ABOUT TYPE 2 DIABETES
Because the more you know, the better you’ll feel. This booklet is designed to help you understand type 2 diabetes and the things you can do every day to help control it. As always, talk to your doctor for more information.*
Taking your medicine as directed by your doctor is one of the most important things you can do. If you're like most people, this may be easier said than done.
*The term “doctor” is used throughout this booklet to represent your healthcare provider and also includes nurse practitioners and physician assistants.
2
What You’ll Find
Where You’ll Find It
Attitudes and Beliefs
Page
Type 2 Diabetes—What Is It?
45
My Diabetes Goals—What Are They?
67
Taking Medicines
Diabetes Medicines—How Do They Work?
My Medicines—How Can I Get the Most From Them?
89
1011
Lifestyle
Sticking With My Medicines—What Will Work?
1213
Prevent and Manage Complications—What Else Can I Do? 1415 Talking With My Healthcare Team
My Doctor Visits—How Can I Get Ready?
1617
Help From Others
Diabetes Support—Where Can I Go for Help?
1819
About My Type 2 Diabetes Care Record
Back
3
Type 2 Diabetes—What Is It?
To help you deal with your feelings, learn more about diabetes and what you can do to treat it.
“
“
I have diabetes. What does that mean?
Esophagus
What is diabetes? Diabetes means that the Liver Stomach sugar levels in your blood Pancreas Intestines are too high. To understand diabetes, you must first know how glucose and Your body changes insulin work when you the food you eat into glucose digest food. Digestive System
What is glucose? Your body changes the food you eat into glucose (sugar). Your blood carries this sugar to all the cells in your body. Your body uses it for energy.
Glucose (sugar)
What is insulin? Insulin is made by the pancreas. When insulin enters the bloodstream, it acts as a “key.” It opens the cells for sugar to enter and be used by your body. 4
Insulin
Attitudes and Beliefs
Normal Insulin opens the cells so that sugar can enter Blood vessel Sugar entrance
Normally, your pancreas senses the amount of sugar in your blood. It releases the right amount of insulin so that all of the cell “doors” open for sugar to enter.
Cell
Type 2 Diabetes
Sugar entrance closed
“
Type 2 diabetes usually begins when cells no longer use insulin the right way. This is called insulin resistance. It causes sugar to build up in your blood. Over time, high blood sugar can cause serious health problems.
Will I have diabetes for the rest of my life?
“
High sugar levels caused by insulin resistance
Today, there is no cure for diabetes. But there are ways to help manage it:
• • •
Eat smart Don’t smoke Stay active
• • •
Lose weight Keep blood sugar in a healthy range Take your medicine as directed
In most cases, these steps can help you lead a healthier life. Use the goal checklist on the next page. Set goals that you are ready to reach. 5
My Diabetes Goals— What Are They? You are the most important person in managing your diabetes. Talk with your doctor to help you choose one or more goals al 1 you are ready to work on now. Go Meal Plan and Weight Management
al 2 Go
I will eat 3 meals daily. I will include healthy snacks in my daily meal plan. I will eat meals 4 – 5 hours apart. I will eat more _____________________ and less ___________________. I will try to lose_____ pounds by my next visit. Exercise I will exercise for _____ minutes _____ days per week, if my doctor tells me it is safe.* My doctor says the best activities for me are ________________________________________.
al 3 Go
If I notice chest pain, shortness of breath, or chest tightness, I will get emergency help. Foot Care
al 4 Go
I will wash and check my feet daily. I will talk to my doctor about sores or redness. I will have my doctor check my feet at every visit. Medicines
6
I will take my diabetes medicine(s) as directed. I will call my doctor if I have problems. I will ask questions when I do not understand.
Attitudes and Beliefs
al 5 Go
al 6 Go
al 7 Go
al 8 Go
al 9 Go
al 10 Go
Blood Sugar Monitoring I will check my blood sugar ____________. I will call my doctor if the level is below _______ or above _______. A1C (test of blood sugar control over time) I will know my A1C goal. I will take steps to improve my A1C level to __________. I will have my A1C measured twice a year or more if I am not at my A1C goal. Heart Health I will ask my doctor about taking aspirin for my heart. Eye Health I will have a dilated eye exam every year or as my doctor recommends. Smoking Cessation I will talk to my doctor about ways to quit smoking. Social Support I will talk to family and friends about how diabetes makes me feel. I will join a diabetes support group. I will let my doctor know if I feel sad or blue.
