Self-management Blood Glucose Level for Diabetics

This article discusses the importance of self-management Blood Glucose Level for diabetics, especially vulnerable groups such as children and the elderly. It covers non-pharmacological, pharmacological, diet observation, and physical activity methods. The article also emphasizes the importance of monitoring glycemic control and provides steps for self-monitoring blood glucose. Course code and college/university not mentioned.

Running head: SELF-MANAGEMENT BLOOD GLUCOSE LEVEL 1
Self-management Blood Glucose Level for Diabetics
Student Name
Institution Affiliation
Author Note

SELF-MANAGEMENT BLOOD GLUCOSE LEVEL 2
Abstract
Self-management Blood Glucose Level is one of the most effective methods of trying to deal
with cases of many diabetics in the world. The level of diabetes is ever increasing and the need
to teach individuals how to handle the disease conditions in the absence of the physician is of
paramount importance. The vulnerable groups, such as Jaxson in the case study, happen to be the
children and the aged people in the society. The self-management takes different forms such as
pharmacological, non-pharmacological, diet observation, and use of physical activity. Self-
management has become the best diabetes management practice due to the positive results that
have been registered by patients subjected to the practice. The type of care that is patient-
centered helps to enable the patients, such as Jaxson, to manage their conditions from their
comfort zones and that also serves as a way of mitigating the situations where physicians are
absent while the patient needs urgent attention. The situation more or less devolves the
responsibilities such that the Jaxson becomes his own doctor.
Keywords: SMBG, diabetic, Insulin, Insulin resistance, Blood Glucose Level,
Nephropathy.

SELF-MANAGEMENT BLOOD GLUCOSE LEVEL 3
Self-management Blood Glucose Level for Diabetics
Diabetes mellitus is one of the most common kind of diabetes that has plagued the
society in many occasions. The malady is characterized by various symptoms that point towards
the positive identification of the same. The disease can be heritable or acquired depending on the
diverse conditions that may be prevailing in a given environment. The condition is grave serious
but it is treatable if discovered before its chronic stages ("Diabetes Prevention and Control",
2018). The emergence of the disease may be exacerbated by some disorder with the metabolic
system of an individual. Some of the symptoms of Diabetes mellitus are chronic hyperglycemia,
and poor protein, fat, and carbohydrate metabolism. The phenomenon is induced by an anomaly
in the secretion of insulin, action of insulin or both ("Kids & Diabetes - Diabetes Self-
Management", 2018). Effective control of the disease is attached to the reduction of the effects of
mortality and morbidity. Inadequate or absence of consistent and close care results in confusion
among patients. The situation leads to a decline in compliance among the patients. The emotional
shock that arises in the family when a kin is positively identified as diabetic causes gross
discomfiture. The discomfort is due to the negative effects associated with diabetes such as
impotence, extreme unnecessary anxiety, and disruption in the normal family life, irritability, and
increased fatigue (Sim, 2016). The paper will attempt to underscore the nature of diabetes
mellitus and the possible ways of inculcating the self-management Blood Glucose Level in an
individual especially the kids.
Diabetic patients, such as Jaxson, are required to be imparted with the knowledge and
skills that are requisite to the management of their conditions in order to boost the treatment
process even in the physicians’ absentia. Both the young and the aged are supposed to receive
the training or rather teaching so as to avoid cases where the individuals find themselves on
receiving end as a result of the lack of skills to help themselves whenever emergence incidents
transpire. There are a plethora of mechanisms that are employed to ascertain that Jaxson gains
the fundamental and requisite skills that will enable him to lead an ordinary life ("Diabetes -
issues for children and teenagers", 2018). Such mechanisms are non-pharmacological control,
Glycemic control monitoring, pharmacological control, and prevention.
Non-pharmacological Management
Psychosocial Situations

