsinebIGntildekminmanEpnkar

viFankarTI 3 sup3

curren

curren

17

bull Get 30 to 60 minutes of physical activity on most days of the week Brisk walking is a great way to move more

bull Stay at a healthy weight by making healthy food choices and moving more

bull Ask for help if you feel down A mental health counselor support group member of the clergy friend or family member will listen to your concerns and help you feel better

bull Learn to cope with stress Stress can raise your blood glucose While it is hard to remove stress from your life you can learn to handle it

bull Stop smoking Ask for help to quit

bull Take medicines even when you feel good Ask you doctor if you need aspirin to prevent a heart attack or stroke Tell your doctor if you cannot afford your medicine or if you have any side effects

1

bull sszligitenATmparanEdlmansuxPaBlyen edayeFVIkareRCIserIsGaharmansuxPaBlyen nigeFVIclna[kanEteRcIn

bull sMu[eKCYyRbsinebIGntildekmanGarmmicroN_TukccedilRBYy GntildekTIRbwkSasux

PaBposlashUacutevcitthorn RkumKaMRT smaCikbuBVCit mitthornPkthorni bcurrensmaCikRKYsarnwgsthornabkar)armOumlrbsGntildek ehIyCYyGntildek[manGarmmicroN_RbesIreLIg

bull eronedaHRsayPaBtantwgposlashUacutevcitthorn PaBtantwgposlashUacutevcitthorn GacbegaacuteInKoslashuacuteykUskntildeuacutegQam

rbsGntildek edaysarvaBi)akkntildeuacutegkarbM)atPaBtantwgposlashUacutevcitthornBICivit

rbsGntildek

GntildekGaceronRKbRKgva

bull QbBisa)arI cUresntildeIsMuCMnYybBaAumlbBisa)arI

bull TTYlTanfntildeaMeTaHbICaenAeBlGntildekmanGarmmicroN_lyenkfrac34eday

cUrsaksYrevCcentbNETHitrbs Gntildek faetIGntildekRtUvkarfntildeaMGasltIrIn edImITbsaacuteateraKKaMgebHdUgbcurrenCmparaWdacsreacutesQam

EdrbcurrenGt cUrR)abeTAevCcentbNETHitrbsGntildek RbsinebIGntildekminGaceacute

llkTijfntildeaMrbsGntildek

)an bcurrenRbsinebIGntildekmanplvi)akBIfntildeaMNamYy

bull hatR)aNBI 30 eTA 60 naTI[)aneRcIneacutefparakntildeuacutegmYys)athornh_ karedIrelOnsup2 KWCaviFIeFVIclna

dfrac34RbesIrmYy

1

bull Check your feet every day for cuts blisters r ed spots and swelling Call your health car e team right away about any sor es that wonrsquot go away

bull Brush your teeth and floss every day to avoid pr oblems with your mouth teeth or gums

bull Check your blood glucose Y ou may want to test it one or mor e times a day

bull Check your blood pressure If your doctor advises

bull Report any changes in your eyesight to your doctor

q Talk to your health care team

about your blood glucose targets

Ask how and when to test your

blood glucose and how to use the

results to manage your diabetes

q Use this plan as a guide to your

self-care

q Discuss how your self-care plan is

working for you each time you

visit your health care team

20

bullBinit uuml e C Ig r b s k C a e r o g r a l eacute f paraG ntilde E R k g m a n k a r m t d a c u B g E s k k n UumlTHORN l R k h m

ni I U frac12 THORN u M u ntilde oslash I W g e h m Tr s Be h A R k m k a r g a r E f T a sx P a B r b s Gk P a m R ) a b Bk a r Q c a b E d l

min)ateTAvij

U MG a t e F

mat eFmicroj nigGBacopyajeFmicrojrbsGntildek

bulldus e F microj r b s Gntildek n ig e R b IE x S k t s microj C a e r o g r a l eacute f parae d Im Ie c o s p ut b B a etha C a m Yy

bullBi i I oslashuacutent uuml e m l K y k s k ntildeuacuteg Q a m r b s U ntilde Gk R b E h l K r e F I times thorn gGk ntilde Y e t s thornV v a m

bcurreneRcIndg kntildeuacutegmYyeacutefpara

bullBinit uuml e m Il s m lta F Q a m r b s Gntildek R b s in e b Ie v C centb N ETHit r b s Gntildek E N n a M

bull raykarN_BIkarposlashasbthornUacuterkntildeuacutegEPntildekrbsGntildek eTAkanevCcentbNETHitrbsGntildek

q cUrBiPakSaCamYyRkum

kargarEfTaMsuxPaB

rbsGntildekBI eKaled

AKoslashuacuteykUs

kntildeuacutegQamrbsGntildek cUrs

aksYrfa etIeFVIets

thorntimesKoslashuacuteykUskntildeuacutegQam

rbsGntildekedayrebobN

a nigenAeBlNa nigfaet

IeRbIR)as

lTsectpledImIEfrkSa

CmparaWTwkenamEpyenmrbs

GntildekedayrebobNa

q cUrRbIR)asEpnkar

enHCaTisedAENnaMeTAkan

karEfTaM

xoslashUumlnEacutegpTHORNalrbsGntildek

q cUrBiPakSafaetIEpn

karEfTaMxoslashUumlnEacutegpTHORNal

rbsGntildek kMBugdMeN

Irkar

yagemcEdr erogr

aleBlEdlGntildekeTA

CYbRkumEfTaMsuxPaB

rbsGntildek

21

Step 4 Get routine care to avoid problems

See your health care team at least twice a year to find and treat problems early Discuss what steps you can take to reach your goals

At each visit get a bull blood pressure check bull foot check bull weight check bull review of your self-care plan shown in Step 3

Two times each year get an bull A1C testmdashIt may be checked more often if it is over 7

Once each year get a bull cholesterol test bull triglyceride (try-GLISS-er-ide) test- a type of blood fat bull complete foot exam bull dental exam to check teeth and gumsmdashtell your

dentist you have diabetes bull dilated eye exam to check for eye problems bull flu shot bull urine and a blood test to check for kidney problems

At least once get a bull pneumonia (nu-mo-nya) shot

22

CY u M xPaBrbsu Gky I uacute ntilde yqaedmrkemlngBuumla)albB ethbRkmEfTa ntilde B gm ntilde M I I I i aas agehacNas rdgk Y

[)anTan i I ntilde Y i Y I IeBlBPakSafaetGkGacTTlykvFankarNamyedmseRmc)aneKaledA

rbsGntildek

eBleTACYbmthorngsup2 cUr sup3

bull BinituumlsmltaFQam

bull BinituumleCIg bull BinituumlTmparan bullBi i M Uuml oslash alrbsGkeLgvjdc)anbgajkuacutentilde i IntuumlEpnkarEfTaxnEacutegpTHORN ntilde I i U eth gvFankarT3

BIrdgCaerogralqntildeaM cUr sup3

bull eFVIetsthorntimes A1C - GaceFVIjwkjabCagenH)an RbsinebIvaelIsBI 7

mthorngCaerogralqntildeaM cUr sup3

bull BinituumlkUeLesthornrUlI times K t) Y i aj gQamuacutebulleFetsV thorn triglyceride (RTI esrIoslash I -CaRbePTmyeacutenCatxoslash kntilde

bull karBinituumleCIgTaMgmUl bullkarBi i micro I I I micro i copy micro U micro ntildentuumleFjedmemleFjngGBaajeFj-crR)abeBTuumleFjrbsGkfa

GntildekmanCmparaWTwkenamEpyenm

bull BinituumlEPntildek edImIemIlbBaethaEPntildek bull cakfntildeaMkarBarRKunpthornasay bull eFVIetsthorntimesTwkenam nigQam edImIemIlbBaethaRkelon

yagehacNasmthorngmYyqntildeaM cUr sup3

bull cakfntildeaMkarBareraKrlaksYt notnUmUnIyabrvbar

viFankarTI 4 sup3 TTYlkarEfTaMCaRbcaM[eTogTatedImIecosputbBaetha

2

q Ask your health care team about

these and other tests you may

need Ask what your results

mean

qWrite down the date and time of

your next visit

q If you have Medicare ask your

health care team if Medicare

will cover some of the costs for

q learning about healthy eating

and diabetes self

care special shoes if you

need them

qmedical supplies

q diabetes medicines

2

qcUrsYrRkumEfT

aMsuxPaBrbs

GntildekGMBIkareFVIe

tsthorntimes TaMgenH

nigepSgeTot

EdlGntildekGacR

tUvkar cUrs

YrfaetI

lTsectplrbsG

ntildekmannfrac12yyag

dUcemthornc

q cUrktRtakal

briecaumlT nigeB

levlaeacutenkar

eTACYb

elIkeRkayrb

sGntildek

q RbsinebIGntildekm

an Medicare cUrsYrRkum

EfTaM

suxPaBrbsG

ntildekfa etI Medicare nwg

rabrg

cMNaymYycMnYns

Rmab

q sikSaGMBIkarb

riePaKEdlma

nsuxPaBlyen

nigEskeCIgB

iessEfTaMCmparaWT

wkenamEpyenm

xoslashUumlnEacuteg Rbs

inebIGntildekRtUvkar

q smOumlarsup3pAacutetpAacuteg

Buumla)al

q fntildeaMCmparaWTwkenam

Epyenm

2

__________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________

Notes

NATIONAL DIABETES EDUCATION PROGRAM wwwndepnihgov

2

viFankar 4 yag edImIEfrkSa

CmparaWTwkenamEpyenmrbsGntildek

rhUtmYyCIvit

kUnesovePAENnaMenH bgethajCUnviFankarsMxansup2 edImICYyGntildekEfrkSaC

mparaWTwkenamEpyenm

rbsGntildek nigrsranmanCivit)anyUr nigeBareBjedayfamBl

viFankarTI 1 sup3 eronBICmparaWTwkenamEpyenm

viFankarTI 2 sup3 dwgBI ABCs CmparaWTwkenamEpyenmrbsGntildek

viFankarTI 3 sup3 EfrkSaCmparaWTwkenamEpyenmrbsGntildek

viFankarTI 4 sup3 TTYlkarEfTaM[eTogTatedImIecosvagbBaetha

Diabetes is a serious disease It affects almost every part of your body That is why a health care team may help you take care of your diabetes

bull doctor bull dentist bull diabetes educator bull dietitian bull eye doctor bull foot doctor bull mental health counselor bull nurse bull nurse practitioner bull pharmacist bull social worker bull friends and family

You are the most important member of the team

The q in this booklet show actions you

can take to manage your diabetes

q Help your health care team

make a diabetes care plan that

will work for you

q Learn to make wise choices for

your diabetes care each day

CmTpara w kKCaCmW para para para Y M i Y I THORN gGseacutenragkay W kenamEpyen W FnFrmyvabHBaldlcENknmysup2esrEtTaM

rbs ntilde u U ntilde I u M u Y ntilde M W para kenam GkehtdecHehy)anCaRkmEfTasxPaBRbEhlGacCyGkEfTaCmTw

EpyenmrbsGntildek sup3

bull evCcentbNETHit

bull eBTuumleFmicroj bull GntildekGbrMBICmparaWTwkenamEpyenm bull GntildekCMnajxagGahar bull eBTuumlBuumla)alEPntildek bull eBTuumlBuumla)aleCIg bull GntildekRbwkSasuxPaBposlashUacutevcitthorn bull Kilanubdaeligayika bull eBTuumlCMnYs bull raquosfkarI bull buKAacutelikesvasgAacutem bull mitthornPkthorni nigRKYsar

GntildekKW CasmaCikdfrac34sMxanbMputsMrabRkumEfTaMsuxPaB

cMNucqenAkntildeuacutegkUnesovePAenHbgethaj

BIviFankarEdlGntildekGac

eFVIedImEfrkSaCmparaWTwkenam

EpyenmrbsGntildek

q CYyRkumEfTaMsuxPaBrbs

Gntildek

begaacuteItEpnkarEfTaM

CmparaWTwkenamEpyenm[mandMeN

IrkarsRmabGntildek

q eroneRCIserIsrkmeFuumla)ay

sRmabkarEfTaM

CmparaWTwkenamEpyenm rbsGntildekC

aerograleacutefpara

Step 1 Learn about diabetes

Diabetes means that your blood glucose (blood sugar) is too high Here are the main types of diabetes

Type 1 diabetesmdashthe body does not make insulin Insulin helps the body use glucose from food for energy People with type 1 need to take insulin every day

Type 2 diabetesmdashthe body does not make or use insulin well People with type 2 often need to take pills or insulin Type 2 is the most common form of diabetes

Gestational (jes-TAY-shon-al) diabetes mellitus (GDM)mdashoccurs when a woman is pregnant It raises her risk of getting another type of diabetes mostly type 2 for the rest of her life It also raises her childrsquos risk of being overweight and getting diabetes

CmTpara w mmannyfaKuacute oslash U aacute uacute ntilde GkmanxseBkenHKCaRbePT W kenamEpyen frac12 yksnotsrkgQambrvbarrbs ntilde lt W

FMsup2eacutenCmparaWTwkenamEpyenm

gkaymi I aacute eRbR)anbegtb I

Uvkarelb bcurrencakfntildeaMGuin

CmparaTW wkenamEpyenmRbePTTI1-ragkaymi i u i u lsquo i u i u lsquo i Y I npltGnslnGnslnCyragkayeRbR)as

Kykoslash U GaharQam[eTACafamBlmnsSEdlmanRbePTT1Rtvkarcakuacute s)anmkBI u I U

fntildeaMGuinslsquoulinCaerograleacutefpara

2-ra sGiu ulsquo nGtRtmRtv U nsli w

mnusSEdlmanRbePTTI2 Rt slsquoulin RbePTTI 2 enH

KWCaRbePTTUeTAbMput eacutenCmparaWTwkenamEpyenm

[GDM]-ekI I I thorn eBaHvabegI aacute ntilde M IteLgenAeBlEdlRsmaneacutepTHORN neRKaHfakrbsKatna[ekt

CmTpara w mRbePTepSgeToteBjmyCvtEdlPaKeRcnbptKRbePTT2ehyva W kenamEpyen Y i i I M u W I I

kfrac34 I aacute akdlknKatna[mankarelsTmnngektCmW w yenbegneRKaHfntilde U M I para i I Tpara kenamEpmpgEdr

CmparaWTwkenamEpyenmRbePTTI

CmparaWTwkenamEpyenmeBlmaneacutepTHORNeBaH (Gestational diabetes mellitus)

viFankarTI 1 sup3 eronBICmparaWTwkenamEpyenm

curren

7

Diabetes is serious

You may have heard people say they have ldquoa touch of diabetesrdquo or that their ldquosugar is a little highrdquo These words suggest that diabetes is not a serious disease That is not correct Diabetes is serious but you can manage it

All people with diabetes need to make healthy food choices stay at a healthy weight and be active every day

Taking good care of yourself and your diabetes can help you feel better and avoid health problems caused by diabetes such as

bull heart attack and stroke bull eye problems that can lead to trouble seeing or

going blind bull nerve damage that can cause your hands and feet

to hurt tingle or feel numb Some people may even lose a foot or a leg

bull kidney problems that can cause your kidneys to stop working

bull gum disease and loss of teeth

CmparaWTwkenamEpyenmFparanFpararxoslashaMgNas

Gntilde oslash curren u i Y w W para mbfaCatsrkRbEhlGacFabBmnsSnyayfaBkeKmankarTakTgngCmEpyen curren i aacute

rbs Y lt i thorn genHeFI i W para kenamEpmmnEmnCaCmW para paraBkeKmanx bn M [K T yen i para n renaHeT s cBakuumlTa V tfaCm w F F

sM I i w U I W para kenamEpmFnFrNasEtGkGacEfrkSava)aniexcl denaHmnRtmRtveLyCmTw yen para para ntilde

mnusSTaMgGsEdlmanCmparaWTwkenamEpyenm RtUvEteFVIkareRCIserIsmethUacutebGahar

EdlmansuxPaBlyen rkSaTmparan[)anlyen nighatR)aNerograleacutefpara

karEfTaM Uuml oslash knntilde gCmW para w yen G ntilde w U yGY ntilde N_Rbesmicro IxnG i TkenamEpmrbs k)anRtmRtvGacC k[manGarm r

ehIyecosputBIbBaethasuxPaBEdlbNthornalmkBICmparaWTwkenamEpyenmdUcCa sup3

bull eraKKaMgebHdUg nigCmparaWdacsreacutesQam

bull bBaethaEPntildekEdlGaceFVI[manbBaethakntildeuacutegkaremIl bcurrenkoslashayeTACaxVakcxatsreacutesRbsaTEdlGacbNal[eacutedng)ateCgrbsGkQ oacutebsup2 bullxU thorn i I ntilde W esaacute

bcurren micro w lt sSmycnnRbEhlCaGac)atbg)ateCgbeCg manGarmN_skmnu Y M Y I curren I

bull bBaethaRkelon EdlGacbNthornal[RkelonrbsGntildekQbdMeNIrkar

bull CmparaWGBacopyajeFmicroj nig)atbgeFmicroj

When your blood glucose is close to normal you are likely to

bull have more energy bull be less tired and thirsty and urinate less often bull heal better and have fewer skin or bladder

infections bull have fewer problems with your eyesight skin feet

and gums

q Ask your health care team which

type of diabetes you have

q Learn why diabetes is serious

q Learn how caring for your diabetes

helps you feel better today and in

the future

10

enAeBlKykoslash U uacute ntilde ntilde w i micro ntilde micro _ Uuacute skgQamrbsGk enAEkrngkRmtFmta GkmanGarmNdcCa sup3

bull mankmoslashaMgCagmun bull minsUvGskmoslashaMg ehIyeRskTwk nigenamkanEttic bullCasHRbesI I I U curren ireLgehymankarxcEskbkarrlakRkBHenamkanEttc

bull GntildeknwgmanbBaethatictYccMeBaHEPntildek Esk eCIg nigGBacopyajeFmicroj

q cUrsaksYrRkumEfTaMsuxPa

BrbsGntildek faetIGntildek

manCmparaWTwkenamEpyenmRbePT

mYyNa

q sikSafaetIehtuGVICmparaWTwkena

mEpyenmman

eRKaHfntildeakxoslashaMg

q sikSafaetIkarEfTaMCmparaWTwke

namEpyenmrbsGntildek

CYyGntildek[manGarmmicroN_RbesIreLIgen

AeacutefparaenH

nigeTAeacutefparaeRkayeToteday

rebobNa

11

Step 2 Know your diabetes ABCs

Talk to you health care team about how to control your A1C Blood pressure and Cholesterol This can help lower your chances of having a heart attack stroke or other diabetes problem Herersquos what the ABCs of diabetes stand for

A for the A1C test (A-one-C) It shows you how your blood glucose has been over the last three months The A1C goal for most people is below 7

High blood glucose levels can harm your heart and blood vessels kidneys feet and eyes

B for Blood pressure The goal for most people with diabetes is below 13080

High blood pressure makes your heart work too hard It can cause heart attack stroke and kidney disease

C for Cholesterol The LDL goal for most people is below 100 The HDL goal for most people is above 40

LDL or ldquobadrdquo cholesterol can build up and clog your blood vessels It can cause a heart attack or a stroke HDL or ldquogoodrdquo cholesterol helps remove cholesterol from your blood vessels

12

ABCs

cU i Y u M u ntilde M I i I rBPakSaCamyRkmEfTasxPaBrbsGkGBvFRKbRKg A1C smlt i U thorn U aFQam ngkeLesrl

eFVIenHGacCYykatbnszligykMu[maneraKKaMgebHdUg dacsreacutesQam

bcurrenbBaethaCmparaWTwkenamEpyenm epSgeTotrbsGntildek xageRkamenHKWCaGtszlignfrac12yrbs ABCs eacutenCmparaWTwkenamEpyenm

A sRmabetsthorntimes A1C (eG-van-suI) vabgeth ntilde I uacute oslash skuacute ntilde I I lt ajGkfaetKykU ntilde Gk manekneL skgQamrbs gx

uacutentilde LgeBlbEx cugeRkayenHedayrebobemc eKaledA gkM uacute I

A1C sRmabmnusSPaKeRcInKW eRkam 7

kRmitKoslashuacuteykUskntildeuacutegQamxlts GacbHBaldlebHdUg nigsreacutesQam

Rkelon eCIg nigEPntildekrbsGntildek

B sRmab Blood Pressure (smltaFQam) eKaledAsRmabmnusSPaKeRcInEdlmanCmparaWTwkenamEpyenkKWeR

kam 13080

smltaFQamxlts eFVI[ebHdUgrbsGntildekeFVIkarFparanNas

vaGacbNthornal[man

eraKKaMgebHdUg CmparaWdacsreacutesQam nigCmparaWRkelon

C sRmab Cholesterol (kUeLesthornrUl) eKaledA LDL sRmabmnusSPaKeRcInKWeRkam 100

eKaledA HDL sRmabmnusSPaKeRcInKWelI 40

LDL bcurren kUeLesthornrUl GaRkk GacbegaacuteIteLIgnigsTHORNHsreacutesQamrbsGntildek vaGac bNthornal[maneraKKaMgebHdUg

bcurrenCmparaWdacsreacutesQam HDL bcurrenkUeLesthornrUl lyen CYyykkUeLesthornrUlecjBIsreacutesQamrbsGntildek

1

viFankarTI 2 sup3 dwgBI CmparaWTwkenamEpyenmrbsGntildek

q Ask your health care team

q what your A1C Blood pressure

and cholesterol numbers are

q what your ABC numbers should

be

q what you need to do to reach

your targets

1

q cUrsaksYrRkumkargarE

fTaMsuxPaBrbsGntildek sup3

q faetIelx A1C smltaFQ

am

nigkUeLesthornrUlrbsGntildek

mankMritbunmicroan

q faetIelx ABC rbsGntildek

KYrEtmanbunmicroan

q faetIGntildekRtUvkareFVIG

VIedImIQaneTAdl

eKaledArbsGntildek

1

Step 3 Manage your diabetes

Many people avoid the long-term problems of diabetes by taking good care of themselves Work with your health care team to reach your ABC goals Use this self-care plan

bull Use your diabetes food plan If you do not have one ask your health care team for one

- Eat healthy foods such as fruits and vegetables fish lean meats chicken or turkey without the skin dry peas or beans whole grains and low-fat or skim milk and cheese

- Keep fish and lean meat and poultry portions to about 3 ounces (or the size of a pack of cards) Bake broil or grill it

- Eat foods that have less fat and salt

- Eat foods with more fiber such as whole-grain cereals breads crackers rice or pasta

1

EfrkSaCmparawTwkenamEpyenmrbsGntildek

mnu I u eth W para kenamEpmyrrau M Uuml oslash BkeK)anlsSCaeRcnecosptbBaaCmTw yen U eacuterM edayEfTaxnrbs Y yen

cU I V yRkmEfTasxPaBrbsGkedmQaneTAdleKaledAABCrbsGk reFkarCamY u M u ntilde I I ntilde

cUreRbIR)asEpnkarEfTaMedayxoslashUumlnEacutegenH

enHeT cUrsMuEpnkarenHBI RkumEfTaMsuxPaBrbsGntildek

- briePaKGaharmansuxPaBlyendUcCa EposlasheQI nigbEnoslash sacRtI

sac i oslash csacmanbsacman)aragedaymnmanEsk EdlmanCatxajti M i

sENthorn M thorn Uuml para FBaCatTagmlngTkedaHeKa k)aragbsENkstRKab Oslash i M U i w

nigQIsEdlmanCatixoslashajtic nigKmicroanCatiERkm

-bri I i oslash i i ePaKsacRt-sacEdlmanCatxajtc-ngsacmanRbmaN3 eGans_ notbcurrenTMhMebomYyRbGbbrvbar dut GaMg va

- briePaKGaharEdlmanCatixoslashaj nigCatieacuteRbtic

-bri oslash I i I I U Oslash i M UePaKGaharbEnEdlmanCvCateRcneRcndcCaRKabFBaCatTagml

nMbufrac12gcMNit nMeRkkxfrac12r )ay bcurren)asthorna

bulleRbIR)asEpnkarGaharsRmabCmparaWTwkenamEpyenmrbsGntildekRbsinebIGntildekminmanEpnkar

viFankarTI 3 sup3

curren

curren

17

bull Get 30 to 60 minutes of physical activity on most days of the week Brisk walking is a great way to move more

bull Stay at a healthy weight by making healthy food choices and moving more

bull Ask for help if you feel down A mental health counselor support group member of the clergy friend or family member will listen to your concerns and help you feel better

bull Learn to cope with stress Stress can raise your blood glucose While it is hard to remove stress from your life you can learn to handle it

bull Stop smoking Ask for help to quit

bull Take medicines even when you feel good Ask you doctor if you need aspirin to prevent a heart attack or stroke Tell your doctor if you cannot afford your medicine or if you have any side effects

1

bull sszligitenATmparanEdlmansuxPaBlyen edayeFVIkareRCIserIsGaharmansuxPaBlyen nigeFVIclna[kanEteRcIn

bull sMu[eKCYyRbsinebIGntildekmanGarmmicroN_TukccedilRBYy GntildekTIRbwkSasux

PaBposlashUacutevcitthorn RkumKaMRT smaCikbuBVCit mitthornPkthorni bcurrensmaCikRKYsarnwgsthornabkar)armOumlrbsGntildek ehIyCYyGntildek[manGarmmicroN_RbesIreLIg

bull eronedaHRsayPaBtantwgposlashUacutevcitthorn PaBtantwgposlashUacutevcitthorn GacbegaacuteInKoslashuacuteykUskntildeuacutegQam

rbsGntildek edaysarvaBi)akkntildeuacutegkarbM)atPaBtantwgposlashUacutevcitthornBICivit

rbsGntildek

GntildekGaceronRKbRKgva

bull QbBisa)arI cUresntildeIsMuCMnYybBaAumlbBisa)arI

bull TTYlTanfntildeaMeTaHbICaenAeBlGntildekmanGarmmicroN_lyenkfrac34eday

cUrsaksYrevCcentbNETHitrbs Gntildek faetIGntildekRtUvkarfntildeaMGasltIrIn edImITbsaacuteateraKKaMgebHdUgbcurrenCmparaWdacsreacutesQam

EdrbcurrenGt cUrR)abeTAevCcentbNETHitrbsGntildek RbsinebIGntildekminGaceacute

llkTijfntildeaMrbsGntildek

)an bcurrenRbsinebIGntildekmanplvi)akBIfntildeaMNamYy

bull hatR)aNBI 30 eTA 60 naTI[)aneRcIneacutefparakntildeuacutegmYys)athornh_ karedIrelOnsup2 KWCaviFIeFVIclna

dfrac34RbesIrmYy

1

bull Check your feet every day for cuts blisters r ed spots and swelling Call your health car e team right away about any sor es that wonrsquot go away

bull Brush your teeth and floss every day to avoid pr oblems with your mouth teeth or gums

bull Check your blood glucose Y ou may want to test it one or mor e times a day

bull Check your blood pressure If your doctor advises

bull Report any changes in your eyesight to your doctor

q Talk to your health care team

about your blood glucose targets

Ask how and when to test your

blood glucose and how to use the

results to manage your diabetes

q Use this plan as a guide to your

self-care

q Discuss how your self-care plan is

working for you each time you

visit your health care team

20

bullBinit uuml e C Ig r b s k C a e r o g r a l eacute f paraG ntilde E R k g m a n k a r m t d a c u B g E s k k n UumlTHORN l R k h m

ni I U frac12 THORN u M u ntilde oslash I W g e h m Tr s Be h A R k m k a r g a r E f T a sx P a B r b s Gk P a m R ) a b Bk a r Q c a b E d l

min)ateTAvij

U MG a t e F

mat eFmicroj nigGBacopyajeFmicrojrbsGntildek

bulldus e F microj r b s Gntildek n ig e R b IE x S k t s microj C a e r o g r a l eacute f parae d Im Ie c o s p ut b B a etha C a m Yy

bullBi i I oslashuacutent uuml e m l K y k s k ntildeuacuteg Q a m r b s U ntilde Gk R b E h l K r e F I times thorn gGk ntilde Y e t s thornV v a m

bcurreneRcIndg kntildeuacutegmYyeacutefpara

bullBinit uuml e m Il s m lta F Q a m r b s Gntildek R b s in e b Ie v C centb N ETHit r b s Gntildek E N n a M

bull raykarN_BIkarposlashasbthornUacuterkntildeuacutegEPntildekrbsGntildek eTAkanevCcentbNETHitrbsGntildek

q cUrBiPakSaCamYyRkum

kargarEfTaMsuxPaB

rbsGntildekBI eKaled

AKoslashuacuteykUs

kntildeuacutegQamrbsGntildek cUrs

aksYrfa etIeFVIets

thorntimesKoslashuacuteykUskntildeuacutegQam

rbsGntildekedayrebobN

a nigenAeBlNa nigfaet

IeRbIR)as

lTsectpledImIEfrkSa

CmparaWTwkenamEpyenmrbs

GntildekedayrebobNa

q cUrRbIR)asEpnkar

enHCaTisedAENnaMeTAkan

karEfTaM

xoslashUumlnEacutegpTHORNalrbsGntildek

q cUrBiPakSafaetIEpn

karEfTaMxoslashUumlnEacutegpTHORNal

rbsGntildek kMBugdMeN

Irkar

yagemcEdr erogr

aleBlEdlGntildekeTA

CYbRkumEfTaMsuxPaB

rbsGntildek

21

Step 4 Get routine care to avoid problems

See your health care team at least twice a year to find and treat problems early Discuss what steps you can take to reach your goals

At each visit get a bull blood pressure check bull foot check bull weight check bull review of your self-care plan shown in Step 3

Two times each year get an bull A1C testmdashIt may be checked more often if it is over 7

Once each year get a bull cholesterol test bull triglyceride (try-GLISS-er-ide) test- a type of blood fat bull complete foot exam bull dental exam to check teeth and gumsmdashtell your

dentist you have diabetes bull dilated eye exam to check for eye problems bull flu shot bull urine and a blood test to check for kidney problems

At least once get a bull pneumonia (nu-mo-nya) shot

22

CY u M xPaBrbsu Gky I uacute ntilde yqaedmrkemlngBuumla)albB ethbRkmEfTa ntilde B gm ntilde M I I I i aas agehacNas rdgk Y

[)anTan i I ntilde Y i Y I IeBlBPakSafaetGkGacTTlykvFankarNamyedmseRmc)aneKaledA

rbsGntildek

eBleTACYbmthorngsup2 cUr sup3

bull BinituumlsmltaFQam

bull BinituumleCIg bull BinituumlTmparan bullBi i M Uuml oslash alrbsGkeLgvjdc)anbgajkuacutentilde i IntuumlEpnkarEfTaxnEacutegpTHORN ntilde I i U eth gvFankarT3

BIrdgCaerogralqntildeaM cUr sup3

bull eFVIetsthorntimes A1C - GaceFVIjwkjabCagenH)an RbsinebIvaelIsBI 7

mthorngCaerogralqntildeaM cUr sup3

bull BinituumlkUeLesthornrUlI times K t) Y i aj gQamuacutebulleFetsV thorn triglyceride (RTI esrIoslash I -CaRbePTmyeacutenCatxoslash kntilde

bull karBinituumleCIgTaMgmUl bullkarBi i micro I I I micro i copy micro U micro ntildentuumleFjedmemleFjngGBaajeFj-crR)abeBTuumleFjrbsGkfa

GntildekmanCmparaWTwkenamEpyenm

bull BinituumlEPntildek edImIemIlbBaethaEPntildek bull cakfntildeaMkarBarRKunpthornasay bull eFVIetsthorntimesTwkenam nigQam edImIemIlbBaethaRkelon

yagehacNasmthorngmYyqntildeaM cUr sup3

bull cakfntildeaMkarBareraKrlaksYt notnUmUnIyabrvbar

viFankarTI 4 sup3 TTYlkarEfTaMCaRbcaM[eTogTatedImIecosputbBaetha

2

q Ask your health care team about

these and other tests you may

need Ask what your results

mean

qWrite down the date and time of

your next visit

q If you have Medicare ask your

health care team if Medicare

will cover some of the costs for

q learning about healthy eating

and diabetes self

care special shoes if you

need them

qmedical supplies

q diabetes medicines

2

qcUrsYrRkumEfT

aMsuxPaBrbs

GntildekGMBIkareFVIe

tsthorntimes TaMgenH

nigepSgeTot

EdlGntildekGacR

tUvkar cUrs

YrfaetI

lTsectplrbsG

ntildekmannfrac12yyag

dUcemthornc

q cUrktRtakal

briecaumlT nigeB

levlaeacutenkar

eTACYb

elIkeRkayrb

sGntildek

q RbsinebIGntildekm

an Medicare cUrsYrRkum

EfTaM

suxPaBrbsG

ntildekfa etI Medicare nwg

rabrg

cMNaymYycMnYns

Rmab

q sikSaGMBIkarb

riePaKEdlma

nsuxPaBlyen

nigEskeCIgB

iessEfTaMCmparaWT

wkenamEpyenm

xoslashUumlnEacuteg Rbs

inebIGntildekRtUvkar

q smOumlarsup3pAacutetpAacuteg

Buumla)al

q fntildeaMCmparaWTwkenam

Epyenm

2

__________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________

Notes

NATIONAL DIABETES EDUCATION PROGRAM wwwndepnihgov

2

Diabetes is a serious disease It affects almost every part of your body That is why a health care team may help you take care of your diabetes

bull doctor bull dentist bull diabetes educator bull dietitian bull eye doctor bull foot doctor bull mental health counselor bull nurse bull nurse practitioner bull pharmacist bull social worker bull friends and family

You are the most important member of the team

The q in this booklet show actions you

can take to manage your diabetes

q Help your health care team

make a diabetes care plan that

will work for you

q Learn to make wise choices for

your diabetes care each day

CmTpara w kKCaCmW para para para Y M i Y I THORN gGseacutenragkay W kenamEpyen W FnFrmyvabHBaldlcENknmysup2esrEtTaM

rbs ntilde u U ntilde I u M u Y ntilde M W para kenam GkehtdecHehy)anCaRkmEfTasxPaBRbEhlGacCyGkEfTaCmTw

EpyenmrbsGntildek sup3

bull evCcentbNETHit

bull eBTuumleFmicroj bull GntildekGbrMBICmparaWTwkenamEpyenm bull GntildekCMnajxagGahar bull eBTuumlBuumla)alEPntildek bull eBTuumlBuumla)aleCIg bull GntildekRbwkSasuxPaBposlashUacutevcitthorn bull Kilanubdaeligayika bull eBTuumlCMnYs bull raquosfkarI bull buKAacutelikesvasgAacutem bull mitthornPkthorni nigRKYsar

GntildekKW CasmaCikdfrac34sMxanbMputsMrabRkumEfTaMsuxPaB

cMNucqenAkntildeuacutegkUnesovePAenHbgethaj

BIviFankarEdlGntildekGac

eFVIedImEfrkSaCmparaWTwkenam

EpyenmrbsGntildek

q CYyRkumEfTaMsuxPaBrbs

Gntildek

begaacuteItEpnkarEfTaM

CmparaWTwkenamEpyenm[mandMeN

IrkarsRmabGntildek

q eroneRCIserIsrkmeFuumla)ay

sRmabkarEfTaM

CmparaWTwkenamEpyenm rbsGntildekC

aerograleacutefpara

Step 1 Learn about diabetes

Diabetes means that your blood glucose (blood sugar) is too high Here are the main types of diabetes

Type 1 diabetesmdashthe body does not make insulin Insulin helps the body use glucose from food for energy People with type 1 need to take insulin every day

Type 2 diabetesmdashthe body does not make or use insulin well People with type 2 often need to take pills or insulin Type 2 is the most common form of diabetes

Gestational (jes-TAY-shon-al) diabetes mellitus (GDM)mdashoccurs when a woman is pregnant It raises her risk of getting another type of diabetes mostly type 2 for the rest of her life It also raises her childrsquos risk of being overweight and getting diabetes

CmTpara w mmannyfaKuacute oslash U aacute uacute ntilde GkmanxseBkenHKCaRbePT W kenamEpyen frac12 yksnotsrkgQambrvbarrbs ntilde lt W

FMsup2eacutenCmparaWTwkenamEpyenm

gkaymi I aacute eRbR)anbegtb I

Uvkarelb bcurrencakfntildeaMGuin

CmparaTW wkenamEpyenmRbePTTI1-ragkaymi i u i u lsquo i u i u lsquo i Y I npltGnslnGnslnCyragkayeRbR)as

Kykoslash U GaharQam[eTACafamBlmnsSEdlmanRbePTT1Rtvkarcakuacute s)anmkBI u I U

fntildeaMGuinslsquoulinCaerograleacutefpara

2-ra sGiu ulsquo nGtRtmRtv U nsli w

mnusSEdlmanRbePTTI2 Rt slsquoulin RbePTTI 2 enH

KWCaRbePTTUeTAbMput eacutenCmparaWTwkenamEpyenm

[GDM]-ekI I I thorn eBaHvabegI aacute ntilde M IteLgenAeBlEdlRsmaneacutepTHORN neRKaHfakrbsKatna[ekt

CmTpara w mRbePTepSgeToteBjmyCvtEdlPaKeRcnbptKRbePTT2ehyva W kenamEpyen Y i i I M u W I I

kfrac34 I aacute akdlknKatna[mankarelsTmnngektCmW w yenbegneRKaHfntilde U M I para i I Tpara kenamEpmpgEdr

CmparaWTwkenamEpyenmRbePTTI

CmparaWTwkenamEpyenmeBlmaneacutepTHORNeBaH (Gestational diabetes mellitus)

viFankarTI 1 sup3 eronBICmparaWTwkenamEpyenm

curren

7

Diabetes is serious

You may have heard people say they have ldquoa touch of diabetesrdquo or that their ldquosugar is a little highrdquo These words suggest that diabetes is not a serious disease That is not correct Diabetes is serious but you can manage it

All people with diabetes need to make healthy food choices stay at a healthy weight and be active every day

