General Instructions For Diabetics
Author: Safron Jeen

1. Daily estimation of blood sugar levels

Daily estimation of blood sugar levels is necessary in all
cases of diabetes - three times a day i.e. fasting, before lunch
and dinner. However, at least twice daily measurement of blood
sugar levels must be taken - fasting and before dinner. All
diabetics are advised to use a blood glucose meter at home for a
regular check-up of their blood sugar levels.

If a diabetic finds more/elevated sugar in his blood, he should
analyse as follows:

(i) What has he been doing for the last 2 hours? He may be
under stress.

(ii) Did he eat more?

(iii) Did he get less insulin/oral drug?

He should act as follows:

(i) If the result is mild sugar, do exercise, jump, walk; the
sugar will thus get consumed or dissipated.

(ii) Avoid stress.

(iii) If the quantity of sugar is high, he should regulate his
subsequent diet, exercise and drugs.

(iv) If the sugar is alarmingly high, he should consult his
physician immediately.

2. Self-insulin injection

If the patient is on insulin injections, he should preferably
learn the technique of self-injecting insulin into the various
sites of his/her body. In such cases one should know about the
proper sterilisation of syringes, needles, or preferably use
disposabl~ syringes as well as needles which are available
particularly for injecting insulin. A device such as NovoPen 3,
like a pen loaded with penfill (refill containing enough insulin
which can be used for many days depending on the need of the
patient) can also be used for administering the daily dosages of
insulin, under the direction of the physician. The penfill can
be replaced when exhausted.

3. Prevent diabetic coma

A diabetic should avoid fasting. Even if a diabetic is get ting
diarrhoea/vomiting/both, he should take the insulin/oral drug
along with glucose/sugar dissolved in water as soon as the
situation permits. In advanced cases, referral to a hospital is
important for glucose therapy along with parenteral insulin. If
the above is not strictly followed, it will lead to diabetic
coma which is a medical emergency.

4. More about diabetic coma

It occurs when the blood sugar level becomes below normal
(hypoglycaemic coma) or very high (hyperglycaemic coma). In the
former case the patient say have taken more than the prescribed
dosages of antidiabetic drugs in over-enthusiasm to make the
blood sugar levels normal, or he may have taken meagre food with
the same dosages of antidiabetic drugs. In the latter case, the
patient either misses the drug, or takes heavy food as well; the
chances are much more when there is some infection in the body.

The symptoms / signs of both the above types of coma are
different. In hypoglycaemic coma, the skin is moist with profuse
perspiration which can be noticed even by a person standing
nearby. All diabetics should be aware of these symptoms and as
soon as they start perspiring, they should start taking sugar
cubes which every diabetic is required to keep in his pocket. In
hyperglycaemic coma, the skin is dry. To meet this emergency
efficiently, diabetics are required to keep a card in their
pockets indicating that they are diabetic, so that on reaching
the hospital, the doctor on duty can immediately ascertain the
cause of coma and start treatment.


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