SELF-MANAGEMENT BLOOD GLUCOSE LEVEL 4
Physicians deploy the professional communication skills that aid them in communicating
them in relaying the unfriendly news to the patients especially when conveying the diagnosis
information for the very first instance. That capacity will come in handy when identifying and
treating diabetics’ psychological disorders. There are instances when the patient experiences
heightened anxiety and the occurrence of the fear of complications. Besides, the patients may
feel isolated from the rest of the community due to the embarrassment and stigma that stems
from the medical situation. The prevailing conditions culminate in their low self-esteem. Social
back from the network of family members and other diabetic social support parties and groups
are crucial to the wellbeing of the diabetic community ("Diabetes in Children | Type 1 Diabetes |
Type 2 Diabetes | MedlinePlus", 2018). Such an atmosphere fosters an effective self-
management of the diabetic patients since the individuals gather the confidence to lead normal
lives. The ability to realize improvement with regard to glycemic control is linked to the kind of
life the patients subjected to insulin treatment are leading. That case is mostly applicable to the
diabetics who have been diagnosed recently. Research has it that there is no significant
difference in the impact irrespective of the number of injections given to various patients
(Nazmi, Hadithi & Khan, 2013). The quality of life of the diabetics was not adversely affected as
a result.
Health Education
Education on diabetes is the pillar of the diabetic patient care as long as they aspire and strive to
achieve exemplary health status and other related aspects. The physician or clinician serves a
coordinator by ensuring that the patient receives the right and sufficient knowledge regarding the
way of self-managing the diabetic condition in their daily life. The overall goal is attained via a
well-crafted and tailored approach that allows the patients to integrate and understand the
concepts such that s/he can apply the precepts in the real-life situation. The education is imparted
systematically such that the patient and grasp every protocol so as to avoid any error of omission
or commission in the self-management of blood glucose. The various contents of the type of
education conferred to the patient are diabetes explanation, anti-diabetic drug explanation such
as storage, technique, action, and equipment. There is the employment of various diabetes
illustrations so as to create a firm and indelible impression of the various ways that are essential
in the treatment process. The patient is informed of the various complications that arise from the

SELF-MANAGEMENT BLOOD GLUCOSE LEVEL 5
disease, the way to observe the diet, the treatment of hypoglycemia, the effect of either using or
omitting insulin use in case of disease symptoms such as puking and stomach upsets. The patient
needs to undertake frequent urinalysis and hence there should be dipsticks at home for that
function. The patient should be taught on the effect of avoiding smoking, caring for the feet, the
essence of seeking counseling, and the benefits of exercise in a bid to mitigate the gross effect of
the disease.
Physical Activity
The practice of undertaking physical exercise perpetuates the beneficial impact of enhancing the
metabolism of carbohydrate and then makes the insulin sensitive. The benefit of insulin is then
sustained for more than five years. Studies conducted show that regimens of physical activity
undertaken trice to five times in every week for half to one hour edify the body system. There
were significantly improved results of the Hb1c as the reading registered 10 to 20 percent of
baseline. The higher percentage of the population composed of diabetes type 2 patients and
specifically those who demonstrated insulin resistance. A combination of insulin and physical
activity help one achieve the target weight and then maintain the status. The patient is
encouraged to engage in any sort of exercise since it has significant health benefits to the
diabetics.
Diet Observation
Majority of the diabetic patients depict insulin resistance and overweight conditions. Such
patients are subjected to medical nutrition therapy which will center focus on dynamic changes
in the lifestyle of the patient so that there will be a considerable reduction in the amount of
energy intake coupled with physical exercise. Effective health lifestyle is geared towards the
regulation of blood glucose level, blood pressure, and dyslipidemia (Information et al., 2018).
The above strategies should be deployed in the initial stages after diabetes diagnosis. The
patients are supposed to ingest carbohydrate-rich foods such as whole grains, vegetables, fruits,
and low-fat milk. The consumption of large quantities of fibre confers vital metabolic benefits
necessary for the control of hyperinsulinemia, glycemia, and plasma lipids. Carbohydrate is the
major food component that has a significant impact on the blood glucose content in an
individual. The micronutrients such as fat and protein have the influence the ability on the
postprandial level of glucose. The quantity of carbohydrate intake serves as a key predictor of