Taking good care of yourself and your diabetes can help you feel better and avoid health problems caused by diabetes such as

bull heart attack and stroke bull eye problems that can lead to trouble seeing or

going blind bull nerve damage that can cause your hands and feet

to hurt tingle or feel numb Some people may even lose a foot or a leg

bull kidney problems that can cause your kidneys to stop working

bull gum disease and loss of teeth

CmparaWTwkenamEpyenmFparanFpararxoslashaMgNas

Gntilde oslash curren u i Y w W para mbfaCatsrkRbEhlGacFabBmnsSnyayfaBkeKmankarTakTgngCmEpyen curren i aacute

rbs Y lt i thorn genHeFI i W para kenamEpmmnEmnCaCmW para paraBkeKmanx bn M [K T yen i para n renaHeT s cBakuumlTa V tfaCm w F F

sM I i w U I W para kenamEpmFnFrNasEtGkGacEfrkSava)aniexcl denaHmnRtmRtveLyCmTw yen para para ntilde

mnusSTaMgGsEdlmanCmparaWTwkenamEpyenm RtUvEteFVIkareRCIserIsmethUacutebGahar

EdlmansuxPaBlyen rkSaTmparan[)anlyen nighatR)aNerograleacutefpara

karEfTaM Uuml oslash knntilde gCmW para w yen G ntilde w U yGY ntilde N_Rbesmicro IxnG i TkenamEpmrbs k)anRtmRtvGacC k[manGarm r

ehIyecosputBIbBaethasuxPaBEdlbNthornalmkBICmparaWTwkenamEpyenmdUcCa sup3

bull eraKKaMgebHdUg nigCmparaWdacsreacutesQam

bull bBaethaEPntildekEdlGaceFVI[manbBaethakntildeuacutegkaremIl bcurrenkoslashayeTACaxVakcxatsreacutesRbsaTEdlGacbNal[eacutedng)ateCgrbsGkQ oacutebsup2 bullxU thorn i I ntilde W esaacute

bcurren micro w lt sSmycnnRbEhlCaGac)atbg)ateCgbeCg manGarmN_skmnu Y M Y I curren I

bull bBaethaRkelon EdlGacbNthornal[RkelonrbsGntildekQbdMeNIrkar

bull CmparaWGBacopyajeFmicroj nig)atbgeFmicroj

When your blood glucose is close to normal you are likely to

bull have more energy bull be less tired and thirsty and urinate less often bull heal better and have fewer skin or bladder

infections bull have fewer problems with your eyesight skin feet

and gums

q Ask your health care team which

type of diabetes you have

q Learn why diabetes is serious

q Learn how caring for your diabetes

helps you feel better today and in

the future

10

enAeBlKykoslash U uacute ntilde ntilde w i micro ntilde micro _ Uuacute skgQamrbsGk enAEkrngkRmtFmta GkmanGarmNdcCa sup3

bull mankmoslashaMgCagmun bull minsUvGskmoslashaMg ehIyeRskTwk nigenamkanEttic bullCasHRbesI I I U curren ireLgehymankarxcEskbkarrlakRkBHenamkanEttc

bull GntildeknwgmanbBaethatictYccMeBaHEPntildek Esk eCIg nigGBacopyajeFmicroj

q cUrsaksYrRkumEfTaMsuxPa

BrbsGntildek faetIGntildek

manCmparaWTwkenamEpyenmRbePT

mYyNa

q sikSafaetIehtuGVICmparaWTwkena

mEpyenmman

eRKaHfntildeakxoslashaMg

q sikSafaetIkarEfTaMCmparaWTwke

namEpyenmrbsGntildek

CYyGntildek[manGarmmicroN_RbesIreLIgen

AeacutefparaenH

nigeTAeacutefparaeRkayeToteday

rebobNa

11

Step 2 Know your diabetes ABCs

Talk to you health care team about how to control your A1C Blood pressure and Cholesterol This can help lower your chances of having a heart attack stroke or other diabetes problem Herersquos what the ABCs of diabetes stand for

A for the A1C test (A-one-C) It shows you how your blood glucose has been over the last three months The A1C goal for most people is below 7

High blood glucose levels can harm your heart and blood vessels kidneys feet and eyes

B for Blood pressure The goal for most people with diabetes is below 13080

High blood pressure makes your heart work too hard It can cause heart attack stroke and kidney disease

C for Cholesterol The LDL goal for most people is below 100 The HDL goal for most people is above 40

LDL or ldquobadrdquo cholesterol can build up and clog your blood vessels It can cause a heart attack or a stroke HDL or ldquogoodrdquo cholesterol helps remove cholesterol from your blood vessels

12

ABCs

cU i Y u M u ntilde M I i I rBPakSaCamyRkmEfTasxPaBrbsGkGBvFRKbRKg A1C smlt i U thorn U aFQam ngkeLesrl

eFVIenHGacCYykatbnszligykMu[maneraKKaMgebHdUg dacsreacutesQam

bcurrenbBaethaCmparaWTwkenamEpyenm epSgeTotrbsGntildek xageRkamenHKWCaGtszlignfrac12yrbs ABCs eacutenCmparaWTwkenamEpyenm

A sRmabetsthorntimes A1C (eG-van-suI) vabgeth ntilde I uacute oslash skuacute ntilde I I lt ajGkfaetKykU ntilde Gk manekneL skgQamrbs gx

uacutentilde LgeBlbEx cugeRkayenHedayrebobemc eKaledA gkM uacute I

A1C sRmabmnusSPaKeRcInKW eRkam 7

kRmitKoslashuacuteykUskntildeuacutegQamxlts GacbHBaldlebHdUg nigsreacutesQam

Rkelon eCIg nigEPntildekrbsGntildek

B sRmab Blood Pressure (smltaFQam) eKaledAsRmabmnusSPaKeRcInEdlmanCmparaWTwkenamEpyenkKWeR

kam 13080

smltaFQamxlts eFVI[ebHdUgrbsGntildekeFVIkarFparanNas

vaGacbNthornal[man

eraKKaMgebHdUg CmparaWdacsreacutesQam nigCmparaWRkelon

C sRmab Cholesterol (kUeLesthornrUl) eKaledA LDL sRmabmnusSPaKeRcInKWeRkam 100

eKaledA HDL sRmabmnusSPaKeRcInKWelI 40

LDL bcurren kUeLesthornrUl GaRkk GacbegaacuteIteLIgnigsTHORNHsreacutesQamrbsGntildek vaGac bNthornal[maneraKKaMgebHdUg

bcurrenCmparaWdacsreacutesQam HDL bcurrenkUeLesthornrUl lyen CYyykkUeLesthornrUlecjBIsreacutesQamrbsGntildek

1

viFankarTI 2 sup3 dwgBI CmparaWTwkenamEpyenmrbsGntildek

q Ask your health care team

q what your A1C Blood pressure

and cholesterol numbers are

q what your ABC numbers should

be

q what you need to do to reach

your targets

1

q cUrsaksYrRkumkargarE

fTaMsuxPaBrbsGntildek sup3

q faetIelx A1C smltaFQ

am

nigkUeLesthornrUlrbsGntildek

mankMritbunmicroan

q faetIelx ABC rbsGntildek

KYrEtmanbunmicroan

q faetIGntildekRtUvkareFVIG

VIedImIQaneTAdl

eKaledArbsGntildek

1

Step 3 Manage your diabetes

Many people avoid the long-term problems of diabetes by taking good care of themselves Work with your health care team to reach your ABC goals Use this self-care plan

bull Use your diabetes food plan If you do not have one ask your health care team for one

- Eat healthy foods such as fruits and vegetables fish lean meats chicken or turkey without the skin dry peas or beans whole grains and low-fat or skim milk and cheese

- Keep fish and lean meat and poultry portions to about 3 ounces (or the size of a pack of cards) Bake broil or grill it

- Eat foods that have less fat and salt

- Eat foods with more fiber such as whole-grain cereals breads crackers rice or pasta

1

EfrkSaCmparawTwkenamEpyenmrbsGntildek

mnu I u eth W para kenamEpmyrrau M Uuml oslash BkeK)anlsSCaeRcnecosptbBaaCmTw yen U eacuterM edayEfTaxnrbs Y yen

cU I V yRkmEfTasxPaBrbsGkedmQaneTAdleKaledAABCrbsGk reFkarCamY u M u ntilde I I ntilde

cUreRbIR)asEpnkarEfTaMedayxoslashUumlnEacutegenH

enHeT cUrsMuEpnkarenHBI RkumEfTaMsuxPaBrbsGntildek

- briePaKGaharmansuxPaBlyendUcCa EposlasheQI nigbEnoslash sacRtI

sac i oslash csacmanbsacman)aragedaymnmanEsk EdlmanCatxajti M i

sENthorn M thorn Uuml para FBaCatTagmlngTkedaHeKa k)aragbsENkstRKab Oslash i M U i w

nigQIsEdlmanCatixoslashajtic nigKmicroanCatiERkm

-bri I i oslash i i ePaKsacRt-sacEdlmanCatxajtc-ngsacmanRbmaN3 eGans_ notbcurrenTMhMebomYyRbGbbrvbar dut GaMg va

- briePaKGaharEdlmanCatixoslashaj nigCatieacuteRbtic

-bri oslash I i I I U Oslash i M UePaKGaharbEnEdlmanCvCateRcneRcndcCaRKabFBaCatTagml

nMbufrac12gcMNit nMeRkkxfrac12r )ay bcurren)asthorna

bulleRbIR)asEpnkarGaharsRmabCmparaWTwkenamEpyenmrbsGntildekRbsinebIGntildekminmanEpnkar

viFankarTI 3 sup3

curren

curren

17

bull Get 30 to 60 minutes of physical activity on most days of the week Brisk walking is a great way to move more

bull Stay at a healthy weight by making healthy food choices and moving more

bull Ask for help if you feel down A mental health counselor support group member of the clergy friend or family member will listen to your concerns and help you feel better

bull Learn to cope with stress Stress can raise your blood glucose While it is hard to remove stress from your life you can learn to handle it

bull Stop smoking Ask for help to quit

bull Take medicines even when you feel good Ask you doctor if you need aspirin to prevent a heart attack or stroke Tell your doctor if you cannot afford your medicine or if you have any side effects

1

bull sszligitenATmparanEdlmansuxPaBlyen edayeFVIkareRCIserIsGaharmansuxPaBlyen nigeFVIclna[kanEteRcIn

bull sMu[eKCYyRbsinebIGntildekmanGarmmicroN_TukccedilRBYy GntildekTIRbwkSasux

PaBposlashUacutevcitthorn RkumKaMRT smaCikbuBVCit mitthornPkthorni bcurrensmaCikRKYsarnwgsthornabkar)armOumlrbsGntildek ehIyCYyGntildek[manGarmmicroN_RbesIreLIg

bull eronedaHRsayPaBtantwgposlashUacutevcitthorn PaBtantwgposlashUacutevcitthorn GacbegaacuteInKoslashuacuteykUskntildeuacutegQam

rbsGntildek edaysarvaBi)akkntildeuacutegkarbM)atPaBtantwgposlashUacutevcitthornBICivit

rbsGntildek

GntildekGaceronRKbRKgva

bull QbBisa)arI cUresntildeIsMuCMnYybBaAumlbBisa)arI

bull TTYlTanfntildeaMeTaHbICaenAeBlGntildekmanGarmmicroN_lyenkfrac34eday

cUrsaksYrevCcentbNETHitrbs Gntildek faetIGntildekRtUvkarfntildeaMGasltIrIn edImITbsaacuteateraKKaMgebHdUgbcurrenCmparaWdacsreacutesQam

EdrbcurrenGt cUrR)abeTAevCcentbNETHitrbsGntildek RbsinebIGntildekminGaceacute

llkTijfntildeaMrbsGntildek

)an bcurrenRbsinebIGntildekmanplvi)akBIfntildeaMNamYy

bull hatR)aNBI 30 eTA 60 naTI[)aneRcIneacutefparakntildeuacutegmYys)athornh_ karedIrelOnsup2 KWCaviFIeFVIclna

dfrac34RbesIrmYy

1

bull Check your feet every day for cuts blisters r ed spots and swelling Call your health car e team right away about any sor es that wonrsquot go away

bull Brush your teeth and floss every day to avoid pr oblems with your mouth teeth or gums

bull Check your blood glucose Y ou may want to test it one or mor e times a day

bull Check your blood pressure If your doctor advises

bull Report any changes in your eyesight to your doctor

q Talk to your health care team

about your blood glucose targets

Ask how and when to test your

blood glucose and how to use the

results to manage your diabetes

q Use this plan as a guide to your

self-care

q Discuss how your self-care plan is

working for you each time you

visit your health care team

20

bullBinit uuml e C Ig r b s k C a e r o g r a l eacute f paraG ntilde E R k g m a n k a r m t d a c u B g E s k k n UumlTHORN l R k h m

ni I U frac12 THORN u M u ntilde oslash I W g e h m Tr s Be h A R k m k a r g a r E f T a sx P a B r b s Gk P a m R ) a b Bk a r Q c a b E d l

min)ateTAvij

U MG a t e F

mat eFmicroj nigGBacopyajeFmicrojrbsGntildek

bulldus e F microj r b s Gntildek n ig e R b IE x S k t s microj C a e r o g r a l eacute f parae d Im Ie c o s p ut b B a etha C a m Yy

bullBi i I oslashuacutent uuml e m l K y k s k ntildeuacuteg Q a m r b s U ntilde Gk R b E h l K r e F I times thorn gGk ntilde Y e t s thornV v a m

bcurreneRcIndg kntildeuacutegmYyeacutefpara

bullBinit uuml e m Il s m lta F Q a m r b s Gntildek R b s in e b Ie v C centb N ETHit r b s Gntildek E N n a M

bull raykarN_BIkarposlashasbthornUacuterkntildeuacutegEPntildekrbsGntildek eTAkanevCcentbNETHitrbsGntildek

q cUrBiPakSaCamYyRkum

kargarEfTaMsuxPaB

rbsGntildekBI eKaled

AKoslashuacuteykUs

kntildeuacutegQamrbsGntildek cUrs

aksYrfa etIeFVIets

thorntimesKoslashuacuteykUskntildeuacutegQam

rbsGntildekedayrebobN

a nigenAeBlNa nigfaet

IeRbIR)as

lTsectpledImIEfrkSa

CmparaWTwkenamEpyenmrbs

GntildekedayrebobNa

q cUrRbIR)asEpnkar

enHCaTisedAENnaMeTAkan

karEfTaM

xoslashUumlnEacutegpTHORNalrbsGntildek

q cUrBiPakSafaetIEpn

karEfTaMxoslashUumlnEacutegpTHORNal

rbsGntildek kMBugdMeN

Irkar

yagemcEdr erogr

aleBlEdlGntildekeTA

CYbRkumEfTaMsuxPaB

rbsGntildek

21

Step 4 Get routine care to avoid problems

See your health care team at least twice a year to find and treat problems early Discuss what steps you can take to reach your goals

At each visit get a bull blood pressure check bull foot check bull weight check bull review of your self-care plan shown in Step 3

Two times each year get an bull A1C testmdashIt may be checked more often if it is over 7

Once each year get a bull cholesterol test bull triglyceride (try-GLISS-er-ide) test- a type of blood fat bull complete foot exam bull dental exam to check teeth and gumsmdashtell your

dentist you have diabetes bull dilated eye exam to check for eye problems bull flu shot bull urine and a blood test to check for kidney problems

At least once get a bull pneumonia (nu-mo-nya) shot

22

CY u M xPaBrbsu Gky I uacute ntilde yqaedmrkemlngBuumla)albB ethbRkmEfTa ntilde B gm ntilde M I I I i aas agehacNas rdgk Y

[)anTan i I ntilde Y i Y I IeBlBPakSafaetGkGacTTlykvFankarNamyedmseRmc)aneKaledA

rbsGntildek

eBleTACYbmthorngsup2 cUr sup3

bull BinituumlsmltaFQam

bull BinituumleCIg bull BinituumlTmparan bullBi i M Uuml oslash alrbsGkeLgvjdc)anbgajkuacutentilde i IntuumlEpnkarEfTaxnEacutegpTHORN ntilde I i U eth gvFankarT3

BIrdgCaerogralqntildeaM cUr sup3

bull eFVIetsthorntimes A1C - GaceFVIjwkjabCagenH)an RbsinebIvaelIsBI 7

mthorngCaerogralqntildeaM cUr sup3

bull BinituumlkUeLesthornrUlI times K t) Y i aj gQamuacutebulleFetsV thorn triglyceride (RTI esrIoslash I -CaRbePTmyeacutenCatxoslash kntilde

bull karBinituumleCIgTaMgmUl bullkarBi i micro I I I micro i copy micro U micro ntildentuumleFjedmemleFjngGBaajeFj-crR)abeBTuumleFjrbsGkfa

GntildekmanCmparaWTwkenamEpyenm

bull BinituumlEPntildek edImIemIlbBaethaEPntildek bull cakfntildeaMkarBarRKunpthornasay bull eFVIetsthorntimesTwkenam nigQam edImIemIlbBaethaRkelon

yagehacNasmthorngmYyqntildeaM cUr sup3

bull cakfntildeaMkarBareraKrlaksYt notnUmUnIyabrvbar

viFankarTI 4 sup3 TTYlkarEfTaMCaRbcaM[eTogTatedImIecosputbBaetha

2

q Ask your health care team about

these and other tests you may

need Ask what your results

mean

qWrite down the date and time of

your next visit

q If you have Medicare ask your

health care team if Medicare

will cover some of the costs for

q learning about healthy eating

and diabetes self

care special shoes if you

need them

qmedical supplies

q diabetes medicines

2

qcUrsYrRkumEfT

aMsuxPaBrbs

GntildekGMBIkareFVIe

tsthorntimes TaMgenH

nigepSgeTot

EdlGntildekGacR

tUvkar cUrs

YrfaetI

lTsectplrbsG

ntildekmannfrac12yyag

dUcemthornc

q cUrktRtakal

briecaumlT nigeB

levlaeacutenkar

eTACYb

elIkeRkayrb

sGntildek

q RbsinebIGntildekm

an Medicare cUrsYrRkum

EfTaM

suxPaBrbsG

ntildekfa etI Medicare nwg

rabrg

cMNaymYycMnYns

Rmab

q sikSaGMBIkarb

riePaKEdlma

nsuxPaBlyen

nigEskeCIgB

iessEfTaMCmparaWT

wkenamEpyenm

xoslashUumlnEacuteg Rbs

inebIGntildekRtUvkar

q smOumlarsup3pAacutetpAacuteg

Buumla)al

q fntildeaMCmparaWTwkenam

Epyenm

2

__________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________

Notes

NATIONAL DIABETES EDUCATION PROGRAM wwwndepnihgov

2

CmTpara w kKCaCmW para para para Y M i Y I THORN gGseacutenragkay W kenamEpyen W FnFrmyvabHBaldlcENknmysup2esrEtTaM

rbs ntilde u U ntilde I u M u Y ntilde M W para kenam GkehtdecHehy)anCaRkmEfTasxPaBRbEhlGacCyGkEfTaCmTw

EpyenmrbsGntildek sup3

bull evCcentbNETHit

bull eBTuumleFmicroj bull GntildekGbrMBICmparaWTwkenamEpyenm bull GntildekCMnajxagGahar bull eBTuumlBuumla)alEPntildek bull eBTuumlBuumla)aleCIg bull GntildekRbwkSasuxPaBposlashUacutevcitthorn bull Kilanubdaeligayika bull eBTuumlCMnYs bull raquosfkarI bull buKAacutelikesvasgAacutem bull mitthornPkthorni nigRKYsar

GntildekKW CasmaCikdfrac34sMxanbMputsMrabRkumEfTaMsuxPaB

cMNucqenAkntildeuacutegkUnesovePAenHbgethaj

BIviFankarEdlGntildekGac

eFVIedImEfrkSaCmparaWTwkenam

EpyenmrbsGntildek

q CYyRkumEfTaMsuxPaBrbs

Gntildek

begaacuteItEpnkarEfTaM

CmparaWTwkenamEpyenm[mandMeN

IrkarsRmabGntildek

q eroneRCIserIsrkmeFuumla)ay

sRmabkarEfTaM

CmparaWTwkenamEpyenm rbsGntildekC

aerograleacutefpara

Step 1 Learn about diabetes

Diabetes means that your blood glucose (blood sugar) is too high Here are the main types of diabetes

Type 1 diabetesmdashthe body does not make insulin Insulin helps the body use glucose from food for energy People with type 1 need to take insulin every day

Type 2 diabetesmdashthe body does not make or use insulin well People with type 2 often need to take pills or insulin Type 2 is the most common form of diabetes

Gestational (jes-TAY-shon-al) diabetes mellitus (GDM)mdashoccurs when a woman is pregnant It raises her risk of getting another type of diabetes mostly type 2 for the rest of her life It also raises her childrsquos risk of being overweight and getting diabetes

CmTpara w mmannyfaKuacute oslash U aacute uacute ntilde GkmanxseBkenHKCaRbePT W kenamEpyen frac12 yksnotsrkgQambrvbarrbs ntilde lt W

FMsup2eacutenCmparaWTwkenamEpyenm

gkaymi I aacute eRbR)anbegtb I

Uvkarelb bcurrencakfntildeaMGuin

CmparaTW wkenamEpyenmRbePTTI1-ragkaymi i u i u lsquo i u i u lsquo i Y I npltGnslnGnslnCyragkayeRbR)as

Kykoslash U GaharQam[eTACafamBlmnsSEdlmanRbePTT1Rtvkarcakuacute s)anmkBI u I U

fntildeaMGuinslsquoulinCaerograleacutefpara

2-ra sGiu ulsquo nGtRtmRtv U nsli w

mnusSEdlmanRbePTTI2 Rt slsquoulin RbePTTI 2 enH

KWCaRbePTTUeTAbMput eacutenCmparaWTwkenamEpyenm

[GDM]-ekI I I thorn eBaHvabegI aacute ntilde M IteLgenAeBlEdlRsmaneacutepTHORN neRKaHfakrbsKatna[ekt

CmTpara w mRbePTepSgeToteBjmyCvtEdlPaKeRcnbptKRbePTT2ehyva W kenamEpyen Y i i I M u W I I

kfrac34 I aacute akdlknKatna[mankarelsTmnngektCmW w yenbegneRKaHfntilde U M I para i I Tpara kenamEpmpgEdr

CmparaWTwkenamEpyenmRbePTTI

CmparaWTwkenamEpyenmeBlmaneacutepTHORNeBaH (Gestational diabetes mellitus)

viFankarTI 1 sup3 eronBICmparaWTwkenamEpyenm

curren

7

Diabetes is serious

You may have heard people say they have ldquoa touch of diabetesrdquo or that their ldquosugar is a little highrdquo These words suggest that diabetes is not a serious disease That is not correct Diabetes is serious but you can manage it

All people with diabetes need to make healthy food choices stay at a healthy weight and be active every day

Taking good care of yourself and your diabetes can help you feel better and avoid health problems caused by diabetes such as

bull heart attack and stroke bull eye problems that can lead to trouble seeing or

going blind bull nerve damage that can cause your hands and feet

to hurt tingle or feel numb Some people may even lose a foot or a leg

bull kidney problems that can cause your kidneys to stop working

bull gum disease and loss of teeth

CmparaWTwkenamEpyenmFparanFpararxoslashaMgNas

Gntilde oslash curren u i Y w W para mbfaCatsrkRbEhlGacFabBmnsSnyayfaBkeKmankarTakTgngCmEpyen curren i aacute

rbs Y lt i thorn genHeFI i W para kenamEpmmnEmnCaCmW para paraBkeKmanx bn M [K T yen i para n renaHeT s cBakuumlTa V tfaCm w F F

sM I i w U I W para kenamEpmFnFrNasEtGkGacEfrkSava)aniexcl denaHmnRtmRtveLyCmTw yen para para ntilde

mnusSTaMgGsEdlmanCmparaWTwkenamEpyenm RtUvEteFVIkareRCIserIsmethUacutebGahar

EdlmansuxPaBlyen rkSaTmparan[)anlyen nighatR)aNerograleacutefpara

karEfTaM Uuml oslash knntilde gCmW para w yen G ntilde w U yGY ntilde N_Rbesmicro IxnG i TkenamEpmrbs k)anRtmRtvGacC k[manGarm r

ehIyecosputBIbBaethasuxPaBEdlbNthornalmkBICmparaWTwkenamEpyenmdUcCa sup3

bull eraKKaMgebHdUg nigCmparaWdacsreacutesQam

bull bBaethaEPntildekEdlGaceFVI[manbBaethakntildeuacutegkaremIl bcurrenkoslashayeTACaxVakcxatsreacutesRbsaTEdlGacbNal[eacutedng)ateCgrbsGkQ oacutebsup2 bullxU thorn i I ntilde W esaacute

bcurren micro w lt sSmycnnRbEhlCaGac)atbg)ateCgbeCg manGarmN_skmnu Y M Y I curren I

bull bBaethaRkelon EdlGacbNthornal[RkelonrbsGntildekQbdMeNIrkar

bull CmparaWGBacopyajeFmicroj nig)atbgeFmicroj

When your blood glucose is close to normal you are likely to

bull have more energy bull be less tired and thirsty and urinate less often bull heal better and have fewer skin or bladder

infections bull have fewer problems with your eyesight skin feet

and gums

q Ask your health care team which

type of diabetes you have

q Learn why diabetes is serious

q Learn how caring for your diabetes

helps you feel better today and in

the future

10

enAeBlKykoslash U uacute ntilde ntilde w i micro ntilde micro _ Uuacute skgQamrbsGk enAEkrngkRmtFmta GkmanGarmNdcCa sup3

bull mankmoslashaMgCagmun bull minsUvGskmoslashaMg ehIyeRskTwk nigenamkanEttic bullCasHRbesI I I U curren ireLgehymankarxcEskbkarrlakRkBHenamkanEttc

bull GntildeknwgmanbBaethatictYccMeBaHEPntildek Esk eCIg nigGBacopyajeFmicroj

q cUrsaksYrRkumEfTaMsuxPa

BrbsGntildek faetIGntildek

manCmparaWTwkenamEpyenmRbePT

mYyNa

q sikSafaetIehtuGVICmparaWTwkena

mEpyenmman

eRKaHfntildeakxoslashaMg

q sikSafaetIkarEfTaMCmparaWTwke

namEpyenmrbsGntildek

CYyGntildek[manGarmmicroN_RbesIreLIgen

AeacutefparaenH

nigeTAeacutefparaeRkayeToteday

rebobNa

11

Step 2 Know your diabetes ABCs

Talk to you health care team about how to control your A1C Blood pressure and Cholesterol This can help lower your chances of having a heart attack stroke or other diabetes problem Herersquos what the ABCs of diabetes stand for

A for the A1C test (A-one-C) It shows you how your blood glucose has been over the last three months The A1C goal for most people is below 7

High blood glucose levels can harm your heart and blood vessels kidneys feet and eyes

B for Blood pressure The goal for most people with diabetes is below 13080

High blood pressure makes your heart work too hard It can cause heart attack stroke and kidney disease

C for Cholesterol The LDL goal for most people is below 100 The HDL goal for most people is above 40

LDL or ldquobadrdquo cholesterol can build up and clog your blood vessels It can cause a heart attack or a stroke HDL or ldquogoodrdquo cholesterol helps remove cholesterol from your blood vessels

12

ABCs

cU i Y u M u ntilde M I i I rBPakSaCamyRkmEfTasxPaBrbsGkGBvFRKbRKg A1C smlt i U thorn U aFQam ngkeLesrl

eFVIenHGacCYykatbnszligykMu[maneraKKaMgebHdUg dacsreacutesQam

bcurrenbBaethaCmparaWTwkenamEpyenm epSgeTotrbsGntildek xageRkamenHKWCaGtszlignfrac12yrbs ABCs eacutenCmparaWTwkenamEpyenm

A sRmabetsthorntimes A1C (eG-van-suI) vabgeth ntilde I uacute oslash skuacute ntilde I I lt ajGkfaetKykU ntilde Gk manekneL skgQamrbs gx

uacutentilde LgeBlbEx cugeRkayenHedayrebobemc eKaledA gkM uacute I

A1C sRmabmnusSPaKeRcInKW eRkam 7

kRmitKoslashuacuteykUskntildeuacutegQamxlts GacbHBaldlebHdUg nigsreacutesQam

Rkelon eCIg nigEPntildekrbsGntildek

B sRmab Blood Pressure (smltaFQam) eKaledAsRmabmnusSPaKeRcInEdlmanCmparaWTwkenamEpyenkKWeR

kam 13080

smltaFQamxlts eFVI[ebHdUgrbsGntildekeFVIkarFparanNas

vaGacbNthornal[man

eraKKaMgebHdUg CmparaWdacsreacutesQam nigCmparaWRkelon

C sRmab Cholesterol (kUeLesthornrUl) eKaledA LDL sRmabmnusSPaKeRcInKWeRkam 100

eKaledA HDL sRmabmnusSPaKeRcInKWelI 40

LDL bcurren kUeLesthornrUl GaRkk GacbegaacuteIteLIgnigsTHORNHsreacutesQamrbsGntildek vaGac bNthornal[maneraKKaMgebHdUg

bcurrenCmparaWdacsreacutesQam HDL bcurrenkUeLesthornrUl lyen CYyykkUeLesthornrUlecjBIsreacutesQamrbsGntildek

1

viFankarTI 2 sup3 dwgBI CmparaWTwkenamEpyenmrbsGntildek

q Ask your health care team

q what your A1C Blood pressure

and cholesterol numbers are

q what your ABC numbers should

be

q what you need to do to reach

your targets

1

q cUrsaksYrRkumkargarE

fTaMsuxPaBrbsGntildek sup3

q faetIelx A1C smltaFQ

am

nigkUeLesthornrUlrbsGntildek

mankMritbunmicroan

q faetIelx ABC rbsGntildek

KYrEtmanbunmicroan

q faetIGntildekRtUvkareFVIG

VIedImIQaneTAdl

eKaledArbsGntildek

1

Step 3 Manage your diabetes

Many people avoid the long-term problems of diabetes by taking good care of themselves Work with your health care team to reach your ABC goals Use this self-care plan

bull Use your diabetes food plan If you do not have one ask your health care team for one

- Eat healthy foods such as fruits and vegetables fish lean meats chicken or turkey without the skin dry peas or beans whole grains and low-fat or skim milk and cheese

- Keep fish and lean meat and poultry portions to about 3 ounces (or the size of a pack of cards) Bake broil or grill it

- Eat foods that have less fat and salt

- Eat foods with more fiber such as whole-grain cereals breads crackers rice or pasta

1

EfrkSaCmparawTwkenamEpyenmrbsGntildek

mnu I u eth W para kenamEpmyrrau M Uuml oslash BkeK)anlsSCaeRcnecosptbBaaCmTw yen U eacuterM edayEfTaxnrbs Y yen

cU I V yRkmEfTasxPaBrbsGkedmQaneTAdleKaledAABCrbsGk reFkarCamY u M u ntilde I I ntilde

cUreRbIR)asEpnkarEfTaMedayxoslashUumlnEacutegenH

enHeT cUrsMuEpnkarenHBI RkumEfTaMsuxPaBrbsGntildek

- briePaKGaharmansuxPaBlyendUcCa EposlasheQI nigbEnoslash sacRtI

sac i oslash csacmanbsacman)aragedaymnmanEsk EdlmanCatxajti M i

sENthorn M thorn Uuml para FBaCatTagmlngTkedaHeKa k)aragbsENkstRKab Oslash i M U i w

nigQIsEdlmanCatixoslashajtic nigKmicroanCatiERkm

-bri I i oslash i i ePaKsacRt-sacEdlmanCatxajtc-ngsacmanRbmaN3 eGans_ notbcurrenTMhMebomYyRbGbbrvbar dut GaMg va

- briePaKGaharEdlmanCatixoslashaj nigCatieacuteRbtic

-bri oslash I i I I U Oslash i M UePaKGaharbEnEdlmanCvCateRcneRcndcCaRKabFBaCatTagml

nMbufrac12gcMNit nMeRkkxfrac12r )ay bcurren)asthorna

bulleRbIR)asEpnkarGaharsRmabCmparaWTwkenamEpyenmrbsGntildekRbsinebIGntildekminmanEpnkar

viFankarTI 3 sup3

curren

curren

17

bull Get 30 to 60 minutes of physical activity on most days of the week Brisk walking is a great way to move more

bull Stay at a healthy weight by making healthy food choices and moving more

bull Ask for help if you feel down A mental health counselor support group member of the clergy friend or family member will listen to your concerns and help you feel better

bull Learn to cope with stress Stress can raise your blood glucose While it is hard to remove stress from your life you can learn to handle it

bull Stop smoking Ask for help to quit

bull Take medicines even when you feel good Ask you doctor if you need aspirin to prevent a heart attack or stroke Tell your doctor if you cannot afford your medicine or if you have any side effects

1

bull sszligitenATmparanEdlmansuxPaBlyen edayeFVIkareRCIserIsGaharmansuxPaBlyen nigeFVIclna[kanEteRcIn

bull sMu[eKCYyRbsinebIGntildekmanGarmmicroN_TukccedilRBYy GntildekTIRbwkSasux

PaBposlashUacutevcitthorn RkumKaMRT smaCikbuBVCit mitthornPkthorni bcurrensmaCikRKYsarnwgsthornabkar)armOumlrbsGntildek ehIyCYyGntildek[manGarmmicroN_RbesIreLIg

bull eronedaHRsayPaBtantwgposlashUacutevcitthorn PaBtantwgposlashUacutevcitthorn GacbegaacuteInKoslashuacuteykUskntildeuacutegQam

rbsGntildek edaysarvaBi)akkntildeuacutegkarbM)atPaBtantwgposlashUacutevcitthornBICivit

rbsGntildek

GntildekGaceronRKbRKgva

bull QbBisa)arI cUresntildeIsMuCMnYybBaAumlbBisa)arI

bull TTYlTanfntildeaMeTaHbICaenAeBlGntildekmanGarmmicroN_lyenkfrac34eday

cUrsaksYrevCcentbNETHitrbs Gntildek faetIGntildekRtUvkarfntildeaMGasltIrIn edImITbsaacuteateraKKaMgebHdUgbcurrenCmparaWdacsreacutesQam

EdrbcurrenGt cUrR)abeTAevCcentbNETHitrbsGntildek RbsinebIGntildekminGaceacute

llkTijfntildeaMrbsGntildek

)an bcurrenRbsinebIGntildekmanplvi)akBIfntildeaMNamYy

bull hatR)aNBI 30 eTA 60 naTI[)aneRcIneacutefparakntildeuacutegmYys)athornh_ karedIrelOnsup2 KWCaviFIeFVIclna

dfrac34RbesIrmYy

1

bull Check your feet every day for cuts blisters r ed spots and swelling Call your health car e team right away about any sor es that wonrsquot go away

bull Brush your teeth and floss every day to avoid pr oblems with your mouth teeth or gums

bull Check your blood glucose Y ou may want to test it one or mor e times a day

bull Check your blood pressure If your doctor advises

bull Report any changes in your eyesight to your doctor

q Talk to your health care team

about your blood glucose targets

Ask how and when to test your

blood glucose and how to use the

results to manage your diabetes

q Use this plan as a guide to your

self-care

q Discuss how your self-care plan is

working for you each time you

visit your health care team

20

bullBinit uuml e C Ig r b s k C a e r o g r a l eacute f paraG ntilde E R k g m a n k a r m t d a c u B g E s k k n UumlTHORN l R k h m

ni I U frac12 THORN u M u ntilde oslash I W g e h m Tr s Be h A R k m k a r g a r E f T a sx P a B r b s Gk P a m R ) a b Bk a r Q c a b E d l

min)ateTAvij

U MG a t e F

mat eFmicroj nigGBacopyajeFmicrojrbsGntildek

bulldus e F microj r b s Gntildek n ig e R b IE x S k t s microj C a e r o g r a l eacute f parae d Im Ie c o s p ut b B a etha C a m Yy

bullBi i I oslashuacutent uuml e m l K y k s k ntildeuacuteg Q a m r b s U ntilde Gk R b E h l K r e F I times thorn gGk ntilde Y e t s thornV v a m

bcurreneRcIndg kntildeuacutegmYyeacutefpara

bullBinit uuml e m Il s m lta F Q a m r b s Gntildek R b s in e b Ie v C centb N ETHit r b s Gntildek E N n a M

bull raykarN_BIkarposlashasbthornUacuterkntildeuacutegEPntildekrbsGntildek eTAkanevCcentbNETHitrbsGntildek

q cUrBiPakSaCamYyRkum

kargarEfTaMsuxPaB

rbsGntildekBI eKaled

AKoslashuacuteykUs

kntildeuacutegQamrbsGntildek cUrs

aksYrfa etIeFVIets

thorntimesKoslashuacuteykUskntildeuacutegQam

rbsGntildekedayrebobN

a nigenAeBlNa nigfaet

IeRbIR)as

lTsectpledImIEfrkSa

CmparaWTwkenamEpyenmrbs

GntildekedayrebobNa

q cUrRbIR)asEpnkar

enHCaTisedAENnaMeTAkan

karEfTaM

xoslashUumlnEacutegpTHORNalrbsGntildek

q cUrBiPakSafaetIEpn

karEfTaMxoslashUumlnEacutegpTHORNal

rbsGntildek kMBugdMeN

Irkar

yagemcEdr erogr

aleBlEdlGntildekeTA

CYbRkumEfTaMsuxPaB

rbsGntildek

21

Step 4 Get routine care to avoid problems

See your health care team at least twice a year to find and treat problems early Discuss what steps you can take to reach your goals

At each visit get a bull blood pressure check bull foot check bull weight check bull review of your self-care plan shown in Step 3

Two times each year get an bull A1C testmdashIt may be checked more often if it is over 7

Once each year get a bull cholesterol test bull triglyceride (try-GLISS-er-ide) test- a type of blood fat bull complete foot exam bull dental exam to check teeth and gumsmdashtell your

dentist you have diabetes bull dilated eye exam to check for eye problems bull flu shot bull urine and a blood test to check for kidney problems

At least once get a bull pneumonia (nu-mo-nya) shot

22

CY u M xPaBrbsu Gky I uacute ntilde yqaedmrkemlngBuumla)albB ethbRkmEfTa ntilde B gm ntilde M I I I i aas agehacNas rdgk Y

[)anTan i I ntilde Y i Y I IeBlBPakSafaetGkGacTTlykvFankarNamyedmseRmc)aneKaledA

rbsGntildek

eBleTACYbmthorngsup2 cUr sup3

bull BinituumlsmltaFQam

bull BinituumleCIg bull BinituumlTmparan bullBi i M Uuml oslash alrbsGkeLgvjdc)anbgajkuacutentilde i IntuumlEpnkarEfTaxnEacutegpTHORN ntilde I i U eth gvFankarT3

BIrdgCaerogralqntildeaM cUr sup3

bull eFVIetsthorntimes A1C - GaceFVIjwkjabCagenH)an RbsinebIvaelIsBI 7

mthorngCaerogralqntildeaM cUr sup3

bull BinituumlkUeLesthornrUlI times K t) Y i aj gQamuacutebulleFetsV thorn triglyceride (RTI esrIoslash I -CaRbePTmyeacutenCatxoslash kntilde

bull karBinituumleCIgTaMgmUl bullkarBi i micro I I I micro i copy micro U micro ntildentuumleFjedmemleFjngGBaajeFj-crR)abeBTuumleFjrbsGkfa

