Diabetes Management Checklist

The is a preplanning checklist that provides guidelines and principles on how to manage your diabetes for a lifetime.  

1.           Plan what you eat and follow a balanced meal plan.  See your dietitian at least once a year.)

2.           Exercise at least 30 minutes a day. Talk to your doctor so adjustments can be made to your medicine schedule or meal plan, if necessary.

3.           Follow your medicine schedule as prescribed by your doctor.

4.           Know what medicines (brand and generic names) you are taking and how they work. Always keep a list of your medicines with you.

5.           Test your blood glucose regularly, as recommended by your health care provider. Test more often when you are sick.

6.           Try to continuously keep your blood glucose level at the recommended range. If your blood glucose is less than 70 mg/dl and you have more than one unexplained low blood glucose reaction a week, call your doctor. If your blood glucose is greater than 160 mg/dl for more than a week or if you have two consecutive readings greater than 300 mg/dl, call your doctor.

7.           Contact your doctor when your blood glucose is over 300 mg/dl. Test your urine for ketones if recommended by your doctor.

8.          Record your blood glucose and in a recordkeeping log. Bring your logbook with you to your doctor's visits.

9.           Keep your scheduled appointments with your health care providers. See your doctor at least every three to four months for regular check-ups if you are treated with insulin. See your doctor every four to six months if you are treated with other diabetes medicines or if you are managing diabetes with diet and exercise alone. More frequent visits might be necessary if your blood glucose is not controlled or if complications of diabetes are progressing. Make sure your health care provider checks your blood pressure and weight and examines your feet and insulin injection sites.

10.       Have a glycosylated hemoglobin test (HbA1c) at least two times a year or more frequently as recommended by your doctor.

11.       Have an eye exam (including a retinopathy screening test) and urinalysis test once a year, or as recommended by your doctor. (Your doctor might request that you have these tests more frequently.)

12.       Have your cholesterol and triglyceride levels checked (lipid profile test) once a year

13.       Have a dental exam every six months.

14.       If you have any signs of infection, call your doctor or health care provider.

15.       Practice good foot care and skincare.

16.       Manage stress as best as you can. You might think about attending a stress management workshop, exercise, get enough sleep.

17.       Discuss your travel plans with your doctor. Make sure to bring enough medicine and supplies with you on your trip. Keep medicines, syringes, and blood glucose testing supplies in your carry-on bag. Do not check these supplies in case your luggage is lost.

18.       Continue learning about your diabetes to maintain and improve your health.

No can not only save you time and trouble - it can also save your life.

I am so proud of myself because this past weekend I told someone no and put my health first.  It does not come naturally to me to put myself first usually.  I was so surprised after the words came out of my mouth!  I was asked to go pick up my granddaughter around 6 in the evening when I was just about to start dinner.  Dinner was already later than I hoped to start, but picking her up would have set me back at least two more hours.  (She lives about 45 minutes one-way.)

Historically, I would have postponed dinner or not cooked at all and grabbed something en route or on the way back for her and me through a drive-through in an effort to save time, not inconvenienced anyone else (except myself) and not even considered saying no.

This time I said they would have to wait until after I had cooked and eaten dinner (around 8p) - before I could leave to pick her up.  Okay, that was not technically a "no", but it is a start!  The result caught me by surprise. They ended up bringing her and suddenly all the reasons given why they couldn't bring her before did not matter as much as bringing her earlier.  Funny how that worked out.

T2D Daily Checklist

This is a self-care planning list to be included in your morning and bedtime routines. Some of the to-do items on this list seem obvious but trust the process. Writing the tasks down or entering the routine into your calendar gives your mind more space to think about things that are not routine; those things you do not have to remember every single day for the rest of your life. Once you have a static list, you can just refer to it, and literally and mentally check it off as done. That is a very satisfying feeling.

• Take your medication. (I know. I know. Write it down anyway.)

• Inspect your feet. (Catch problems early due to nerve damage early and/or poor circulation and get them treated right away. Amputation can come from simply not caching a problem in time.)

• Brush and floss your teeth. (The higher your blood sugar level, the greater the supply of sugars and starches — and the more acid wearing away at your teeth.

• Stay active. (Do not overthink it. Park far away from the store entrance. Do housework. Dance. Ride your bike.)

• Eat healthy meals and snacks. (Have a snack before bed. Remember to bring lunch      and snacks with you when you are out and about so you are not caught off guard when you get hungry.)

• Protect your skin. (Wear a good sunscreen during the day.  Moisturize your skin before bed.)

• Get a good night's sleep. (Go to bed at the same time every day. Turn off the lights. Listen to ambient noise or better yet nothing. Whatever will help your mind and body turn off.)

Meal Planning 101: Set aside time to plan meals.

"When you follow a healthy meal plan, exercise regularly, and take your medicine as scheduled, you’ll successfully manage your diabetes without a problem." I read that and I want to scream.  It is partially true, but it is also incomplete, shallow and simplistic.

The issue is not lacking desire, willpower, or drive.  It is not due to self-pity. Let's just get that out of the way once and for all.

