dietician nutritionist or a diabetes educator can be consulted some people need medication no matter how carefully they eat and exercise understanding how the medication works when to take it how much to take and potential side effects is important an understanding of the peak onset and duration of any medication used to treat high blood glucose is important it is also important to learn good insulin injection technique if applicable patient should be taught that daily selfmonitoring of blood sugar with a blood glucose meter provides the feedback on how food physical activity and medications affect blood sugar patient could talk to his health care team if he has any questions about how to use his meter or when to check his blood sugar there is no wrong time to check different times give different kinds of information monitoring however doesnt stop there people with diabetes may also want to regularly check their blood pressure and weight high blood glucose greater than 240 mg dl is potentially dangerous especially if untreated always check the urine for ketones if the blood glucose is more than 240 mgdl contact the physician if the blood glucose is greater than 240 mgdl and the urine is positive for ketones patient should be explained briefly about ketones and its presence in the urine blood glucose of less than 60 mgdl is dangerous and may lead to confusion disorientation and coma signs of low blood glucose include sweating slurred speech headache weakness tremors hunger nervousness tingling of the lips and rapid heartbeat in the event these signs are noted immediately ingest 15 to 20 grams of glucose sucrose can be substituted as a second choice glucose tablets or cup of orange juice or 6 hard candies is equal to this amount of carbohydrates cho initial response to treatment should be seen in 10 to 20 minutes evaluate blood glucose in about 60 minutes as additional treatment may be necessary repeat the process if blood glucose is less than 100 mgdl over the long term diabetes can lead to foot problems including infection and amputation check the feet and legs daily look for sores redness infection drainage swelling or bruises report problems to the doctor early keep the feet clean and dry never go barefoot protect any area where sensation is lost keeping your problemsolving skills sharp is important because on any given day a high or low blood sugar will require rapid informed decisions about food activity and medications even after decades of living with diabetes stability can still be a challenge the disease is progressive and life situations change learn to identify problem areas and find possible solutions have an annual examination with a boardcertified ophthalmologist a doctor specializing in eye care diabetic retinopathy can lead to the loss of vision diabetes is the leading cause of adult blindness in many countries often there are no symptoms before damage occurs the person with diabetes should wear a personal identification bracelet or necklace