GntildekmanCmparaWTwkenamEpyenm

bull BinituumlEPntildek edImIemIlbBaethaEPntildek bull cakfntildeaMkarBarRKunpthornasay bull eFVIetsthorntimesTwkenam nigQam edImIemIlbBaethaRkelon

yagehacNasmthorngmYyqntildeaM cUr sup3

bull cakfntildeaMkarBareraKrlaksYt notnUmUnIyabrvbar

viFankarTI 4 sup3 TTYlkarEfTaMCaRbcaM[eTogTatedImIecosputbBaetha

2

q Ask your health care team about

these and other tests you may

need Ask what your results

mean

qWrite down the date and time of

your next visit

q If you have Medicare ask your

health care team if Medicare

will cover some of the costs for

q learning about healthy eating

and diabetes self

care special shoes if you

need them

qmedical supplies

q diabetes medicines

2

qcUrsYrRkumEfT

aMsuxPaBrbs

GntildekGMBIkareFVIe

tsthorntimes TaMgenH

nigepSgeTot

EdlGntildekGacR

tUvkar cUrs

YrfaetI

lTsectplrbsG

ntildekmannfrac12yyag

dUcemthornc

q cUrktRtakal

briecaumlT nigeB

levlaeacutenkar

eTACYb

elIkeRkayrb

sGntildek

q RbsinebIGntildekm

an Medicare cUrsYrRkum

EfTaM

suxPaBrbsG

ntildekfa etI Medicare nwg

rabrg

cMNaymYycMnYns

Rmab

q sikSaGMBIkarb

riePaKEdlma

nsuxPaBlyen

nigEskeCIgB

iessEfTaMCmparaWT

wkenamEpyenm

xoslashUumlnEacuteg Rbs

inebIGntildekRtUvkar

q smOumlarsup3pAacutetpAacuteg

Buumla)al

q fntildeaMCmparaWTwkenam

Epyenm

2

__________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________

Notes

NATIONAL DIABETES EDUCATION PROGRAM wwwndepnihgov

2

Step 1 Learn about diabetes

Diabetes means that your blood glucose (blood sugar) is too high Here are the main types of diabetes

Type 1 diabetesmdashthe body does not make insulin Insulin helps the body use glucose from food for energy People with type 1 need to take insulin every day

Type 2 diabetesmdashthe body does not make or use insulin well People with type 2 often need to take pills or insulin Type 2 is the most common form of diabetes

Gestational (jes-TAY-shon-al) diabetes mellitus (GDM)mdashoccurs when a woman is pregnant It raises her risk of getting another type of diabetes mostly type 2 for the rest of her life It also raises her childrsquos risk of being overweight and getting diabetes

CmTpara w mmannyfaKuacute oslash U aacute uacute ntilde GkmanxseBkenHKCaRbePT W kenamEpyen frac12 yksnotsrkgQambrvbarrbs ntilde lt W

FMsup2eacutenCmparaWTwkenamEpyenm

gkaymi I aacute eRbR)anbegtb I

Uvkarelb bcurrencakfntildeaMGuin

CmparaTW wkenamEpyenmRbePTTI1-ragkaymi i u i u lsquo i u i u lsquo i Y I npltGnslnGnslnCyragkayeRbR)as

Kykoslash U GaharQam[eTACafamBlmnsSEdlmanRbePTT1Rtvkarcakuacute s)anmkBI u I U

fntildeaMGuinslsquoulinCaerograleacutefpara

2-ra sGiu ulsquo nGtRtmRtv U nsli w

mnusSEdlmanRbePTTI2 Rt slsquoulin RbePTTI 2 enH

KWCaRbePTTUeTAbMput eacutenCmparaWTwkenamEpyenm

[GDM]-ekI I I thorn eBaHvabegI aacute ntilde M IteLgenAeBlEdlRsmaneacutepTHORN neRKaHfakrbsKatna[ekt

CmTpara w mRbePTepSgeToteBjmyCvtEdlPaKeRcnbptKRbePTT2ehyva W kenamEpyen Y i i I M u W I I

kfrac34 I aacute akdlknKatna[mankarelsTmnngektCmW w yenbegneRKaHfntilde U M I para i I Tpara kenamEpmpgEdr

CmparaWTwkenamEpyenmRbePTTI

CmparaWTwkenamEpyenmeBlmaneacutepTHORNeBaH (Gestational diabetes mellitus)

viFankarTI 1 sup3 eronBICmparaWTwkenamEpyenm

curren

7

Diabetes is serious

You may have heard people say they have ldquoa touch of diabetesrdquo or that their ldquosugar is a little highrdquo These words suggest that diabetes is not a serious disease That is not correct Diabetes is serious but you can manage it

All people with diabetes need to make healthy food choices stay at a healthy weight and be active every day

Taking good care of yourself and your diabetes can help you feel better and avoid health problems caused by diabetes such as

bull heart attack and stroke bull eye problems that can lead to trouble seeing or

going blind bull nerve damage that can cause your hands and feet

to hurt tingle or feel numb Some people may even lose a foot or a leg

bull kidney problems that can cause your kidneys to stop working

bull gum disease and loss of teeth

CmparaWTwkenamEpyenmFparanFpararxoslashaMgNas

Gntilde oslash curren u i Y w W para mbfaCatsrkRbEhlGacFabBmnsSnyayfaBkeKmankarTakTgngCmEpyen curren i aacute

rbs Y lt i thorn genHeFI i W para kenamEpmmnEmnCaCmW para paraBkeKmanx bn M [K T yen i para n renaHeT s cBakuumlTa V tfaCm w F F

sM I i w U I W para kenamEpmFnFrNasEtGkGacEfrkSava)aniexcl denaHmnRtmRtveLyCmTw yen para para ntilde

mnusSTaMgGsEdlmanCmparaWTwkenamEpyenm RtUvEteFVIkareRCIserIsmethUacutebGahar

EdlmansuxPaBlyen rkSaTmparan[)anlyen nighatR)aNerograleacutefpara

karEfTaM Uuml oslash knntilde gCmW para w yen G ntilde w U yGY ntilde N_Rbesmicro IxnG i TkenamEpmrbs k)anRtmRtvGacC k[manGarm r

ehIyecosputBIbBaethasuxPaBEdlbNthornalmkBICmparaWTwkenamEpyenmdUcCa sup3

bull eraKKaMgebHdUg nigCmparaWdacsreacutesQam

bull bBaethaEPntildekEdlGaceFVI[manbBaethakntildeuacutegkaremIl bcurrenkoslashayeTACaxVakcxatsreacutesRbsaTEdlGacbNal[eacutedng)ateCgrbsGkQ oacutebsup2 bullxU thorn i I ntilde W esaacute

bcurren micro w lt sSmycnnRbEhlCaGac)atbg)ateCgbeCg manGarmN_skmnu Y M Y I curren I

bull bBaethaRkelon EdlGacbNthornal[RkelonrbsGntildekQbdMeNIrkar

bull CmparaWGBacopyajeFmicroj nig)atbgeFmicroj

When your blood glucose is close to normal you are likely to

bull have more energy bull be less tired and thirsty and urinate less often bull heal better and have fewer skin or bladder

infections bull have fewer problems with your eyesight skin feet

and gums

q Ask your health care team which

type of diabetes you have

q Learn why diabetes is serious

q Learn how caring for your diabetes

helps you feel better today and in

the future

10

enAeBlKykoslash U uacute ntilde ntilde w i micro ntilde micro _ Uuacute skgQamrbsGk enAEkrngkRmtFmta GkmanGarmNdcCa sup3

bull mankmoslashaMgCagmun bull minsUvGskmoslashaMg ehIyeRskTwk nigenamkanEttic bullCasHRbesI I I U curren ireLgehymankarxcEskbkarrlakRkBHenamkanEttc

bull GntildeknwgmanbBaethatictYccMeBaHEPntildek Esk eCIg nigGBacopyajeFmicroj

q cUrsaksYrRkumEfTaMsuxPa

BrbsGntildek faetIGntildek

manCmparaWTwkenamEpyenmRbePT

mYyNa

q sikSafaetIehtuGVICmparaWTwkena

mEpyenmman

eRKaHfntildeakxoslashaMg

q sikSafaetIkarEfTaMCmparaWTwke

namEpyenmrbsGntildek

CYyGntildek[manGarmmicroN_RbesIreLIgen

AeacutefparaenH

nigeTAeacutefparaeRkayeToteday

rebobNa

11

Step 2 Know your diabetes ABCs

Talk to you health care team about how to control your A1C Blood pressure and Cholesterol This can help lower your chances of having a heart attack stroke or other diabetes problem Herersquos what the ABCs of diabetes stand for

A for the A1C test (A-one-C) It shows you how your blood glucose has been over the last three months The A1C goal for most people is below 7

High blood glucose levels can harm your heart and blood vessels kidneys feet and eyes

B for Blood pressure The goal for most people with diabetes is below 13080

High blood pressure makes your heart work too hard It can cause heart attack stroke and kidney disease

C for Cholesterol The LDL goal for most people is below 100 The HDL goal for most people is above 40

LDL or ldquobadrdquo cholesterol can build up and clog your blood vessels It can cause a heart attack or a stroke HDL or ldquogoodrdquo cholesterol helps remove cholesterol from your blood vessels

12

ABCs

cU i Y u M u ntilde M I i I rBPakSaCamyRkmEfTasxPaBrbsGkGBvFRKbRKg A1C smlt i U thorn U aFQam ngkeLesrl

eFVIenHGacCYykatbnszligykMu[maneraKKaMgebHdUg dacsreacutesQam

bcurrenbBaethaCmparaWTwkenamEpyenm epSgeTotrbsGntildek xageRkamenHKWCaGtszlignfrac12yrbs ABCs eacutenCmparaWTwkenamEpyenm

A sRmabetsthorntimes A1C (eG-van-suI) vabgeth ntilde I uacute oslash skuacute ntilde I I lt ajGkfaetKykU ntilde Gk manekneL skgQamrbs gx

uacutentilde LgeBlbEx cugeRkayenHedayrebobemc eKaledA gkM uacute I

A1C sRmabmnusSPaKeRcInKW eRkam 7

kRmitKoslashuacuteykUskntildeuacutegQamxlts GacbHBaldlebHdUg nigsreacutesQam

Rkelon eCIg nigEPntildekrbsGntildek

B sRmab Blood Pressure (smltaFQam) eKaledAsRmabmnusSPaKeRcInEdlmanCmparaWTwkenamEpyenkKWeR

kam 13080

smltaFQamxlts eFVI[ebHdUgrbsGntildekeFVIkarFparanNas

vaGacbNthornal[man

eraKKaMgebHdUg CmparaWdacsreacutesQam nigCmparaWRkelon

C sRmab Cholesterol (kUeLesthornrUl) eKaledA LDL sRmabmnusSPaKeRcInKWeRkam 100

eKaledA HDL sRmabmnusSPaKeRcInKWelI 40

LDL bcurren kUeLesthornrUl GaRkk GacbegaacuteIteLIgnigsTHORNHsreacutesQamrbsGntildek vaGac bNthornal[maneraKKaMgebHdUg

bcurrenCmparaWdacsreacutesQam HDL bcurrenkUeLesthornrUl lyen CYyykkUeLesthornrUlecjBIsreacutesQamrbsGntildek

1

viFankarTI 2 sup3 dwgBI CmparaWTwkenamEpyenmrbsGntildek

q Ask your health care team

q what your A1C Blood pressure

and cholesterol numbers are

q what your ABC numbers should

be

q what you need to do to reach

your targets

1

q cUrsaksYrRkumkargarE

fTaMsuxPaBrbsGntildek sup3

q faetIelx A1C smltaFQ

am

nigkUeLesthornrUlrbsGntildek

mankMritbunmicroan

q faetIelx ABC rbsGntildek

KYrEtmanbunmicroan

q faetIGntildekRtUvkareFVIG

VIedImIQaneTAdl

eKaledArbsGntildek

1

Step 3 Manage your diabetes

Many people avoid the long-term problems of diabetes by taking good care of themselves Work with your health care team to reach your ABC goals Use this self-care plan

bull Use your diabetes food plan If you do not have one ask your health care team for one

- Eat healthy foods such as fruits and vegetables fish lean meats chicken or turkey without the skin dry peas or beans whole grains and low-fat or skim milk and cheese

- Keep fish and lean meat and poultry portions to about 3 ounces (or the size of a pack of cards) Bake broil or grill it

- Eat foods that have less fat and salt

- Eat foods with more fiber such as whole-grain cereals breads crackers rice or pasta

1

EfrkSaCmparawTwkenamEpyenmrbsGntildek

mnu I u eth W para kenamEpmyrrau M Uuml oslash BkeK)anlsSCaeRcnecosptbBaaCmTw yen U eacuterM edayEfTaxnrbs Y yen

cU I V yRkmEfTasxPaBrbsGkedmQaneTAdleKaledAABCrbsGk reFkarCamY u M u ntilde I I ntilde

cUreRbIR)asEpnkarEfTaMedayxoslashUumlnEacutegenH

enHeT cUrsMuEpnkarenHBI RkumEfTaMsuxPaBrbsGntildek

- briePaKGaharmansuxPaBlyendUcCa EposlasheQI nigbEnoslash sacRtI

sac i oslash csacmanbsacman)aragedaymnmanEsk EdlmanCatxajti M i

sENthorn M thorn Uuml para FBaCatTagmlngTkedaHeKa k)aragbsENkstRKab Oslash i M U i w

nigQIsEdlmanCatixoslashajtic nigKmicroanCatiERkm

-bri I i oslash i i ePaKsacRt-sacEdlmanCatxajtc-ngsacmanRbmaN3 eGans_ notbcurrenTMhMebomYyRbGbbrvbar dut GaMg va

- briePaKGaharEdlmanCatixoslashaj nigCatieacuteRbtic

-bri oslash I i I I U Oslash i M UePaKGaharbEnEdlmanCvCateRcneRcndcCaRKabFBaCatTagml

nMbufrac12gcMNit nMeRkkxfrac12r )ay bcurren)asthorna

bulleRbIR)asEpnkarGaharsRmabCmparaWTwkenamEpyenmrbsGntildekRbsinebIGntildekminmanEpnkar

viFankarTI 3 sup3

curren

curren

17

bull Get 30 to 60 minutes of physical activity on most days of the week Brisk walking is a great way to move more

bull Stay at a healthy weight by making healthy food choices and moving more

bull Ask for help if you feel down A mental health counselor support group member of the clergy friend or family member will listen to your concerns and help you feel better

bull Learn to cope with stress Stress can raise your blood glucose While it is hard to remove stress from your life you can learn to handle it

bull Stop smoking Ask for help to quit

bull Take medicines even when you feel good Ask you doctor if you need aspirin to prevent a heart attack or stroke Tell your doctor if you cannot afford your medicine or if you have any side effects

1

bull sszligitenATmparanEdlmansuxPaBlyen edayeFVIkareRCIserIsGaharmansuxPaBlyen nigeFVIclna[kanEteRcIn

bull sMu[eKCYyRbsinebIGntildekmanGarmmicroN_TukccedilRBYy GntildekTIRbwkSasux

PaBposlashUacutevcitthorn RkumKaMRT smaCikbuBVCit mitthornPkthorni bcurrensmaCikRKYsarnwgsthornabkar)armOumlrbsGntildek ehIyCYyGntildek[manGarmmicroN_RbesIreLIg

bull eronedaHRsayPaBtantwgposlashUacutevcitthorn PaBtantwgposlashUacutevcitthorn GacbegaacuteInKoslashuacuteykUskntildeuacutegQam

rbsGntildek edaysarvaBi)akkntildeuacutegkarbM)atPaBtantwgposlashUacutevcitthornBICivit

rbsGntildek

GntildekGaceronRKbRKgva

bull QbBisa)arI cUresntildeIsMuCMnYybBaAumlbBisa)arI

bull TTYlTanfntildeaMeTaHbICaenAeBlGntildekmanGarmmicroN_lyenkfrac34eday

cUrsaksYrevCcentbNETHitrbs Gntildek faetIGntildekRtUvkarfntildeaMGasltIrIn edImITbsaacuteateraKKaMgebHdUgbcurrenCmparaWdacsreacutesQam

EdrbcurrenGt cUrR)abeTAevCcentbNETHitrbsGntildek RbsinebIGntildekminGaceacute

llkTijfntildeaMrbsGntildek

)an bcurrenRbsinebIGntildekmanplvi)akBIfntildeaMNamYy

bull hatR)aNBI 30 eTA 60 naTI[)aneRcIneacutefparakntildeuacutegmYys)athornh_ karedIrelOnsup2 KWCaviFIeFVIclna

dfrac34RbesIrmYy

1

bull Check your feet every day for cuts blisters r ed spots and swelling Call your health car e team right away about any sor es that wonrsquot go away

bull Brush your teeth and floss every day to avoid pr oblems with your mouth teeth or gums

bull Check your blood glucose Y ou may want to test it one or mor e times a day

bull Check your blood pressure If your doctor advises

bull Report any changes in your eyesight to your doctor

q Talk to your health care team

about your blood glucose targets

Ask how and when to test your

blood glucose and how to use the

results to manage your diabetes

q Use this plan as a guide to your

self-care

q Discuss how your self-care plan is

working for you each time you

visit your health care team

20

bullBinit uuml e C Ig r b s k C a e r o g r a l eacute f paraG ntilde E R k g m a n k a r m t d a c u B g E s k k n UumlTHORN l R k h m

ni I U frac12 THORN u M u ntilde oslash I W g e h m Tr s Be h A R k m k a r g a r E f T a sx P a B r b s Gk P a m R ) a b Bk a r Q c a b E d l

min)ateTAvij

U MG a t e F

mat eFmicroj nigGBacopyajeFmicrojrbsGntildek

bulldus e F microj r b s Gntildek n ig e R b IE x S k t s microj C a e r o g r a l eacute f parae d Im Ie c o s p ut b B a etha C a m Yy

bullBi i I oslashuacutent uuml e m l K y k s k ntildeuacuteg Q a m r b s U ntilde Gk R b E h l K r e F I times thorn gGk ntilde Y e t s thornV v a m

bcurreneRcIndg kntildeuacutegmYyeacutefpara

bullBinit uuml e m Il s m lta F Q a m r b s Gntildek R b s in e b Ie v C centb N ETHit r b s Gntildek E N n a M

bull raykarN_BIkarposlashasbthornUacuterkntildeuacutegEPntildekrbsGntildek eTAkanevCcentbNETHitrbsGntildek

q cUrBiPakSaCamYyRkum

kargarEfTaMsuxPaB

rbsGntildekBI eKaled

AKoslashuacuteykUs

kntildeuacutegQamrbsGntildek cUrs

aksYrfa etIeFVIets

thorntimesKoslashuacuteykUskntildeuacutegQam

rbsGntildekedayrebobN

a nigenAeBlNa nigfaet

IeRbIR)as

lTsectpledImIEfrkSa

CmparaWTwkenamEpyenmrbs

GntildekedayrebobNa

q cUrRbIR)asEpnkar

enHCaTisedAENnaMeTAkan

karEfTaM

xoslashUumlnEacutegpTHORNalrbsGntildek

q cUrBiPakSafaetIEpn

karEfTaMxoslashUumlnEacutegpTHORNal

rbsGntildek kMBugdMeN

Irkar

yagemcEdr erogr

aleBlEdlGntildekeTA

CYbRkumEfTaMsuxPaB

rbsGntildek

21

Step 4 Get routine care to avoid problems

See your health care team at least twice a year to find and treat problems early Discuss what steps you can take to reach your goals

At each visit get a bull blood pressure check bull foot check bull weight check bull review of your self-care plan shown in Step 3

Two times each year get an bull A1C testmdashIt may be checked more often if it is over 7

Once each year get a bull cholesterol test bull triglyceride (try-GLISS-er-ide) test- a type of blood fat bull complete foot exam bull dental exam to check teeth and gumsmdashtell your

dentist you have diabetes bull dilated eye exam to check for eye problems bull flu shot bull urine and a blood test to check for kidney problems

At least once get a bull pneumonia (nu-mo-nya) shot

22

CY u M xPaBrbsu Gky I uacute ntilde yqaedmrkemlngBuumla)albB ethbRkmEfTa ntilde B gm ntilde M I I I i aas agehacNas rdgk Y

[)anTan i I ntilde Y i Y I IeBlBPakSafaetGkGacTTlykvFankarNamyedmseRmc)aneKaledA

rbsGntildek

eBleTACYbmthorngsup2 cUr sup3

bull BinituumlsmltaFQam

bull BinituumleCIg bull BinituumlTmparan bullBi i M Uuml oslash alrbsGkeLgvjdc)anbgajkuacutentilde i IntuumlEpnkarEfTaxnEacutegpTHORN ntilde I i U eth gvFankarT3

BIrdgCaerogralqntildeaM cUr sup3

bull eFVIetsthorntimes A1C - GaceFVIjwkjabCagenH)an RbsinebIvaelIsBI 7

mthorngCaerogralqntildeaM cUr sup3

bull BinituumlkUeLesthornrUlI times K t) Y i aj gQamuacutebulleFetsV thorn triglyceride (RTI esrIoslash I -CaRbePTmyeacutenCatxoslash kntilde

bull karBinituumleCIgTaMgmUl bullkarBi i micro I I I micro i copy micro U micro ntildentuumleFjedmemleFjngGBaajeFj-crR)abeBTuumleFjrbsGkfa

GntildekmanCmparaWTwkenamEpyenm

bull BinituumlEPntildek edImIemIlbBaethaEPntildek bull cakfntildeaMkarBarRKunpthornasay bull eFVIetsthorntimesTwkenam nigQam edImIemIlbBaethaRkelon

yagehacNasmthorngmYyqntildeaM cUr sup3

bull cakfntildeaMkarBareraKrlaksYt notnUmUnIyabrvbar

viFankarTI 4 sup3 TTYlkarEfTaMCaRbcaM[eTogTatedImIecosputbBaetha

2

q Ask your health care team about

these and other tests you may

need Ask what your results

mean

qWrite down the date and time of

your next visit

q If you have Medicare ask your

health care team if Medicare

will cover some of the costs for

q learning about healthy eating

and diabetes self

care special shoes if you

need them

qmedical supplies

q diabetes medicines

2

qcUrsYrRkumEfT

aMsuxPaBrbs

GntildekGMBIkareFVIe

tsthorntimes TaMgenH

nigepSgeTot

EdlGntildekGacR

tUvkar cUrs

YrfaetI

lTsectplrbsG

ntildekmannfrac12yyag

dUcemthornc

q cUrktRtakal

briecaumlT nigeB

levlaeacutenkar

eTACYb

elIkeRkayrb

sGntildek

q RbsinebIGntildekm

an Medicare cUrsYrRkum

EfTaM

suxPaBrbsG

ntildekfa etI Medicare nwg

rabrg

cMNaymYycMnYns

Rmab

q sikSaGMBIkarb

riePaKEdlma

nsuxPaBlyen

nigEskeCIgB

iessEfTaMCmparaWT

wkenamEpyenm

xoslashUumlnEacuteg Rbs

inebIGntildekRtUvkar

q smOumlarsup3pAacutetpAacuteg

Buumla)al

q fntildeaMCmparaWTwkenam

Epyenm

2

__________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________

Notes

NATIONAL DIABETES EDUCATION PROGRAM wwwndepnihgov

2

CmTpara w mmannyfaKuacute oslash U aacute uacute ntilde GkmanxseBkenHKCaRbePT W kenamEpyen frac12 yksnotsrkgQambrvbarrbs ntilde lt W

FMsup2eacutenCmparaWTwkenamEpyenm

gkaymi I aacute eRbR)anbegtb I

Uvkarelb bcurrencakfntildeaMGuin

CmparaTW wkenamEpyenmRbePTTI1-ragkaymi i u i u lsquo i u i u lsquo i Y I npltGnslnGnslnCyragkayeRbR)as

Kykoslash U GaharQam[eTACafamBlmnsSEdlmanRbePTT1Rtvkarcakuacute s)anmkBI u I U

fntildeaMGuinslsquoulinCaerograleacutefpara

2-ra sGiu ulsquo nGtRtmRtv U nsli w

mnusSEdlmanRbePTTI2 Rt slsquoulin RbePTTI 2 enH

KWCaRbePTTUeTAbMput eacutenCmparaWTwkenamEpyenm

[GDM]-ekI I I thorn eBaHvabegI aacute ntilde M IteLgenAeBlEdlRsmaneacutepTHORN neRKaHfakrbsKatna[ekt

CmTpara w mRbePTepSgeToteBjmyCvtEdlPaKeRcnbptKRbePTT2ehyva W kenamEpyen Y i i I M u W I I

kfrac34 I aacute akdlknKatna[mankarelsTmnngektCmW w yenbegneRKaHfntilde U M I para i I Tpara kenamEpmpgEdr

CmparaWTwkenamEpyenmRbePTTI

CmparaWTwkenamEpyenmeBlmaneacutepTHORNeBaH (Gestational diabetes mellitus)

viFankarTI 1 sup3 eronBICmparaWTwkenamEpyenm

curren

7

Diabetes is serious

You may have heard people say they have ldquoa touch of diabetesrdquo or that their ldquosugar is a little highrdquo These words suggest that diabetes is not a serious disease That is not correct Diabetes is serious but you can manage it

All people with diabetes need to make healthy food choices stay at a healthy weight and be active every day

Taking good care of yourself and your diabetes can help you feel better and avoid health problems caused by diabetes such as

bull heart attack and stroke bull eye problems that can lead to trouble seeing or

going blind bull nerve damage that can cause your hands and feet

to hurt tingle or feel numb Some people may even lose a foot or a leg

bull kidney problems that can cause your kidneys to stop working

bull gum disease and loss of teeth

CmparaWTwkenamEpyenmFparanFpararxoslashaMgNas

Gntilde oslash curren u i Y w W para mbfaCatsrkRbEhlGacFabBmnsSnyayfaBkeKmankarTakTgngCmEpyen curren i aacute

rbs Y lt i thorn genHeFI i W para kenamEpmmnEmnCaCmW para paraBkeKmanx bn M [K T yen i para n renaHeT s cBakuumlTa V tfaCm w F F

sM I i w U I W para kenamEpmFnFrNasEtGkGacEfrkSava)aniexcl denaHmnRtmRtveLyCmTw yen para para ntilde

mnusSTaMgGsEdlmanCmparaWTwkenamEpyenm RtUvEteFVIkareRCIserIsmethUacutebGahar

EdlmansuxPaBlyen rkSaTmparan[)anlyen nighatR)aNerograleacutefpara

karEfTaM Uuml oslash knntilde gCmW para w yen G ntilde w U yGY ntilde N_Rbesmicro IxnG i TkenamEpmrbs k)anRtmRtvGacC k[manGarm r

ehIyecosputBIbBaethasuxPaBEdlbNthornalmkBICmparaWTwkenamEpyenmdUcCa sup3

bull eraKKaMgebHdUg nigCmparaWdacsreacutesQam

bull bBaethaEPntildekEdlGaceFVI[manbBaethakntildeuacutegkaremIl bcurrenkoslashayeTACaxVakcxatsreacutesRbsaTEdlGacbNal[eacutedng)ateCgrbsGkQ oacutebsup2 bullxU thorn i I ntilde W esaacute

bcurren micro w lt sSmycnnRbEhlCaGac)atbg)ateCgbeCg manGarmN_skmnu Y M Y I curren I

bull bBaethaRkelon EdlGacbNthornal[RkelonrbsGntildekQbdMeNIrkar

bull CmparaWGBacopyajeFmicroj nig)atbgeFmicroj

When your blood glucose is close to normal you are likely to

bull have more energy bull be less tired and thirsty and urinate less often bull heal better and have fewer skin or bladder

infections bull have fewer problems with your eyesight skin feet

and gums

q Ask your health care team which

type of diabetes you have

q Learn why diabetes is serious

q Learn how caring for your diabetes

helps you feel better today and in

the future

10

enAeBlKykoslash U uacute ntilde ntilde w i micro ntilde micro _ Uuacute skgQamrbsGk enAEkrngkRmtFmta GkmanGarmNdcCa sup3

bull mankmoslashaMgCagmun bull minsUvGskmoslashaMg ehIyeRskTwk nigenamkanEttic bullCasHRbesI I I U curren ireLgehymankarxcEskbkarrlakRkBHenamkanEttc

bull GntildeknwgmanbBaethatictYccMeBaHEPntildek Esk eCIg nigGBacopyajeFmicroj

q cUrsaksYrRkumEfTaMsuxPa

BrbsGntildek faetIGntildek

manCmparaWTwkenamEpyenmRbePT

mYyNa

q sikSafaetIehtuGVICmparaWTwkena

mEpyenmman

eRKaHfntildeakxoslashaMg

q sikSafaetIkarEfTaMCmparaWTwke

namEpyenmrbsGntildek

CYyGntildek[manGarmmicroN_RbesIreLIgen

AeacutefparaenH

nigeTAeacutefparaeRkayeToteday

rebobNa

11

Step 2 Know your diabetes ABCs

Talk to you health care team about how to control your A1C Blood pressure and Cholesterol This can help lower your chances of having a heart attack stroke or other diabetes problem Herersquos what the ABCs of diabetes stand for

A for the A1C test (A-one-C) It shows you how your blood glucose has been over the last three months The A1C goal for most people is below 7

High blood glucose levels can harm your heart and blood vessels kidneys feet and eyes

B for Blood pressure The goal for most people with diabetes is below 13080

High blood pressure makes your heart work too hard It can cause heart attack stroke and kidney disease

C for Cholesterol The LDL goal for most people is below 100 The HDL goal for most people is above 40

LDL or ldquobadrdquo cholesterol can build up and clog your blood vessels It can cause a heart attack or a stroke HDL or ldquogoodrdquo cholesterol helps remove cholesterol from your blood vessels

12

ABCs

cU i Y u M u ntilde M I i I rBPakSaCamyRkmEfTasxPaBrbsGkGBvFRKbRKg A1C smlt i U thorn U aFQam ngkeLesrl

eFVIenHGacCYykatbnszligykMu[maneraKKaMgebHdUg dacsreacutesQam

bcurrenbBaethaCmparaWTwkenamEpyenm epSgeTotrbsGntildek xageRkamenHKWCaGtszlignfrac12yrbs ABCs eacutenCmparaWTwkenamEpyenm

A sRmabetsthorntimes A1C (eG-van-suI) vabgeth ntilde I uacute oslash skuacute ntilde I I lt ajGkfaetKykU ntilde Gk manekneL skgQamrbs gx

uacutentilde LgeBlbEx cugeRkayenHedayrebobemc eKaledA gkM uacute I

A1C sRmabmnusSPaKeRcInKW eRkam 7

kRmitKoslashuacuteykUskntildeuacutegQamxlts GacbHBaldlebHdUg nigsreacutesQam

Rkelon eCIg nigEPntildekrbsGntildek

B sRmab Blood Pressure (smltaFQam) eKaledAsRmabmnusSPaKeRcInEdlmanCmparaWTwkenamEpyenkKWeR

kam 13080

smltaFQamxlts eFVI[ebHdUgrbsGntildekeFVIkarFparanNas

vaGacbNthornal[man

eraKKaMgebHdUg CmparaWdacsreacutesQam nigCmparaWRkelon

C sRmab Cholesterol (kUeLesthornrUl) eKaledA LDL sRmabmnusSPaKeRcInKWeRkam 100

eKaledA HDL sRmabmnusSPaKeRcInKWelI 40

LDL bcurren kUeLesthornrUl GaRkk GacbegaacuteIteLIgnigsTHORNHsreacutesQamrbsGntildek vaGac bNthornal[maneraKKaMgebHdUg

bcurrenCmparaWdacsreacutesQam HDL bcurrenkUeLesthornrUl lyen CYyykkUeLesthornrUlecjBIsreacutesQamrbsGntildek

1

viFankarTI 2 sup3 dwgBI CmparaWTwkenamEpyenmrbsGntildek

q Ask your health care team

q what your A1C Blood pressure

and cholesterol numbers are

q what your ABC numbers should

be

q what you need to do to reach

your targets

1

q cUrsaksYrRkumkargarE

fTaMsuxPaBrbsGntildek sup3

q faetIelx A1C smltaFQ

am

nigkUeLesthornrUlrbsGntildek

mankMritbunmicroan

q faetIelx ABC rbsGntildek

KYrEtmanbunmicroan

q faetIGntildekRtUvkareFVIG

VIedImIQaneTAdl

eKaledArbsGntildek

1

Step 3 Manage your diabetes

Many people avoid the long-term problems of diabetes by taking good care of themselves Work with your health care team to reach your ABC goals Use this self-care plan

bull Use your diabetes food plan If you do not have one ask your health care team for one

- Eat healthy foods such as fruits and vegetables fish lean meats chicken or turkey without the skin dry peas or beans whole grains and low-fat or skim milk and cheese

- Keep fish and lean meat and poultry portions to about 3 ounces (or the size of a pack of cards) Bake broil or grill it

- Eat foods that have less fat and salt

- Eat foods with more fiber such as whole-grain cereals breads crackers rice or pasta

1

EfrkSaCmparawTwkenamEpyenmrbsGntildek

mnu I u eth W para kenamEpmyrrau M Uuml oslash BkeK)anlsSCaeRcnecosptbBaaCmTw yen U eacuterM edayEfTaxnrbs Y yen

cU I V yRkmEfTasxPaBrbsGkedmQaneTAdleKaledAABCrbsGk reFkarCamY u M u ntilde I I ntilde

cUreRbIR)asEpnkarEfTaMedayxoslashUumlnEacutegenH

enHeT cUrsMuEpnkarenHBI RkumEfTaMsuxPaBrbsGntildek

- briePaKGaharmansuxPaBlyendUcCa EposlasheQI nigbEnoslash sacRtI

sac i oslash csacmanbsacman)aragedaymnmanEsk EdlmanCatxajti M i

sENthorn M thorn Uuml para FBaCatTagmlngTkedaHeKa k)aragbsENkstRKab Oslash i M U i w

nigQIsEdlmanCatixoslashajtic nigKmicroanCatiERkm

-bri I i oslash i i ePaKsacRt-sacEdlmanCatxajtc-ngsacmanRbmaN3 eGans_ notbcurrenTMhMebomYyRbGbbrvbar dut GaMg va

- briePaKGaharEdlmanCatixoslashaj nigCatieacuteRbtic

-bri oslash I i I I U Oslash i M UePaKGaharbEnEdlmanCvCateRcneRcndcCaRKabFBaCatTagml

nMbufrac12gcMNit nMeRkkxfrac12r )ay bcurren)asthorna

bulleRbIR)asEpnkarGaharsRmabCmparaWTwkenamEpyenmrbsGntildekRbsinebIGntildekminmanEpnkar

viFankarTI 3 sup3

curren

curren

17

bull Get 30 to 60 minutes of physical activity on most days of the week Brisk walking is a great way to move more

bull Stay at a healthy weight by making healthy food choices and moving more

bull Ask for help if you feel down A mental health counselor support group member of the clergy friend or family member will listen to your concerns and help you feel better

bull Learn to cope with stress Stress can raise your blood glucose While it is hard to remove stress from your life you can learn to handle it

bull Stop smoking Ask for help to quit

bull Take medicines even when you feel good Ask you doctor if you need aspirin to prevent a heart attack or stroke Tell your doctor if you cannot afford your medicine or if you have any side effects

1

bull sszligitenATmparanEdlmansuxPaBlyen edayeFVIkareRCIserIsGaharmansuxPaBlyen nigeFVIclna[kanEteRcIn

bull sMu[eKCYyRbsinebIGntildekmanGarmmicroN_TukccedilRBYy GntildekTIRbwkSasux

PaBposlashUacutevcitthorn RkumKaMRT smaCikbuBVCit mitthornPkthorni bcurrensmaCikRKYsarnwgsthornabkar)armOumlrbsGntildek ehIyCYyGntildek[manGarmmicroN_RbesIreLIg

bull eronedaHRsayPaBtantwgposlashUacutevcitthorn PaBtantwgposlashUacutevcitthorn GacbegaacuteInKoslashuacuteykUskntildeuacutegQam

rbsGntildek edaysarvaBi)akkntildeuacutegkarbM)atPaBtantwgposlashUacutevcitthornBICivit

rbsGntildek

GntildekGaceronRKbRKgva

bull QbBisa)arI cUresntildeIsMuCMnYybBaAumlbBisa)arI

bull TTYlTanfntildeaMeTaHbICaenAeBlGntildekmanGarmmicroN_lyenkfrac34eday

cUrsaksYrevCcentbNETHitrbs Gntildek faetIGntildekRtUvkarfntildeaMGasltIrIn edImITbsaacuteateraKKaMgebHdUgbcurrenCmparaWdacsreacutesQam

EdrbcurrenGt cUrR)abeTAevCcentbNETHitrbsGntildek RbsinebIGntildekminGaceacute

llkTijfntildeaMrbsGntildek

)an bcurrenRbsinebIGntildekmanplvi)akBIfntildeaMNamYy

bull hatR)aNBI 30 eTA 60 naTI[)aneRcIneacutefparakntildeuacutegmYys)athornh_ karedIrelOnsup2 KWCaviFIeFVIclna

dfrac34RbesIrmYy

1

bull Check your feet every day for cuts blisters r ed spots and swelling Call your health car e team right away about any sor es that wonrsquot go away

bull Brush your teeth and floss every day to avoid pr oblems with your mouth teeth or gums

bull Check your blood glucose Y ou may want to test it one or mor e times a day

bull Check your blood pressure If your doctor advises

bull Report any changes in your eyesight to your doctor

q Talk to your health care team

about your blood glucose targets

Ask how and when to test your

blood glucose and how to use the

results to manage your diabetes

q Use this plan as a guide to your

self-care

q Discuss how your self-care plan is

working for you each time you

visit your health care team

20

bullBinit uuml e C Ig r b s k C a e r o g r a l eacute f paraG ntilde E R k g m a n k a r m t d a c u B g E s k k n UumlTHORN l R k h m

ni I U frac12 THORN u M u ntilde oslash I W g e h m Tr s Be h A R k m k a r g a r E f T a sx P a B r b s Gk P a m R ) a b Bk a r Q c a b E d l

min)ateTAvij

U MG a t e F

mat eFmicroj nigGBacopyajeFmicrojrbsGntildek

bulldus e F microj r b s Gntildek n ig e R b IE x S k t s microj C a e r o g r a l eacute f parae d Im Ie c o s p ut b B a etha C a m Yy

bullBi i I oslashuacutent uuml e m l K y k s k ntildeuacuteg Q a m r b s U ntilde Gk R b E h l K r e F I times thorn gGk ntilde Y e t s thornV v a m

bcurreneRcIndg kntildeuacutegmYyeacutefpara

bullBinit uuml e m Il s m lta F Q a m r b s Gntildek R b s in e b Ie v C centb N ETHit r b s Gntildek E N n a M

bull raykarN_BIkarposlashasbthornUacuterkntildeuacutegEPntildekrbsGntildek eTAkanevCcentbNETHitrbsGntildek

q cUrBiPakSaCamYyRkum

kargarEfTaMsuxPaB

rbsGntildekBI eKaled

AKoslashuacuteykUs

kntildeuacutegQamrbsGntildek cUrs

aksYrfa etIeFVIets

thorntimesKoslashuacuteykUskntildeuacutegQam

rbsGntildekedayrebobN

a nigenAeBlNa nigfaet

IeRbIR)as

lTsectpledImIEfrkSa

CmparaWTwkenamEpyenmrbs

GntildekedayrebobNa

q cUrRbIR)asEpnkar

enHCaTisedAENnaMeTAkan

karEfTaM

xoslashUumlnEacutegpTHORNalrbsGntildek

q cUrBiPakSafaetIEpn

karEfTaMxoslashUumlnEacutegpTHORNal

rbsGntildek kMBugdMeN

Irkar

yagemcEdr erogr

aleBlEdlGntildekeTA

CYbRkumEfTaMsuxPaB

rbsGntildek

21

Step 4 Get routine care to avoid problems

See your health care team at least twice a year to find and treat problems early Discuss what steps you can take to reach your goals

