I may be a little full of myself, but last week I looked up the requirements to become a diabetes educator. Sitting with my coworker earlier this month and comparing war stories about our diabetes and the intermittent calls from my mom or my aunt about the best ways to manage my nearly 91-year-old grandmother's type 2 diabetes really give me a thrill. Maybe that sounds kind of kookie, but I suppose I have simple pleasures.
So, anyway, I'm not becoming a diabetes educator, mainly because I'd need to become a registered nurse (I think) and, frankly, that's not something I want to do. I was a little disappointed, though, reading the list of requirements and realizing that this was something that was out of reach for me.
However, this weekend drove it home how badly I don't want that career change. It's one thing to talk abstractly about diabetes management--Try having a carb and a protein as a bedtime snack to see if you stop going low overnight--it's quite another to have someone asking you specific, urgent questions.
Mom called on Friday. She and Aunt G., who lives with my grandmother, were on a short trip together. Aunt G. was on the phone with Little G., her daughter. Little G. said B's blood sugar was 44 and she felt terrible, and Little G. didn't know what to do.
"Have her drink a regular soda or some non-diet juice," I relayed. "And then check her every 15 minutes or so to make sure she's going up. When's the last time she ate? What was it? OK, yes, drink the soda or juice and continue to check her. And call me if you need anything."
I didn't hear back, so I knew everything was OK. Again, I felt as if I had really helped in this situation. But Little G. called again. B was getting ready to eat dinner the next day and she was 282. This was different. This was almost bedtime, need to eat something, try not to go low overnight, can't let B get too much higher.
"Drink lots of water," I told her. "Try to eat as few carbs as possible, but still eat some slow-digesting carbs like bread or crackers. At one hour after eating, start checking her every 15 minutes. Make sure she takes her bedtime meds. If she goes over 300, go to the hospital. Don't let her go to bed until you see that she's coming down. Call me if you need anything."
I passed my instructions off to Little G., who was probably scared out of her mind, and sat back and got pretty scared myself. What if my meal suggestion made B go too high and they had to go to the hospital? What if she goes low in the middle of the night because I told her not to eat too many carbs?
I'll stick to passing out my two-cents' worth to family and friends.


Diabetic Recipes










"B" as in "bubbe"?
Remember that if you are doing this as a career, you probably won't have patients calling you in the middle of the night unless you were the person "on call" or answering the phones. You might also have access to your patients' history, including data dumps of their meters and pumps. That, along with copies of their logs (or notes made in software such as co-pilot) might give you a better idea of how much of what to use to treat the immediate high or low.
/<*lightbulb illuminates*/> Based on this, and a thread on tudiabetes (EMTs not trained to recognize or deal with diabetes-related emergencies), maybe one of the things the Diabetes Community needs to think about establishing is a Diabetes Hotline. Basic IVR (interactive voice response -- "press 1 for type 1, 2 for type 2") to a person who will talk with you, handhold if necessary, escalate to a supervising CDE or physician if required, look up and patch through to local 911 if required, and keep you on the line until you've either started trending in the right direction, or until help arrives and is responding appropriately.
What a great idea, tmana. I used to be on a helpline for nursing moms and they were thrilled to have someone to talk to when the baby was just home from the hospital and wouldn't nurse! We were trained by La Leche League to offer suggestions ("Many mothers have found....") and to know when we needed to refer them to a professional lactation consultant or other healthcare professional. That is done on a local basis using volunteers from local LLL groups. Not sure how it would work for diabetes, but it's a great thing to aim for.
I have some ideas, and I've tagged some supporting Web conversations, and put them into a Word document with what and how I'd want the service to act/react, some basic protocols, and some issues with this sort of service (there are quite a number of legal issues)... It's not been vetted with anyone with either medical or legal or project management background... not sure who I would pitch it to, or in what order.
I think it's a great idea, too, but would have no idea where to start either. Maybe start with the American Association of Diabetes Educators. Or, heck, maybe it's something dLife would want to take on.
Sorry if this has no relevance to this subject, however... I just didcovered this site (and being the computer Klutz that I am) I don't know how to post a question... so if anyone could help I would greatly appreciate it...and if anyone wants to make suggestions on my issue that would be good too... so my Issue is that I keep forgetting to take my meds... :( I have tied setting alarm, getting one of those daily compartment thingies and I still forget...any suggestions...??
Hey Fatima. It sounds like you're taking orals. For me, it's partly about location. There was a time that I was forgetting to take one of my meds in the mornings and I discovered that if I put the bottle in a more prominent place that it was harder to forget. Also, it just has to become part of your routine. Just like checking your blood sugar. So if you're taking orals when you eat, try putting your pills in a cabinet where you'll see them, say, every time you reach for a glass or a clean plate. And just try to make it part of your daily ritual.