SELF-MANAGEMENT BLOOD GLUCOSE LEVEL 6
glycemic response (Sakurai, Kawai, Yamazaki & Komatsu, 2018). Monitoring the cumulative
quantity of the grams of carbohydrate is essential in the quest to control the blood glucose levels.
Low glycemic index contributes considerably towards mitigating the levels of glucose in the
blood. Protein consumption is supposed to consist of fifteen to twenty percent of the mean
energy intake. Patients manifesting microalbuminuria should reduce protein intake from 0.8g to
1 g in each 1kg body weight every day. Patients experiencing overt nephropathy requires to lose
0.8 g in every one kilogram of body weight each day which will reduce the progress of
nephropathy ("Type 1 diabetes in children - Diagnosis and treatment - Mayo Clinic", 2018).
Pharmacological Management
Pharmacological management involves the use of drugs to help lower or maintain the HbA1c
close to the levels of the normal physiological status. The lower threshold for initiating insulin in
the patient manifesting type 2 diabetes is linked to the reduction of complications on a long-term
basis. Insulin should be added early when the therapy of Maximum Sulfonylurea is inactive so as
to boost glycemic control. However, one should ensure that the move does not raise
hypoglycemia or overweight. All the lifestyle intervention strategies would be integrated into
therapies in the process of arresting the situation. The kind of diet diabetics should embrace
would be discussed and offered by the physician ("What Is a Normal Blood Sugar Level? -
Diabetes Self-Management", 2018). Problematics incidents emerging during the entire is closely
monitored by medical professions in order to avoid a healing crisis. Insulin therapy should be
observed strictly as it has been discovered in patients who have survived the malady for a range
of five to fifteen years. Diabetes 2 patients should be psychologically prepared such that they are
aware of the need for the insulin at some stage in order to avoid future inconveniences. Patients
suffering from frequent hypoglycemia are recommended to utilize insulin glargine (Bond &
Hewitt-Taylor, 2014). Insulin glargine exacerbates reduced nocturnal hypoglycemia than NPH.
By so doing, there is the removal of the barrier associated with the initiation of insulin therapy.
Metformin is included during the insulin therapy since the combination boosts glycemic control
and at the same time reducing the amount of required insulin.
Monitoring of Glycemic Control
The HbA1c levels in the body are supposed to as close to the normal physiological quantities as
possible that is, close to 7% or less (Walker, 2018). Any slight deviation results in disease

SELF-MANAGEMENT BLOOD GLUCOSE LEVEL 7
symptoms. Checking the glycemic levels frequently allows for the control of metabolism and
reduce the incidents of hospitalizations that result from poor glucose level control. Young
diabetic patients should maintain sustained lower HbA1c levels sometime after the diagnosis. The
patients should then use sensitizers such as Metformin and Glitazone in situations manifesting
negative metabolic response (Cold et al., 2018). Alpha-glucosidase inhibitors such as Acarbose
are essential to contain the sickly situation too.
Steps for Self-Monitoring Blood Glucose (SMBG)
A glucometer is employed in the measuring of the levels of glucose in the blood. The gadget
comes in various versions and models but they are used to achieve a common function.
Jaxson needs to understand fully the mechanics behind the functioning of the machine in order to
obtain relevant and useful results. Some meters’ precision is affected by material substances such
as medical substances, hematocrit level, user technique, and even temperature and hence one
needs to follow the protocols as stipulated in the user manuals. The lancing process and the
blood obtainment process is key to achieving the reliable feedback. Jaxson is supposed to master
the art of the lancing process in order to avoid bruising or unnecessary pain when obtaining the
blood sample (Wooldridge & Ranby, 2018). That is attained when Jaxson can adjust the depth of
the lancing gadget in a practical scenario and s/he should be familiar with the various types of
lancing tools available in the market. Jaxson should observe extreme hygiene and dry conditions
when handling the meter to avoid contamination and errors in results respectively. The test strips
are only used once for every meter. The strips are housed in the canister to avoid the effect of
moisture interference that will compromise the result. Jaxson should check the expiry date to
avoid errors (Das, 2016). Jaxson should then come with the table of results to the office in a
meeting with diabetes educators for further advice.
Jaxson should clean the skin surface with warm and soapy water and then dry. Jaxson
will then adjust the depth of the lancing device in order to control the penetration of the stick in
order to foster comfort and also obtain the best-required blood sample. The sides of the finger are
the most ideal sites for obtaining the sample since there is less pain and the process should be
done gently via “milking” the site (Panchbhai, 2012). Alternative sites for tests are the upper
arms, palms, and the thighs. The lancers should then be disposed of responsibly to avoid
unnecessary injury or contamination.

SELF-MANAGEMENT BLOOD GLUCOSE LEVEL 8
Factors considered in the Acquisition of Devices for SMBG
The degree of dexterity of Jaxson, the sample size of the blood required to produce the
desired result especially in situations where lancing hiccups and challenges with blood flow
prevail, and the cost-effectiveness of the consumption of the tools especially with regard to the
insurance coverage (Wu, 2014). The above factors help in counteracting any future problems that
any arise either during or after the Self-management Blood Glucose level.