At each visit get a bull blood pressure check bull foot check bull weight check bull review of your self-care plan shown in Step 3

Two times each year get an bull A1C testmdashIt may be checked more often if it is over 7

Once each year get a bull cholesterol test bull triglyceride (try-GLISS-er-ide) test- a type of blood fat bull complete foot exam bull dental exam to check teeth and gumsmdashtell your

dentist you have diabetes bull dilated eye exam to check for eye problems bull flu shot bull urine and a blood test to check for kidney problems

At least once get a bull pneumonia (nu-mo-nya) shot

22

CY u M xPaBrbsu Gky I uacute ntilde yqaedmrkemlngBuumla)albB ethbRkmEfTa ntilde B gm ntilde M I I I i aas agehacNas rdgk Y

[)anTan i I ntilde Y i Y I IeBlBPakSafaetGkGacTTlykvFankarNamyedmseRmc)aneKaledA

rbsGntildek

eBleTACYbmthorngsup2 cUr sup3

bull BinituumlsmltaFQam

bull BinituumleCIg bull BinituumlTmparan bullBi i M Uuml oslash alrbsGkeLgvjdc)anbgajkuacutentilde i IntuumlEpnkarEfTaxnEacutegpTHORN ntilde I i U eth gvFankarT3

BIrdgCaerogralqntildeaM cUr sup3

bull eFVIetsthorntimes A1C - GaceFVIjwkjabCagenH)an RbsinebIvaelIsBI 7

mthorngCaerogralqntildeaM cUr sup3

bull BinituumlkUeLesthornrUlI times K t) Y i aj gQamuacutebulleFetsV thorn triglyceride (RTI esrIoslash I -CaRbePTmyeacutenCatxoslash kntilde

bull karBinituumleCIgTaMgmUl bullkarBi i micro I I I micro i copy micro U micro ntildentuumleFjedmemleFjngGBaajeFj-crR)abeBTuumleFjrbsGkfa

GntildekmanCmparaWTwkenamEpyenm

bull BinituumlEPntildek edImIemIlbBaethaEPntildek bull cakfntildeaMkarBarRKunpthornasay bull eFVIetsthorntimesTwkenam nigQam edImIemIlbBaethaRkelon

yagehacNasmthorngmYyqntildeaM cUr sup3

bull cakfntildeaMkarBareraKrlaksYt notnUmUnIyabrvbar

viFankarTI 4 sup3 TTYlkarEfTaMCaRbcaM[eTogTatedImIecosputbBaetha

2

q Ask your health care team about

these and other tests you may

need Ask what your results

mean

qWrite down the date and time of

your next visit

q If you have Medicare ask your

health care team if Medicare

will cover some of the costs for

q learning about healthy eating

and diabetes self

care special shoes if you

need them

qmedical supplies

q diabetes medicines

2

qcUrsYrRkumEfT

aMsuxPaBrbs

GntildekGMBIkareFVIe

tsthorntimes TaMgenH

nigepSgeTot

EdlGntildekGacR

tUvkar cUrs

YrfaetI

lTsectplrbsG

ntildekmannfrac12yyag

dUcemthornc

q cUrktRtakal

briecaumlT nigeB

levlaeacutenkar

eTACYb

elIkeRkayrb

sGntildek

q RbsinebIGntildekm

an Medicare cUrsYrRkum

EfTaM

suxPaBrbsG

ntildekfa etI Medicare nwg

rabrg

cMNaymYycMnYns

Rmab

q sikSaGMBIkarb

riePaKEdlma

nsuxPaBlyen

nigEskeCIgB

iessEfTaMCmparaWT

wkenamEpyenm

xoslashUumlnEacuteg Rbs

inebIGntildekRtUvkar

q smOumlarsup3pAacutetpAacuteg

Buumla)al

q fntildeaMCmparaWTwkenam

Epyenm

2

__________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________

Notes

NATIONAL DIABETES EDUCATION PROGRAM wwwndepnihgov

2

Diabetes is serious

You may have heard people say they have ldquoa touch of diabetesrdquo or that their ldquosugar is a little highrdquo These words suggest that diabetes is not a serious disease That is not correct Diabetes is serious but you can manage it

All people with diabetes need to make healthy food choices stay at a healthy weight and be active every day

Taking good care of yourself and your diabetes can help you feel better and avoid health problems caused by diabetes such as

bull heart attack and stroke bull eye problems that can lead to trouble seeing or

going blind bull nerve damage that can cause your hands and feet

to hurt tingle or feel numb Some people may even lose a foot or a leg

bull kidney problems that can cause your kidneys to stop working

bull gum disease and loss of teeth

CmparaWTwkenamEpyenmFparanFpararxoslashaMgNas

Gntilde oslash curren u i Y w W para mbfaCatsrkRbEhlGacFabBmnsSnyayfaBkeKmankarTakTgngCmEpyen curren i aacute

rbs Y lt i thorn genHeFI i W para kenamEpmmnEmnCaCmW para paraBkeKmanx bn M [K T yen i para n renaHeT s cBakuumlTa V tfaCm w F F

sM I i w U I W para kenamEpmFnFrNasEtGkGacEfrkSava)aniexcl denaHmnRtmRtveLyCmTw yen para para ntilde

mnusSTaMgGsEdlmanCmparaWTwkenamEpyenm RtUvEteFVIkareRCIserIsmethUacutebGahar

EdlmansuxPaBlyen rkSaTmparan[)anlyen nighatR)aNerograleacutefpara

karEfTaM Uuml oslash knntilde gCmW para w yen G ntilde w U yGY ntilde N_Rbesmicro IxnG i TkenamEpmrbs k)anRtmRtvGacC k[manGarm r

ehIyecosputBIbBaethasuxPaBEdlbNthornalmkBICmparaWTwkenamEpyenmdUcCa sup3

bull eraKKaMgebHdUg nigCmparaWdacsreacutesQam

bull bBaethaEPntildekEdlGaceFVI[manbBaethakntildeuacutegkaremIl bcurrenkoslashayeTACaxVakcxatsreacutesRbsaTEdlGacbNal[eacutedng)ateCgrbsGkQ oacutebsup2 bullxU thorn i I ntilde W esaacute

bcurren micro w lt sSmycnnRbEhlCaGac)atbg)ateCgbeCg manGarmN_skmnu Y M Y I curren I

bull bBaethaRkelon EdlGacbNthornal[RkelonrbsGntildekQbdMeNIrkar

bull CmparaWGBacopyajeFmicroj nig)atbgeFmicroj

When your blood glucose is close to normal you are likely to

bull have more energy bull be less tired and thirsty and urinate less often bull heal better and have fewer skin or bladder

infections bull have fewer problems with your eyesight skin feet

and gums

q Ask your health care team which

type of diabetes you have

q Learn why diabetes is serious

q Learn how caring for your diabetes

helps you feel better today and in

the future

10

enAeBlKykoslash U uacute ntilde ntilde w i micro ntilde micro _ Uuacute skgQamrbsGk enAEkrngkRmtFmta GkmanGarmNdcCa sup3

bull mankmoslashaMgCagmun bull minsUvGskmoslashaMg ehIyeRskTwk nigenamkanEttic bullCasHRbesI I I U curren ireLgehymankarxcEskbkarrlakRkBHenamkanEttc

bull GntildeknwgmanbBaethatictYccMeBaHEPntildek Esk eCIg nigGBacopyajeFmicroj

q cUrsaksYrRkumEfTaMsuxPa

BrbsGntildek faetIGntildek

manCmparaWTwkenamEpyenmRbePT

mYyNa

q sikSafaetIehtuGVICmparaWTwkena

mEpyenmman

eRKaHfntildeakxoslashaMg

q sikSafaetIkarEfTaMCmparaWTwke

namEpyenmrbsGntildek

CYyGntildek[manGarmmicroN_RbesIreLIgen

AeacutefparaenH

nigeTAeacutefparaeRkayeToteday

rebobNa

11

Step 2 Know your diabetes ABCs

Talk to you health care team about how to control your A1C Blood pressure and Cholesterol This can help lower your chances of having a heart attack stroke or other diabetes problem Herersquos what the ABCs of diabetes stand for

A for the A1C test (A-one-C) It shows you how your blood glucose has been over the last three months The A1C goal for most people is below 7

High blood glucose levels can harm your heart and blood vessels kidneys feet and eyes

B for Blood pressure The goal for most people with diabetes is below 13080

High blood pressure makes your heart work too hard It can cause heart attack stroke and kidney disease

C for Cholesterol The LDL goal for most people is below 100 The HDL goal for most people is above 40

LDL or ldquobadrdquo cholesterol can build up and clog your blood vessels It can cause a heart attack or a stroke HDL or ldquogoodrdquo cholesterol helps remove cholesterol from your blood vessels

12

ABCs

cU i Y u M u ntilde M I i I rBPakSaCamyRkmEfTasxPaBrbsGkGBvFRKbRKg A1C smlt i U thorn U aFQam ngkeLesrl

eFVIenHGacCYykatbnszligykMu[maneraKKaMgebHdUg dacsreacutesQam

bcurrenbBaethaCmparaWTwkenamEpyenm epSgeTotrbsGntildek xageRkamenHKWCaGtszlignfrac12yrbs ABCs eacutenCmparaWTwkenamEpyenm

A sRmabetsthorntimes A1C (eG-van-suI) vabgeth ntilde I uacute oslash skuacute ntilde I I lt ajGkfaetKykU ntilde Gk manekneL skgQamrbs gx

uacutentilde LgeBlbEx cugeRkayenHedayrebobemc eKaledA gkM uacute I

A1C sRmabmnusSPaKeRcInKW eRkam 7

kRmitKoslashuacuteykUskntildeuacutegQamxlts GacbHBaldlebHdUg nigsreacutesQam

Rkelon eCIg nigEPntildekrbsGntildek

B sRmab Blood Pressure (smltaFQam) eKaledAsRmabmnusSPaKeRcInEdlmanCmparaWTwkenamEpyenkKWeR

kam 13080

smltaFQamxlts eFVI[ebHdUgrbsGntildekeFVIkarFparanNas

vaGacbNthornal[man

eraKKaMgebHdUg CmparaWdacsreacutesQam nigCmparaWRkelon

C sRmab Cholesterol (kUeLesthornrUl) eKaledA LDL sRmabmnusSPaKeRcInKWeRkam 100

eKaledA HDL sRmabmnusSPaKeRcInKWelI 40

LDL bcurren kUeLesthornrUl GaRkk GacbegaacuteIteLIgnigsTHORNHsreacutesQamrbsGntildek vaGac bNthornal[maneraKKaMgebHdUg

bcurrenCmparaWdacsreacutesQam HDL bcurrenkUeLesthornrUl lyen CYyykkUeLesthornrUlecjBIsreacutesQamrbsGntildek

1

viFankarTI 2 sup3 dwgBI CmparaWTwkenamEpyenmrbsGntildek

q Ask your health care team

q what your A1C Blood pressure

and cholesterol numbers are

q what your ABC numbers should

be

q what you need to do to reach

your targets

1

q cUrsaksYrRkumkargarE

fTaMsuxPaBrbsGntildek sup3

q faetIelx A1C smltaFQ

am

nigkUeLesthornrUlrbsGntildek

mankMritbunmicroan

q faetIelx ABC rbsGntildek

KYrEtmanbunmicroan

q faetIGntildekRtUvkareFVIG

VIedImIQaneTAdl

eKaledArbsGntildek

1

Step 3 Manage your diabetes

Many people avoid the long-term problems of diabetes by taking good care of themselves Work with your health care team to reach your ABC goals Use this self-care plan

bull Use your diabetes food plan If you do not have one ask your health care team for one

- Eat healthy foods such as fruits and vegetables fish lean meats chicken or turkey without the skin dry peas or beans whole grains and low-fat or skim milk and cheese

- Keep fish and lean meat and poultry portions to about 3 ounces (or the size of a pack of cards) Bake broil or grill it

- Eat foods that have less fat and salt

- Eat foods with more fiber such as whole-grain cereals breads crackers rice or pasta

1

EfrkSaCmparawTwkenamEpyenmrbsGntildek

mnu I u eth W para kenamEpmyrrau M Uuml oslash BkeK)anlsSCaeRcnecosptbBaaCmTw yen U eacuterM edayEfTaxnrbs Y yen

cU I V yRkmEfTasxPaBrbsGkedmQaneTAdleKaledAABCrbsGk reFkarCamY u M u ntilde I I ntilde

cUreRbIR)asEpnkarEfTaMedayxoslashUumlnEacutegenH

enHeT cUrsMuEpnkarenHBI RkumEfTaMsuxPaBrbsGntildek

- briePaKGaharmansuxPaBlyendUcCa EposlasheQI nigbEnoslash sacRtI

sac i oslash csacmanbsacman)aragedaymnmanEsk EdlmanCatxajti M i

sENthorn M thorn Uuml para FBaCatTagmlngTkedaHeKa k)aragbsENkstRKab Oslash i M U i w

nigQIsEdlmanCatixoslashajtic nigKmicroanCatiERkm

-bri I i oslash i i ePaKsacRt-sacEdlmanCatxajtc-ngsacmanRbmaN3 eGans_ notbcurrenTMhMebomYyRbGbbrvbar dut GaMg va

- briePaKGaharEdlmanCatixoslashaj nigCatieacuteRbtic

-bri oslash I i I I U Oslash i M UePaKGaharbEnEdlmanCvCateRcneRcndcCaRKabFBaCatTagml

nMbufrac12gcMNit nMeRkkxfrac12r )ay bcurren)asthorna

bulleRbIR)asEpnkarGaharsRmabCmparaWTwkenamEpyenmrbsGntildekRbsinebIGntildekminmanEpnkar

viFankarTI 3 sup3

curren

curren

17

bull Get 30 to 60 minutes of physical activity on most days of the week Brisk walking is a great way to move more

bull Stay at a healthy weight by making healthy food choices and moving more

bull Ask for help if you feel down A mental health counselor support group member of the clergy friend or family member will listen to your concerns and help you feel better

bull Learn to cope with stress Stress can raise your blood glucose While it is hard to remove stress from your life you can learn to handle it

bull Stop smoking Ask for help to quit

bull Take medicines even when you feel good Ask you doctor if you need aspirin to prevent a heart attack or stroke Tell your doctor if you cannot afford your medicine or if you have any side effects

1

bull sszligitenATmparanEdlmansuxPaBlyen edayeFVIkareRCIserIsGaharmansuxPaBlyen nigeFVIclna[kanEteRcIn

bull sMu[eKCYyRbsinebIGntildekmanGarmmicroN_TukccedilRBYy GntildekTIRbwkSasux

PaBposlashUacutevcitthorn RkumKaMRT smaCikbuBVCit mitthornPkthorni bcurrensmaCikRKYsarnwgsthornabkar)armOumlrbsGntildek ehIyCYyGntildek[manGarmmicroN_RbesIreLIg

bull eronedaHRsayPaBtantwgposlashUacutevcitthorn PaBtantwgposlashUacutevcitthorn GacbegaacuteInKoslashuacuteykUskntildeuacutegQam

rbsGntildek edaysarvaBi)akkntildeuacutegkarbM)atPaBtantwgposlashUacutevcitthornBICivit

rbsGntildek

GntildekGaceronRKbRKgva

bull QbBisa)arI cUresntildeIsMuCMnYybBaAumlbBisa)arI

bull TTYlTanfntildeaMeTaHbICaenAeBlGntildekmanGarmmicroN_lyenkfrac34eday

cUrsaksYrevCcentbNETHitrbs Gntildek faetIGntildekRtUvkarfntildeaMGasltIrIn edImITbsaacuteateraKKaMgebHdUgbcurrenCmparaWdacsreacutesQam

EdrbcurrenGt cUrR)abeTAevCcentbNETHitrbsGntildek RbsinebIGntildekminGaceacute

llkTijfntildeaMrbsGntildek

)an bcurrenRbsinebIGntildekmanplvi)akBIfntildeaMNamYy

bull hatR)aNBI 30 eTA 60 naTI[)aneRcIneacutefparakntildeuacutegmYys)athornh_ karedIrelOnsup2 KWCaviFIeFVIclna

dfrac34RbesIrmYy

1

bull Check your feet every day for cuts blisters r ed spots and swelling Call your health car e team right away about any sor es that wonrsquot go away

bull Brush your teeth and floss every day to avoid pr oblems with your mouth teeth or gums

bull Check your blood glucose Y ou may want to test it one or mor e times a day

bull Check your blood pressure If your doctor advises

bull Report any changes in your eyesight to your doctor

q Talk to your health care team

about your blood glucose targets

Ask how and when to test your

blood glucose and how to use the

results to manage your diabetes

q Use this plan as a guide to your

self-care

q Discuss how your self-care plan is

working for you each time you

visit your health care team

20

bullBinit uuml e C Ig r b s k C a e r o g r a l eacute f paraG ntilde E R k g m a n k a r m t d a c u B g E s k k n UumlTHORN l R k h m

ni I U frac12 THORN u M u ntilde oslash I W g e h m Tr s Be h A R k m k a r g a r E f T a sx P a B r b s Gk P a m R ) a b Bk a r Q c a b E d l

min)ateTAvij

U MG a t e F

mat eFmicroj nigGBacopyajeFmicrojrbsGntildek

bulldus e F microj r b s Gntildek n ig e R b IE x S k t s microj C a e r o g r a l eacute f parae d Im Ie c o s p ut b B a etha C a m Yy

bullBi i I oslashuacutent uuml e m l K y k s k ntildeuacuteg Q a m r b s U ntilde Gk R b E h l K r e F I times thorn gGk ntilde Y e t s thornV v a m

bcurreneRcIndg kntildeuacutegmYyeacutefpara

bullBinit uuml e m Il s m lta F Q a m r b s Gntildek R b s in e b Ie v C centb N ETHit r b s Gntildek E N n a M

bull raykarN_BIkarposlashasbthornUacuterkntildeuacutegEPntildekrbsGntildek eTAkanevCcentbNETHitrbsGntildek

q cUrBiPakSaCamYyRkum

kargarEfTaMsuxPaB

rbsGntildekBI eKaled

AKoslashuacuteykUs

kntildeuacutegQamrbsGntildek cUrs

aksYrfa etIeFVIets

thorntimesKoslashuacuteykUskntildeuacutegQam

rbsGntildekedayrebobN

a nigenAeBlNa nigfaet

IeRbIR)as

lTsectpledImIEfrkSa

CmparaWTwkenamEpyenmrbs

GntildekedayrebobNa

q cUrRbIR)asEpnkar

enHCaTisedAENnaMeTAkan

karEfTaM

xoslashUumlnEacutegpTHORNalrbsGntildek

q cUrBiPakSafaetIEpn

karEfTaMxoslashUumlnEacutegpTHORNal

rbsGntildek kMBugdMeN

Irkar

yagemcEdr erogr

aleBlEdlGntildekeTA

CYbRkumEfTaMsuxPaB

rbsGntildek

21

Step 4 Get routine care to avoid problems

See your health care team at least twice a year to find and treat problems early Discuss what steps you can take to reach your goals

At each visit get a bull blood pressure check bull foot check bull weight check bull review of your self-care plan shown in Step 3

Two times each year get an bull A1C testmdashIt may be checked more often if it is over 7

Once each year get a bull cholesterol test bull triglyceride (try-GLISS-er-ide) test- a type of blood fat bull complete foot exam bull dental exam to check teeth and gumsmdashtell your

dentist you have diabetes bull dilated eye exam to check for eye problems bull flu shot bull urine and a blood test to check for kidney problems

At least once get a bull pneumonia (nu-mo-nya) shot

22

CY u M xPaBrbsu Gky I uacute ntilde yqaedmrkemlngBuumla)albB ethbRkmEfTa ntilde B gm ntilde M I I I i aas agehacNas rdgk Y

[)anTan i I ntilde Y i Y I IeBlBPakSafaetGkGacTTlykvFankarNamyedmseRmc)aneKaledA

rbsGntildek

eBleTACYbmthorngsup2 cUr sup3

bull BinituumlsmltaFQam

bull BinituumleCIg bull BinituumlTmparan bullBi i M Uuml oslash alrbsGkeLgvjdc)anbgajkuacutentilde i IntuumlEpnkarEfTaxnEacutegpTHORN ntilde I i U eth gvFankarT3

BIrdgCaerogralqntildeaM cUr sup3

bull eFVIetsthorntimes A1C - GaceFVIjwkjabCagenH)an RbsinebIvaelIsBI 7

mthorngCaerogralqntildeaM cUr sup3

bull BinituumlkUeLesthornrUlI times K t) Y i aj gQamuacutebulleFetsV thorn triglyceride (RTI esrIoslash I -CaRbePTmyeacutenCatxoslash kntilde

bull karBinituumleCIgTaMgmUl bullkarBi i micro I I I micro i copy micro U micro ntildentuumleFjedmemleFjngGBaajeFj-crR)abeBTuumleFjrbsGkfa

GntildekmanCmparaWTwkenamEpyenm

bull BinituumlEPntildek edImIemIlbBaethaEPntildek bull cakfntildeaMkarBarRKunpthornasay bull eFVIetsthorntimesTwkenam nigQam edImIemIlbBaethaRkelon

yagehacNasmthorngmYyqntildeaM cUr sup3

bull cakfntildeaMkarBareraKrlaksYt notnUmUnIyabrvbar

viFankarTI 4 sup3 TTYlkarEfTaMCaRbcaM[eTogTatedImIecosputbBaetha

2

q Ask your health care team about

these and other tests you may

need Ask what your results

mean

qWrite down the date and time of

your next visit

q If you have Medicare ask your

health care team if Medicare

will cover some of the costs for

q learning about healthy eating

and diabetes self

care special shoes if you

need them

qmedical supplies

q diabetes medicines

2

qcUrsYrRkumEfT

aMsuxPaBrbs

GntildekGMBIkareFVIe

tsthorntimes TaMgenH

nigepSgeTot

EdlGntildekGacR

tUvkar cUrs

YrfaetI

lTsectplrbsG

ntildekmannfrac12yyag

dUcemthornc

q cUrktRtakal

briecaumlT nigeB

levlaeacutenkar

eTACYb

elIkeRkayrb

sGntildek

q RbsinebIGntildekm

an Medicare cUrsYrRkum

EfTaM

suxPaBrbsG

ntildekfa etI Medicare nwg

rabrg

cMNaymYycMnYns

Rmab

q sikSaGMBIkarb

riePaKEdlma

nsuxPaBlyen

nigEskeCIgB

iessEfTaMCmparaWT

wkenamEpyenm

xoslashUumlnEacuteg Rbs

inebIGntildekRtUvkar

q smOumlarsup3pAacutetpAacuteg

Buumla)al

q fntildeaMCmparaWTwkenam

Epyenm

2

__________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________

Notes

NATIONAL DIABETES EDUCATION PROGRAM wwwndepnihgov

2

CmparaWTwkenamEpyenmFparanFpararxoslashaMgNas

Gntilde oslash curren u i Y w W para mbfaCatsrkRbEhlGacFabBmnsSnyayfaBkeKmankarTakTgngCmEpyen curren i aacute

rbs Y lt i thorn genHeFI i W para kenamEpmmnEmnCaCmW para paraBkeKmanx bn M [K T yen i para n renaHeT s cBakuumlTa V tfaCm w F F

sM I i w U I W para kenamEpmFnFrNasEtGkGacEfrkSava)aniexcl denaHmnRtmRtveLyCmTw yen para para ntilde

mnusSTaMgGsEdlmanCmparaWTwkenamEpyenm RtUvEteFVIkareRCIserIsmethUacutebGahar

EdlmansuxPaBlyen rkSaTmparan[)anlyen nighatR)aNerograleacutefpara

karEfTaM Uuml oslash knntilde gCmW para w yen G ntilde w U yGY ntilde N_Rbesmicro IxnG i TkenamEpmrbs k)anRtmRtvGacC k[manGarm r

ehIyecosputBIbBaethasuxPaBEdlbNthornalmkBICmparaWTwkenamEpyenmdUcCa sup3

bull eraKKaMgebHdUg nigCmparaWdacsreacutesQam

bull bBaethaEPntildekEdlGaceFVI[manbBaethakntildeuacutegkaremIl bcurrenkoslashayeTACaxVakcxatsreacutesRbsaTEdlGacbNal[eacutedng)ateCgrbsGkQ oacutebsup2 bullxU thorn i I ntilde W esaacute

bcurren micro w lt sSmycnnRbEhlCaGac)atbg)ateCgbeCg manGarmN_skmnu Y M Y I curren I

bull bBaethaRkelon EdlGacbNthornal[RkelonrbsGntildekQbdMeNIrkar

bull CmparaWGBacopyajeFmicroj nig)atbgeFmicroj

When your blood glucose is close to normal you are likely to

bull have more energy bull be less tired and thirsty and urinate less often bull heal better and have fewer skin or bladder

infections bull have fewer problems with your eyesight skin feet

and gums

q Ask your health care team which

type of diabetes you have

q Learn why diabetes is serious

q Learn how caring for your diabetes

helps you feel better today and in

the future

10

enAeBlKykoslash U uacute ntilde ntilde w i micro ntilde micro _ Uuacute skgQamrbsGk enAEkrngkRmtFmta GkmanGarmNdcCa sup3

bull mankmoslashaMgCagmun bull minsUvGskmoslashaMg ehIyeRskTwk nigenamkanEttic bullCasHRbesI I I U curren ireLgehymankarxcEskbkarrlakRkBHenamkanEttc

bull GntildeknwgmanbBaethatictYccMeBaHEPntildek Esk eCIg nigGBacopyajeFmicroj

q cUrsaksYrRkumEfTaMsuxPa

BrbsGntildek faetIGntildek

manCmparaWTwkenamEpyenmRbePT

mYyNa

q sikSafaetIehtuGVICmparaWTwkena

mEpyenmman

eRKaHfntildeakxoslashaMg

q sikSafaetIkarEfTaMCmparaWTwke

namEpyenmrbsGntildek

CYyGntildek[manGarmmicroN_RbesIreLIgen

AeacutefparaenH

nigeTAeacutefparaeRkayeToteday

rebobNa

11

Step 2 Know your diabetes ABCs

Talk to you health care team about how to control your A1C Blood pressure and Cholesterol This can help lower your chances of having a heart attack stroke or other diabetes problem Herersquos what the ABCs of diabetes stand for

A for the A1C test (A-one-C) It shows you how your blood glucose has been over the last three months The A1C goal for most people is below 7

High blood glucose levels can harm your heart and blood vessels kidneys feet and eyes

B for Blood pressure The goal for most people with diabetes is below 13080

High blood pressure makes your heart work too hard It can cause heart attack stroke and kidney disease

C for Cholesterol The LDL goal for most people is below 100 The HDL goal for most people is above 40

LDL or ldquobadrdquo cholesterol can build up and clog your blood vessels It can cause a heart attack or a stroke HDL or ldquogoodrdquo cholesterol helps remove cholesterol from your blood vessels

12

ABCs

cU i Y u M u ntilde M I i I rBPakSaCamyRkmEfTasxPaBrbsGkGBvFRKbRKg A1C smlt i U thorn U aFQam ngkeLesrl

eFVIenHGacCYykatbnszligykMu[maneraKKaMgebHdUg dacsreacutesQam

bcurrenbBaethaCmparaWTwkenamEpyenm epSgeTotrbsGntildek xageRkamenHKWCaGtszlignfrac12yrbs ABCs eacutenCmparaWTwkenamEpyenm

A sRmabetsthorntimes A1C (eG-van-suI) vabgeth ntilde I uacute oslash skuacute ntilde I I lt ajGkfaetKykU ntilde Gk manekneL skgQamrbs gx

uacutentilde LgeBlbEx cugeRkayenHedayrebobemc eKaledA gkM uacute I

A1C sRmabmnusSPaKeRcInKW eRkam 7

kRmitKoslashuacuteykUskntildeuacutegQamxlts GacbHBaldlebHdUg nigsreacutesQam

Rkelon eCIg nigEPntildekrbsGntildek

B sRmab Blood Pressure (smltaFQam) eKaledAsRmabmnusSPaKeRcInEdlmanCmparaWTwkenamEpyenkKWeR

kam 13080

smltaFQamxlts eFVI[ebHdUgrbsGntildekeFVIkarFparanNas

vaGacbNthornal[man

eraKKaMgebHdUg CmparaWdacsreacutesQam nigCmparaWRkelon

C sRmab Cholesterol (kUeLesthornrUl) eKaledA LDL sRmabmnusSPaKeRcInKWeRkam 100

eKaledA HDL sRmabmnusSPaKeRcInKWelI 40

LDL bcurren kUeLesthornrUl GaRkk GacbegaacuteIteLIgnigsTHORNHsreacutesQamrbsGntildek vaGac bNthornal[maneraKKaMgebHdUg

bcurrenCmparaWdacsreacutesQam HDL bcurrenkUeLesthornrUl lyen CYyykkUeLesthornrUlecjBIsreacutesQamrbsGntildek

1

viFankarTI 2 sup3 dwgBI CmparaWTwkenamEpyenmrbsGntildek

q Ask your health care team

q what your A1C Blood pressure

and cholesterol numbers are

q what your ABC numbers should

be

q what you need to do to reach

your targets

1

q cUrsaksYrRkumkargarE

fTaMsuxPaBrbsGntildek sup3

q faetIelx A1C smltaFQ

am

nigkUeLesthornrUlrbsGntildek

mankMritbunmicroan

q faetIelx ABC rbsGntildek

KYrEtmanbunmicroan

q faetIGntildekRtUvkareFVIG

VIedImIQaneTAdl

eKaledArbsGntildek

1

Step 3 Manage your diabetes

Many people avoid the long-term problems of diabetes by taking good care of themselves Work with your health care team to reach your ABC goals Use this self-care plan

bull Use your diabetes food plan If you do not have one ask your health care team for one

- Eat healthy foods such as fruits and vegetables fish lean meats chicken or turkey without the skin dry peas or beans whole grains and low-fat or skim milk and cheese

- Keep fish and lean meat and poultry portions to about 3 ounces (or the size of a pack of cards) Bake broil or grill it

- Eat foods that have less fat and salt

- Eat foods with more fiber such as whole-grain cereals breads crackers rice or pasta

1

EfrkSaCmparawTwkenamEpyenmrbsGntildek

mnu I u eth W para kenamEpmyrrau M Uuml oslash BkeK)anlsSCaeRcnecosptbBaaCmTw yen U eacuterM edayEfTaxnrbs Y yen

cU I V yRkmEfTasxPaBrbsGkedmQaneTAdleKaledAABCrbsGk reFkarCamY u M u ntilde I I ntilde

cUreRbIR)asEpnkarEfTaMedayxoslashUumlnEacutegenH

enHeT cUrsMuEpnkarenHBI RkumEfTaMsuxPaBrbsGntildek

- briePaKGaharmansuxPaBlyendUcCa EposlasheQI nigbEnoslash sacRtI

sac i oslash csacmanbsacman)aragedaymnmanEsk EdlmanCatxajti M i

sENthorn M thorn Uuml para FBaCatTagmlngTkedaHeKa k)aragbsENkstRKab Oslash i M U i w

nigQIsEdlmanCatixoslashajtic nigKmicroanCatiERkm

-bri I i oslash i i ePaKsacRt-sacEdlmanCatxajtc-ngsacmanRbmaN3 eGans_ notbcurrenTMhMebomYyRbGbbrvbar dut GaMg va

- briePaKGaharEdlmanCatixoslashaj nigCatieacuteRbtic

-bri oslash I i I I U Oslash i M UePaKGaharbEnEdlmanCvCateRcneRcndcCaRKabFBaCatTagml

nMbufrac12gcMNit nMeRkkxfrac12r )ay bcurren)asthorna

bulleRbIR)asEpnkarGaharsRmabCmparaWTwkenamEpyenmrbsGntildekRbsinebIGntildekminmanEpnkar

viFankarTI 3 sup3

curren

curren

17

bull Get 30 to 60 minutes of physical activity on most days of the week Brisk walking is a great way to move more

bull Stay at a healthy weight by making healthy food choices and moving more

bull Ask for help if you feel down A mental health counselor support group member of the clergy friend or family member will listen to your concerns and help you feel better

bull Learn to cope with stress Stress can raise your blood glucose While it is hard to remove stress from your life you can learn to handle it

bull Stop smoking Ask for help to quit

bull Take medicines even when you feel good Ask you doctor if you need aspirin to prevent a heart attack or stroke Tell your doctor if you cannot afford your medicine or if you have any side effects

1

bull sszligitenATmparanEdlmansuxPaBlyen edayeFVIkareRCIserIsGaharmansuxPaBlyen nigeFVIclna[kanEteRcIn

bull sMu[eKCYyRbsinebIGntildekmanGarmmicroN_TukccedilRBYy GntildekTIRbwkSasux

PaBposlashUacutevcitthorn RkumKaMRT smaCikbuBVCit mitthornPkthorni bcurrensmaCikRKYsarnwgsthornabkar)armOumlrbsGntildek ehIyCYyGntildek[manGarmmicroN_RbesIreLIg

bull eronedaHRsayPaBtantwgposlashUacutevcitthorn PaBtantwgposlashUacutevcitthorn GacbegaacuteInKoslashuacuteykUskntildeuacutegQam

rbsGntildek edaysarvaBi)akkntildeuacutegkarbM)atPaBtantwgposlashUacutevcitthornBICivit

rbsGntildek

GntildekGaceronRKbRKgva

bull QbBisa)arI cUresntildeIsMuCMnYybBaAumlbBisa)arI

bull TTYlTanfntildeaMeTaHbICaenAeBlGntildekmanGarmmicroN_lyenkfrac34eday

cUrsaksYrevCcentbNETHitrbs Gntildek faetIGntildekRtUvkarfntildeaMGasltIrIn edImITbsaacuteateraKKaMgebHdUgbcurrenCmparaWdacsreacutesQam

EdrbcurrenGt cUrR)abeTAevCcentbNETHitrbsGntildek RbsinebIGntildekminGaceacute

llkTijfntildeaMrbsGntildek

)an bcurrenRbsinebIGntildekmanplvi)akBIfntildeaMNamYy

bull hatR)aNBI 30 eTA 60 naTI[)aneRcIneacutefparakntildeuacutegmYys)athornh_ karedIrelOnsup2 KWCaviFIeFVIclna

dfrac34RbesIrmYy

1

bull Check your feet every day for cuts blisters r ed spots and swelling Call your health car e team right away about any sor es that wonrsquot go away

bull Brush your teeth and floss every day to avoid pr oblems with your mouth teeth or gums

bull Check your blood glucose Y ou may want to test it one or mor e times a day

bull Check your blood pressure If your doctor advises

bull Report any changes in your eyesight to your doctor

q Talk to your health care team

about your blood glucose targets

Ask how and when to test your

blood glucose and how to use the

results to manage your diabetes

q Use this plan as a guide to your

self-care

q Discuss how your self-care plan is

working for you each time you

visit your health care team

20

bullBinit uuml e C Ig r b s k C a e r o g r a l eacute f paraG ntilde E R k g m a n k a r m t d a c u B g E s k k n UumlTHORN l R k h m

ni I U frac12 THORN u M u ntilde oslash I W g e h m Tr s Be h A R k m k a r g a r E f T a sx P a B r b s Gk P a m R ) a b Bk a r Q c a b E d l

min)ateTAvij

U MG a t e F

mat eFmicroj nigGBacopyajeFmicrojrbsGntildek

bulldus e F microj r b s Gntildek n ig e R b IE x S k t s microj C a e r o g r a l eacute f parae d Im Ie c o s p ut b B a etha C a m Yy

bullBi i I oslashuacutent uuml e m l K y k s k ntildeuacuteg Q a m r b s U ntilde Gk R b E h l K r e F I times thorn gGk ntilde Y e t s thornV v a m

bcurreneRcIndg kntildeuacutegmYyeacutefpara

bullBinit uuml e m Il s m lta F Q a m r b s Gntildek R b s in e b Ie v C centb N ETHit r b s Gntildek E N n a M

bull raykarN_BIkarposlashasbthornUacuterkntildeuacutegEPntildekrbsGntildek eTAkanevCcentbNETHitrbsGntildek

q cUrBiPakSaCamYyRkum

kargarEfTaMsuxPaB

rbsGntildekBI eKaled

AKoslashuacuteykUs

kntildeuacutegQamrbsGntildek cUrs

aksYrfa etIeFVIets

thorntimesKoslashuacuteykUskntildeuacutegQam

rbsGntildekedayrebobN

a nigenAeBlNa nigfaet

IeRbIR)as

lTsectpledImIEfrkSa

CmparaWTwkenamEpyenmrbs

GntildekedayrebobNa

q cUrRbIR)asEpnkar

enHCaTisedAENnaMeTAkan

karEfTaM

xoslashUumlnEacutegpTHORNalrbsGntildek

q cUrBiPakSafaetIEpn

karEfTaMxoslashUumlnEacutegpTHORNal

rbsGntildek kMBugdMeN

Irkar

yagemcEdr erogr

aleBlEdlGntildekeTA

CYbRkumEfTaMsuxPaB

rbsGntildek

21

Step 4 Get routine care to avoid problems

See your health care team at least twice a year to find and treat problems early Discuss what steps you can take to reach your goals

At each visit get a bull blood pressure check bull foot check bull weight check bull review of your self-care plan shown in Step 3

Two times each year get an bull A1C testmdashIt may be checked more often if it is over 7

Once each year get a bull cholesterol test bull triglyceride (try-GLISS-er-ide) test- a type of blood fat bull complete foot exam bull dental exam to check teeth and gumsmdashtell your

dentist you have diabetes bull dilated eye exam to check for eye problems bull flu shot bull urine and a blood test to check for kidney problems

At least once get a bull pneumonia (nu-mo-nya) shot

22

CY u M xPaBrbsu Gky I uacute ntilde yqaedmrkemlngBuumla)albB ethbRkmEfTa ntilde B gm ntilde M I I I i aas agehacNas rdgk Y

