Diabetes Diary? Me, I am not the journal type

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Nora Saul is a Certified Diabetes Educator and Manager of Nutritional Education at the Joslin Diabetes Center

In life, there seem to be two kinds of people. Some are big picture people—they see a whole, beautiful forest, but they overlook the lone oak tree losing its leaves right in front of them. Some are more detail-oriented—they focus on that desolate oak tree, but don’t appreciate the glory of the whole forest.

Whichever category you fall into can color how you see your diabetes care. Today, I am going to talk to the big picture people, who may sometimes have difficulty with the details of diabetes management, especially in recording the daily minutiae.

I understand the sentiment; I find record keeping tedious, also.  But, if you focus on the big picture that record keeping can provide in the long run, you can divide the dense forest of information up into a number of sectors and tackle them one by one. You will wind up with a lot of important information about what is happening overall. And that makes your diabetes easier to control, and keeps yourself in better health- a definite big picture goal.

Blood Glucose Records

So why keep blood glucose records? After all, today’s glucose meters store hundreds of records for us.

But when looking at these individual readings, you are only looking at one static point in time. That point certainly has a story to tell, but the more interesting tale begins when you look at what your blood glucose readings are doing over time.

Hooking up to a continuous glucose monitor will give you both the details and the big picture, but not everyone has the luxury of owning one of these. You could be your own continuous glucose monitor, though, by taking and recording blood glucose readings at multiple times per day.

Then, you can look at trends—you will be able to see if you are always high after breakfast, for example, and you can ask yourself, “hmm, is it what or how much I am eating, or is it the amount or timing of my medication?” Once you’ve identified patterns, you can start the detective work to determine the causes of these trends and brainstorm ways to remedy them.

Remember that when you have diabetes, you are in charge. You can either alter your regimen if you have a good understanding of cause and effect, or you can call your health care team to discuss making changes in between visits.  Because, after all, diabetes is 24/7 – it doesn’t wait until your next medical visit.

Which brings us to ….Food and Blood Glucose Records

For those of us who feel the details are so much flotsam, keeping food records have to be a grinding bore. You need to keep a record of everything that you put in your mouth, including an estimate of the carbohydrate values. It can feel overwhelming and, at times, a bit unnecessary.

But food and blood glucose records can be an incisive tool if used appropriately.  If you are high before lunch only on Tuesdays and Fridays, keeping food records for breakfasts will show you that, say, the two cups of cereal you had those mornings is spiking your blood glucose.  Or maybe it can show you if the insulin you took is matching your blood glucose arc after eating veal parmesan.

“Yes,” you say, “but filling out food records still reeks of ennui.”

To make it less so,

  • Keep the records for only a few days: 3 to 4 days is usually enough to unveil patterns
  • Only keep records of the meal period that is giving you a problem.  If you are low or high after dinner each night, concentrate your efforts there.

Food, Blood Glucose and Exercise Records

The devil is in the details, isn’t it?  Just as food has a major impact on blood glucose values, so does exercise. Adding information about your physical activity to your chart will really bring everything together, giving you a comprehensive overview of the reasons for what is happening with your blood glucose throughout the day.

Remember exercise can have an effect on your glucose values over a 24-hour period.  The hour-long run you did in the morning may be lowering your numbers in the afternoon.  But without a record of patterns over time, you will never know.

So don’t get worked up about the tedium of having to record every detail. Keep in mind the impact their sum total will have on the biggest picture—your health.

2 Responses to Diabetes Diary? Me, I am not the journal type

  1. Brenda Moubray says:

    I’ve had type 1 diabetes and on insulin for 57 years. My age is 61 years old. I was just curious as to how you get the 50 year Bronze Medal.

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