SELF-MANAGEMENT BLOOD GLUCOSE LEVEL 9
References
Bond, C., & Hewitt-Taylor, J. (2014). How people with diabetes integrate self-monitoring of
blood glucose into their self-management strategies. Journal Of Innovation In Health
Informatics, 21(2), 64-69. doi: 10.14236/jhi.v21i1.11
Cold, F., Health, E., Disease, H., Management, P., Conditions, S., & Problems, S. et al. (2018).
Tests to Diagnose Diabetes. Retrieved from https://www.webmd.com/diabetes/type-2-
diabetes-guide/diagnosing-type-2-diabetes
Das, S. (2016). Evaluating the Relationship of Fasting Capillary and Venous Blood Sugar Level
in Self-Glucose Monitoring Device, Fasting Plasma Glucose Level and Glycosylated
Hemoglobin (HbA1C). Nursing & Care Open Access Journal, 1(2). doi:
10.15406/ncoaj.2016.01.00011
Diabetes - issues for children and teenagers. (2018). Retrieved from
https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/diabetes-issues-for-
children-and-teenagers
Diabetes in Children | Type 1 Diabetes | Type 2 Diabetes | MedlinePlus. (2018). Retrieved from
https://medlineplus.gov/diabetesinchildrenandteens.html
Diabetes Prevention and Control. (2018). Retrieved from https://www.mass.gov/diabetes-
prevention-and-control
Information, H., Overview, D., Diabetes?, W., Diabetes?, W., Center, T., & Health, N. (2018).
What is Diabetes? | NIDDK. Retrieved from https://www.niddk.nih.gov/health-
information/diabetes/overview/what-is-diabetes
Kids & Diabetes - Diabetes Self-Management. (2018). Retrieved from
https://www.diabetesselfmanagement.com/about-diabetes/kids-diabetes/
Nazmi, A., Hadithi, D., & Khan, S. (2013). Self monitoring of blood glucose level among
diabetic patients in Muscat, Oman: A pilot study. Saudi Journal For Health
Sciences, 2(1), 54. doi: 10.4103/2278-0521.112632

SELF-MANAGEMENT BLOOD GLUCOSE LEVEL 10
Panchbhai, A. (2012). Correlation of Salivary Glucose Level with Blood Glucose Level in
Diabetes Mellitus. Journal Of Oral And Maxillofacial Research, 3(3). doi:
10.5037/jomr.2012.3303
Sakurai, K., Kawai, Y., Yamazaki, M., & Komatsu, M. (2018). Prediction of lowest nocturnal
blood glucose level based on self-monitoring of blood glucose in Japanese patients with
type 2 diabetes. Journal Of Diabetes And Its Complications. doi:
10.1016/j.jdiacomp.2018.09.007
Sheila Walker, M. (2018). Self-management of Blood Glucose (SMBG) and Type 2 Diabetes.
Retrieved from http://www.diabetescareguide.com/selfmanagement-blood-glucose-smbg-
type-2-diabetes/
Sim, K. (2016). Effective Diabetes Self-Management Education: Focus on Blood Glucose
Pattern Management. The Journal Of Korean Diabetes, 17(1), 35. doi:
10.4093/jkd.2016.17.1.35
Type 1 diabetes in children - Diagnosis and treatment - Mayo Clinic. (2018). Retrieved from
https://www.mayoclinic.org/diseases-conditions/type-1-diabetes-in-children/diagnosis-
treatment/drc-20355312
What Is a Normal Blood Sugar Level? - Diabetes Self-Management. (2018). Retrieved from
https://www.diabetesselfmanagement.com/blog/what-is-a-normal-blood-sugar-level/
Wooldridge, J., & Ranby, K. (2018). Influence of Relationship Partners on Self-Efficacy for
Self-Management Behaviors Among Adults With Type 2 Diabetes. Diabetes Spectrum,
ds170069. doi: 10.2337/ds17-0069
Wu, Y. (2014). Application of Self-Regulatory Behavioral Management in Postprandial Self-
Blood Glucose Monitoring for Noninsulin Treated Type 2 Diabetic Patients. Acta
Endocrinologica (Bucharest), 10(4), 629-639. doi: 10.4183/aeb.2014.629