[)anTan i I ntilde Y i Y I IeBlBPakSafaetGkGacTTlykvFankarNamyedmseRmc)aneKaledA

rbsGntildek

eBleTACYbmthorngsup2 cUr sup3

bull BinituumlsmltaFQam

bull BinituumleCIg bull BinituumlTmparan bullBi i M Uuml oslash alrbsGkeLgvjdc)anbgajkuacutentilde i IntuumlEpnkarEfTaxnEacutegpTHORN ntilde I i U eth gvFankarT3

BIrdgCaerogralqntildeaM cUr sup3

bull eFVIetsthorntimes A1C - GaceFVIjwkjabCagenH)an RbsinebIvaelIsBI 7

mthorngCaerogralqntildeaM cUr sup3

bull BinituumlkUeLesthornrUlI times K t) Y i aj gQamuacutebulleFetsV thorn triglyceride (RTI esrIoslash I -CaRbePTmyeacutenCatxoslash kntilde

bull karBinituumleCIgTaMgmUl bullkarBi i micro I I I micro i copy micro U micro ntildentuumleFjedmemleFjngGBaajeFj-crR)abeBTuumleFjrbsGkfa

GntildekmanCmparaWTwkenamEpyenm

bull BinituumlEPntildek edImIemIlbBaethaEPntildek bull cakfntildeaMkarBarRKunpthornasay bull eFVIetsthorntimesTwkenam nigQam edImIemIlbBaethaRkelon

yagehacNasmthorngmYyqntildeaM cUr sup3

bull cakfntildeaMkarBareraKrlaksYt notnUmUnIyabrvbar

viFankarTI 4 sup3 TTYlkarEfTaMCaRbcaM[eTogTatedImIecosputbBaetha

2

q Ask your health care team about

these and other tests you may

need Ask what your results

mean

qWrite down the date and time of

your next visit

q If you have Medicare ask your

health care team if Medicare

will cover some of the costs for

q learning about healthy eating

and diabetes self

care special shoes if you

need them

qmedical supplies

q diabetes medicines

2

qcUrsYrRkumEfT

aMsuxPaBrbs

GntildekGMBIkareFVIe

tsthorntimes TaMgenH

nigepSgeTot

EdlGntildekGacR

tUvkar cUrs

YrfaetI

lTsectplrbsG

ntildekmannfrac12yyag

dUcemthornc

q cUrktRtakal

briecaumlT nigeB

levlaeacutenkar

eTACYb

elIkeRkayrb

sGntildek

q RbsinebIGntildekm

an Medicare cUrsYrRkum

EfTaM

suxPaBrbsG

ntildekfa etI Medicare nwg

rabrg

cMNaymYycMnYns

Rmab

q sikSaGMBIkarb

riePaKEdlma

nsuxPaBlyen

nigEskeCIgB

iessEfTaMCmparaWT

wkenamEpyenm

xoslashUumlnEacuteg Rbs

inebIGntildekRtUvkar

q smOumlarsup3pAacutetpAacuteg

Buumla)al

q fntildeaMCmparaWTwkenam

Epyenm

2

__________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________

Notes

NATIONAL DIABETES EDUCATION PROGRAM wwwndepnihgov

2

When your blood glucose is close to normal you are likely to

bull have more energy bull be less tired and thirsty and urinate less often bull heal better and have fewer skin or bladder

infections bull have fewer problems with your eyesight skin feet

and gums

q Ask your health care team which

type of diabetes you have

q Learn why diabetes is serious

q Learn how caring for your diabetes

helps you feel better today and in

the future

10

enAeBlKykoslash U uacute ntilde ntilde w i micro ntilde micro _ Uuacute skgQamrbsGk enAEkrngkRmtFmta GkmanGarmNdcCa sup3

bull mankmoslashaMgCagmun bull minsUvGskmoslashaMg ehIyeRskTwk nigenamkanEttic bullCasHRbesI I I U curren ireLgehymankarxcEskbkarrlakRkBHenamkanEttc

bull GntildeknwgmanbBaethatictYccMeBaHEPntildek Esk eCIg nigGBacopyajeFmicroj

q cUrsaksYrRkumEfTaMsuxPa

BrbsGntildek faetIGntildek

manCmparaWTwkenamEpyenmRbePT

mYyNa

q sikSafaetIehtuGVICmparaWTwkena

mEpyenmman

eRKaHfntildeakxoslashaMg

q sikSafaetIkarEfTaMCmparaWTwke

namEpyenmrbsGntildek

CYyGntildek[manGarmmicroN_RbesIreLIgen

AeacutefparaenH

nigeTAeacutefparaeRkayeToteday

rebobNa

11

Step 2 Know your diabetes ABCs

Talk to you health care team about how to control your A1C Blood pressure and Cholesterol This can help lower your chances of having a heart attack stroke or other diabetes problem Herersquos what the ABCs of diabetes stand for

A for the A1C test (A-one-C) It shows you how your blood glucose has been over the last three months The A1C goal for most people is below 7

High blood glucose levels can harm your heart and blood vessels kidneys feet and eyes

B for Blood pressure The goal for most people with diabetes is below 13080

High blood pressure makes your heart work too hard It can cause heart attack stroke and kidney disease

C for Cholesterol The LDL goal for most people is below 100 The HDL goal for most people is above 40

LDL or ldquobadrdquo cholesterol can build up and clog your blood vessels It can cause a heart attack or a stroke HDL or ldquogoodrdquo cholesterol helps remove cholesterol from your blood vessels

12

ABCs

cU i Y u M u ntilde M I i I rBPakSaCamyRkmEfTasxPaBrbsGkGBvFRKbRKg A1C smlt i U thorn U aFQam ngkeLesrl

eFVIenHGacCYykatbnszligykMu[maneraKKaMgebHdUg dacsreacutesQam

bcurrenbBaethaCmparaWTwkenamEpyenm epSgeTotrbsGntildek xageRkamenHKWCaGtszlignfrac12yrbs ABCs eacutenCmparaWTwkenamEpyenm

A sRmabetsthorntimes A1C (eG-van-suI) vabgeth ntilde I uacute oslash skuacute ntilde I I lt ajGkfaetKykU ntilde Gk manekneL skgQamrbs gx

uacutentilde LgeBlbEx cugeRkayenHedayrebobemc eKaledA gkM uacute I

A1C sRmabmnusSPaKeRcInKW eRkam 7

kRmitKoslashuacuteykUskntildeuacutegQamxlts GacbHBaldlebHdUg nigsreacutesQam

Rkelon eCIg nigEPntildekrbsGntildek

B sRmab Blood Pressure (smltaFQam) eKaledAsRmabmnusSPaKeRcInEdlmanCmparaWTwkenamEpyenkKWeR

kam 13080

smltaFQamxlts eFVI[ebHdUgrbsGntildekeFVIkarFparanNas

vaGacbNthornal[man

eraKKaMgebHdUg CmparaWdacsreacutesQam nigCmparaWRkelon

C sRmab Cholesterol (kUeLesthornrUl) eKaledA LDL sRmabmnusSPaKeRcInKWeRkam 100

eKaledA HDL sRmabmnusSPaKeRcInKWelI 40

LDL bcurren kUeLesthornrUl GaRkk GacbegaacuteIteLIgnigsTHORNHsreacutesQamrbsGntildek vaGac bNthornal[maneraKKaMgebHdUg

bcurrenCmparaWdacsreacutesQam HDL bcurrenkUeLesthornrUl lyen CYyykkUeLesthornrUlecjBIsreacutesQamrbsGntildek

1

viFankarTI 2 sup3 dwgBI CmparaWTwkenamEpyenmrbsGntildek

q Ask your health care team

q what your A1C Blood pressure

and cholesterol numbers are

q what your ABC numbers should

be

q what you need to do to reach

your targets

1

q cUrsaksYrRkumkargarE

fTaMsuxPaBrbsGntildek sup3

q faetIelx A1C smltaFQ

am

nigkUeLesthornrUlrbsGntildek

mankMritbunmicroan

q faetIelx ABC rbsGntildek

KYrEtmanbunmicroan

q faetIGntildekRtUvkareFVIG

VIedImIQaneTAdl

eKaledArbsGntildek

1

Step 3 Manage your diabetes

Many people avoid the long-term problems of diabetes by taking good care of themselves Work with your health care team to reach your ABC goals Use this self-care plan

bull Use your diabetes food plan If you do not have one ask your health care team for one

- Eat healthy foods such as fruits and vegetables fish lean meats chicken or turkey without the skin dry peas or beans whole grains and low-fat or skim milk and cheese

- Keep fish and lean meat and poultry portions to about 3 ounces (or the size of a pack of cards) Bake broil or grill it

- Eat foods that have less fat and salt

- Eat foods with more fiber such as whole-grain cereals breads crackers rice or pasta

1

EfrkSaCmparawTwkenamEpyenmrbsGntildek

mnu I u eth W para kenamEpmyrrau M Uuml oslash BkeK)anlsSCaeRcnecosptbBaaCmTw yen U eacuterM edayEfTaxnrbs Y yen

cU I V yRkmEfTasxPaBrbsGkedmQaneTAdleKaledAABCrbsGk reFkarCamY u M u ntilde I I ntilde

cUreRbIR)asEpnkarEfTaMedayxoslashUumlnEacutegenH

enHeT cUrsMuEpnkarenHBI RkumEfTaMsuxPaBrbsGntildek

- briePaKGaharmansuxPaBlyendUcCa EposlasheQI nigbEnoslash sacRtI

sac i oslash csacmanbsacman)aragedaymnmanEsk EdlmanCatxajti M i

sENthorn M thorn Uuml para FBaCatTagmlngTkedaHeKa k)aragbsENkstRKab Oslash i M U i w

nigQIsEdlmanCatixoslashajtic nigKmicroanCatiERkm

-bri I i oslash i i ePaKsacRt-sacEdlmanCatxajtc-ngsacmanRbmaN3 eGans_ notbcurrenTMhMebomYyRbGbbrvbar dut GaMg va

- briePaKGaharEdlmanCatixoslashaj nigCatieacuteRbtic

-bri oslash I i I I U Oslash i M UePaKGaharbEnEdlmanCvCateRcneRcndcCaRKabFBaCatTagml

nMbufrac12gcMNit nMeRkkxfrac12r )ay bcurren)asthorna

bulleRbIR)asEpnkarGaharsRmabCmparaWTwkenamEpyenmrbsGntildekRbsinebIGntildekminmanEpnkar

viFankarTI 3 sup3

curren

curren

17

bull Get 30 to 60 minutes of physical activity on most days of the week Brisk walking is a great way to move more

bull Stay at a healthy weight by making healthy food choices and moving more

bull Ask for help if you feel down A mental health counselor support group member of the clergy friend or family member will listen to your concerns and help you feel better

bull Learn to cope with stress Stress can raise your blood glucose While it is hard to remove stress from your life you can learn to handle it

bull Stop smoking Ask for help to quit

bull Take medicines even when you feel good Ask you doctor if you need aspirin to prevent a heart attack or stroke Tell your doctor if you cannot afford your medicine or if you have any side effects

1

bull sszligitenATmparanEdlmansuxPaBlyen edayeFVIkareRCIserIsGaharmansuxPaBlyen nigeFVIclna[kanEteRcIn

bull sMu[eKCYyRbsinebIGntildekmanGarmmicroN_TukccedilRBYy GntildekTIRbwkSasux

PaBposlashUacutevcitthorn RkumKaMRT smaCikbuBVCit mitthornPkthorni bcurrensmaCikRKYsarnwgsthornabkar)armOumlrbsGntildek ehIyCYyGntildek[manGarmmicroN_RbesIreLIg

bull eronedaHRsayPaBtantwgposlashUacutevcitthorn PaBtantwgposlashUacutevcitthorn GacbegaacuteInKoslashuacuteykUskntildeuacutegQam

rbsGntildek edaysarvaBi)akkntildeuacutegkarbM)atPaBtantwgposlashUacutevcitthornBICivit

rbsGntildek

GntildekGaceronRKbRKgva

bull QbBisa)arI cUresntildeIsMuCMnYybBaAumlbBisa)arI

bull TTYlTanfntildeaMeTaHbICaenAeBlGntildekmanGarmmicroN_lyenkfrac34eday

cUrsaksYrevCcentbNETHitrbs Gntildek faetIGntildekRtUvkarfntildeaMGasltIrIn edImITbsaacuteateraKKaMgebHdUgbcurrenCmparaWdacsreacutesQam

EdrbcurrenGt cUrR)abeTAevCcentbNETHitrbsGntildek RbsinebIGntildekminGaceacute

llkTijfntildeaMrbsGntildek

)an bcurrenRbsinebIGntildekmanplvi)akBIfntildeaMNamYy

bull hatR)aNBI 30 eTA 60 naTI[)aneRcIneacutefparakntildeuacutegmYys)athornh_ karedIrelOnsup2 KWCaviFIeFVIclna

dfrac34RbesIrmYy

1

bull Check your feet every day for cuts blisters r ed spots and swelling Call your health car e team right away about any sor es that wonrsquot go away

bull Brush your teeth and floss every day to avoid pr oblems with your mouth teeth or gums

bull Check your blood glucose Y ou may want to test it one or mor e times a day

bull Check your blood pressure If your doctor advises

bull Report any changes in your eyesight to your doctor

q Talk to your health care team

about your blood glucose targets

Ask how and when to test your

blood glucose and how to use the

results to manage your diabetes

q Use this plan as a guide to your

self-care

q Discuss how your self-care plan is

working for you each time you

visit your health care team

20

bullBinit uuml e C Ig r b s k C a e r o g r a l eacute f paraG ntilde E R k g m a n k a r m t d a c u B g E s k k n UumlTHORN l R k h m

ni I U frac12 THORN u M u ntilde oslash I W g e h m Tr s Be h A R k m k a r g a r E f T a sx P a B r b s Gk P a m R ) a b Bk a r Q c a b E d l

min)ateTAvij

U MG a t e F

mat eFmicroj nigGBacopyajeFmicrojrbsGntildek

bulldus e F microj r b s Gntildek n ig e R b IE x S k t s microj C a e r o g r a l eacute f parae d Im Ie c o s p ut b B a etha C a m Yy

bullBi i I oslashuacutent uuml e m l K y k s k ntildeuacuteg Q a m r b s U ntilde Gk R b E h l K r e F I times thorn gGk ntilde Y e t s thornV v a m

bcurreneRcIndg kntildeuacutegmYyeacutefpara

bullBinit uuml e m Il s m lta F Q a m r b s Gntildek R b s in e b Ie v C centb N ETHit r b s Gntildek E N n a M

bull raykarN_BIkarposlashasbthornUacuterkntildeuacutegEPntildekrbsGntildek eTAkanevCcentbNETHitrbsGntildek

q cUrBiPakSaCamYyRkum

kargarEfTaMsuxPaB

rbsGntildekBI eKaled

AKoslashuacuteykUs

kntildeuacutegQamrbsGntildek cUrs

aksYrfa etIeFVIets

thorntimesKoslashuacuteykUskntildeuacutegQam

rbsGntildekedayrebobN

a nigenAeBlNa nigfaet

IeRbIR)as

lTsectpledImIEfrkSa

CmparaWTwkenamEpyenmrbs

GntildekedayrebobNa

q cUrRbIR)asEpnkar

enHCaTisedAENnaMeTAkan

karEfTaM

xoslashUumlnEacutegpTHORNalrbsGntildek

q cUrBiPakSafaetIEpn

karEfTaMxoslashUumlnEacutegpTHORNal

rbsGntildek kMBugdMeN

Irkar

yagemcEdr erogr

aleBlEdlGntildekeTA

CYbRkumEfTaMsuxPaB

rbsGntildek

21

Step 4 Get routine care to avoid problems

See your health care team at least twice a year to find and treat problems early Discuss what steps you can take to reach your goals

At each visit get a bull blood pressure check bull foot check bull weight check bull review of your self-care plan shown in Step 3

Two times each year get an bull A1C testmdashIt may be checked more often if it is over 7

Once each year get a bull cholesterol test bull triglyceride (try-GLISS-er-ide) test- a type of blood fat bull complete foot exam bull dental exam to check teeth and gumsmdashtell your

dentist you have diabetes bull dilated eye exam to check for eye problems bull flu shot bull urine and a blood test to check for kidney problems

At least once get a bull pneumonia (nu-mo-nya) shot

22

CY u M xPaBrbsu Gky I uacute ntilde yqaedmrkemlngBuumla)albB ethbRkmEfTa ntilde B gm ntilde M I I I i aas agehacNas rdgk Y

[)anTan i I ntilde Y i Y I IeBlBPakSafaetGkGacTTlykvFankarNamyedmseRmc)aneKaledA

rbsGntildek

eBleTACYbmthorngsup2 cUr sup3

bull BinituumlsmltaFQam

bull BinituumleCIg bull BinituumlTmparan bullBi i M Uuml oslash alrbsGkeLgvjdc)anbgajkuacutentilde i IntuumlEpnkarEfTaxnEacutegpTHORN ntilde I i U eth gvFankarT3

BIrdgCaerogralqntildeaM cUr sup3

bull eFVIetsthorntimes A1C - GaceFVIjwkjabCagenH)an RbsinebIvaelIsBI 7

mthorngCaerogralqntildeaM cUr sup3

bull BinituumlkUeLesthornrUlI times K t) Y i aj gQamuacutebulleFetsV thorn triglyceride (RTI esrIoslash I -CaRbePTmyeacutenCatxoslash kntilde

bull karBinituumleCIgTaMgmUl bullkarBi i micro I I I micro i copy micro U micro ntildentuumleFjedmemleFjngGBaajeFj-crR)abeBTuumleFjrbsGkfa

GntildekmanCmparaWTwkenamEpyenm

bull BinituumlEPntildek edImIemIlbBaethaEPntildek bull cakfntildeaMkarBarRKunpthornasay bull eFVIetsthorntimesTwkenam nigQam edImIemIlbBaethaRkelon

yagehacNasmthorngmYyqntildeaM cUr sup3

bull cakfntildeaMkarBareraKrlaksYt notnUmUnIyabrvbar

viFankarTI 4 sup3 TTYlkarEfTaMCaRbcaM[eTogTatedImIecosputbBaetha

2

q Ask your health care team about

these and other tests you may

need Ask what your results

mean

qWrite down the date and time of

your next visit

q If you have Medicare ask your

health care team if Medicare

will cover some of the costs for

q learning about healthy eating

and diabetes self

care special shoes if you

need them

qmedical supplies

q diabetes medicines

2

qcUrsYrRkumEfT

aMsuxPaBrbs

GntildekGMBIkareFVIe

tsthorntimes TaMgenH

nigepSgeTot

EdlGntildekGacR

tUvkar cUrs

YrfaetI

lTsectplrbsG

ntildekmannfrac12yyag

dUcemthornc

q cUrktRtakal

briecaumlT nigeB

levlaeacutenkar

eTACYb

elIkeRkayrb

sGntildek

q RbsinebIGntildekm

an Medicare cUrsYrRkum

EfTaM

suxPaBrbsG

ntildekfa etI Medicare nwg

rabrg

cMNaymYycMnYns

Rmab

q sikSaGMBIkarb

riePaKEdlma

nsuxPaBlyen

nigEskeCIgB

iessEfTaMCmparaWT

wkenamEpyenm

xoslashUumlnEacuteg Rbs

inebIGntildekRtUvkar

q smOumlarsup3pAacutetpAacuteg

Buumla)al

q fntildeaMCmparaWTwkenam

Epyenm

2

__________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________

Notes

NATIONAL DIABETES EDUCATION PROGRAM wwwndepnihgov

2

enAeBlKykoslash U uacute ntilde ntilde w i micro ntilde micro _ Uuacute skgQamrbsGk enAEkrngkRmtFmta GkmanGarmNdcCa sup3

bull mankmoslashaMgCagmun bull minsUvGskmoslashaMg ehIyeRskTwk nigenamkanEttic bullCasHRbesI I I U curren ireLgehymankarxcEskbkarrlakRkBHenamkanEttc

bull GntildeknwgmanbBaethatictYccMeBaHEPntildek Esk eCIg nigGBacopyajeFmicroj

q cUrsaksYrRkumEfTaMsuxPa

BrbsGntildek faetIGntildek

manCmparaWTwkenamEpyenmRbePT

mYyNa

q sikSafaetIehtuGVICmparaWTwkena

mEpyenmman

eRKaHfntildeakxoslashaMg

q sikSafaetIkarEfTaMCmparaWTwke

namEpyenmrbsGntildek

CYyGntildek[manGarmmicroN_RbesIreLIgen

AeacutefparaenH

nigeTAeacutefparaeRkayeToteday

rebobNa

11

Step 2 Know your diabetes ABCs

Talk to you health care team about how to control your A1C Blood pressure and Cholesterol This can help lower your chances of having a heart attack stroke or other diabetes problem Herersquos what the ABCs of diabetes stand for

A for the A1C test (A-one-C) It shows you how your blood glucose has been over the last three months The A1C goal for most people is below 7

High blood glucose levels can harm your heart and blood vessels kidneys feet and eyes

B for Blood pressure The goal for most people with diabetes is below 13080

High blood pressure makes your heart work too hard It can cause heart attack stroke and kidney disease

C for Cholesterol The LDL goal for most people is below 100 The HDL goal for most people is above 40

LDL or ldquobadrdquo cholesterol can build up and clog your blood vessels It can cause a heart attack or a stroke HDL or ldquogoodrdquo cholesterol helps remove cholesterol from your blood vessels

12

ABCs

cU i Y u M u ntilde M I i I rBPakSaCamyRkmEfTasxPaBrbsGkGBvFRKbRKg A1C smlt i U thorn U aFQam ngkeLesrl

eFVIenHGacCYykatbnszligykMu[maneraKKaMgebHdUg dacsreacutesQam

bcurrenbBaethaCmparaWTwkenamEpyenm epSgeTotrbsGntildek xageRkamenHKWCaGtszlignfrac12yrbs ABCs eacutenCmparaWTwkenamEpyenm

A sRmabetsthorntimes A1C (eG-van-suI) vabgeth ntilde I uacute oslash skuacute ntilde I I lt ajGkfaetKykU ntilde Gk manekneL skgQamrbs gx

uacutentilde LgeBlbEx cugeRkayenHedayrebobemc eKaledA gkM uacute I

A1C sRmabmnusSPaKeRcInKW eRkam 7

kRmitKoslashuacuteykUskntildeuacutegQamxlts GacbHBaldlebHdUg nigsreacutesQam

Rkelon eCIg nigEPntildekrbsGntildek

B sRmab Blood Pressure (smltaFQam) eKaledAsRmabmnusSPaKeRcInEdlmanCmparaWTwkenamEpyenkKWeR

kam 13080

smltaFQamxlts eFVI[ebHdUgrbsGntildekeFVIkarFparanNas

vaGacbNthornal[man

eraKKaMgebHdUg CmparaWdacsreacutesQam nigCmparaWRkelon

C sRmab Cholesterol (kUeLesthornrUl) eKaledA LDL sRmabmnusSPaKeRcInKWeRkam 100

eKaledA HDL sRmabmnusSPaKeRcInKWelI 40

LDL bcurren kUeLesthornrUl GaRkk GacbegaacuteIteLIgnigsTHORNHsreacutesQamrbsGntildek vaGac bNthornal[maneraKKaMgebHdUg

bcurrenCmparaWdacsreacutesQam HDL bcurrenkUeLesthornrUl lyen CYyykkUeLesthornrUlecjBIsreacutesQamrbsGntildek

1

viFankarTI 2 sup3 dwgBI CmparaWTwkenamEpyenmrbsGntildek

q Ask your health care team

q what your A1C Blood pressure

and cholesterol numbers are

q what your ABC numbers should

be

q what you need to do to reach

your targets

1

q cUrsaksYrRkumkargarE

fTaMsuxPaBrbsGntildek sup3

q faetIelx A1C smltaFQ

am

nigkUeLesthornrUlrbsGntildek

mankMritbunmicroan

q faetIelx ABC rbsGntildek

KYrEtmanbunmicroan

q faetIGntildekRtUvkareFVIG

VIedImIQaneTAdl

eKaledArbsGntildek

1

Step 3 Manage your diabetes

Many people avoid the long-term problems of diabetes by taking good care of themselves Work with your health care team to reach your ABC goals Use this self-care plan

bull Use your diabetes food plan If you do not have one ask your health care team for one

- Eat healthy foods such as fruits and vegetables fish lean meats chicken or turkey without the skin dry peas or beans whole grains and low-fat or skim milk and cheese

- Keep fish and lean meat and poultry portions to about 3 ounces (or the size of a pack of cards) Bake broil or grill it

- Eat foods that have less fat and salt

- Eat foods with more fiber such as whole-grain cereals breads crackers rice or pasta

1

EfrkSaCmparawTwkenamEpyenmrbsGntildek

mnu I u eth W para kenamEpmyrrau M Uuml oslash BkeK)anlsSCaeRcnecosptbBaaCmTw yen U eacuterM edayEfTaxnrbs Y yen

cU I V yRkmEfTasxPaBrbsGkedmQaneTAdleKaledAABCrbsGk reFkarCamY u M u ntilde I I ntilde

cUreRbIR)asEpnkarEfTaMedayxoslashUumlnEacutegenH

enHeT cUrsMuEpnkarenHBI RkumEfTaMsuxPaBrbsGntildek

- briePaKGaharmansuxPaBlyendUcCa EposlasheQI nigbEnoslash sacRtI

sac i oslash csacmanbsacman)aragedaymnmanEsk EdlmanCatxajti M i

sENthorn M thorn Uuml para FBaCatTagmlngTkedaHeKa k)aragbsENkstRKab Oslash i M U i w

nigQIsEdlmanCatixoslashajtic nigKmicroanCatiERkm

-bri I i oslash i i ePaKsacRt-sacEdlmanCatxajtc-ngsacmanRbmaN3 eGans_ notbcurrenTMhMebomYyRbGbbrvbar dut GaMg va

- briePaKGaharEdlmanCatixoslashaj nigCatieacuteRbtic

-bri oslash I i I I U Oslash i M UePaKGaharbEnEdlmanCvCateRcneRcndcCaRKabFBaCatTagml

nMbufrac12gcMNit nMeRkkxfrac12r )ay bcurren)asthorna

bulleRbIR)asEpnkarGaharsRmabCmparaWTwkenamEpyenmrbsGntildekRbsinebIGntildekminmanEpnkar

viFankarTI 3 sup3

curren

curren

17

bull Get 30 to 60 minutes of physical activity on most days of the week Brisk walking is a great way to move more

bull Stay at a healthy weight by making healthy food choices and moving more

bull Ask for help if you feel down A mental health counselor support group member of the clergy friend or family member will listen to your concerns and help you feel better

bull Learn to cope with stress Stress can raise your blood glucose While it is hard to remove stress from your life you can learn to handle it

bull Stop smoking Ask for help to quit

bull Take medicines even when you feel good Ask you doctor if you need aspirin to prevent a heart attack or stroke Tell your doctor if you cannot afford your medicine or if you have any side effects

1

bull sszligitenATmparanEdlmansuxPaBlyen edayeFVIkareRCIserIsGaharmansuxPaBlyen nigeFVIclna[kanEteRcIn

bull sMu[eKCYyRbsinebIGntildekmanGarmmicroN_TukccedilRBYy GntildekTIRbwkSasux

PaBposlashUacutevcitthorn RkumKaMRT smaCikbuBVCit mitthornPkthorni bcurrensmaCikRKYsarnwgsthornabkar)armOumlrbsGntildek ehIyCYyGntildek[manGarmmicroN_RbesIreLIg

bull eronedaHRsayPaBtantwgposlashUacutevcitthorn PaBtantwgposlashUacutevcitthorn GacbegaacuteInKoslashuacuteykUskntildeuacutegQam

rbsGntildek edaysarvaBi)akkntildeuacutegkarbM)atPaBtantwgposlashUacutevcitthornBICivit

rbsGntildek

GntildekGaceronRKbRKgva

bull QbBisa)arI cUresntildeIsMuCMnYybBaAumlbBisa)arI

bull TTYlTanfntildeaMeTaHbICaenAeBlGntildekmanGarmmicroN_lyenkfrac34eday

cUrsaksYrevCcentbNETHitrbs Gntildek faetIGntildekRtUvkarfntildeaMGasltIrIn edImITbsaacuteateraKKaMgebHdUgbcurrenCmparaWdacsreacutesQam

EdrbcurrenGt cUrR)abeTAevCcentbNETHitrbsGntildek RbsinebIGntildekminGaceacute

llkTijfntildeaMrbsGntildek

)an bcurrenRbsinebIGntildekmanplvi)akBIfntildeaMNamYy

bull hatR)aNBI 30 eTA 60 naTI[)aneRcIneacutefparakntildeuacutegmYys)athornh_ karedIrelOnsup2 KWCaviFIeFVIclna

dfrac34RbesIrmYy

1

bull Check your feet every day for cuts blisters r ed spots and swelling Call your health car e team right away about any sor es that wonrsquot go away

bull Brush your teeth and floss every day to avoid pr oblems with your mouth teeth or gums

bull Check your blood glucose Y ou may want to test it one or mor e times a day

bull Check your blood pressure If your doctor advises

bull Report any changes in your eyesight to your doctor

q Talk to your health care team

about your blood glucose targets

Ask how and when to test your

blood glucose and how to use the

results to manage your diabetes

q Use this plan as a guide to your

self-care

q Discuss how your self-care plan is

working for you each time you

visit your health care team

20

bullBinit uuml e C Ig r b s k C a e r o g r a l eacute f paraG ntilde E R k g m a n k a r m t d a c u B g E s k k n UumlTHORN l R k h m

ni I U frac12 THORN u M u ntilde oslash I W g e h m Tr s Be h A R k m k a r g a r E f T a sx P a B r b s Gk P a m R ) a b Bk a r Q c a b E d l

min)ateTAvij

U MG a t e F

mat eFmicroj nigGBacopyajeFmicrojrbsGntildek

bulldus e F microj r b s Gntildek n ig e R b IE x S k t s microj C a e r o g r a l eacute f parae d Im Ie c o s p ut b B a etha C a m Yy

bullBi i I oslashuacutent uuml e m l K y k s k ntildeuacuteg Q a m r b s U ntilde Gk R b E h l K r e F I times thorn gGk ntilde Y e t s thornV v a m

bcurreneRcIndg kntildeuacutegmYyeacutefpara

bullBinit uuml e m Il s m lta F Q a m r b s Gntildek R b s in e b Ie v C centb N ETHit r b s Gntildek E N n a M

bull raykarN_BIkarposlashasbthornUacuterkntildeuacutegEPntildekrbsGntildek eTAkanevCcentbNETHitrbsGntildek

q cUrBiPakSaCamYyRkum

kargarEfTaMsuxPaB

rbsGntildekBI eKaled

AKoslashuacuteykUs

kntildeuacutegQamrbsGntildek cUrs

aksYrfa etIeFVIets

thorntimesKoslashuacuteykUskntildeuacutegQam

rbsGntildekedayrebobN

a nigenAeBlNa nigfaet

IeRbIR)as

lTsectpledImIEfrkSa

CmparaWTwkenamEpyenmrbs

GntildekedayrebobNa

q cUrRbIR)asEpnkar

enHCaTisedAENnaMeTAkan

karEfTaM

xoslashUumlnEacutegpTHORNalrbsGntildek

q cUrBiPakSafaetIEpn

karEfTaMxoslashUumlnEacutegpTHORNal

rbsGntildek kMBugdMeN

Irkar

yagemcEdr erogr

aleBlEdlGntildekeTA

CYbRkumEfTaMsuxPaB

rbsGntildek

21

Step 4 Get routine care to avoid problems

See your health care team at least twice a year to find and treat problems early Discuss what steps you can take to reach your goals

At each visit get a bull blood pressure check bull foot check bull weight check bull review of your self-care plan shown in Step 3

Two times each year get an bull A1C testmdashIt may be checked more often if it is over 7

Once each year get a bull cholesterol test bull triglyceride (try-GLISS-er-ide) test- a type of blood fat bull complete foot exam bull dental exam to check teeth and gumsmdashtell your

dentist you have diabetes bull dilated eye exam to check for eye problems bull flu shot bull urine and a blood test to check for kidney problems

At least once get a bull pneumonia (nu-mo-nya) shot

22

CY u M xPaBrbsu Gky I uacute ntilde yqaedmrkemlngBuumla)albB ethbRkmEfTa ntilde B gm ntilde M I I I i aas agehacNas rdgk Y

[)anTan i I ntilde Y i Y I IeBlBPakSafaetGkGacTTlykvFankarNamyedmseRmc)aneKaledA

rbsGntildek

eBleTACYbmthorngsup2 cUr sup3

bull BinituumlsmltaFQam

bull BinituumleCIg bull BinituumlTmparan bullBi i M Uuml oslash alrbsGkeLgvjdc)anbgajkuacutentilde i IntuumlEpnkarEfTaxnEacutegpTHORN ntilde I i U eth gvFankarT3

BIrdgCaerogralqntildeaM cUr sup3

bull eFVIetsthorntimes A1C - GaceFVIjwkjabCagenH)an RbsinebIvaelIsBI 7

mthorngCaerogralqntildeaM cUr sup3

bull BinituumlkUeLesthornrUlI times K t) Y i aj gQamuacutebulleFetsV thorn triglyceride (RTI esrIoslash I -CaRbePTmyeacutenCatxoslash kntilde

bull karBinituumleCIgTaMgmUl bullkarBi i micro I I I micro i copy micro U micro ntildentuumleFjedmemleFjngGBaajeFj-crR)abeBTuumleFjrbsGkfa

GntildekmanCmparaWTwkenamEpyenm

bull BinituumlEPntildek edImIemIlbBaethaEPntildek bull cakfntildeaMkarBarRKunpthornasay bull eFVIetsthorntimesTwkenam nigQam edImIemIlbBaethaRkelon

yagehacNasmthorngmYyqntildeaM cUr sup3

bull cakfntildeaMkarBareraKrlaksYt notnUmUnIyabrvbar

viFankarTI 4 sup3 TTYlkarEfTaMCaRbcaM[eTogTatedImIecosputbBaetha

2

q Ask your health care team about

these and other tests you may

need Ask what your results

mean

qWrite down the date and time of

your next visit

q If you have Medicare ask your

health care team if Medicare

will cover some of the costs for

q learning about healthy eating

and diabetes self

care special shoes if you

need them

qmedical supplies

q diabetes medicines

2

qcUrsYrRkumEfT

aMsuxPaBrbs

GntildekGMBIkareFVIe

tsthorntimes TaMgenH

nigepSgeTot

EdlGntildekGacR

tUvkar cUrs

YrfaetI

lTsectplrbsG

ntildekmannfrac12yyag

dUcemthornc

q cUrktRtakal

briecaumlT nigeB

levlaeacutenkar

eTACYb

elIkeRkayrb

sGntildek

q RbsinebIGntildekm

an Medicare cUrsYrRkum

EfTaM

suxPaBrbsG

ntildekfa etI Medicare nwg

rabrg

cMNaymYycMnYns

Rmab

q sikSaGMBIkarb

riePaKEdlma

nsuxPaBlyen

nigEskeCIgB

iessEfTaMCmparaWT

wkenamEpyenm

xoslashUumlnEacuteg Rbs

inebIGntildekRtUvkar

q smOumlarsup3pAacutetpAacuteg

Buumla)al

q fntildeaMCmparaWTwkenam

Epyenm

2

__________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________

Notes

NATIONAL DIABETES EDUCATION PROGRAM wwwndepnihgov

2

Step 2 Know your diabetes ABCs

Talk to you health care team about how to control your A1C Blood pressure and Cholesterol This can help lower your chances of having a heart attack stroke or other diabetes problem Herersquos what the ABCs of diabetes stand for

A for the A1C test (A-one-C) It shows you how your blood glucose has been over the last three months The A1C goal for most people is below 7

High blood glucose levels can harm your heart and blood vessels kidneys feet and eyes

B for Blood pressure The goal for most people with diabetes is below 13080

High blood pressure makes your heart work too hard It can cause heart attack stroke and kidney disease

C for Cholesterol The LDL goal for most people is below 100 The HDL goal for most people is above 40

LDL or ldquobadrdquo cholesterol can build up and clog your blood vessels It can cause a heart attack or a stroke HDL or ldquogoodrdquo cholesterol helps remove cholesterol from your blood vessels

12

ABCs

cU i Y u M u ntilde M I i I rBPakSaCamyRkmEfTasxPaBrbsGkGBvFRKbRKg A1C smlt i U thorn U aFQam ngkeLesrl

eFVIenHGacCYykatbnszligykMu[maneraKKaMgebHdUg dacsreacutesQam

bcurrenbBaethaCmparaWTwkenamEpyenm epSgeTotrbsGntildek xageRkamenHKWCaGtszlignfrac12yrbs ABCs eacutenCmparaWTwkenamEpyenm

A sRmabetsthorntimes A1C (eG-van-suI) vabgeth ntilde I uacute oslash skuacute ntilde I I lt ajGkfaetKykU ntilde Gk manekneL skgQamrbs gx

uacutentilde LgeBlbEx cugeRkayenHedayrebobemc eKaledA gkM uacute I

A1C sRmabmnusSPaKeRcInKW eRkam 7

kRmitKoslashuacuteykUskntildeuacutegQamxlts GacbHBaldlebHdUg nigsreacutesQam

Rkelon eCIg nigEPntildekrbsGntildek

B sRmab Blood Pressure (smltaFQam) eKaledAsRmabmnusSPaKeRcInEdlmanCmparaWTwkenamEpyenkKWeR

kam 13080

smltaFQamxlts eFVI[ebHdUgrbsGntildekeFVIkarFparanNas

vaGacbNthornal[man

eraKKaMgebHdUg CmparaWdacsreacutesQam nigCmparaWRkelon

C sRmab Cholesterol (kUeLesthornrUl) eKaledA LDL sRmabmnusSPaKeRcInKWeRkam 100

eKaledA HDL sRmabmnusSPaKeRcInKWelI 40

LDL bcurren kUeLesthornrUl GaRkk GacbegaacuteIteLIgnigsTHORNHsreacutesQamrbsGntildek vaGac bNthornal[maneraKKaMgebHdUg

bcurrenCmparaWdacsreacutesQam HDL bcurrenkUeLesthornrUl lyen CYyykkUeLesthornrUlecjBIsreacutesQamrbsGntildek

1

viFankarTI 2 sup3 dwgBI CmparaWTwkenamEpyenmrbsGntildek

q Ask your health care team

q what your A1C Blood pressure

and cholesterol numbers are

q what your ABC numbers should

be

q what you need to do to reach

your targets

1

q cUrsaksYrRkumkargarE

fTaMsuxPaBrbsGntildek sup3

q faetIelx A1C smltaFQ

am

nigkUeLesthornrUlrbsGntildek

mankMritbunmicroan

q faetIelx ABC rbsGntildek

KYrEtmanbunmicroan

q faetIGntildekRtUvkareFVIG

VIedImIQaneTAdl

eKaledArbsGntildek

1

Step 3 Manage your diabetes

Many people avoid the long-term problems of diabetes by taking good care of themselves Work with your health care team to reach your ABC goals Use this self-care plan

bull Use your diabetes food plan If you do not have one ask your health care team for one