The challenge is the logistics of it all.  If you have a partner, it helps but it still frustrating in the best of circumstances.  How does a person with a full-time job find the time to prepare healthy meals? The last thing on your mind when you come home from work is finding a healthy recipe, all the ingredients, preparing it, cooking it, and then cleaning up.

Throw family and their needs and wants into the mix and it is enough to make anyone order a pizza and call it a day. In the United States, fast food is abundantly available at any time of the day or night, ridiculously cheap and extremely accessible and convenient.

That is where meal planning can offer very real, very practical help.  It is an essential tool in managing diabetes.

Because what we eat, how much we eat,  and even when we eat  - all play an important part in managing our blood glucose levels, meal planning helps create optimal conditions for your body to work better.

The key is to plan far enough in advance so that you anticipate what you are eating, are well prepared for the meal, keep the meal preparation and cooking as easy as possible, and train others to respect that by keeping to your plan.

Stick to what you know in the beginning.  If you want to plan a meal outside of the routine, prepare for that meal by jotting it down and any ingredients you will need you do not already have, and schedule time for the day you want to cook that particular meal - preferably on a day off.

Remember: The hardest part is the logistics.  Set aside time to plan meals.  Meal planning does require some time but it time well spent. Try to give yourself 30 minutes once a week to think about what meals to make. If you need more or less time that's okay.

It is very easy to feel overwhelmed by planning ahead for meals. Start with planning dinner meals only and instead of 7 meals, cook 3-4 meals and plan for some leftovers and free days.

Current  Menu Planning Checklist:

1. Try to plan on the same day every week. 
2. What meal will you cook? (Center meals around the vegetables instead of around the protein.)
3. What ingredients do you need? 
4. How much time does it take to prepare the meal? 
5. How much time does it take to cook? (I prefer recipes with a cooking time under 30 minutes unless it is the weekend.  
6. What day do you plan to cook each meal?
7. Are you cooking enough to have leftovers? (Make leftovers into another meal by adding something else.)
8. Create a grocery list based on the ingredients needed for the next week or two.
9. Adapt recipes to taste.  Here is where you can get creative without feeling overwhelmed.
10. Stick to the plan.

Turkey Tacos

INGREDIENTS

• 1 lb lean ground turkey (Buy this in bulk when it's on sale, I stock up.)
• 1 tbs of olive oil
• 2 tbs diced fresh onions
• 2 tbs Seasoning of choice for that Latin flavor, I use my blend of cumin, salt, pepper, oregano
• 1/2 cup salsa Your favorite salsa (I prefer to make my own and keep it at the ready.)
• 2 cups shredded lettuce. Use whatever lettuce you have. (Don't overthink it.)
• 1 cup of diced Roma tomatoes
• 1-2 avocados add to taco bowl
• 1 lime optional
• 1 cup salsa for topping

INSTRUCTIONS

1. Add the seasoning to the raw meat and blend it well.
2. Heat skillet on medium/ high heat with olive oil.
3. Add ground turkey, start to brown.
4. Add the onion, and garlic and stir.
5. Once fully browned, (10-15 minutes). Add salsa & stir.  Turkey cooks fast.
6. Cook 1-2 minutes.
7. Serve with corn or flour or tortillas, shredded lettuce, add other veggies: tomatoes, avocado, cucumber (whatever you have). For an even healthier option serve it over the shredded lettuce, veggie mix and skip the tortillas!
8. Top with hot sauce, salsa, and greek yogurt!
9. Optional: lime wedge for flavor

COOK TIME: 15 Minutes

Why I Want to Meal Plan

Meal planning consists of three basic steps: 1. Selecting your meals for at least a week. 2.  Shipping for the ingredients based on the meals you have selected.  3. Setting aside time to prepare the upcoming meals you chose.  I like to add 4. Entering it all in my paper planner (pen to paper makes me happy).

Most people know that meal planning can help save money, lose weight, simplify the cooking process, and reduce the stress of "what's for dinner?" Those are all common reasons that many choose to have a meal plan.

For me, it is about finding that sweet spot between meal planning and getting to eat spontaneous meals from time to time. It is about avoiding foods that are slowly poisoning me when someone else prepares the food without feeling remorse afterward or beating myself up because I made a poor choice or made someone feel awkward, rejected or slighted in some way. Saying no at a restaurant is simple; you order what you want from a menu and skip what you do not want. Rejecting a meal specially made meal when you are invited as a dinner guest in someone's home is an entirely different, much more delicate matter - especially among Latinos.

I have gone to both extremes: coming up with a reason to cancel, or accepting the invitation and eating whatever I was served; neither of which I recommend.  The more consistently I meal plan, the less anxious I will feel about occasionally indulging in a meal made with love at a friend's.

Meal prepping can involve eating the same dish or types of food a few days in a row.  It is not for people who prize variety and freshness above all else.  I do not mind leftovers, I would even say I enjoy them. What I want is options and simple recipes for everyday meals. I want sanity and peace.

I will not stick to fancy dishes or the time and effort they take on a daily basis. I do not always want to start from scratch or spend hours perusing a cookbook.  That is just not for me.  I want to be intentional and mindful about what I eat, understand how it fuels my body, be aware of how it makes me feel, and enjoy the company I am with. I am not fascinated with or entertained by how unique or special the dish is.