*Some medical conditions may make exercise dangerous for some people. 7 Before starting any exercise program, talk to your doctor.
Diabetes Medicines— How Do They Work? Eating right and exercising may not be enough to control your blood sugar. Your doctor may ask you to take medicines as well. There are different types of diabetes medicines. Each one works in a different way to control blood sugar. Not every medicine is right for every type 2 diabetes patient. For complete information, including potential side effects and drug interactions, talk with your doctor or pharmacist. Over time, you may need more than one kind of medicine to manage your diabetes. It may take a while before the medicine takes effect. Even when your diabetes is under control, you may need to continue taking your medicine for a long time.
Thiazolidinediones (TZDs)
• •
Help your body use its own insulin better. This helps more sugar get into your cells. May take a few weeks or more to work.
Biguanides
•
Target the liver and prevent it from releasing too much sugar into the blood.
Sulfonylureas
•
8
Help the pancreas release more insulin throughout the day. This helps more sugar get into your cells.
Taking Medicines
Meglitinides • Help the pancreas release more insulin during meals.
•
Should be taken no more than 30 minutes before meals.
Starch blockers (alpha-glucosidase inhibitors)
• •
Slow the breakdown of some foods such as bread, pasta, or table sugar. Taken with the first bite of each main meal. This helps prevent your blood sugar from going too high after meals.
DPP-4 inhibitors (dipeptidyl peptidase-4) • Help the pancreas release more insulin after meals.
•
Help control the amount of sugar released from the liver.
Insulin
•
If pills alone do not work, your doctor may have you take insulin to help lower blood sugar. Almost all forms of insulin must be taken by shots into the skin with a short needle. There are different kinds of insulin that work at different speeds.
Other diabetes medicines taken as shots:
• •
Amylin agonists help keep your blood sugar under control after you eat. Incretin mimetics help your pancreas release more insulin.
Fill out the medicine chart on page 10 with the help of your doctor. 9
My Medicines—How Can I Get the Most From Them?
Fill out the medicine chart below for all the medicines you take. This will help you know how, when, and why you take each medicine. Make sure you know the name, exact shape, color, and any words on your medicine. Name and Strength of Medicine
10
How Much I Take
When I Take It
Doctor’s office contact name / phone number
I Take It For
Taking Medicines
• •
Mark medicine refill dates on a calendar.
•
Check your blood sugar as directed to make sure your medicine is working.
•
Use reminder notes to remember to take your medicines.
Talk to your doctor if you have questions about your medicines or how to take them.
What My Pill Looks Like
Dates to Refill Rx
Special Instructions
Pharmacy contact name / phone number
11
Sticking With My Medicines—
What Will Work? Taking your diabetes medicine as directed by your doctor is one of the most important things you can do to control blood sugar.
Not taking your diabetes medicine as directed by your doctor means:
• • • •
Your blood sugar may go up. You may be at risk for serious health complications, like those on pages 14 – 15. Your blood sugar may become harder to control.
“
“
Your medicines will not work the way they should.
I don’t have time to take my medicine every day. Taking more than one medicine at different times each day can be hard. The key is to create a routine that fits your life:
•
What you eat and when you eat has an effect on how your diabetes medicines work. Talk to your doctor about a routine for taking your diabetes medicines.
• Your medicine routine may need to be timed with your meals, snacks, and/or physical activity.
• 12
Ask your doctor if there are medicines available that may be right for you and may reduce the number of medicines you have to take. Only your doctor can decide.
Lifestyle
If you forget doses often:
• • •
Use a pill box marked with the days of the week. Take it with you when you are away from home. Wear a watch. Set an alarm. Leave yourself a note on the bathroom mirror or your refrigerator. Keep your medicine in a place where you will see it daily.
If you forget to refill your medicine on time:
• • •
Make sure you have enough refills to last you until your next doctor visit. Ask your pharmacy to send you reminders to refill your prescription.
“
“
Mark a calendar with “Refill on [date]”. Choose a date about a week before you will run out.
I feel fine. Why do I need to take all these medicines? You may feel fine today because high blood sugar does not always cause symptoms. But you need to take medicine every day to prevent serious health problems over time. 13
Prevent and Manage Complications— What Else Can I Do? High blood sugar can harm your body in many ways. It is important to keep your blood sugar levels under control. You can do this with diet, exercise, and medicine. To see how well your treatment plan is working, your doctor will check your A1C levels at least twice a year.* You can help prevent and manage complications by taking these steps.