- Eat healthy foods such as fruits and vegetables fish lean meats chicken or turkey without the skin dry peas or beans whole grains and low-fat or skim milk and cheese

- Keep fish and lean meat and poultry portions to about 3 ounces (or the size of a pack of cards) Bake broil or grill it

- Eat foods that have less fat and salt

- Eat foods with more fiber such as whole-grain cereals breads crackers rice or pasta

1

EfrkSaCmparawTwkenamEpyenmrbsGntildek

mnu I u eth W para kenamEpmyrrau M Uuml oslash BkeK)anlsSCaeRcnecosptbBaaCmTw yen U eacuterM edayEfTaxnrbs Y yen

cU I V yRkmEfTasxPaBrbsGkedmQaneTAdleKaledAABCrbsGk reFkarCamY u M u ntilde I I ntilde

cUreRbIR)asEpnkarEfTaMedayxoslashUumlnEacutegenH

enHeT cUrsMuEpnkarenHBI RkumEfTaMsuxPaBrbsGntildek

- briePaKGaharmansuxPaBlyendUcCa EposlasheQI nigbEnoslash sacRtI

sac i oslash csacmanbsacman)aragedaymnmanEsk EdlmanCatxajti M i

sENthorn M thorn Uuml para FBaCatTagmlngTkedaHeKa k)aragbsENkstRKab Oslash i M U i w

nigQIsEdlmanCatixoslashajtic nigKmicroanCatiERkm

-bri I i oslash i i ePaKsacRt-sacEdlmanCatxajtc-ngsacmanRbmaN3 eGans_ notbcurrenTMhMebomYyRbGbbrvbar dut GaMg va

- briePaKGaharEdlmanCatixoslashaj nigCatieacuteRbtic

-bri oslash I i I I U Oslash i M UePaKGaharbEnEdlmanCvCateRcneRcndcCaRKabFBaCatTagml

nMbufrac12gcMNit nMeRkkxfrac12r )ay bcurren)asthorna

bulleRbIR)asEpnkarGaharsRmabCmparaWTwkenamEpyenmrbsGntildekRbsinebIGntildekminmanEpnkar

viFankarTI 3 sup3

curren

curren

17

bull Get 30 to 60 minutes of physical activity on most days of the week Brisk walking is a great way to move more

bull Stay at a healthy weight by making healthy food choices and moving more

bull Ask for help if you feel down A mental health counselor support group member of the clergy friend or family member will listen to your concerns and help you feel better

bull Learn to cope with stress Stress can raise your blood glucose While it is hard to remove stress from your life you can learn to handle it

bull Stop smoking Ask for help to quit

bull Take medicines even when you feel good Ask you doctor if you need aspirin to prevent a heart attack or stroke Tell your doctor if you cannot afford your medicine or if you have any side effects

1

bull sszligitenATmparanEdlmansuxPaBlyen edayeFVIkareRCIserIsGaharmansuxPaBlyen nigeFVIclna[kanEteRcIn

bull sMu[eKCYyRbsinebIGntildekmanGarmmicroN_TukccedilRBYy GntildekTIRbwkSasux

PaBposlashUacutevcitthorn RkumKaMRT smaCikbuBVCit mitthornPkthorni bcurrensmaCikRKYsarnwgsthornabkar)armOumlrbsGntildek ehIyCYyGntildek[manGarmmicroN_RbesIreLIg

bull eronedaHRsayPaBtantwgposlashUacutevcitthorn PaBtantwgposlashUacutevcitthorn GacbegaacuteInKoslashuacuteykUskntildeuacutegQam

rbsGntildek edaysarvaBi)akkntildeuacutegkarbM)atPaBtantwgposlashUacutevcitthornBICivit

rbsGntildek

GntildekGaceronRKbRKgva

bull QbBisa)arI cUresntildeIsMuCMnYybBaAumlbBisa)arI

bull TTYlTanfntildeaMeTaHbICaenAeBlGntildekmanGarmmicroN_lyenkfrac34eday

cUrsaksYrevCcentbNETHitrbs Gntildek faetIGntildekRtUvkarfntildeaMGasltIrIn edImITbsaacuteateraKKaMgebHdUgbcurrenCmparaWdacsreacutesQam

EdrbcurrenGt cUrR)abeTAevCcentbNETHitrbsGntildek RbsinebIGntildekminGaceacute

llkTijfntildeaMrbsGntildek

)an bcurrenRbsinebIGntildekmanplvi)akBIfntildeaMNamYy

bull hatR)aNBI 30 eTA 60 naTI[)aneRcIneacutefparakntildeuacutegmYys)athornh_ karedIrelOnsup2 KWCaviFIeFVIclna

dfrac34RbesIrmYy

1

bull Check your feet every day for cuts blisters r ed spots and swelling Call your health car e team right away about any sor es that wonrsquot go away

bull Brush your teeth and floss every day to avoid pr oblems with your mouth teeth or gums

bull Check your blood glucose Y ou may want to test it one or mor e times a day

bull Check your blood pressure If your doctor advises

bull Report any changes in your eyesight to your doctor

q Talk to your health care team

about your blood glucose targets

Ask how and when to test your

blood glucose and how to use the

results to manage your diabetes

q Use this plan as a guide to your

self-care

q Discuss how your self-care plan is

working for you each time you

visit your health care team

20

bullBinit uuml e C Ig r b s k C a e r o g r a l eacute f paraG ntilde E R k g m a n k a r m t d a c u B g E s k k n UumlTHORN l R k h m

ni I U frac12 THORN u M u ntilde oslash I W g e h m Tr s Be h A R k m k a r g a r E f T a sx P a B r b s Gk P a m R ) a b Bk a r Q c a b E d l

min)ateTAvij

U MG a t e F

mat eFmicroj nigGBacopyajeFmicrojrbsGntildek

bulldus e F microj r b s Gntildek n ig e R b IE x S k t s microj C a e r o g r a l eacute f parae d Im Ie c o s p ut b B a etha C a m Yy

bullBi i I oslashuacutent uuml e m l K y k s k ntildeuacuteg Q a m r b s U ntilde Gk R b E h l K r e F I times thorn gGk ntilde Y e t s thornV v a m

bcurreneRcIndg kntildeuacutegmYyeacutefpara

bullBinit uuml e m Il s m lta F Q a m r b s Gntildek R b s in e b Ie v C centb N ETHit r b s Gntildek E N n a M

bull raykarN_BIkarposlashasbthornUacuterkntildeuacutegEPntildekrbsGntildek eTAkanevCcentbNETHitrbsGntildek

q cUrBiPakSaCamYyRkum

kargarEfTaMsuxPaB

rbsGntildekBI eKaled

AKoslashuacuteykUs

kntildeuacutegQamrbsGntildek cUrs

aksYrfa etIeFVIets

thorntimesKoslashuacuteykUskntildeuacutegQam

rbsGntildekedayrebobN

a nigenAeBlNa nigfaet

IeRbIR)as

lTsectpledImIEfrkSa

CmparaWTwkenamEpyenmrbs

GntildekedayrebobNa

q cUrRbIR)asEpnkar

enHCaTisedAENnaMeTAkan

karEfTaM

xoslashUumlnEacutegpTHORNalrbsGntildek

q cUrBiPakSafaetIEpn

karEfTaMxoslashUumlnEacutegpTHORNal

rbsGntildek kMBugdMeN

Irkar

yagemcEdr erogr

aleBlEdlGntildekeTA

CYbRkumEfTaMsuxPaB

rbsGntildek

21

Step 4 Get routine care to avoid problems

See your health care team at least twice a year to find and treat problems early Discuss what steps you can take to reach your goals

At each visit get a bull blood pressure check bull foot check bull weight check bull review of your self-care plan shown in Step 3

Two times each year get an bull A1C testmdashIt may be checked more often if it is over 7

Once each year get a bull cholesterol test bull triglyceride (try-GLISS-er-ide) test- a type of blood fat bull complete foot exam bull dental exam to check teeth and gumsmdashtell your

dentist you have diabetes bull dilated eye exam to check for eye problems bull flu shot bull urine and a blood test to check for kidney problems

At least once get a bull pneumonia (nu-mo-nya) shot

22

CY u M xPaBrbsu Gky I uacute ntilde yqaedmrkemlngBuumla)albB ethbRkmEfTa ntilde B gm ntilde M I I I i aas agehacNas rdgk Y

[)anTan i I ntilde Y i Y I IeBlBPakSafaetGkGacTTlykvFankarNamyedmseRmc)aneKaledA

rbsGntildek

eBleTACYbmthorngsup2 cUr sup3

bull BinituumlsmltaFQam

bull BinituumleCIg bull BinituumlTmparan bullBi i M Uuml oslash alrbsGkeLgvjdc)anbgajkuacutentilde i IntuumlEpnkarEfTaxnEacutegpTHORN ntilde I i U eth gvFankarT3

BIrdgCaerogralqntildeaM cUr sup3

bull eFVIetsthorntimes A1C - GaceFVIjwkjabCagenH)an RbsinebIvaelIsBI 7

mthorngCaerogralqntildeaM cUr sup3

bull BinituumlkUeLesthornrUlI times K t) Y i aj gQamuacutebulleFetsV thorn triglyceride (RTI esrIoslash I -CaRbePTmyeacutenCatxoslash kntilde

bull karBinituumleCIgTaMgmUl bullkarBi i micro I I I micro i copy micro U micro ntildentuumleFjedmemleFjngGBaajeFj-crR)abeBTuumleFjrbsGkfa

GntildekmanCmparaWTwkenamEpyenm

bull BinituumlEPntildek edImIemIlbBaethaEPntildek bull cakfntildeaMkarBarRKunpthornasay bull eFVIetsthorntimesTwkenam nigQam edImIemIlbBaethaRkelon

yagehacNasmthorngmYyqntildeaM cUr sup3

bull cakfntildeaMkarBareraKrlaksYt notnUmUnIyabrvbar

viFankarTI 4 sup3 TTYlkarEfTaMCaRbcaM[eTogTatedImIecosputbBaetha

2

q Ask your health care team about

these and other tests you may

need Ask what your results

mean

qWrite down the date and time of

your next visit

q If you have Medicare ask your

health care team if Medicare

will cover some of the costs for

q learning about healthy eating

and diabetes self

care special shoes if you

need them

qmedical supplies

q diabetes medicines

2

qcUrsYrRkumEfT

aMsuxPaBrbs

GntildekGMBIkareFVIe

tsthorntimes TaMgenH

nigepSgeTot

EdlGntildekGacR

tUvkar cUrs

YrfaetI

lTsectplrbsG

ntildekmannfrac12yyag

dUcemthornc

q cUrktRtakal

briecaumlT nigeB

levlaeacutenkar

eTACYb

elIkeRkayrb

sGntildek

q RbsinebIGntildekm

an Medicare cUrsYrRkum

EfTaM

suxPaBrbsG

ntildekfa etI Medicare nwg

rabrg

cMNaymYycMnYns

Rmab

q sikSaGMBIkarb

riePaKEdlma

nsuxPaBlyen

nigEskeCIgB

iessEfTaMCmparaWT

wkenamEpyenm

xoslashUumlnEacuteg Rbs

inebIGntildekRtUvkar

q smOumlarsup3pAacutetpAacuteg

Buumla)al

q fntildeaMCmparaWTwkenam

Epyenm

2

__________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________

Notes

NATIONAL DIABETES EDUCATION PROGRAM wwwndepnihgov

2

ABCs

cU i Y u M u ntilde M I i I rBPakSaCamyRkmEfTasxPaBrbsGkGBvFRKbRKg A1C smlt i U thorn U aFQam ngkeLesrl

eFVIenHGacCYykatbnszligykMu[maneraKKaMgebHdUg dacsreacutesQam

bcurrenbBaethaCmparaWTwkenamEpyenm epSgeTotrbsGntildek xageRkamenHKWCaGtszlignfrac12yrbs ABCs eacutenCmparaWTwkenamEpyenm

A sRmabetsthorntimes A1C (eG-van-suI) vabgeth ntilde I uacute oslash skuacute ntilde I I lt ajGkfaetKykU ntilde Gk manekneL skgQamrbs gx

uacutentilde LgeBlbEx cugeRkayenHedayrebobemc eKaledA gkM uacute I

A1C sRmabmnusSPaKeRcInKW eRkam 7

kRmitKoslashuacuteykUskntildeuacutegQamxlts GacbHBaldlebHdUg nigsreacutesQam

Rkelon eCIg nigEPntildekrbsGntildek

B sRmab Blood Pressure (smltaFQam) eKaledAsRmabmnusSPaKeRcInEdlmanCmparaWTwkenamEpyenkKWeR

kam 13080

smltaFQamxlts eFVI[ebHdUgrbsGntildekeFVIkarFparanNas

vaGacbNthornal[man

eraKKaMgebHdUg CmparaWdacsreacutesQam nigCmparaWRkelon

C sRmab Cholesterol (kUeLesthornrUl) eKaledA LDL sRmabmnusSPaKeRcInKWeRkam 100

eKaledA HDL sRmabmnusSPaKeRcInKWelI 40

LDL bcurren kUeLesthornrUl GaRkk GacbegaacuteIteLIgnigsTHORNHsreacutesQamrbsGntildek vaGac bNthornal[maneraKKaMgebHdUg

bcurrenCmparaWdacsreacutesQam HDL bcurrenkUeLesthornrUl lyen CYyykkUeLesthornrUlecjBIsreacutesQamrbsGntildek

1

viFankarTI 2 sup3 dwgBI CmparaWTwkenamEpyenmrbsGntildek

q Ask your health care team

q what your A1C Blood pressure

and cholesterol numbers are

q what your ABC numbers should

be

q what you need to do to reach

your targets

1

q cUrsaksYrRkumkargarE

fTaMsuxPaBrbsGntildek sup3

q faetIelx A1C smltaFQ

am

nigkUeLesthornrUlrbsGntildek

mankMritbunmicroan

q faetIelx ABC rbsGntildek

KYrEtmanbunmicroan

q faetIGntildekRtUvkareFVIG

VIedImIQaneTAdl

eKaledArbsGntildek

1

Step 3 Manage your diabetes

Many people avoid the long-term problems of diabetes by taking good care of themselves Work with your health care team to reach your ABC goals Use this self-care plan

bull Use your diabetes food plan If you do not have one ask your health care team for one

- Eat healthy foods such as fruits and vegetables fish lean meats chicken or turkey without the skin dry peas or beans whole grains and low-fat or skim milk and cheese

- Keep fish and lean meat and poultry portions to about 3 ounces (or the size of a pack of cards) Bake broil or grill it

- Eat foods that have less fat and salt

- Eat foods with more fiber such as whole-grain cereals breads crackers rice or pasta

1

EfrkSaCmparawTwkenamEpyenmrbsGntildek

mnu I u eth W para kenamEpmyrrau M Uuml oslash BkeK)anlsSCaeRcnecosptbBaaCmTw yen U eacuterM edayEfTaxnrbs Y yen

cU I V yRkmEfTasxPaBrbsGkedmQaneTAdleKaledAABCrbsGk reFkarCamY u M u ntilde I I ntilde

cUreRbIR)asEpnkarEfTaMedayxoslashUumlnEacutegenH

enHeT cUrsMuEpnkarenHBI RkumEfTaMsuxPaBrbsGntildek

- briePaKGaharmansuxPaBlyendUcCa EposlasheQI nigbEnoslash sacRtI

sac i oslash csacmanbsacman)aragedaymnmanEsk EdlmanCatxajti M i

sENthorn M thorn Uuml para FBaCatTagmlngTkedaHeKa k)aragbsENkstRKab Oslash i M U i w

nigQIsEdlmanCatixoslashajtic nigKmicroanCatiERkm

-bri I i oslash i i ePaKsacRt-sacEdlmanCatxajtc-ngsacmanRbmaN3 eGans_ notbcurrenTMhMebomYyRbGbbrvbar dut GaMg va

- briePaKGaharEdlmanCatixoslashaj nigCatieacuteRbtic

-bri oslash I i I I U Oslash i M UePaKGaharbEnEdlmanCvCateRcneRcndcCaRKabFBaCatTagml

nMbufrac12gcMNit nMeRkkxfrac12r )ay bcurren)asthorna

bulleRbIR)asEpnkarGaharsRmabCmparaWTwkenamEpyenmrbsGntildekRbsinebIGntildekminmanEpnkar

viFankarTI 3 sup3

curren

curren

17

bull Get 30 to 60 minutes of physical activity on most days of the week Brisk walking is a great way to move more

bull Stay at a healthy weight by making healthy food choices and moving more

bull Ask for help if you feel down A mental health counselor support group member of the clergy friend or family member will listen to your concerns and help you feel better

bull Learn to cope with stress Stress can raise your blood glucose While it is hard to remove stress from your life you can learn to handle it

bull Stop smoking Ask for help to quit

bull Take medicines even when you feel good Ask you doctor if you need aspirin to prevent a heart attack or stroke Tell your doctor if you cannot afford your medicine or if you have any side effects

1

bull sszligitenATmparanEdlmansuxPaBlyen edayeFVIkareRCIserIsGaharmansuxPaBlyen nigeFVIclna[kanEteRcIn

bull sMu[eKCYyRbsinebIGntildekmanGarmmicroN_TukccedilRBYy GntildekTIRbwkSasux

PaBposlashUacutevcitthorn RkumKaMRT smaCikbuBVCit mitthornPkthorni bcurrensmaCikRKYsarnwgsthornabkar)armOumlrbsGntildek ehIyCYyGntildek[manGarmmicroN_RbesIreLIg

bull eronedaHRsayPaBtantwgposlashUacutevcitthorn PaBtantwgposlashUacutevcitthorn GacbegaacuteInKoslashuacuteykUskntildeuacutegQam

rbsGntildek edaysarvaBi)akkntildeuacutegkarbM)atPaBtantwgposlashUacutevcitthornBICivit

rbsGntildek

GntildekGaceronRKbRKgva

bull QbBisa)arI cUresntildeIsMuCMnYybBaAumlbBisa)arI

bull TTYlTanfntildeaMeTaHbICaenAeBlGntildekmanGarmmicroN_lyenkfrac34eday

cUrsaksYrevCcentbNETHitrbs Gntildek faetIGntildekRtUvkarfntildeaMGasltIrIn edImITbsaacuteateraKKaMgebHdUgbcurrenCmparaWdacsreacutesQam

EdrbcurrenGt cUrR)abeTAevCcentbNETHitrbsGntildek RbsinebIGntildekminGaceacute

llkTijfntildeaMrbsGntildek

)an bcurrenRbsinebIGntildekmanplvi)akBIfntildeaMNamYy

bull hatR)aNBI 30 eTA 60 naTI[)aneRcIneacutefparakntildeuacutegmYys)athornh_ karedIrelOnsup2 KWCaviFIeFVIclna

dfrac34RbesIrmYy

1

bull Check your feet every day for cuts blisters r ed spots and swelling Call your health car e team right away about any sor es that wonrsquot go away

bull Brush your teeth and floss every day to avoid pr oblems with your mouth teeth or gums

bull Check your blood glucose Y ou may want to test it one or mor e times a day

bull Check your blood pressure If your doctor advises

bull Report any changes in your eyesight to your doctor

q Talk to your health care team

about your blood glucose targets

Ask how and when to test your

blood glucose and how to use the

results to manage your diabetes

q Use this plan as a guide to your

self-care

q Discuss how your self-care plan is

working for you each time you

visit your health care team

20

bullBinit uuml e C Ig r b s k C a e r o g r a l eacute f paraG ntilde E R k g m a n k a r m t d a c u B g E s k k n UumlTHORN l R k h m

ni I U frac12 THORN u M u ntilde oslash I W g e h m Tr s Be h A R k m k a r g a r E f T a sx P a B r b s Gk P a m R ) a b Bk a r Q c a b E d l

min)ateTAvij

U MG a t e F

mat eFmicroj nigGBacopyajeFmicrojrbsGntildek

bulldus e F microj r b s Gntildek n ig e R b IE x S k t s microj C a e r o g r a l eacute f parae d Im Ie c o s p ut b B a etha C a m Yy

bullBi i I oslashuacutent uuml e m l K y k s k ntildeuacuteg Q a m r b s U ntilde Gk R b E h l K r e F I times thorn gGk ntilde Y e t s thornV v a m

bcurreneRcIndg kntildeuacutegmYyeacutefpara

bullBinit uuml e m Il s m lta F Q a m r b s Gntildek R b s in e b Ie v C centb N ETHit r b s Gntildek E N n a M

bull raykarN_BIkarposlashasbthornUacuterkntildeuacutegEPntildekrbsGntildek eTAkanevCcentbNETHitrbsGntildek

q cUrBiPakSaCamYyRkum

kargarEfTaMsuxPaB

rbsGntildekBI eKaled

AKoslashuacuteykUs

kntildeuacutegQamrbsGntildek cUrs

aksYrfa etIeFVIets

thorntimesKoslashuacuteykUskntildeuacutegQam

rbsGntildekedayrebobN

a nigenAeBlNa nigfaet

IeRbIR)as

lTsectpledImIEfrkSa

CmparaWTwkenamEpyenmrbs

GntildekedayrebobNa

q cUrRbIR)asEpnkar

enHCaTisedAENnaMeTAkan

karEfTaM

xoslashUumlnEacutegpTHORNalrbsGntildek

q cUrBiPakSafaetIEpn

karEfTaMxoslashUumlnEacutegpTHORNal

rbsGntildek kMBugdMeN

Irkar

yagemcEdr erogr

aleBlEdlGntildekeTA

CYbRkumEfTaMsuxPaB

rbsGntildek

21

Step 4 Get routine care to avoid problems

See your health care team at least twice a year to find and treat problems early Discuss what steps you can take to reach your goals

At each visit get a bull blood pressure check bull foot check bull weight check bull review of your self-care plan shown in Step 3

Two times each year get an bull A1C testmdashIt may be checked more often if it is over 7

Once each year get a bull cholesterol test bull triglyceride (try-GLISS-er-ide) test- a type of blood fat bull complete foot exam bull dental exam to check teeth and gumsmdashtell your

dentist you have diabetes bull dilated eye exam to check for eye problems bull flu shot bull urine and a blood test to check for kidney problems

At least once get a bull pneumonia (nu-mo-nya) shot

22

CY u M xPaBrbsu Gky I uacute ntilde yqaedmrkemlngBuumla)albB ethbRkmEfTa ntilde B gm ntilde M I I I i aas agehacNas rdgk Y

[)anTan i I ntilde Y i Y I IeBlBPakSafaetGkGacTTlykvFankarNamyedmseRmc)aneKaledA

rbsGntildek

eBleTACYbmthorngsup2 cUr sup3

bull BinituumlsmltaFQam

bull BinituumleCIg bull BinituumlTmparan bullBi i M Uuml oslash alrbsGkeLgvjdc)anbgajkuacutentilde i IntuumlEpnkarEfTaxnEacutegpTHORN ntilde I i U eth gvFankarT3

BIrdgCaerogralqntildeaM cUr sup3

bull eFVIetsthorntimes A1C - GaceFVIjwkjabCagenH)an RbsinebIvaelIsBI 7

mthorngCaerogralqntildeaM cUr sup3

bull BinituumlkUeLesthornrUlI times K t) Y i aj gQamuacutebulleFetsV thorn triglyceride (RTI esrIoslash I -CaRbePTmyeacutenCatxoslash kntilde

bull karBinituumleCIgTaMgmUl bullkarBi i micro I I I micro i copy micro U micro ntildentuumleFjedmemleFjngGBaajeFj-crR)abeBTuumleFjrbsGkfa

GntildekmanCmparaWTwkenamEpyenm

bull BinituumlEPntildek edImIemIlbBaethaEPntildek bull cakfntildeaMkarBarRKunpthornasay bull eFVIetsthorntimesTwkenam nigQam edImIemIlbBaethaRkelon

yagehacNasmthorngmYyqntildeaM cUr sup3

bull cakfntildeaMkarBareraKrlaksYt notnUmUnIyabrvbar

viFankarTI 4 sup3 TTYlkarEfTaMCaRbcaM[eTogTatedImIecosputbBaetha

2

q Ask your health care team about

these and other tests you may

need Ask what your results

mean

qWrite down the date and time of

your next visit

q If you have Medicare ask your

health care team if Medicare

will cover some of the costs for

q learning about healthy eating

and diabetes self

care special shoes if you

need them

qmedical supplies

q diabetes medicines

2

qcUrsYrRkumEfT

aMsuxPaBrbs

GntildekGMBIkareFVIe

tsthorntimes TaMgenH

nigepSgeTot

EdlGntildekGacR

tUvkar cUrs

YrfaetI

lTsectplrbsG

ntildekmannfrac12yyag

dUcemthornc

q cUrktRtakal

briecaumlT nigeB

levlaeacutenkar

eTACYb

elIkeRkayrb

sGntildek

q RbsinebIGntildekm

an Medicare cUrsYrRkum

EfTaM

suxPaBrbsG

ntildekfa etI Medicare nwg

rabrg

cMNaymYycMnYns

Rmab

q sikSaGMBIkarb

riePaKEdlma

nsuxPaBlyen

nigEskeCIgB

iessEfTaMCmparaWT

wkenamEpyenm

xoslashUumlnEacuteg Rbs

inebIGntildekRtUvkar

q smOumlarsup3pAacutetpAacuteg

Buumla)al

q fntildeaMCmparaWTwkenam

Epyenm

2

__________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________

Notes

NATIONAL DIABETES EDUCATION PROGRAM wwwndepnihgov

2

q Ask your health care team

q what your A1C Blood pressure

and cholesterol numbers are

q what your ABC numbers should

be

q what you need to do to reach

your targets

1

q cUrsaksYrRkumkargarE

fTaMsuxPaBrbsGntildek sup3

q faetIelx A1C smltaFQ

am

nigkUeLesthornrUlrbsGntildek

mankMritbunmicroan

q faetIelx ABC rbsGntildek

KYrEtmanbunmicroan

q faetIGntildekRtUvkareFVIG

VIedImIQaneTAdl

eKaledArbsGntildek

1

Step 3 Manage your diabetes

Many people avoid the long-term problems of diabetes by taking good care of themselves Work with your health care team to reach your ABC goals Use this self-care plan

bull Use your diabetes food plan If you do not have one ask your health care team for one

- Eat healthy foods such as fruits and vegetables fish lean meats chicken or turkey without the skin dry peas or beans whole grains and low-fat or skim milk and cheese

- Keep fish and lean meat and poultry portions to about 3 ounces (or the size of a pack of cards) Bake broil or grill it

- Eat foods that have less fat and salt

- Eat foods with more fiber such as whole-grain cereals breads crackers rice or pasta

1

EfrkSaCmparawTwkenamEpyenmrbsGntildek

mnu I u eth W para kenamEpmyrrau M Uuml oslash BkeK)anlsSCaeRcnecosptbBaaCmTw yen U eacuterM edayEfTaxnrbs Y yen

cU I V yRkmEfTasxPaBrbsGkedmQaneTAdleKaledAABCrbsGk reFkarCamY u M u ntilde I I ntilde

cUreRbIR)asEpnkarEfTaMedayxoslashUumlnEacutegenH

enHeT cUrsMuEpnkarenHBI RkumEfTaMsuxPaBrbsGntildek

- briePaKGaharmansuxPaBlyendUcCa EposlasheQI nigbEnoslash sacRtI

sac i oslash csacmanbsacman)aragedaymnmanEsk EdlmanCatxajti M i

sENthorn M thorn Uuml para FBaCatTagmlngTkedaHeKa k)aragbsENkstRKab Oslash i M U i w

nigQIsEdlmanCatixoslashajtic nigKmicroanCatiERkm

-bri I i oslash i i ePaKsacRt-sacEdlmanCatxajtc-ngsacmanRbmaN3 eGans_ notbcurrenTMhMebomYyRbGbbrvbar dut GaMg va

- briePaKGaharEdlmanCatixoslashaj nigCatieacuteRbtic

-bri oslash I i I I U Oslash i M UePaKGaharbEnEdlmanCvCateRcneRcndcCaRKabFBaCatTagml

nMbufrac12gcMNit nMeRkkxfrac12r )ay bcurren)asthorna

bulleRbIR)asEpnkarGaharsRmabCmparaWTwkenamEpyenmrbsGntildekRbsinebIGntildekminmanEpnkar

viFankarTI 3 sup3

curren

curren

17

bull Get 30 to 60 minutes of physical activity on most days of the week Brisk walking is a great way to move more

bull Stay at a healthy weight by making healthy food choices and moving more

bull Ask for help if you feel down A mental health counselor support group member of the clergy friend or family member will listen to your concerns and help you feel better

bull Learn to cope with stress Stress can raise your blood glucose While it is hard to remove stress from your life you can learn to handle it

bull Stop smoking Ask for help to quit

bull Take medicines even when you feel good Ask you doctor if you need aspirin to prevent a heart attack or stroke Tell your doctor if you cannot afford your medicine or if you have any side effects

1

bull sszligitenATmparanEdlmansuxPaBlyen edayeFVIkareRCIserIsGaharmansuxPaBlyen nigeFVIclna[kanEteRcIn

bull sMu[eKCYyRbsinebIGntildekmanGarmmicroN_TukccedilRBYy GntildekTIRbwkSasux

PaBposlashUacutevcitthorn RkumKaMRT smaCikbuBVCit mitthornPkthorni bcurrensmaCikRKYsarnwgsthornabkar)armOumlrbsGntildek ehIyCYyGntildek[manGarmmicroN_RbesIreLIg

bull eronedaHRsayPaBtantwgposlashUacutevcitthorn PaBtantwgposlashUacutevcitthorn GacbegaacuteInKoslashuacuteykUskntildeuacutegQam

rbsGntildek edaysarvaBi)akkntildeuacutegkarbM)atPaBtantwgposlashUacutevcitthornBICivit

rbsGntildek

GntildekGaceronRKbRKgva

bull QbBisa)arI cUresntildeIsMuCMnYybBaAumlbBisa)arI

bull TTYlTanfntildeaMeTaHbICaenAeBlGntildekmanGarmmicroN_lyenkfrac34eday

cUrsaksYrevCcentbNETHitrbs Gntildek faetIGntildekRtUvkarfntildeaMGasltIrIn edImITbsaacuteateraKKaMgebHdUgbcurrenCmparaWdacsreacutesQam

EdrbcurrenGt cUrR)abeTAevCcentbNETHitrbsGntildek RbsinebIGntildekminGaceacute

llkTijfntildeaMrbsGntildek

)an bcurrenRbsinebIGntildekmanplvi)akBIfntildeaMNamYy

bull hatR)aNBI 30 eTA 60 naTI[)aneRcIneacutefparakntildeuacutegmYys)athornh_ karedIrelOnsup2 KWCaviFIeFVIclna

dfrac34RbesIrmYy

1

bull Check your feet every day for cuts blisters r ed spots and swelling Call your health car e team right away about any sor es that wonrsquot go away

bull Brush your teeth and floss every day to avoid pr oblems with your mouth teeth or gums

bull Check your blood glucose Y ou may want to test it one or mor e times a day

bull Check your blood pressure If your doctor advises

bull Report any changes in your eyesight to your doctor

q Talk to your health care team

about your blood glucose targets

Ask how and when to test your

blood glucose and how to use the

results to manage your diabetes

q Use this plan as a guide to your

self-care

q Discuss how your self-care plan is

working for you each time you

visit your health care team

20

bullBinit uuml e C Ig r b s k C a e r o g r a l eacute f paraG ntilde E R k g m a n k a r m t d a c u B g E s k k n UumlTHORN l R k h m

ni I U frac12 THORN u M u ntilde oslash I W g e h m Tr s Be h A R k m k a r g a r E f T a sx P a B r b s Gk P a m R ) a b Bk a r Q c a b E d l

min)ateTAvij

U MG a t e F

mat eFmicroj nigGBacopyajeFmicrojrbsGntildek

bulldus e F microj r b s Gntildek n ig e R b IE x S k t s microj C a e r o g r a l eacute f parae d Im Ie c o s p ut b B a etha C a m Yy

bullBi i I oslashuacutent uuml e m l K y k s k ntildeuacuteg Q a m r b s U ntilde Gk R b E h l K r e F I times thorn gGk ntilde Y e t s thornV v a m

bcurreneRcIndg kntildeuacutegmYyeacutefpara

bullBinit uuml e m Il s m lta F Q a m r b s Gntildek R b s in e b Ie v C centb N ETHit r b s Gntildek E N n a M

bull raykarN_BIkarposlashasbthornUacuterkntildeuacutegEPntildekrbsGntildek eTAkanevCcentbNETHitrbsGntildek

q cUrBiPakSaCamYyRkum

kargarEfTaMsuxPaB

rbsGntildekBI eKaled

AKoslashuacuteykUs

kntildeuacutegQamrbsGntildek cUrs

aksYrfa etIeFVIets

thorntimesKoslashuacuteykUskntildeuacutegQam

rbsGntildekedayrebobN

a nigenAeBlNa nigfaet

IeRbIR)as

lTsectpledImIEfrkSa

CmparaWTwkenamEpyenmrbs

GntildekedayrebobNa

q cUrRbIR)asEpnkar

enHCaTisedAENnaMeTAkan

karEfTaM

xoslashUumlnEacutegpTHORNalrbsGntildek

q cUrBiPakSafaetIEpn

karEfTaMxoslashUumlnEacutegpTHORNal

rbsGntildek kMBugdMeN

Irkar

yagemcEdr erogr

aleBlEdlGntildekeTA

CYbRkumEfTaMsuxPaB

rbsGntildek

21

Step 4 Get routine care to avoid problems

See your health care team at least twice a year to find and treat problems early Discuss what steps you can take to reach your goals

At each visit get a bull blood pressure check bull foot check bull weight check bull review of your self-care plan shown in Step 3

Two times each year get an bull A1C testmdashIt may be checked more often if it is over 7

Once each year get a bull cholesterol test bull triglyceride (try-GLISS-er-ide) test- a type of blood fat bull complete foot exam bull dental exam to check teeth and gumsmdashtell your

dentist you have diabetes bull dilated eye exam to check for eye problems bull flu shot bull urine and a blood test to check for kidney problems

At least once get a bull pneumonia (nu-mo-nya) shot

22

CY u M xPaBrbsu Gky I uacute ntilde yqaedmrkemlngBuumla)albB ethbRkmEfTa ntilde B gm ntilde M I I I i aas agehacNas rdgk Y

[)anTan i I ntilde Y i Y I IeBlBPakSafaetGkGacTTlykvFankarNamyedmseRmc)aneKaledA

rbsGntildek

eBleTACYbmthorngsup2 cUr sup3

bull BinituumlsmltaFQam

bull BinituumleCIg bull BinituumlTmparan bullBi i M Uuml oslash alrbsGkeLgvjdc)anbgajkuacutentilde i IntuumlEpnkarEfTaxnEacutegpTHORN ntilde I i U eth gvFankarT3

BIrdgCaerogralqntildeaM cUr sup3

bull eFVIetsthorntimes A1C - GaceFVIjwkjabCagenH)an RbsinebIvaelIsBI 7

mthorngCaerogralqntildeaM cUr sup3

bull BinituumlkUeLesthornrUlI times K t) Y i aj gQamuacutebulleFetsV thorn triglyceride (RTI esrIoslash I -CaRbePTmyeacutenCatxoslash kntilde

bull karBinituumleCIgTaMgmUl bullkarBi i micro I I I micro i copy micro U micro ntildentuumleFjedmemleFjngGBaajeFj-crR)abeBTuumleFjrbsGkfa

GntildekmanCmparaWTwkenamEpyenm

bull BinituumlEPntildek edImIemIlbBaethaEPntildek bull cakfntildeaMkarBarRKunpthornasay bull eFVIetsthorntimesTwkenam nigQam edImIemIlbBaethaRkelon

yagehacNasmthorngmYyqntildeaM cUr sup3

bull cakfntildeaMkarBareraKrlaksYt notnUmUnIyabrvbar

viFankarTI 4 sup3 TTYlkarEfTaMCaRbcaM[eTogTatedImIecosputbBaetha

2

q Ask your health care team about

these and other tests you may

need Ask what your results

mean

qWrite down the date and time of

your next visit

q If you have Medicare ask your

health care team if Medicare

will cover some of the costs for

q learning about healthy eating

and diabetes self

care special shoes if you

need them

qmedical supplies

q diabetes medicines

2

qcUrsYrRkumEfT

aMsuxPaBrbs

GntildekGMBIkareFVIe

tsthorntimes TaMgenH

nigepSgeTot

EdlGntildekGacR

tUvkar cUrs

YrfaetI

lTsectplrbsG

ntildekmannfrac12yyag

dUcemthornc

q cUrktRtakal

briecaumlT nigeB

levlaeacutenkar

eTACYb

elIkeRkayrb

sGntildek

q RbsinebIGntildekm

an Medicare cUrsYrRkum

EfTaM

suxPaBrbsG

ntildekfa etI Medicare nwg

rabrg

cMNaymYycMnYns

Rmab

q sikSaGMBIkarb

riePaKEdlma

nsuxPaBlyen

nigEskeCIgB

iessEfTaMCmparaWT

wkenamEpyenm

xoslashUumlnEacuteg Rbs

inebIGntildekRtUvkar

q smOumlarsup3pAacutetpAacuteg

Buumla)al

q fntildeaMCmparaWTwkenam

Epyenm

2

__________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________

Notes

NATIONAL DIABETES EDUCATION PROGRAM wwwndepnihgov

2

q cUrsaksYrRkumkargarE

fTaMsuxPaBrbsGntildek sup3

q faetIelx A1C smltaFQ

am

nigkUeLesthornrUlrbsGntildek

mankMritbunmicroan

q faetIelx ABC rbsGntildek

KYrEtmanbunmicroan

q faetIGntildekRtUvkareFVIG

VIedImIQaneTAdl

eKaledArbsGntildek

1

Step 3 Manage your diabetes

Many people avoid the long-term problems of diabetes by taking good care of themselves Work with your health care team to reach your ABC goals Use this self-care plan

bull Use your diabetes food plan If you do not have one ask your health care team for one

- Eat healthy foods such as fruits and vegetables fish lean meats chicken or turkey without the skin dry peas or beans whole grains and low-fat or skim milk and cheese

- Keep fish and lean meat and poultry portions to about 3 ounces (or the size of a pack of cards) Bake broil or grill it

- Eat foods that have less fat and salt

- Eat foods with more fiber such as whole-grain cereals breads crackers rice or pasta

