Diabetes and Care Planning
Diabetes doesn’t have to limit your lifestyle if it’s managed effectively. As with many other long-term health conditions, if managed correctly you will be able to incorporate the necessary changes into your life. However, without proper management and self-care, diabetes can become a debilitating illness which can cause severe complications, lead to other long term health issues, and sometimes amputation and blindness.
The NHS recommends working with your healthcare professionals to devise a Care Plan to help you manage your condition and allow you to continue with your life as normal.
What you can include in your care plan
- Changes in diet – eating more fresh food, changing the way you prepare meals, and introducing more fibre to your diet.
- Weight loss – if you are overweight, or over the ideal weight, your symptoms may be worse. Your care plan can include goals for weight loss over time.
- Increase in exercise. This goes hand in hand with diet and weight loss and may help with your symptoms. It will have a positive effect on other health issues such as high blood pressure and your mental health.
- Medication and testing your blood glucose levels
Care Planning Appointment
You can make an appointment with your GP to discuss your condition, how it affects your life, and what you’d like to do to improve how your condition fits into your life. In the appointment, you’ll be given all the information you need on how to improve your situation, and it’ll give you the opportunity to talk about what’s really important to you when thinking about implementing your care plan.
After this discussion, you’ll start putting the goals you have set yourself into a plan. This can be recorded in your medical notes only, or you can take a copy home to refer to in your own time. In the case of diabetes, these goals may include a change in diet, tips on how to improve your exercise regime in way which is safe for you and tailored to your condition, and ways to ensure you stay on top of your medication. Depending on what you agree with your GP, the plan may be very detailed or only consist of some simple guidelines. What’s important is that it works for you.
Ultimately discussing your care plan with your doctor will help you understand your diabetes in more detail. You should review the care plan every year to see if there are any changes you need to make.
Even if you don’t want a care plan, you should still make regular trips to your doctor to keep track of your condition. All decisions should be made for you, with you.
Self-care is something you’ll practice every day by taking your medication and tracking your diet. This helps you keep track of things you might not realise you’re doing. Other things you can do include getting the following health checks on a regular basis:
- Get regular blood HbA1c tests (blood glucose levels)
- Blood pressure checks
- Blood fats and cholesterol
- Eye tests for signs of retinopathy
- Regular kidney function tests
- Have your legs and feet checked for any circulation issues (this is particularly important, poor management of diabetes can lead to severe complications including amputation)
- Monitoring your mental health. Having a long-term condition can be stressful and difficult to cope with at times. It’s equally important to maintain your psychological wellbeing as well as your physical health.
You can make changes to your personal health such as giving up smoking, and regularly keeping track of your diet to make sure it’s still right for you. If you want more information on how to manage diabetes, you can visit a diabetes specialist who may be able to help you build a more complete picture of your condition. You should visit a specialist if you are planning to have a baby, for advice on how to manage your condition for a safe pregnancy. You are also entitled to a free NHS flu vaccination.
Risks and complications of diabetes
If you don’t have a care plan, or if you find it difficult to implement the changes and actions you have agreed with your healthcare professional, then you leave yourself at risk of developing further health problems and complications of diabetes. If you’re struggling to keep to your care plan, go back to your GP and discuss ways in which you can make it easier for you.
Not keeping up with your care plan leaves you at risk of:
If you don’t attend regular eye appointments, you run the risk of missing the signs of retinopathy until it’s too late. Retinopathy occurs when the blood vessels at the back of the eye supplying the retina become blocked, constricted or grow incorrectly, all of which can be caused by high blood glucose. This causes damage to the retina at the back of the eye and impairs sight. To avoid this happening you should keep your blood pressure, glucose and fats within your target range.
Effective foot care will be a big part of any diabetes care plan. Your health care professional will discuss with you how to check your feet at home and know the warning signs of a foot attack.
Reduced sensation in the feet because of diabetes may mean that you don’t notice if you injure your foot in some way, which can lead to infection or cause a foot ulcer. This is an urgent problem and if you spot any of the signs you must seek medical attention immediately.
Part of your care plan will involve planning a foot health check at least once a year with a trained professional. If you are at moderate or high risk of severe complications you will need to see a podiatrist once every three months. Failure to do this could lead to amputation. Your healthcare professional should advise you on how often you need to book in for a foot check.
Kidney disease can be caused by damage to the small blood vessels and capillaries, which can be caused by high blood glucose levels. If you don’t manage your diabetes effectively, the level of glucose in your urine can be high, which causes urinary tract infections as this creates a breeding ground for bacteria. If the infection persists then this may spread to the kidneys and further cause damage. You should factor regular urine and kidney function tests into your care plan to ensure that your kidneys are healthy and to catch any signs of kidney disease early when it is more easily treatable.
Reviewing your care plan
Depending on the type of diabetes you have, and the state of your general health over all, you will agree with your GP how often you need to review your care plan. As a minimum you should review the plan every 12 months and discuss how you are using it to manage your health. You may find it necessary to review the plan every three to six months.
It’s important to regularly examine and update your care plan to ensure that it is still relevant to your life and still helping to maintain your health to ensure you can live a full and active life. If you do experience any major lifestyle changes it may be necessary to update your care plan to accommodate these.
For more information about managing diabetes and care plans, you can follow these links: