It was a beautiful day. A patient of mine who has type 1 and her friends who do not have diabetes decided at the last minute to go out and enjoy it. They walked and walked, ate out for lunch, and walked and walked some more. She walked a lot more than she usually does. She ate healthier and ate less, even lower carb than she usually does. Not having expected such a day, she did not decrease her long-acting insulin the night before. Neither did she take her activity into account when she covered for her food. Sure enough, her glucose was low.
She treated, but realized she better not walk to a train or bus stop to get home. She needed a taxi. She did not bring her credit card or extra money to pay for the cab. Her friends pitched in. Her ride home was paid for. She got home safely and “took care of herself.”
1. Good diabetes management includes planning and preparing, but you can never plan for everything.
2. People who have diabetes want to be flexible in their plans.
3. It may not be planned exercise, but if patients are going to be more active, they need to be taught how and when to check and adjust for more active days.
4. Health care professionals usually do or should teach how to be ready for the “unexpecteds,” which include having one’s insulin, meds, supplies, ID, etc…. But do we teach to bring extra money?
5. Teach to make sure your patients carry some extra money with them just in case….
Joy Pape, FNP-C, CDE, WOCN, CFCN, FAADE
Associate Medical Editor, Diabetes in Control
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