1

EfrkSaCmparawTwkenamEpyenmrbsGntildek

mnu I u eth W para kenamEpmyrrau M Uuml oslash BkeK)anlsSCaeRcnecosptbBaaCmTw yen U eacuterM edayEfTaxnrbs Y yen

cU I V yRkmEfTasxPaBrbsGkedmQaneTAdleKaledAABCrbsGk reFkarCamY u M u ntilde I I ntilde

cUreRbIR)asEpnkarEfTaMedayxoslashUumlnEacutegenH

enHeT cUrsMuEpnkarenHBI RkumEfTaMsuxPaBrbsGntildek

- briePaKGaharmansuxPaBlyendUcCa EposlasheQI nigbEnoslash sacRtI

sac i oslash csacmanbsacman)aragedaymnmanEsk EdlmanCatxajti M i

sENthorn M thorn Uuml para FBaCatTagmlngTkedaHeKa k)aragbsENkstRKab Oslash i M U i w

nigQIsEdlmanCatixoslashajtic nigKmicroanCatiERkm

-bri I i oslash i i ePaKsacRt-sacEdlmanCatxajtc-ngsacmanRbmaN3 eGans_ notbcurrenTMhMebomYyRbGbbrvbar dut GaMg va

- briePaKGaharEdlmanCatixoslashaj nigCatieacuteRbtic

-bri oslash I i I I U Oslash i M UePaKGaharbEnEdlmanCvCateRcneRcndcCaRKabFBaCatTagml

nMbufrac12gcMNit nMeRkkxfrac12r )ay bcurren)asthorna

bulleRbIR)asEpnkarGaharsRmabCmparaWTwkenamEpyenmrbsGntildekRbsinebIGntildekminmanEpnkar

viFankarTI 3 sup3

curren

curren

17

bull Get 30 to 60 minutes of physical activity on most days of the week Brisk walking is a great way to move more

bull Stay at a healthy weight by making healthy food choices and moving more

bull Ask for help if you feel down A mental health counselor support group member of the clergy friend or family member will listen to your concerns and help you feel better

bull Learn to cope with stress Stress can raise your blood glucose While it is hard to remove stress from your life you can learn to handle it

bull Stop smoking Ask for help to quit

bull Take medicines even when you feel good Ask you doctor if you need aspirin to prevent a heart attack or stroke Tell your doctor if you cannot afford your medicine or if you have any side effects

1

bull sszligitenATmparanEdlmansuxPaBlyen edayeFVIkareRCIserIsGaharmansuxPaBlyen nigeFVIclna[kanEteRcIn

bull sMu[eKCYyRbsinebIGntildekmanGarmmicroN_TukccedilRBYy GntildekTIRbwkSasux

PaBposlashUacutevcitthorn RkumKaMRT smaCikbuBVCit mitthornPkthorni bcurrensmaCikRKYsarnwgsthornabkar)armOumlrbsGntildek ehIyCYyGntildek[manGarmmicroN_RbesIreLIg

bull eronedaHRsayPaBtantwgposlashUacutevcitthorn PaBtantwgposlashUacutevcitthorn GacbegaacuteInKoslashuacuteykUskntildeuacutegQam

rbsGntildek edaysarvaBi)akkntildeuacutegkarbM)atPaBtantwgposlashUacutevcitthornBICivit

rbsGntildek

GntildekGaceronRKbRKgva

bull QbBisa)arI cUresntildeIsMuCMnYybBaAumlbBisa)arI

bull TTYlTanfntildeaMeTaHbICaenAeBlGntildekmanGarmmicroN_lyenkfrac34eday

cUrsaksYrevCcentbNETHitrbs Gntildek faetIGntildekRtUvkarfntildeaMGasltIrIn edImITbsaacuteateraKKaMgebHdUgbcurrenCmparaWdacsreacutesQam

EdrbcurrenGt cUrR)abeTAevCcentbNETHitrbsGntildek RbsinebIGntildekminGaceacute

llkTijfntildeaMrbsGntildek

)an bcurrenRbsinebIGntildekmanplvi)akBIfntildeaMNamYy

bull hatR)aNBI 30 eTA 60 naTI[)aneRcIneacutefparakntildeuacutegmYys)athornh_ karedIrelOnsup2 KWCaviFIeFVIclna

dfrac34RbesIrmYy

1

bull Check your feet every day for cuts blisters r ed spots and swelling Call your health car e team right away about any sor es that wonrsquot go away

bull Brush your teeth and floss every day to avoid pr oblems with your mouth teeth or gums

bull Check your blood glucose Y ou may want to test it one or mor e times a day

bull Check your blood pressure If your doctor advises

bull Report any changes in your eyesight to your doctor

q Talk to your health care team

about your blood glucose targets

Ask how and when to test your

blood glucose and how to use the

results to manage your diabetes

q Use this plan as a guide to your

self-care

q Discuss how your self-care plan is

working for you each time you

visit your health care team

20

bullBinit uuml e C Ig r b s k C a e r o g r a l eacute f paraG ntilde E R k g m a n k a r m t d a c u B g E s k k n UumlTHORN l R k h m

ni I U frac12 THORN u M u ntilde oslash I W g e h m Tr s Be h A R k m k a r g a r E f T a sx P a B r b s Gk P a m R ) a b Bk a r Q c a b E d l

min)ateTAvij

U MG a t e F

mat eFmicroj nigGBacopyajeFmicrojrbsGntildek

bulldus e F microj r b s Gntildek n ig e R b IE x S k t s microj C a e r o g r a l eacute f parae d Im Ie c o s p ut b B a etha C a m Yy

bullBi i I oslashuacutent uuml e m l K y k s k ntildeuacuteg Q a m r b s U ntilde Gk R b E h l K r e F I times thorn gGk ntilde Y e t s thornV v a m

bcurreneRcIndg kntildeuacutegmYyeacutefpara

bullBinit uuml e m Il s m lta F Q a m r b s Gntildek R b s in e b Ie v C centb N ETHit r b s Gntildek E N n a M

bull raykarN_BIkarposlashasbthornUacuterkntildeuacutegEPntildekrbsGntildek eTAkanevCcentbNETHitrbsGntildek

q cUrBiPakSaCamYyRkum

kargarEfTaMsuxPaB

rbsGntildekBI eKaled

AKoslashuacuteykUs

kntildeuacutegQamrbsGntildek cUrs

aksYrfa etIeFVIets

thorntimesKoslashuacuteykUskntildeuacutegQam

rbsGntildekedayrebobN

a nigenAeBlNa nigfaet

IeRbIR)as

lTsectpledImIEfrkSa

CmparaWTwkenamEpyenmrbs

GntildekedayrebobNa

q cUrRbIR)asEpnkar

enHCaTisedAENnaMeTAkan

karEfTaM

xoslashUumlnEacutegpTHORNalrbsGntildek

q cUrBiPakSafaetIEpn

karEfTaMxoslashUumlnEacutegpTHORNal

rbsGntildek kMBugdMeN

Irkar

yagemcEdr erogr

aleBlEdlGntildekeTA

CYbRkumEfTaMsuxPaB

rbsGntildek

21

Step 4 Get routine care to avoid problems

See your health care team at least twice a year to find and treat problems early Discuss what steps you can take to reach your goals

At each visit get a bull blood pressure check bull foot check bull weight check bull review of your self-care plan shown in Step 3

Two times each year get an bull A1C testmdashIt may be checked more often if it is over 7

Once each year get a bull cholesterol test bull triglyceride (try-GLISS-er-ide) test- a type of blood fat bull complete foot exam bull dental exam to check teeth and gumsmdashtell your

dentist you have diabetes bull dilated eye exam to check for eye problems bull flu shot bull urine and a blood test to check for kidney problems

At least once get a bull pneumonia (nu-mo-nya) shot

22

CY u M xPaBrbsu Gky I uacute ntilde yqaedmrkemlngBuumla)albB ethbRkmEfTa ntilde B gm ntilde M I I I i aas agehacNas rdgk Y

[)anTan i I ntilde Y i Y I IeBlBPakSafaetGkGacTTlykvFankarNamyedmseRmc)aneKaledA

rbsGntildek

eBleTACYbmthorngsup2 cUr sup3

bull BinituumlsmltaFQam

bull BinituumleCIg bull BinituumlTmparan bullBi i M Uuml oslash alrbsGkeLgvjdc)anbgajkuacutentilde i IntuumlEpnkarEfTaxnEacutegpTHORN ntilde I i U eth gvFankarT3

BIrdgCaerogralqntildeaM cUr sup3

bull eFVIetsthorntimes A1C - GaceFVIjwkjabCagenH)an RbsinebIvaelIsBI 7

mthorngCaerogralqntildeaM cUr sup3

bull BinituumlkUeLesthornrUlI times K t) Y i aj gQamuacutebulleFetsV thorn triglyceride (RTI esrIoslash I -CaRbePTmyeacutenCatxoslash kntilde

bull karBinituumleCIgTaMgmUl bullkarBi i micro I I I micro i copy micro U micro ntildentuumleFjedmemleFjngGBaajeFj-crR)abeBTuumleFjrbsGkfa

GntildekmanCmparaWTwkenamEpyenm

bull BinituumlEPntildek edImIemIlbBaethaEPntildek bull cakfntildeaMkarBarRKunpthornasay bull eFVIetsthorntimesTwkenam nigQam edImIemIlbBaethaRkelon

yagehacNasmthorngmYyqntildeaM cUr sup3

bull cakfntildeaMkarBareraKrlaksYt notnUmUnIyabrvbar

viFankarTI 4 sup3 TTYlkarEfTaMCaRbcaM[eTogTatedImIecosputbBaetha

2

q Ask your health care team about

these and other tests you may

need Ask what your results

mean

qWrite down the date and time of

your next visit

q If you have Medicare ask your

health care team if Medicare

will cover some of the costs for

q learning about healthy eating

and diabetes self

care special shoes if you

need them

qmedical supplies

q diabetes medicines

2

qcUrsYrRkumEfT

aMsuxPaBrbs

GntildekGMBIkareFVIe

tsthorntimes TaMgenH

nigepSgeTot

EdlGntildekGacR

tUvkar cUrs

YrfaetI

lTsectplrbsG

ntildekmannfrac12yyag

dUcemthornc

q cUrktRtakal

briecaumlT nigeB

levlaeacutenkar

eTACYb

elIkeRkayrb

sGntildek

q RbsinebIGntildekm

an Medicare cUrsYrRkum

EfTaM

suxPaBrbsG

ntildekfa etI Medicare nwg

rabrg

cMNaymYycMnYns

Rmab

q sikSaGMBIkarb

riePaKEdlma

nsuxPaBlyen

nigEskeCIgB

iessEfTaMCmparaWT

wkenamEpyenm

xoslashUumlnEacuteg Rbs

inebIGntildekRtUvkar

q smOumlarsup3pAacutetpAacuteg

Buumla)al

q fntildeaMCmparaWTwkenam

Epyenm

2

__________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________

Notes

NATIONAL DIABETES EDUCATION PROGRAM wwwndepnihgov

2

Step 3 Manage your diabetes

Many people avoid the long-term problems of diabetes by taking good care of themselves Work with your health care team to reach your ABC goals Use this self-care plan

bull Use your diabetes food plan If you do not have one ask your health care team for one

- Eat healthy foods such as fruits and vegetables fish lean meats chicken or turkey without the skin dry peas or beans whole grains and low-fat or skim milk and cheese

- Keep fish and lean meat and poultry portions to about 3 ounces (or the size of a pack of cards) Bake broil or grill it

- Eat foods that have less fat and salt

- Eat foods with more fiber such as whole-grain cereals breads crackers rice or pasta

1

EfrkSaCmparawTwkenamEpyenmrbsGntildek

mnu I u eth W para kenamEpmyrrau M Uuml oslash BkeK)anlsSCaeRcnecosptbBaaCmTw yen U eacuterM edayEfTaxnrbs Y yen

cU I V yRkmEfTasxPaBrbsGkedmQaneTAdleKaledAABCrbsGk reFkarCamY u M u ntilde I I ntilde

cUreRbIR)asEpnkarEfTaMedayxoslashUumlnEacutegenH

enHeT cUrsMuEpnkarenHBI RkumEfTaMsuxPaBrbsGntildek

- briePaKGaharmansuxPaBlyendUcCa EposlasheQI nigbEnoslash sacRtI

sac i oslash csacmanbsacman)aragedaymnmanEsk EdlmanCatxajti M i

sENthorn M thorn Uuml para FBaCatTagmlngTkedaHeKa k)aragbsENkstRKab Oslash i M U i w

nigQIsEdlmanCatixoslashajtic nigKmicroanCatiERkm

-bri I i oslash i i ePaKsacRt-sacEdlmanCatxajtc-ngsacmanRbmaN3 eGans_ notbcurrenTMhMebomYyRbGbbrvbar dut GaMg va

- briePaKGaharEdlmanCatixoslashaj nigCatieacuteRbtic

-bri oslash I i I I U Oslash i M UePaKGaharbEnEdlmanCvCateRcneRcndcCaRKabFBaCatTagml

nMbufrac12gcMNit nMeRkkxfrac12r )ay bcurren)asthorna

bulleRbIR)asEpnkarGaharsRmabCmparaWTwkenamEpyenmrbsGntildekRbsinebIGntildekminmanEpnkar

viFankarTI 3 sup3

curren

curren

17

bull Get 30 to 60 minutes of physical activity on most days of the week Brisk walking is a great way to move more

bull Stay at a healthy weight by making healthy food choices and moving more

bull Ask for help if you feel down A mental health counselor support group member of the clergy friend or family member will listen to your concerns and help you feel better

bull Learn to cope with stress Stress can raise your blood glucose While it is hard to remove stress from your life you can learn to handle it

bull Stop smoking Ask for help to quit

bull Take medicines even when you feel good Ask you doctor if you need aspirin to prevent a heart attack or stroke Tell your doctor if you cannot afford your medicine or if you have any side effects

1

bull sszligitenATmparanEdlmansuxPaBlyen edayeFVIkareRCIserIsGaharmansuxPaBlyen nigeFVIclna[kanEteRcIn

bull sMu[eKCYyRbsinebIGntildekmanGarmmicroN_TukccedilRBYy GntildekTIRbwkSasux

PaBposlashUacutevcitthorn RkumKaMRT smaCikbuBVCit mitthornPkthorni bcurrensmaCikRKYsarnwgsthornabkar)armOumlrbsGntildek ehIyCYyGntildek[manGarmmicroN_RbesIreLIg

bull eronedaHRsayPaBtantwgposlashUacutevcitthorn PaBtantwgposlashUacutevcitthorn GacbegaacuteInKoslashuacuteykUskntildeuacutegQam

rbsGntildek edaysarvaBi)akkntildeuacutegkarbM)atPaBtantwgposlashUacutevcitthornBICivit

rbsGntildek

GntildekGaceronRKbRKgva

bull QbBisa)arI cUresntildeIsMuCMnYybBaAumlbBisa)arI

bull TTYlTanfntildeaMeTaHbICaenAeBlGntildekmanGarmmicroN_lyenkfrac34eday

cUrsaksYrevCcentbNETHitrbs Gntildek faetIGntildekRtUvkarfntildeaMGasltIrIn edImITbsaacuteateraKKaMgebHdUgbcurrenCmparaWdacsreacutesQam

EdrbcurrenGt cUrR)abeTAevCcentbNETHitrbsGntildek RbsinebIGntildekminGaceacute

llkTijfntildeaMrbsGntildek

)an bcurrenRbsinebIGntildekmanplvi)akBIfntildeaMNamYy

bull hatR)aNBI 30 eTA 60 naTI[)aneRcIneacutefparakntildeuacutegmYys)athornh_ karedIrelOnsup2 KWCaviFIeFVIclna

dfrac34RbesIrmYy

1

bull Check your feet every day for cuts blisters r ed spots and swelling Call your health car e team right away about any sor es that wonrsquot go away

bull Brush your teeth and floss every day to avoid pr oblems with your mouth teeth or gums

bull Check your blood glucose Y ou may want to test it one or mor e times a day

bull Check your blood pressure If your doctor advises

bull Report any changes in your eyesight to your doctor

q Talk to your health care team

about your blood glucose targets

Ask how and when to test your

blood glucose and how to use the

results to manage your diabetes

q Use this plan as a guide to your

self-care

q Discuss how your self-care plan is

working for you each time you

visit your health care team

20

bullBinit uuml e C Ig r b s k C a e r o g r a l eacute f paraG ntilde E R k g m a n k a r m t d a c u B g E s k k n UumlTHORN l R k h m

ni I U frac12 THORN u M u ntilde oslash I W g e h m Tr s Be h A R k m k a r g a r E f T a sx P a B r b s Gk P a m R ) a b Bk a r Q c a b E d l

min)ateTAvij

U MG a t e F

mat eFmicroj nigGBacopyajeFmicrojrbsGntildek

bulldus e F microj r b s Gntildek n ig e R b IE x S k t s microj C a e r o g r a l eacute f parae d Im Ie c o s p ut b B a etha C a m Yy

bullBi i I oslashuacutent uuml e m l K y k s k ntildeuacuteg Q a m r b s U ntilde Gk R b E h l K r e F I times thorn gGk ntilde Y e t s thornV v a m

bcurreneRcIndg kntildeuacutegmYyeacutefpara

bullBinit uuml e m Il s m lta F Q a m r b s Gntildek R b s in e b Ie v C centb N ETHit r b s Gntildek E N n a M

bull raykarN_BIkarposlashasbthornUacuterkntildeuacutegEPntildekrbsGntildek eTAkanevCcentbNETHitrbsGntildek

q cUrBiPakSaCamYyRkum

kargarEfTaMsuxPaB

rbsGntildekBI eKaled

AKoslashuacuteykUs

kntildeuacutegQamrbsGntildek cUrs

aksYrfa etIeFVIets

thorntimesKoslashuacuteykUskntildeuacutegQam

rbsGntildekedayrebobN

a nigenAeBlNa nigfaet

IeRbIR)as

lTsectpledImIEfrkSa

CmparaWTwkenamEpyenmrbs

GntildekedayrebobNa

q cUrRbIR)asEpnkar

enHCaTisedAENnaMeTAkan

karEfTaM

xoslashUumlnEacutegpTHORNalrbsGntildek

q cUrBiPakSafaetIEpn

karEfTaMxoslashUumlnEacutegpTHORNal

rbsGntildek kMBugdMeN

Irkar

yagemcEdr erogr

aleBlEdlGntildekeTA

CYbRkumEfTaMsuxPaB

rbsGntildek

21

Step 4 Get routine care to avoid problems

See your health care team at least twice a year to find and treat problems early Discuss what steps you can take to reach your goals

At each visit get a bull blood pressure check bull foot check bull weight check bull review of your self-care plan shown in Step 3

Two times each year get an bull A1C testmdashIt may be checked more often if it is over 7

Once each year get a bull cholesterol test bull triglyceride (try-GLISS-er-ide) test- a type of blood fat bull complete foot exam bull dental exam to check teeth and gumsmdashtell your

dentist you have diabetes bull dilated eye exam to check for eye problems bull flu shot bull urine and a blood test to check for kidney problems

At least once get a bull pneumonia (nu-mo-nya) shot

22

CY u M xPaBrbsu Gky I uacute ntilde yqaedmrkemlngBuumla)albB ethbRkmEfTa ntilde B gm ntilde M I I I i aas agehacNas rdgk Y

[)anTan i I ntilde Y i Y I IeBlBPakSafaetGkGacTTlykvFankarNamyedmseRmc)aneKaledA

rbsGntildek

eBleTACYbmthorngsup2 cUr sup3

bull BinituumlsmltaFQam

bull BinituumleCIg bull BinituumlTmparan bullBi i M Uuml oslash alrbsGkeLgvjdc)anbgajkuacutentilde i IntuumlEpnkarEfTaxnEacutegpTHORN ntilde I i U eth gvFankarT3

BIrdgCaerogralqntildeaM cUr sup3

bull eFVIetsthorntimes A1C - GaceFVIjwkjabCagenH)an RbsinebIvaelIsBI 7

mthorngCaerogralqntildeaM cUr sup3

bull BinituumlkUeLesthornrUlI times K t) Y i aj gQamuacutebulleFetsV thorn triglyceride (RTI esrIoslash I -CaRbePTmyeacutenCatxoslash kntilde

bull karBinituumleCIgTaMgmUl bullkarBi i micro I I I micro i copy micro U micro ntildentuumleFjedmemleFjngGBaajeFj-crR)abeBTuumleFjrbsGkfa

GntildekmanCmparaWTwkenamEpyenm

bull BinituumlEPntildek edImIemIlbBaethaEPntildek bull cakfntildeaMkarBarRKunpthornasay bull eFVIetsthorntimesTwkenam nigQam edImIemIlbBaethaRkelon

yagehacNasmthorngmYyqntildeaM cUr sup3

bull cakfntildeaMkarBareraKrlaksYt notnUmUnIyabrvbar

viFankarTI 4 sup3 TTYlkarEfTaMCaRbcaM[eTogTatedImIecosputbBaetha

2

q Ask your health care team about

these and other tests you may

need Ask what your results

mean

qWrite down the date and time of

your next visit

q If you have Medicare ask your

health care team if Medicare

will cover some of the costs for

q learning about healthy eating

and diabetes self

care special shoes if you

need them

qmedical supplies

q diabetes medicines

2

qcUrsYrRkumEfT

aMsuxPaBrbs

GntildekGMBIkareFVIe

tsthorntimes TaMgenH

nigepSgeTot

EdlGntildekGacR

tUvkar cUrs

YrfaetI

lTsectplrbsG

ntildekmannfrac12yyag

dUcemthornc

q cUrktRtakal

briecaumlT nigeB

levlaeacutenkar

eTACYb

elIkeRkayrb

sGntildek

q RbsinebIGntildekm

an Medicare cUrsYrRkum

EfTaM

suxPaBrbsG

ntildekfa etI Medicare nwg

rabrg

cMNaymYycMnYns

Rmab

q sikSaGMBIkarb

riePaKEdlma

nsuxPaBlyen

nigEskeCIgB

iessEfTaMCmparaWT

wkenamEpyenm

xoslashUumlnEacuteg Rbs

inebIGntildekRtUvkar

q smOumlarsup3pAacutetpAacuteg

Buumla)al

q fntildeaMCmparaWTwkenam

Epyenm

2

__________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________

Notes

NATIONAL DIABETES EDUCATION PROGRAM wwwndepnihgov

2

EfrkSaCmparawTwkenamEpyenmrbsGntildek

mnu I u eth W para kenamEpmyrrau M Uuml oslash BkeK)anlsSCaeRcnecosptbBaaCmTw yen U eacuterM edayEfTaxnrbs Y yen

cU I V yRkmEfTasxPaBrbsGkedmQaneTAdleKaledAABCrbsGk reFkarCamY u M u ntilde I I ntilde

cUreRbIR)asEpnkarEfTaMedayxoslashUumlnEacutegenH

enHeT cUrsMuEpnkarenHBI RkumEfTaMsuxPaBrbsGntildek

- briePaKGaharmansuxPaBlyendUcCa EposlasheQI nigbEnoslash sacRtI

sac i oslash csacmanbsacman)aragedaymnmanEsk EdlmanCatxajti M i

sENthorn M thorn Uuml para FBaCatTagmlngTkedaHeKa k)aragbsENkstRKab Oslash i M U i w

nigQIsEdlmanCatixoslashajtic nigKmicroanCatiERkm

-bri I i oslash i i ePaKsacRt-sacEdlmanCatxajtc-ngsacmanRbmaN3 eGans_ notbcurrenTMhMebomYyRbGbbrvbar dut GaMg va

- briePaKGaharEdlmanCatixoslashaj nigCatieacuteRbtic

-bri oslash I i I I U Oslash i M UePaKGaharbEnEdlmanCvCateRcneRcndcCaRKabFBaCatTagml

nMbufrac12gcMNit nMeRkkxfrac12r )ay bcurren)asthorna

bulleRbIR)asEpnkarGaharsRmabCmparaWTwkenamEpyenmrbsGntildekRbsinebIGntildekminmanEpnkar

viFankarTI 3 sup3

curren

curren

17

bull Get 30 to 60 minutes of physical activity on most days of the week Brisk walking is a great way to move more

bull Stay at a healthy weight by making healthy food choices and moving more

bull Ask for help if you feel down A mental health counselor support group member of the clergy friend or family member will listen to your concerns and help you feel better

bull Learn to cope with stress Stress can raise your blood glucose While it is hard to remove stress from your life you can learn to handle it

bull Stop smoking Ask for help to quit

bull Take medicines even when you feel good Ask you doctor if you need aspirin to prevent a heart attack or stroke Tell your doctor if you cannot afford your medicine or if you have any side effects

1

bull sszligitenATmparanEdlmansuxPaBlyen edayeFVIkareRCIserIsGaharmansuxPaBlyen nigeFVIclna[kanEteRcIn

bull sMu[eKCYyRbsinebIGntildekmanGarmmicroN_TukccedilRBYy GntildekTIRbwkSasux

PaBposlashUacutevcitthorn RkumKaMRT smaCikbuBVCit mitthornPkthorni bcurrensmaCikRKYsarnwgsthornabkar)armOumlrbsGntildek ehIyCYyGntildek[manGarmmicroN_RbesIreLIg

bull eronedaHRsayPaBtantwgposlashUacutevcitthorn PaBtantwgposlashUacutevcitthorn GacbegaacuteInKoslashuacuteykUskntildeuacutegQam

rbsGntildek edaysarvaBi)akkntildeuacutegkarbM)atPaBtantwgposlashUacutevcitthornBICivit

rbsGntildek

GntildekGaceronRKbRKgva

bull QbBisa)arI cUresntildeIsMuCMnYybBaAumlbBisa)arI

bull TTYlTanfntildeaMeTaHbICaenAeBlGntildekmanGarmmicroN_lyenkfrac34eday

cUrsaksYrevCcentbNETHitrbs Gntildek faetIGntildekRtUvkarfntildeaMGasltIrIn edImITbsaacuteateraKKaMgebHdUgbcurrenCmparaWdacsreacutesQam

EdrbcurrenGt cUrR)abeTAevCcentbNETHitrbsGntildek RbsinebIGntildekminGaceacute

llkTijfntildeaMrbsGntildek

)an bcurrenRbsinebIGntildekmanplvi)akBIfntildeaMNamYy

bull hatR)aNBI 30 eTA 60 naTI[)aneRcIneacutefparakntildeuacutegmYys)athornh_ karedIrelOnsup2 KWCaviFIeFVIclna

dfrac34RbesIrmYy

1

bull Check your feet every day for cuts blisters r ed spots and swelling Call your health car e team right away about any sor es that wonrsquot go away

bull Brush your teeth and floss every day to avoid pr oblems with your mouth teeth or gums

bull Check your blood glucose Y ou may want to test it one or mor e times a day

bull Check your blood pressure If your doctor advises

bull Report any changes in your eyesight to your doctor

q Talk to your health care team

about your blood glucose targets

Ask how and when to test your

blood glucose and how to use the

results to manage your diabetes

q Use this plan as a guide to your

self-care

q Discuss how your self-care plan is

working for you each time you

visit your health care team

20

bullBinit uuml e C Ig r b s k C a e r o g r a l eacute f paraG ntilde E R k g m a n k a r m t d a c u B g E s k k n UumlTHORN l R k h m

ni I U frac12 THORN u M u ntilde oslash I W g e h m Tr s Be h A R k m k a r g a r E f T a sx P a B r b s Gk P a m R ) a b Bk a r Q c a b E d l

min)ateTAvij

U MG a t e F

mat eFmicroj nigGBacopyajeFmicrojrbsGntildek

bulldus e F microj r b s Gntildek n ig e R b IE x S k t s microj C a e r o g r a l eacute f parae d Im Ie c o s p ut b B a etha C a m Yy

bullBi i I oslashuacutent uuml e m l K y k s k ntildeuacuteg Q a m r b s U ntilde Gk R b E h l K r e F I times thorn gGk ntilde Y e t s thornV v a m

bcurreneRcIndg kntildeuacutegmYyeacutefpara

bullBinit uuml e m Il s m lta F Q a m r b s Gntildek R b s in e b Ie v C centb N ETHit r b s Gntildek E N n a M

bull raykarN_BIkarposlashasbthornUacuterkntildeuacutegEPntildekrbsGntildek eTAkanevCcentbNETHitrbsGntildek

q cUrBiPakSaCamYyRkum

kargarEfTaMsuxPaB

rbsGntildekBI eKaled

AKoslashuacuteykUs

kntildeuacutegQamrbsGntildek cUrs

aksYrfa etIeFVIets

thorntimesKoslashuacuteykUskntildeuacutegQam

rbsGntildekedayrebobN

a nigenAeBlNa nigfaet

IeRbIR)as

lTsectpledImIEfrkSa

CmparaWTwkenamEpyenmrbs

GntildekedayrebobNa

q cUrRbIR)asEpnkar

enHCaTisedAENnaMeTAkan

karEfTaM

xoslashUumlnEacutegpTHORNalrbsGntildek

q cUrBiPakSafaetIEpn

karEfTaMxoslashUumlnEacutegpTHORNal

rbsGntildek kMBugdMeN

Irkar

yagemcEdr erogr

aleBlEdlGntildekeTA

CYbRkumEfTaMsuxPaB

rbsGntildek

21

Step 4 Get routine care to avoid problems

See your health care team at least twice a year to find and treat problems early Discuss what steps you can take to reach your goals

At each visit get a bull blood pressure check bull foot check bull weight check bull review of your self-care plan shown in Step 3

Two times each year get an bull A1C testmdashIt may be checked more often if it is over 7

Once each year get a bull cholesterol test bull triglyceride (try-GLISS-er-ide) test- a type of blood fat bull complete foot exam bull dental exam to check teeth and gumsmdashtell your

dentist you have diabetes bull dilated eye exam to check for eye problems bull flu shot bull urine and a blood test to check for kidney problems

At least once get a bull pneumonia (nu-mo-nya) shot

22

CY u M xPaBrbsu Gky I uacute ntilde yqaedmrkemlngBuumla)albB ethbRkmEfTa ntilde B gm ntilde M I I I i aas agehacNas rdgk Y

[)anTan i I ntilde Y i Y I IeBlBPakSafaetGkGacTTlykvFankarNamyedmseRmc)aneKaledA

rbsGntildek

eBleTACYbmthorngsup2 cUr sup3

bull BinituumlsmltaFQam

bull BinituumleCIg bull BinituumlTmparan bullBi i M Uuml oslash alrbsGkeLgvjdc)anbgajkuacutentilde i IntuumlEpnkarEfTaxnEacutegpTHORN ntilde I i U eth gvFankarT3

BIrdgCaerogralqntildeaM cUr sup3

bull eFVIetsthorntimes A1C - GaceFVIjwkjabCagenH)an RbsinebIvaelIsBI 7

mthorngCaerogralqntildeaM cUr sup3

bull BinituumlkUeLesthornrUlI times K t) Y i aj gQamuacutebulleFetsV thorn triglyceride (RTI esrIoslash I -CaRbePTmyeacutenCatxoslash kntilde

bull karBinituumleCIgTaMgmUl bullkarBi i micro I I I micro i copy micro U micro ntildentuumleFjedmemleFjngGBaajeFj-crR)abeBTuumleFjrbsGkfa

GntildekmanCmparaWTwkenamEpyenm

bull BinituumlEPntildek edImIemIlbBaethaEPntildek bull cakfntildeaMkarBarRKunpthornasay bull eFVIetsthorntimesTwkenam nigQam edImIemIlbBaethaRkelon

yagehacNasmthorngmYyqntildeaM cUr sup3

bull cakfntildeaMkarBareraKrlaksYt notnUmUnIyabrvbar

viFankarTI 4 sup3 TTYlkarEfTaMCaRbcaM[eTogTatedImIecosputbBaetha

2

q Ask your health care team about

these and other tests you may

need Ask what your results

mean

qWrite down the date and time of

your next visit

q If you have Medicare ask your

health care team if Medicare

will cover some of the costs for

q learning about healthy eating

and diabetes self

care special shoes if you

need them

qmedical supplies

q diabetes medicines

2

qcUrsYrRkumEfT

aMsuxPaBrbs

GntildekGMBIkareFVIe

tsthorntimes TaMgenH

nigepSgeTot

EdlGntildekGacR

tUvkar cUrs

YrfaetI

lTsectplrbsG

ntildekmannfrac12yyag

dUcemthornc

q cUrktRtakal

briecaumlT nigeB

levlaeacutenkar

eTACYb

elIkeRkayrb

sGntildek

q RbsinebIGntildekm

an Medicare cUrsYrRkum

EfTaM

suxPaBrbsG

ntildekfa etI Medicare nwg

rabrg

cMNaymYycMnYns

Rmab

q sikSaGMBIkarb

riePaKEdlma

nsuxPaBlyen

nigEskeCIgB

iessEfTaMCmparaWT

wkenamEpyenm

xoslashUumlnEacuteg Rbs

inebIGntildekRtUvkar

q smOumlarsup3pAacutetpAacuteg

Buumla)al

q fntildeaMCmparaWTwkenam

Epyenm

2

__________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________

Notes

NATIONAL DIABETES EDUCATION PROGRAM wwwndepnihgov

2

bull Get 30 to 60 minutes of physical activity on most days of the week Brisk walking is a great way to move more

bull Stay at a healthy weight by making healthy food choices and moving more

bull Ask for help if you feel down A mental health counselor support group member of the clergy friend or family member will listen to your concerns and help you feel better

bull Learn to cope with stress Stress can raise your blood glucose While it is hard to remove stress from your life you can learn to handle it

bull Stop smoking Ask for help to quit

bull Take medicines even when you feel good Ask you doctor if you need aspirin to prevent a heart attack or stroke Tell your doctor if you cannot afford your medicine or if you have any side effects

1

bull sszligitenATmparanEdlmansuxPaBlyen edayeFVIkareRCIserIsGaharmansuxPaBlyen nigeFVIclna[kanEteRcIn

bull sMu[eKCYyRbsinebIGntildekmanGarmmicroN_TukccedilRBYy GntildekTIRbwkSasux

PaBposlashUacutevcitthorn RkumKaMRT smaCikbuBVCit mitthornPkthorni bcurrensmaCikRKYsarnwgsthornabkar)armOumlrbsGntildek ehIyCYyGntildek[manGarmmicroN_RbesIreLIg

bull eronedaHRsayPaBtantwgposlashUacutevcitthorn PaBtantwgposlashUacutevcitthorn GacbegaacuteInKoslashuacuteykUskntildeuacutegQam

rbsGntildek edaysarvaBi)akkntildeuacutegkarbM)atPaBtantwgposlashUacutevcitthornBICivit

rbsGntildek

GntildekGaceronRKbRKgva

bull QbBisa)arI cUresntildeIsMuCMnYybBaAumlbBisa)arI

bull TTYlTanfntildeaMeTaHbICaenAeBlGntildekmanGarmmicroN_lyenkfrac34eday

cUrsaksYrevCcentbNETHitrbs Gntildek faetIGntildekRtUvkarfntildeaMGasltIrIn edImITbsaacuteateraKKaMgebHdUgbcurrenCmparaWdacsreacutesQam

EdrbcurrenGt cUrR)abeTAevCcentbNETHitrbsGntildek RbsinebIGntildekminGaceacute

llkTijfntildeaMrbsGntildek

)an bcurrenRbsinebIGntildekmanplvi)akBIfntildeaMNamYy

bull hatR)aNBI 30 eTA 60 naTI[)aneRcIneacutefparakntildeuacutegmYys)athornh_ karedIrelOnsup2 KWCaviFIeFVIclna

dfrac34RbesIrmYy

1

bull Check your feet every day for cuts blisters r ed spots and swelling Call your health car e team right away about any sor es that wonrsquot go away

bull Brush your teeth and floss every day to avoid pr oblems with your mouth teeth or gums

bull Check your blood glucose Y ou may want to test it one or mor e times a day

bull Check your blood pressure If your doctor advises

bull Report any changes in your eyesight to your doctor

q Talk to your health care team

about your blood glucose targets

Ask how and when to test your

blood glucose and how to use the

results to manage your diabetes

q Use this plan as a guide to your

self-care

q Discuss how your self-care plan is

working for you each time you

visit your health care team

20

bullBinit uuml e C Ig r b s k C a e r o g r a l eacute f paraG ntilde E R k g m a n k a r m t d a c u B g E s k k n UumlTHORN l R k h m

ni I U frac12 THORN u M u ntilde oslash I W g e h m Tr s Be h A R k m k a r g a r E f T a sx P a B r b s Gk P a m R ) a b Bk a r Q c a b E d l

min)ateTAvij

U MG a t e F

mat eFmicroj nigGBacopyajeFmicrojrbsGntildek

bulldus e F microj r b s Gntildek n ig e R b IE x S k t s microj C a e r o g r a l eacute f parae d Im Ie c o s p ut b B a etha C a m Yy

bullBi i I oslashuacutent uuml e m l K y k s k ntildeuacuteg Q a m r b s U ntilde Gk R b E h l K r e F I times thorn gGk ntilde Y e t s thornV v a m

bcurreneRcIndg kntildeuacutegmYyeacutefpara

bullBinit uuml e m Il s m lta F Q a m r b s Gntildek R b s in e b Ie v C centb N ETHit r b s Gntildek E N n a M

bull raykarN_BIkarposlashasbthornUacuterkntildeuacutegEPntildekrbsGntildek eTAkanevCcentbNETHitrbsGntildek

q cUrBiPakSaCamYyRkum

kargarEfTaMsuxPaB

rbsGntildekBI eKaled

AKoslashuacuteykUs

kntildeuacutegQamrbsGntildek cUrs

aksYrfa etIeFVIets

thorntimesKoslashuacuteykUskntildeuacutegQam

rbsGntildekedayrebobN

a nigenAeBlNa nigfaet

IeRbIR)as

lTsectpledImIEfrkSa

CmparaWTwkenamEpyenmrbs

GntildekedayrebobNa

q cUrRbIR)asEpnkar

enHCaTisedAENnaMeTAkan

karEfTaM

xoslashUumlnEacutegpTHORNalrbsGntildek

q cUrBiPakSafaetIEpn

karEfTaMxoslashUumlnEacutegpTHORNal

rbsGntildek kMBugdMeN

Irkar

yagemcEdr erogr

aleBlEdlGntildekeTA

CYbRkumEfTaMsuxPaB

rbsGntildek

21

Step 4 Get routine care to avoid problems

See your health care team at least twice a year to find and treat problems early Discuss what steps you can take to reach your goals

At each visit get a bull blood pressure check bull foot check bull weight check bull review of your self-care plan shown in Step 3

Two times each year get an bull A1C testmdashIt may be checked more often if it is over 7

Once each year get a bull cholesterol test bull triglyceride (try-GLISS-er-ide) test- a type of blood fat bull complete foot exam bull dental exam to check teeth and gumsmdashtell your

dentist you have diabetes bull dilated eye exam to check for eye problems bull flu shot bull urine and a blood test to check for kidney problems

At least once get a bull pneumonia (nu-mo-nya) shot

22

CY u M xPaBrbsu Gky I uacute ntilde yqaedmrkemlngBuumla)albB ethbRkmEfTa ntilde B gm ntilde M I I I i aas agehacNas rdgk Y