Cooking is the means to an end for me. It is not a passion of mine, although I love cooking for loved ones, I am not a foodie or an epicurean by any means.  I love a well-prepared meal and enjoy it most when in good company.   I need to enjoy meal planning and to keep it simple for it to be sustainable.

Book of Days - Week 17 - April 20, 2020

* Outside my window… (weather, what do you hear, what do you see?)  it is Spring and the birds are singing.  It’s  65 F in the mornings and 85 F in the afternoons.  Can’t ask for better weather but hardly no one is outside.  We are still under the COVID-19 “Stay-Home, Stay-Safe” order.  This reads like the start of a book or sci-fi novel I’ve read somewhere before.  

* My thoughts are.... on meal planning and whether I will master it and stick to it or burn out. I have been having mixed feelings.  I am excited about getting my levels even more under control, resigned to saying bye to spontaneous meals and anxious about the awkwardness in insisting on a specific food or saying no to certain foods when I am sharing meals with others. I am a Latina.  Both of my parents were Cuban and the vast majority of my friends eat when they get together to socialize. And I am not talking take-out. I am talking about homemade meals made with love, that took time and energy. Culturally, rejecting food offered is a no-no.  I mean you CAN say no, but it is very awkward.  The host or hostess does not know what to offer the guest instead. The guest politely declines and insists he or she is fine and then when dessert arrives, everyone stops to see if the person who said no to something at dinner is not going to have even the smallest bit of dessert. It happens and it is very uncomfortable.

* Today’s Quote… “My own experience has taught me this/ if you wait for the perfect moment when all is safe and assured it may never arrive.” ~ Maurice Chevalier

One can miss out on once in a lifetime opportunities that way.  I know I have.

* I am thankful for…still having a job amidst this COVID-19 pandemic, for the insurance which is so incredibly instrumental in my treatment. For reuniting and getting close to my daughter and having both my kids home during the “stay home, stay safe” order. I am thankful for my faith routines, even if it is virtual.

* From my research …(any skills, training, etc.; notes you want to share this week) Meal Planning is basically a three-step process: a) Plan the meals b) List and buy the ingredients c) Create your grocery list around those ingredients. I add a fourth step, which is to d) enter steps one through three down in my ring-bound paper planner.

Continuous Glucose Monitoring (CGM) is a way to measure glucose levels in real-time throughout the day and night. A tiny electrode called a glucose sensor is inserted under the skin to measure glucose levels in the tissue fluid. I am not new to it but when I first wore one, I thought, "Yay, fewer finger sticks!"  What I have come to realize over time is that the real-time feedback helps change patterns of behavior because now you have a way to "see" how your body is reacting to a certain food or activity - with the added bonus of a lot fewer finger sticks for the win!

* From the kitchen…(menu for the week, what are you cooking?)  Monday: Ground turkey tacos with cubed tomato, avocado, shredded cheese, and cilantro. Tuesday: Brown or Wild rice, leftover lentils and grilled Chicken breast; Wednesday: Fend for yourself day; Thursday: Cabbage with Turkey Sausage and Red-Skinned Potatoes; Fun Friday: Take out; Saturday: Fend for yourself day or leftovers; Sunday: Broccoli, chicken and cheese rice casserole.

* I am wearing… make up every day.  I believe it is a part of leaving the house in a decent condition. There are different levels of make-up. It is about presenting ourselves as put-together and beautiful at all times.  You have to dress for the occasion and the audience, not necessarily for your own comfort levels, but that does not mean you always have to glamor up.

* I am creating…(crafts, sewing, etc;)  a life planner, faith planner, and an art journal. Paper planning makes me happy.  I have been using ring-bound planners since 2014 and I love using them. Something about putting pen to paper, and seeing my schedule all in one spread that I find very satisfying.  This year I discovered stickers and that added just the right touch of playfulness and whimsy to the planing process. Pretty with a purpose. Gotta love that!

* My adventures this week…(where are you going this week?)  I am going grocery shopping to start my meal planning. Believe me, that is an adventure right now with the COVID-19 quarantine still in effect.

* Becoming well-read…(What are you reading this week?)  I am reading a book called, "The Immortal Life of Henrietta Lacks”.  It is a true story about a woman whose cells were taken without asking. The cells never died and they launched a medical revolution.  More than twenty years later her kids find out and that is where the book begins.

* I manifest and co-create…(what are your hopes, dreams, and prayers this week) Peace and tranquility in my house and with my children.

* Today’s Melody…(what music are you listening to? even if it’s just the sound of a bird…) The birds singing this morning, announcing Springtime.

* One of my favorite things... is having my granddaughter over to visit.

* Further plans for this week… regarding my faith routines are all online: the midweek meeting, letter-writing, and Sunday service.  I also plan on spending the night at a friend's house on Thursday.

* Still….life (share a picture you’ve taken OR a picture you found online that speaks to you)

Retrieved April 20, 2020, from http://www.artimess.co.uk/wp-content/uploads/2016/02/Hopewm.jpg