1 Heart Attack and Stroke A
•
Have your blood pressure checked at every doctor visit.
•
Have your cholesterol checked yearly.
High blood sugar levels can harm your blood vessels and raise your blood pressure. This can lead to a heart attack or a stroke. 2 Eye Problems B
• •
Have a dilated† eye exam every year.
Call your doctor right away if you notice any problems with your vision, like spots or blurriness.
High blood sugar can also harm the blood vessels in your eyes. This can lead to blindness. *The A1C test tells your average blood sugar level over the past 2 to 3 months. †Your eye doctor needs to dilate your eyes with eyedrops. This helps your
14
doctor see the blood vessels in the back of your eyes.
Lifestyle
3 Foot Problems and Amputations C
•
Check your feet every day for cuts, sores, bumps, and/or red spots. Call your doctor if you notice any changes.
•
Take off your shoes and socks at every doctor visit to have your feet checked.
High blood sugar can lead to nerve damage, like a loss of feeling in your feet. When this happens, a cut or sore can become infected badly before you know it. It may also take longer for it to heal. 4 Kidney Problems D
•
Your doctor should check your urine for small amounts of protein (microalbumin) at least once a year.
•
Your doctor should also check your serum creatinine levels once a year. This helps your doctor know how well your kidneys remove waste (glomerular filtration rate, or GFR).
Your kidneys help remove wastes from your blood. Over time, high blood sugar can cause the kidneys to stop work ing the right way. When this happens, wastes build up in your body and good things (like protein) leak out. This can lead to kidney failure.
Taking care of your diabetes every day may help you prevent and manage health problems that diabetes can cause over time. 15
My Doctor Visits—
How Can I Get Ready?
“
“
You and your doctor are a team in managing your diabetes. To get the most from your treatment, talk openly and honestly with your doctor.
I’m embarrassed to ask my doctor
some questions.
•
All questions are important. Do not be afraid to speak up if you do not understand something.
•
Do not be embarrassed to bring up more personal problems, like your sexual health. Your doctor is used to talking about these problems.
•
Ask a family member to join you for doctor visits. They can write down your doctor’s answers.
If you have trouble understanding what your doctor says:
•
Ask for written information about your medicine. Is this available in large print or another language?
•
Review the following checklist before each doctor’s visit.
Side effects may occur with any medicine. Tell your doctor about any side effects you may have or have had in the past. Never stop taking your medicine without first talking to your doctor. 16
Talking With My Healthcare Team
Prepare before you go to the doctor’s office. Check off the statements that apply to you and discuss with your doctor. Since my last visit: I have taken my medicine(s) as directed every day. I have stopped or changed how I take my medicine. My medicines have caused side effects that bother me. I have checked my blood sugar as directed. My blood sugar has been in my target range. I have checked my feet every day. I have felt sick some days due to diabetes. I have felt “sad” or “hopeless” much of the time. I have made progress on my goals for managing diabetes.
17
“
I need help. I can’t do this on my own.
“
Diabetes Support— Where Can I Go for Help? •
Ask a family member or friend to support you, such as going with you to your next doctor visit.
•
Ask your doctor about a diabetes support group. You can find a group in your area at www.diabetes.org.
If you have trouble paying for your medicines:
•
Visit www.togetherrxaccess.com, www.gskforyou.com, or www.PPARx.org for more information.
•
Another option is to call 1800Medicare or visit www.medicare.gov.
Have you felt down or hopeless? It’s normal for people with diabetes to feel down from time to time. But if you have been feeling down much of the time, talk to your doctor.
18
Help From Others
For more help and information, contact one or more of these diabetes resources: 1on1Health®
www.1on1health.com American Diabetes Association (ADA)
1-800-DIABETES (342-2383) www.diabetes.org National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
1-800-860-8747 www.diabetes.niddk.nih.gov National Diabetes Education Program
1-800-438-5383 www.ndep.nih.gov/diabetes/diabetes.htm
To learn more about what may be getting in the way of taking your medicines, go to www.takingmeds.com.
Many of the Web sites above are external to GlaxoSmithKline. GlaxoSmithKline does not have editorial control over the content of the information provided in these Web sites and therefore does not guarantee their accuracy and completeness. 19
About My Type 2 Diabetes Care Record The American Diabetes Association (ADA) recommends these items for good diabetes care. Work with your doctor to use this chart to track your progress. Test/Service (How Often)
ADA Target
/
/
/
/
/