[)anTan i I ntilde Y i Y I IeBlBPakSafaetGkGacTTlykvFankarNamyedmseRmc)aneKaledA

rbsGntildek

eBleTACYbmthorngsup2 cUr sup3

bull BinituumlsmltaFQam

bull BinituumleCIg bull BinituumlTmparan bullBi i M Uuml oslash alrbsGkeLgvjdc)anbgajkuacutentilde i IntuumlEpnkarEfTaxnEacutegpTHORN ntilde I i U eth gvFankarT3

BIrdgCaerogralqntildeaM cUr sup3

bull eFVIetsthorntimes A1C - GaceFVIjwkjabCagenH)an RbsinebIvaelIsBI 7

mthorngCaerogralqntildeaM cUr sup3

bull BinituumlkUeLesthornrUlI times K t) Y i aj gQamuacutebulleFetsV thorn triglyceride (RTI esrIoslash I -CaRbePTmyeacutenCatxoslash kntilde

bull karBinituumleCIgTaMgmUl bullkarBi i micro I I I micro i copy micro U micro ntildentuumleFjedmemleFjngGBaajeFj-crR)abeBTuumleFjrbsGkfa

GntildekmanCmparaWTwkenamEpyenm

bull BinituumlEPntildek edImIemIlbBaethaEPntildek bull cakfntildeaMkarBarRKunpthornasay bull eFVIetsthorntimesTwkenam nigQam edImIemIlbBaethaRkelon

yagehacNasmthorngmYyqntildeaM cUr sup3

bull cakfntildeaMkarBareraKrlaksYt notnUmUnIyabrvbar

viFankarTI 4 sup3 TTYlkarEfTaMCaRbcaM[eTogTatedImIecosputbBaetha

2

q Ask your health care team about

these and other tests you may

need Ask what your results

mean

qWrite down the date and time of

your next visit

q If you have Medicare ask your

health care team if Medicare

will cover some of the costs for

q learning about healthy eating

and diabetes self

care special shoes if you

need them

qmedical supplies

q diabetes medicines

2

qcUrsYrRkumEfT

aMsuxPaBrbs

GntildekGMBIkareFVIe

tsthorntimes TaMgenH

nigepSgeTot

EdlGntildekGacR

tUvkar cUrs

YrfaetI

lTsectplrbsG

ntildekmannfrac12yyag

dUcemthornc

q cUrktRtakal

briecaumlT nigeB

levlaeacutenkar

eTACYb

elIkeRkayrb

sGntildek

q RbsinebIGntildekm

an Medicare cUrsYrRkum

EfTaM

suxPaBrbsG

ntildekfa etI Medicare nwg

rabrg

cMNaymYycMnYns

Rmab

q sikSaGMBIkarb

riePaKEdlma

nsuxPaBlyen

nigEskeCIgB

iessEfTaMCmparaWT

wkenamEpyenm

xoslashUumlnEacuteg Rbs

inebIGntildekRtUvkar

q smOumlarsup3pAacutetpAacuteg

Buumla)al

q fntildeaMCmparaWTwkenam

Epyenm

2

__________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________

Notes

NATIONAL DIABETES EDUCATION PROGRAM wwwndepnihgov

2

bull sszligitenATmparanEdlmansuxPaBlyen edayeFVIkareRCIserIsGaharmansuxPaBlyen nigeFVIclna[kanEteRcIn

bull sMu[eKCYyRbsinebIGntildekmanGarmmicroN_TukccedilRBYy GntildekTIRbwkSasux

PaBposlashUacutevcitthorn RkumKaMRT smaCikbuBVCit mitthornPkthorni bcurrensmaCikRKYsarnwgsthornabkar)armOumlrbsGntildek ehIyCYyGntildek[manGarmmicroN_RbesIreLIg

bull eronedaHRsayPaBtantwgposlashUacutevcitthorn PaBtantwgposlashUacutevcitthorn GacbegaacuteInKoslashuacuteykUskntildeuacutegQam

rbsGntildek edaysarvaBi)akkntildeuacutegkarbM)atPaBtantwgposlashUacutevcitthornBICivit

rbsGntildek

GntildekGaceronRKbRKgva

bull QbBisa)arI cUresntildeIsMuCMnYybBaAumlbBisa)arI

bull TTYlTanfntildeaMeTaHbICaenAeBlGntildekmanGarmmicroN_lyenkfrac34eday

cUrsaksYrevCcentbNETHitrbs Gntildek faetIGntildekRtUvkarfntildeaMGasltIrIn edImITbsaacuteateraKKaMgebHdUgbcurrenCmparaWdacsreacutesQam

EdrbcurrenGt cUrR)abeTAevCcentbNETHitrbsGntildek RbsinebIGntildekminGaceacute

llkTijfntildeaMrbsGntildek

)an bcurrenRbsinebIGntildekmanplvi)akBIfntildeaMNamYy

bull hatR)aNBI 30 eTA 60 naTI[)aneRcIneacutefparakntildeuacutegmYys)athornh_ karedIrelOnsup2 KWCaviFIeFVIclna

dfrac34RbesIrmYy

1

bull Check your feet every day for cuts blisters r ed spots and swelling Call your health car e team right away about any sor es that wonrsquot go away

bull Brush your teeth and floss every day to avoid pr oblems with your mouth teeth or gums

bull Check your blood glucose Y ou may want to test it one or mor e times a day

bull Check your blood pressure If your doctor advises

bull Report any changes in your eyesight to your doctor

q Talk to your health care team

about your blood glucose targets

Ask how and when to test your

blood glucose and how to use the

results to manage your diabetes

q Use this plan as a guide to your

self-care

q Discuss how your self-care plan is

working for you each time you

visit your health care team

20

bullBinit uuml e C Ig r b s k C a e r o g r a l eacute f paraG ntilde E R k g m a n k a r m t d a c u B g E s k k n UumlTHORN l R k h m

ni I U frac12 THORN u M u ntilde oslash I W g e h m Tr s Be h A R k m k a r g a r E f T a sx P a B r b s Gk P a m R ) a b Bk a r Q c a b E d l

min)ateTAvij

U MG a t e F

mat eFmicroj nigGBacopyajeFmicrojrbsGntildek

bulldus e F microj r b s Gntildek n ig e R b IE x S k t s microj C a e r o g r a l eacute f parae d Im Ie c o s p ut b B a etha C a m Yy

bullBi i I oslashuacutent uuml e m l K y k s k ntildeuacuteg Q a m r b s U ntilde Gk R b E h l K r e F I times thorn gGk ntilde Y e t s thornV v a m

bcurreneRcIndg kntildeuacutegmYyeacutefpara

bullBinit uuml e m Il s m lta F Q a m r b s Gntildek R b s in e b Ie v C centb N ETHit r b s Gntildek E N n a M

bull raykarN_BIkarposlashasbthornUacuterkntildeuacutegEPntildekrbsGntildek eTAkanevCcentbNETHitrbsGntildek

q cUrBiPakSaCamYyRkum

kargarEfTaMsuxPaB

rbsGntildekBI eKaled

AKoslashuacuteykUs

kntildeuacutegQamrbsGntildek cUrs

aksYrfa etIeFVIets

thorntimesKoslashuacuteykUskntildeuacutegQam

rbsGntildekedayrebobN

a nigenAeBlNa nigfaet

IeRbIR)as

lTsectpledImIEfrkSa

CmparaWTwkenamEpyenmrbs

GntildekedayrebobNa

q cUrRbIR)asEpnkar

enHCaTisedAENnaMeTAkan

karEfTaM

xoslashUumlnEacutegpTHORNalrbsGntildek

q cUrBiPakSafaetIEpn

karEfTaMxoslashUumlnEacutegpTHORNal

rbsGntildek kMBugdMeN

Irkar

yagemcEdr erogr

aleBlEdlGntildekeTA

CYbRkumEfTaMsuxPaB

rbsGntildek

21

Step 4 Get routine care to avoid problems

See your health care team at least twice a year to find and treat problems early Discuss what steps you can take to reach your goals

At each visit get a bull blood pressure check bull foot check bull weight check bull review of your self-care plan shown in Step 3

Two times each year get an bull A1C testmdashIt may be checked more often if it is over 7

Once each year get a bull cholesterol test bull triglyceride (try-GLISS-er-ide) test- a type of blood fat bull complete foot exam bull dental exam to check teeth and gumsmdashtell your

dentist you have diabetes bull dilated eye exam to check for eye problems bull flu shot bull urine and a blood test to check for kidney problems

At least once get a bull pneumonia (nu-mo-nya) shot

22

CY u M xPaBrbsu Gky I uacute ntilde yqaedmrkemlngBuumla)albB ethbRkmEfTa ntilde B gm ntilde M I I I i aas agehacNas rdgk Y

[)anTan i I ntilde Y i Y I IeBlBPakSafaetGkGacTTlykvFankarNamyedmseRmc)aneKaledA

rbsGntildek

eBleTACYbmthorngsup2 cUr sup3

bull BinituumlsmltaFQam

bull BinituumleCIg bull BinituumlTmparan bullBi i M Uuml oslash alrbsGkeLgvjdc)anbgajkuacutentilde i IntuumlEpnkarEfTaxnEacutegpTHORN ntilde I i U eth gvFankarT3

BIrdgCaerogralqntildeaM cUr sup3

bull eFVIetsthorntimes A1C - GaceFVIjwkjabCagenH)an RbsinebIvaelIsBI 7

mthorngCaerogralqntildeaM cUr sup3

bull BinituumlkUeLesthornrUlI times K t) Y i aj gQamuacutebulleFetsV thorn triglyceride (RTI esrIoslash I -CaRbePTmyeacutenCatxoslash kntilde

bull karBinituumleCIgTaMgmUl bullkarBi i micro I I I micro i copy micro U micro ntildentuumleFjedmemleFjngGBaajeFj-crR)abeBTuumleFjrbsGkfa

GntildekmanCmparaWTwkenamEpyenm

bull BinituumlEPntildek edImIemIlbBaethaEPntildek bull cakfntildeaMkarBarRKunpthornasay bull eFVIetsthorntimesTwkenam nigQam edImIemIlbBaethaRkelon

yagehacNasmthorngmYyqntildeaM cUr sup3

bull cakfntildeaMkarBareraKrlaksYt notnUmUnIyabrvbar

viFankarTI 4 sup3 TTYlkarEfTaMCaRbcaM[eTogTatedImIecosputbBaetha

2

q Ask your health care team about

these and other tests you may

need Ask what your results

mean

qWrite down the date and time of

your next visit

q If you have Medicare ask your

health care team if Medicare

will cover some of the costs for

q learning about healthy eating

and diabetes self

care special shoes if you

need them

qmedical supplies

q diabetes medicines

2

qcUrsYrRkumEfT

aMsuxPaBrbs

GntildekGMBIkareFVIe

tsthorntimes TaMgenH

nigepSgeTot

EdlGntildekGacR

tUvkar cUrs

YrfaetI

lTsectplrbsG

ntildekmannfrac12yyag

dUcemthornc

q cUrktRtakal

briecaumlT nigeB

levlaeacutenkar

eTACYb

elIkeRkayrb

sGntildek

q RbsinebIGntildekm

an Medicare cUrsYrRkum

EfTaM

suxPaBrbsG

ntildekfa etI Medicare nwg

rabrg

cMNaymYycMnYns

Rmab

q sikSaGMBIkarb

riePaKEdlma

nsuxPaBlyen

nigEskeCIgB

iessEfTaMCmparaWT

wkenamEpyenm

xoslashUumlnEacuteg Rbs

inebIGntildekRtUvkar

q smOumlarsup3pAacutetpAacuteg

Buumla)al

q fntildeaMCmparaWTwkenam

Epyenm

2

__________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________

Notes

NATIONAL DIABETES EDUCATION PROGRAM wwwndepnihgov

2

bull Check your feet every day for cuts blisters r ed spots and swelling Call your health car e team right away about any sor es that wonrsquot go away

bull Brush your teeth and floss every day to avoid pr oblems with your mouth teeth or gums

bull Check your blood glucose Y ou may want to test it one or mor e times a day

bull Check your blood pressure If your doctor advises

bull Report any changes in your eyesight to your doctor

q Talk to your health care team

about your blood glucose targets

Ask how and when to test your

blood glucose and how to use the

results to manage your diabetes

q Use this plan as a guide to your

self-care

q Discuss how your self-care plan is

working for you each time you

visit your health care team

20

bullBinit uuml e C Ig r b s k C a e r o g r a l eacute f paraG ntilde E R k g m a n k a r m t d a c u B g E s k k n UumlTHORN l R k h m

ni I U frac12 THORN u M u ntilde oslash I W g e h m Tr s Be h A R k m k a r g a r E f T a sx P a B r b s Gk P a m R ) a b Bk a r Q c a b E d l

min)ateTAvij

U MG a t e F

mat eFmicroj nigGBacopyajeFmicrojrbsGntildek

bulldus e F microj r b s Gntildek n ig e R b IE x S k t s microj C a e r o g r a l eacute f parae d Im Ie c o s p ut b B a etha C a m Yy

bullBi i I oslashuacutent uuml e m l K y k s k ntildeuacuteg Q a m r b s U ntilde Gk R b E h l K r e F I times thorn gGk ntilde Y e t s thornV v a m

bcurreneRcIndg kntildeuacutegmYyeacutefpara

bullBinit uuml e m Il s m lta F Q a m r b s Gntildek R b s in e b Ie v C centb N ETHit r b s Gntildek E N n a M

bull raykarN_BIkarposlashasbthornUacuterkntildeuacutegEPntildekrbsGntildek eTAkanevCcentbNETHitrbsGntildek

q cUrBiPakSaCamYyRkum

kargarEfTaMsuxPaB

rbsGntildekBI eKaled

AKoslashuacuteykUs

kntildeuacutegQamrbsGntildek cUrs

aksYrfa etIeFVIets

thorntimesKoslashuacuteykUskntildeuacutegQam

rbsGntildekedayrebobN

a nigenAeBlNa nigfaet

IeRbIR)as

lTsectpledImIEfrkSa

CmparaWTwkenamEpyenmrbs

GntildekedayrebobNa

q cUrRbIR)asEpnkar

enHCaTisedAENnaMeTAkan

karEfTaM

xoslashUumlnEacutegpTHORNalrbsGntildek

q cUrBiPakSafaetIEpn

karEfTaMxoslashUumlnEacutegpTHORNal

rbsGntildek kMBugdMeN

Irkar

yagemcEdr erogr

aleBlEdlGntildekeTA

CYbRkumEfTaMsuxPaB

rbsGntildek

21

Step 4 Get routine care to avoid problems

See your health care team at least twice a year to find and treat problems early Discuss what steps you can take to reach your goals

At each visit get a bull blood pressure check bull foot check bull weight check bull review of your self-care plan shown in Step 3

Two times each year get an bull A1C testmdashIt may be checked more often if it is over 7

Once each year get a bull cholesterol test bull triglyceride (try-GLISS-er-ide) test- a type of blood fat bull complete foot exam bull dental exam to check teeth and gumsmdashtell your

dentist you have diabetes bull dilated eye exam to check for eye problems bull flu shot bull urine and a blood test to check for kidney problems

At least once get a bull pneumonia (nu-mo-nya) shot

22

CY u M xPaBrbsu Gky I uacute ntilde yqaedmrkemlngBuumla)albB ethbRkmEfTa ntilde B gm ntilde M I I I i aas agehacNas rdgk Y

[)anTan i I ntilde Y i Y I IeBlBPakSafaetGkGacTTlykvFankarNamyedmseRmc)aneKaledA

rbsGntildek

eBleTACYbmthorngsup2 cUr sup3

bull BinituumlsmltaFQam

bull BinituumleCIg bull BinituumlTmparan bullBi i M Uuml oslash alrbsGkeLgvjdc)anbgajkuacutentilde i IntuumlEpnkarEfTaxnEacutegpTHORN ntilde I i U eth gvFankarT3

BIrdgCaerogralqntildeaM cUr sup3

bull eFVIetsthorntimes A1C - GaceFVIjwkjabCagenH)an RbsinebIvaelIsBI 7

mthorngCaerogralqntildeaM cUr sup3

bull BinituumlkUeLesthornrUlI times K t) Y i aj gQamuacutebulleFetsV thorn triglyceride (RTI esrIoslash I -CaRbePTmyeacutenCatxoslash kntilde

bull karBinituumleCIgTaMgmUl bullkarBi i micro I I I micro i copy micro U micro ntildentuumleFjedmemleFjngGBaajeFj-crR)abeBTuumleFjrbsGkfa

GntildekmanCmparaWTwkenamEpyenm

bull BinituumlEPntildek edImIemIlbBaethaEPntildek bull cakfntildeaMkarBarRKunpthornasay bull eFVIetsthorntimesTwkenam nigQam edImIemIlbBaethaRkelon

yagehacNasmthorngmYyqntildeaM cUr sup3

bull cakfntildeaMkarBareraKrlaksYt notnUmUnIyabrvbar

viFankarTI 4 sup3 TTYlkarEfTaMCaRbcaM[eTogTatedImIecosputbBaetha

2

q Ask your health care team about

these and other tests you may

need Ask what your results

mean

qWrite down the date and time of

your next visit

q If you have Medicare ask your

health care team if Medicare

will cover some of the costs for

q learning about healthy eating

and diabetes self

care special shoes if you

need them

qmedical supplies

q diabetes medicines

2

qcUrsYrRkumEfT

aMsuxPaBrbs

GntildekGMBIkareFVIe

tsthorntimes TaMgenH

nigepSgeTot

EdlGntildekGacR

tUvkar cUrs

YrfaetI

lTsectplrbsG

ntildekmannfrac12yyag

dUcemthornc

q cUrktRtakal

briecaumlT nigeB

levlaeacutenkar

eTACYb

elIkeRkayrb

sGntildek

q RbsinebIGntildekm

an Medicare cUrsYrRkum

EfTaM

suxPaBrbsG

ntildekfa etI Medicare nwg

rabrg

cMNaymYycMnYns

Rmab

q sikSaGMBIkarb

riePaKEdlma

nsuxPaBlyen

nigEskeCIgB

iessEfTaMCmparaWT

wkenamEpyenm

xoslashUumlnEacuteg Rbs

inebIGntildekRtUvkar

q smOumlarsup3pAacutetpAacuteg

Buumla)al

q fntildeaMCmparaWTwkenam

Epyenm

2

__________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________

Notes

NATIONAL DIABETES EDUCATION PROGRAM wwwndepnihgov

2

bullBinit uuml e C Ig r b s k C a e r o g r a l eacute f paraG ntilde E R k g m a n k a r m t d a c u B g E s k k n UumlTHORN l R k h m

ni I U frac12 THORN u M u ntilde oslash I W g e h m Tr s Be h A R k m k a r g a r E f T a sx P a B r b s Gk P a m R ) a b Bk a r Q c a b E d l

min)ateTAvij

U MG a t e F

mat eFmicroj nigGBacopyajeFmicrojrbsGntildek

bulldus e F microj r b s Gntildek n ig e R b IE x S k t s microj C a e r o g r a l eacute f parae d Im Ie c o s p ut b B a etha C a m Yy

bullBi i I oslashuacutent uuml e m l K y k s k ntildeuacuteg Q a m r b s U ntilde Gk R b E h l K r e F I times thorn gGk ntilde Y e t s thornV v a m

bcurreneRcIndg kntildeuacutegmYyeacutefpara

bullBinit uuml e m Il s m lta F Q a m r b s Gntildek R b s in e b Ie v C centb N ETHit r b s Gntildek E N n a M

bull raykarN_BIkarposlashasbthornUacuterkntildeuacutegEPntildekrbsGntildek eTAkanevCcentbNETHitrbsGntildek

q cUrBiPakSaCamYyRkum

kargarEfTaMsuxPaB

rbsGntildekBI eKaled

AKoslashuacuteykUs

kntildeuacutegQamrbsGntildek cUrs

aksYrfa etIeFVIets

thorntimesKoslashuacuteykUskntildeuacutegQam

rbsGntildekedayrebobN

a nigenAeBlNa nigfaet

IeRbIR)as

lTsectpledImIEfrkSa

CmparaWTwkenamEpyenmrbs

GntildekedayrebobNa

q cUrRbIR)asEpnkar

enHCaTisedAENnaMeTAkan

karEfTaM

xoslashUumlnEacutegpTHORNalrbsGntildek

q cUrBiPakSafaetIEpn

karEfTaMxoslashUumlnEacutegpTHORNal

rbsGntildek kMBugdMeN

Irkar

yagemcEdr erogr

aleBlEdlGntildekeTA

CYbRkumEfTaMsuxPaB

rbsGntildek

21

Step 4 Get routine care to avoid problems

See your health care team at least twice a year to find and treat problems early Discuss what steps you can take to reach your goals

At each visit get a bull blood pressure check bull foot check bull weight check bull review of your self-care plan shown in Step 3

Two times each year get an bull A1C testmdashIt may be checked more often if it is over 7

Once each year get a bull cholesterol test bull triglyceride (try-GLISS-er-ide) test- a type of blood fat bull complete foot exam bull dental exam to check teeth and gumsmdashtell your

dentist you have diabetes bull dilated eye exam to check for eye problems bull flu shot bull urine and a blood test to check for kidney problems

At least once get a bull pneumonia (nu-mo-nya) shot

22

CY u M xPaBrbsu Gky I uacute ntilde yqaedmrkemlngBuumla)albB ethbRkmEfTa ntilde B gm ntilde M I I I i aas agehacNas rdgk Y

[)anTan i I ntilde Y i Y I IeBlBPakSafaetGkGacTTlykvFankarNamyedmseRmc)aneKaledA

rbsGntildek

eBleTACYbmthorngsup2 cUr sup3

bull BinituumlsmltaFQam

bull BinituumleCIg bull BinituumlTmparan bullBi i M Uuml oslash alrbsGkeLgvjdc)anbgajkuacutentilde i IntuumlEpnkarEfTaxnEacutegpTHORN ntilde I i U eth gvFankarT3

BIrdgCaerogralqntildeaM cUr sup3

bull eFVIetsthorntimes A1C - GaceFVIjwkjabCagenH)an RbsinebIvaelIsBI 7

mthorngCaerogralqntildeaM cUr sup3

bull BinituumlkUeLesthornrUlI times K t) Y i aj gQamuacutebulleFetsV thorn triglyceride (RTI esrIoslash I -CaRbePTmyeacutenCatxoslash kntilde

bull karBinituumleCIgTaMgmUl bullkarBi i micro I I I micro i copy micro U micro ntildentuumleFjedmemleFjngGBaajeFj-crR)abeBTuumleFjrbsGkfa

GntildekmanCmparaWTwkenamEpyenm

bull BinituumlEPntildek edImIemIlbBaethaEPntildek bull cakfntildeaMkarBarRKunpthornasay bull eFVIetsthorntimesTwkenam nigQam edImIemIlbBaethaRkelon

yagehacNasmthorngmYyqntildeaM cUr sup3

bull cakfntildeaMkarBareraKrlaksYt notnUmUnIyabrvbar

viFankarTI 4 sup3 TTYlkarEfTaMCaRbcaM[eTogTatedImIecosputbBaetha

2

q Ask your health care team about

these and other tests you may

need Ask what your results

mean

qWrite down the date and time of

your next visit

q If you have Medicare ask your

health care team if Medicare

will cover some of the costs for

q learning about healthy eating

and diabetes self

care special shoes if you

need them

qmedical supplies

q diabetes medicines

2

qcUrsYrRkumEfT

aMsuxPaBrbs

GntildekGMBIkareFVIe

tsthorntimes TaMgenH

nigepSgeTot

EdlGntildekGacR

tUvkar cUrs

YrfaetI

lTsectplrbsG

ntildekmannfrac12yyag

dUcemthornc

q cUrktRtakal

briecaumlT nigeB

levlaeacutenkar

eTACYb

elIkeRkayrb

sGntildek

q RbsinebIGntildekm

an Medicare cUrsYrRkum

EfTaM

suxPaBrbsG

ntildekfa etI Medicare nwg

rabrg

cMNaymYycMnYns

Rmab

q sikSaGMBIkarb

riePaKEdlma

nsuxPaBlyen

nigEskeCIgB

iessEfTaMCmparaWT

wkenamEpyenm

xoslashUumlnEacuteg Rbs

inebIGntildekRtUvkar

q smOumlarsup3pAacutetpAacuteg

Buumla)al

q fntildeaMCmparaWTwkenam

Epyenm

2

__________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________

Notes

NATIONAL DIABETES EDUCATION PROGRAM wwwndepnihgov

2

Step 4 Get routine care to avoid problems

See your health care team at least twice a year to find and treat problems early Discuss what steps you can take to reach your goals

At each visit get a bull blood pressure check bull foot check bull weight check bull review of your self-care plan shown in Step 3

Two times each year get an bull A1C testmdashIt may be checked more often if it is over 7

Once each year get a bull cholesterol test bull triglyceride (try-GLISS-er-ide) test- a type of blood fat bull complete foot exam bull dental exam to check teeth and gumsmdashtell your

dentist you have diabetes bull dilated eye exam to check for eye problems bull flu shot bull urine and a blood test to check for kidney problems

At least once get a bull pneumonia (nu-mo-nya) shot

22

CY u M xPaBrbsu Gky I uacute ntilde yqaedmrkemlngBuumla)albB ethbRkmEfTa ntilde B gm ntilde M I I I i aas agehacNas rdgk Y

[)anTan i I ntilde Y i Y I IeBlBPakSafaetGkGacTTlykvFankarNamyedmseRmc)aneKaledA

rbsGntildek

eBleTACYbmthorngsup2 cUr sup3

bull BinituumlsmltaFQam

bull BinituumleCIg bull BinituumlTmparan bullBi i M Uuml oslash alrbsGkeLgvjdc)anbgajkuacutentilde i IntuumlEpnkarEfTaxnEacutegpTHORN ntilde I i U eth gvFankarT3

BIrdgCaerogralqntildeaM cUr sup3

bull eFVIetsthorntimes A1C - GaceFVIjwkjabCagenH)an RbsinebIvaelIsBI 7

mthorngCaerogralqntildeaM cUr sup3

bull BinituumlkUeLesthornrUlI times K t) Y i aj gQamuacutebulleFetsV thorn triglyceride (RTI esrIoslash I -CaRbePTmyeacutenCatxoslash kntilde

bull karBinituumleCIgTaMgmUl bullkarBi i micro I I I micro i copy micro U micro ntildentuumleFjedmemleFjngGBaajeFj-crR)abeBTuumleFjrbsGkfa

GntildekmanCmparaWTwkenamEpyenm

bull BinituumlEPntildek edImIemIlbBaethaEPntildek bull cakfntildeaMkarBarRKunpthornasay bull eFVIetsthorntimesTwkenam nigQam edImIemIlbBaethaRkelon

yagehacNasmthorngmYyqntildeaM cUr sup3

bull cakfntildeaMkarBareraKrlaksYt notnUmUnIyabrvbar

viFankarTI 4 sup3 TTYlkarEfTaMCaRbcaM[eTogTatedImIecosputbBaetha

2

q Ask your health care team about

these and other tests you may

need Ask what your results

mean

qWrite down the date and time of

your next visit

q If you have Medicare ask your

health care team if Medicare

will cover some of the costs for

q learning about healthy eating

and diabetes self

care special shoes if you

need them

qmedical supplies

q diabetes medicines

2

qcUrsYrRkumEfT

aMsuxPaBrbs

GntildekGMBIkareFVIe

tsthorntimes TaMgenH

nigepSgeTot

EdlGntildekGacR

tUvkar cUrs

YrfaetI

lTsectplrbsG

ntildekmannfrac12yyag

dUcemthornc

q cUrktRtakal

briecaumlT nigeB

levlaeacutenkar

eTACYb

elIkeRkayrb

sGntildek

q RbsinebIGntildekm

an Medicare cUrsYrRkum

EfTaM

suxPaBrbsG

ntildekfa etI Medicare nwg

rabrg

cMNaymYycMnYns

Rmab

q sikSaGMBIkarb

riePaKEdlma

nsuxPaBlyen

nigEskeCIgB

iessEfTaMCmparaWT

wkenamEpyenm

xoslashUumlnEacuteg Rbs

inebIGntildekRtUvkar

q smOumlarsup3pAacutetpAacuteg

Buumla)al

q fntildeaMCmparaWTwkenam

Epyenm

2

__________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________

Notes

NATIONAL DIABETES EDUCATION PROGRAM wwwndepnihgov

2

CY u M xPaBrbsu Gky I uacute ntilde yqaedmrkemlngBuumla)albB ethbRkmEfTa ntilde B gm ntilde M I I I i aas agehacNas rdgk Y

[)anTan i I ntilde Y i Y I IeBlBPakSafaetGkGacTTlykvFankarNamyedmseRmc)aneKaledA

rbsGntildek

eBleTACYbmthorngsup2 cUr sup3

bull BinituumlsmltaFQam

bull BinituumleCIg bull BinituumlTmparan bullBi i M Uuml oslash alrbsGkeLgvjdc)anbgajkuacutentilde i IntuumlEpnkarEfTaxnEacutegpTHORN ntilde I i U eth gvFankarT3

BIrdgCaerogralqntildeaM cUr sup3

bull eFVIetsthorntimes A1C - GaceFVIjwkjabCagenH)an RbsinebIvaelIsBI 7

mthorngCaerogralqntildeaM cUr sup3

bull BinituumlkUeLesthornrUlI times K t) Y i aj gQamuacutebulleFetsV thorn triglyceride (RTI esrIoslash I -CaRbePTmyeacutenCatxoslash kntilde

bull karBinituumleCIgTaMgmUl bullkarBi i micro I I I micro i copy micro U micro ntildentuumleFjedmemleFjngGBaajeFj-crR)abeBTuumleFjrbsGkfa

GntildekmanCmparaWTwkenamEpyenm

bull BinituumlEPntildek edImIemIlbBaethaEPntildek bull cakfntildeaMkarBarRKunpthornasay bull eFVIetsthorntimesTwkenam nigQam edImIemIlbBaethaRkelon

yagehacNasmthorngmYyqntildeaM cUr sup3

bull cakfntildeaMkarBareraKrlaksYt notnUmUnIyabrvbar

viFankarTI 4 sup3 TTYlkarEfTaMCaRbcaM[eTogTatedImIecosputbBaetha

2

q Ask your health care team about

these and other tests you may

need Ask what your results

mean

qWrite down the date and time of

your next visit

q If you have Medicare ask your

health care team if Medicare

will cover some of the costs for

q learning about healthy eating

and diabetes self

care special shoes if you

need them

qmedical supplies

q diabetes medicines

2

qcUrsYrRkumEfT

aMsuxPaBrbs

GntildekGMBIkareFVIe

tsthorntimes TaMgenH

nigepSgeTot

EdlGntildekGacR

tUvkar cUrs

YrfaetI

lTsectplrbsG

ntildekmannfrac12yyag

dUcemthornc

q cUrktRtakal

briecaumlT nigeB

levlaeacutenkar

eTACYb

elIkeRkayrb

sGntildek

q RbsinebIGntildekm

an Medicare cUrsYrRkum

EfTaM

suxPaBrbsG

ntildekfa etI Medicare nwg

rabrg

cMNaymYycMnYns

Rmab

q sikSaGMBIkarb

riePaKEdlma

nsuxPaBlyen

nigEskeCIgB

iessEfTaMCmparaWT

wkenamEpyenm

xoslashUumlnEacuteg Rbs

inebIGntildekRtUvkar

q smOumlarsup3pAacutetpAacuteg

Buumla)al

q fntildeaMCmparaWTwkenam

Epyenm

2

__________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________

Notes

NATIONAL DIABETES EDUCATION PROGRAM wwwndepnihgov

2

q Ask your health care team about

these and other tests you may

need Ask what your results

mean

qWrite down the date and time of

your next visit

q If you have Medicare ask your

health care team if Medicare

will cover some of the costs for

q learning about healthy eating

and diabetes self

care special shoes if you

need them

qmedical supplies

q diabetes medicines

2

qcUrsYrRkumEfT

aMsuxPaBrbs

GntildekGMBIkareFVIe

tsthorntimes TaMgenH

nigepSgeTot

EdlGntildekGacR

tUvkar cUrs

YrfaetI

lTsectplrbsG

ntildekmannfrac12yyag

dUcemthornc

q cUrktRtakal

briecaumlT nigeB

levlaeacutenkar

eTACYb

elIkeRkayrb

sGntildek

q RbsinebIGntildekm

an Medicare cUrsYrRkum

EfTaM

suxPaBrbsG

ntildekfa etI Medicare nwg

rabrg

cMNaymYycMnYns

Rmab

q sikSaGMBIkarb

riePaKEdlma

nsuxPaBlyen

nigEskeCIgB

iessEfTaMCmparaWT

wkenamEpyenm

xoslashUumlnEacuteg Rbs

inebIGntildekRtUvkar

q smOumlarsup3pAacutetpAacuteg

Buumla)al

q fntildeaMCmparaWTwkenam

Epyenm

2

__________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________

Notes

NATIONAL DIABETES EDUCATION PROGRAM wwwndepnihgov

2

qcUrsYrRkumEfT

aMsuxPaBrbs

GntildekGMBIkareFVIe

tsthorntimes TaMgenH

nigepSgeTot

EdlGntildekGacR

tUvkar cUrs

YrfaetI

lTsectplrbsG

ntildekmannfrac12yyag

dUcemthornc

q cUrktRtakal

briecaumlT nigeB

levlaeacutenkar

eTACYb

elIkeRkayrb

sGntildek

q RbsinebIGntildekm

an Medicare cUrsYrRkum

EfTaM

suxPaBrbsG

ntildekfa etI Medicare nwg

rabrg

cMNaymYycMnYns

Rmab

q sikSaGMBIkarb

riePaKEdlma

nsuxPaBlyen

nigEskeCIgB

iessEfTaMCmparaWT

wkenamEpyenm

xoslashUumlnEacuteg Rbs

inebIGntildekRtUvkar

q smOumlarsup3pAacutetpAacuteg

Buumla)al

q fntildeaMCmparaWTwkenam

Epyenm

2

__________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________

Notes

NATIONAL DIABETES EDUCATION PROGRAM wwwndepnihgov

2

__________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________

Notes

NATIONAL DIABETES EDUCATION PROGRAM wwwndepnihgov

2

__________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________

kmmicroviFICatisMraberonGMBICmparaWTwkenamEpyenm

(NATIONAL DIABETES EDUCATION PROGRAM) wwwndepnihgov

27

esckthornIktsmAacuteal

Where to get help Many items are offered in English and Spanish

National Diabetes Education Program 1-800-438-5383 wwwndepnihgov

American Association of Diabetes Educators 1-800-TEAM-UP4 (800-832-6874) wwwdiabeteseducatororg

American Diabetes Association 1-800-DIABETES (800-342-2383) wwwdiabetesorg

American Dietetic Association 1-800-366-1655 wwweatrightorg

American Heart Association 800-AHA-USA1 (800-242-8721) wwwamericanheartorg

Centers for Disease Control and Prevention 1-877-232-3422 wwwcdcgovdiabetes

Centers for Medicare amp Medicaid Services 1-800-MEDICARE or (800-633-4227) wwwmedicaregovhealthdiabetesasp

National Institute of Diabetes and Digestive and Kidney Diseases National Diabetes Information Clearinghouse 1-800-860-8747 wwwniddknihgov

2

(National Diabetes Education Program) 1-800-438-5383 wwwndepnihgov

smaKmGaemrikaMgGbrM xagCmparaWTwkenamEpyenm

(American Association of Diabetes Educators) 1-800-TEAM-UP4 (800-832-6874) wwwdiabeteseducatororg

m(AmericanDiabetesAssociation) 1-800-DIABETES (800-342-2383) wwwdiabetesorg

wwwamericanheartorg

(Centers for Disease Control and Prevention) 1-877-232-3422 wwwcdcgovdiabetes

smaKmGaemrikaMgEpntildekCmparaWTwkenamEpyen

smaKmGaemrikaMgEpntildekxagtmGahar(AmericanDieteticAssociation) 1-800-366-1655 wwweatrightorg

smaKmGaemrikaMgEpntildekxagebHdUg (American Heart Association) 800-AHA-USA1 (800-242-8721)

mCAumlmNETHlRKbRKg nigTbsaacuteatCmparaW

mCAumlmNETHlesva Medicare amp Medicaid

viTuumlasszliganCatiCmparaWTwkenamEpyenm nigCmparaWRbdabrMlayGahar niglMEBg

(Centers for Medicare amp Medicaid Services) 1-800-MEDICARE bcurren (800-633-4227) wwwmedicaregovhealthdiabetesasp

(National Institute of Diabetes and Digestive and Kidney Diseases)kari frac12 frac12 rsquo W para kenamEpmfakCat(NationalDiabetesInformation yalyBtmanCmTw yen ntilde iClearinghouse) 1-800-860-8747 wwwniddknihgov

kEnoslashgedImITTYlCMnYy)ansup3

smOumlarsup3CaeRcInRtUv)anpthornl[CaPasaGgeKoslashs nigeGsaj

kmmicroviFICatisMrabGbrM BICmparaWTwkenamEpyenm

2

viTuumlasszligansuxPaBCati (National Institutes of Health) [NIH]nigmCAumlmNETHlRKbRKg nigTbsaacuteatCmparaW (Centers for

Disease Control and Prevention) [CDC] edaymankarKaMRTBIGgAacutekarCaeacutedKUCag 200 eTot

The US Department of Health and Human Servicesrsquo National Diabetes Education Program (NDEP) is jointly sponsored by the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention

(CDC) with the support of more than 200 partner organizations

kmmicroviFIGbrMCmparaWTwkenamEpyenmfntildeakCati (National Diabetes Education Program) [NDEP] rbsRksYgsuxPaBnigesvakmmicromnusSGaemrik RtUv)anshkar]btszligmOumleday

Reviewed by Martha Funnell MS RN CDE Michigan Diabetes Research and Training Center

)anBinituumleLIgvijeday Martha Funnell MS RN CDEmCAumlmNETHlRsavRCav nigbNthornuacuteHbNthornalCmparaWTwkenamEpyenmmIQIehAacuten (Michigan Diabetes Research and Training Center)

Cambodian (Khmer) translation provided by the Centers for Disease Control and Prevention Multilingual Services

Cambodian (Khmer) translation reviewed by Theanvy Kuoch MA LPC Khmer Health Advocates

West Hartford CT

karbkERbCaPasaExmicrorenH RtUv)anpthornleday esvaBhuPasaeacutenmCAumlmNETHlRKbRKg nigTbsaacuteatCMgW (Centers for Disease

Control and Prevention Multilingual Services)EacuteksarEdlbkCaPasaExmicrorenH RtUv)anRtYtBinituumleday Theanvy

Kuoch MA LPC Khmer Health Advocates West Hartford CT

NIH Publication No NDEP-67CA bull June 2007

CS109589