|Living with diabetes and doing all the planning, testing, and caretaking that comes with it can be lonely and overwhelming at times.
Sometimes the daily tasks can feel like too much for one person to handle. That’s why it’s important to assemble and educate a backup team of people who can support you and even pitch in as you care for yourself.
And no matter how good your intentions and capabilities are, there may come a time when you are unable to make an appropriate decision about your diabetes care.
Your backup team can jump in on your behalf and provide you with the help you need.
What’s a backup team?
Imagine that you are a coach and the people you spend time with-your family, friends, co-workers, and teachers, for example-are the players. These people are vital to your diabetes game plan. After all, a baseball team can’t win without a pitcher, batter, and fielders, and a basketball team should just stay in the locker room if only one person shoots the ball. Likewise, teaching the people you spend time with how to help you care for your diabetes can ease your burden, improve your quality of care, and perhaps save your life.
A backup team should include all the people you can count on to help you in an emergency, such as a hypoglycaemic or low blood sugar reaction. If you don’t have a backup team in place and you experience a hypoglycemic episode, you could end up in the emergency room when you could have managed the situation with the common sense of a few people who knew what to do. Your team will understand when you need to excuse yourself from a meeting at work to check your blood sugar.
They’ll help you remember to restock the glucose tablets in the car, or they’ll ask for a break during choir rehearsal when it’s time for an injection. Having a backup team doesn’t mean you’re any less able to manage your diabetes. It means you’ve taken a major step in your diabetes self-care and are planning for any unanticipated circumstances that could happen.
There are some additional benefits, too. Forming a backup team means telling people you have diabetes and no longer hiding a big part of your life. If you’ve had me coming to terms with having diabetes, the process of telling people about it may help you come closer to accepting it. Also, by telling people you have diabetes, you may learn who your true friends and allies are. True friends will accept you for who you are. You probably don’t wan “friends” who would reject you just because you have diabetes.
Assembling a backup team can also be helpful to the people you know. Most people don’t know much about diabetes until they are faced with the diagnosis. When you talk about your diabetes, other people can learn about the symptoms and the treatment. As a result, they may seek early treatment if they suspect that they also have diabetes.
Who should be on your team?
When you form your backup team, you will have to explain to each member what diabetes is and a little about how it impacts your life. In many cases, it is easiest to start with the people you live with. For couples, this includes your spouse or significant other. In families, you’ll need to include the children. Children of all ages can understand basic information about diabetes management and the special situations that arise where they can help you. For young people, a college roommate is an invaluable resource on your backup team. The people you live with know you at your best and at your worst, and can support you with your diabetes management.
Most people spend the majority of their time away from home at work. Therefore, it’s a good idea to include a few co-workers on your backup team. However, which co-workers to include, and whether or not to tell your employer, is entirely up to you. Your decision to tell them depends on your particular job circumstances and the people involved. You might want to seek legal advice to help you determine your rights and responsibilities and the impact of not revealing your medical conditions. Although you may not want to make a big deal out of the fact that you have diabetes, an informed and caring colleague can keep you safe and your work environment safe with just some basic knowledge and insight.
Next, think about where and with whom you spend your leisure time. Do you belong to an exercise club or gym? If you don’t, are you thinking about joining one? Consider the resources you need to have available to you for your diabetes self-care needs when it comes to exercise. Select a gym where the environment is supportive for people with diabetes to exercise. A knowledgeable training staff who will keep an eye on you when you’re working out is important. Water and fruit juice should be accessible as well. If you attend an exercise class, try to get to know some of the regular class participants. They can assist you during your step class or yoga session if you start to feel unwell.
Other backup team members can be found wherever you spend time. The person you regularly share your music with in you church choir is a great person to have on your team. Fellow members of your community theatre acting troupe, the local volunteer group, and maybe even the salesperson at your favourite dress shop are people you encounter throughout your busy schedule who can assist you with your diabetes self management. Your backup team should be diverse!
If your child has diabetes, be sure to include other caregivers on his or her backup team. Your child’s playmates and their parents are key members. Don’t forget to include your child’s teacher, school nurse, and Little League coach. If your child is young, daycare workers may be integral as members of the backup team. You might also need to enlist the den mother of your son’s Cub Scout pack or the ballet instructor when your child starts dance classes.
What do they need to know?
The most important thing your backup team will need to know is how to help you manage hypoglycaemia, or low blood sugar. The backup team is particularly important when wither you cannot treat your own hypoglycaemia or you can’t tell you are having a low blood sugar episode.
Start by saying what hypoglycaemia is (a reaction to having too little sugar in your bloodstream to fuel your body) and describe the classic signs and symptoms they will need to recognize. These include shakiness, nervousness, sweating chills and clamminess, trouble concentrating, headache, dizziness, light-headedness, moodiness, extreme hunger, and irritability. Different people experience different symptoms during hypoglycaemic reactions, so it is important to know what signals you usually experience. Discuss these symptoms with your backup team so they can recognize when your blood sugar begins to drop.
When you experience a low blood sugar reaction, it isn’t always easy to notice it yourself. Emphasize that the members of your backup team may need to point out the symptoms to you and remind you to test your blood sugar. The only sure way to know whether you have hypoglycaemia is to test your blood glucose. If your backup team members are a little intimidated by your sophisticated blood glucose meter, explain that it is simply a tool you use for your daily maintenance of your diabetes. They may even want to test their own blood sugar once to see how it works.
Under the best circumstances you can test your blood sugar when it first appears that your blood sugar is dipping, and then act according to the measurement. Talk with your doctor or educator to determine the blood sugar level at which you should begin treatment.
Of course, testing first may no always be possible. What if you don’t have your equipment with you? Never wait until you get home before treating low blood sugar especially if you have to drive. Help your team to understand that you need to treat your symptoms immediately. If you are still not feeling well, perhaps your team member will be able to accompany you or drive you home.
How can your backup team treat low blood sugar? First, they need to know some sources of fast-acting carbohydrate that can be easily absorbed into your blood. Some good sources of “pocket carbohydrate” are two to five glucose tablets, one tube of glucose get or Cake Mate brand decorator gel, two tablespoons of raisins, half a can of regular soda, four ounces of fruit juice, six to eight ounces of skim milk, or five to seven LifeSavers. Be sure your team knows where you keep your fast-acting carbohydrates. Are they in your purse? The glove compartment in your car? The locker in your gym? The duffel bag you brought to dance class? Keep a few different types of carbohydrate available where your team members can find them.
Your team should also know that more is not necessarily better. Overtreating hypoglycemia with sweets can cause very high blood sugar levels later on in the day, and the extra calories can interfere with your efforts to control your weight. Chocolate or candy bars are poor choices for treating low blood sugar, too, because the fat in these foods slows down absorption.
Once you’ve taken your quick-fix dose of carbohydrate, remember that the episode is not completely over. It is still necessary for you to test your blood sugar 15 minutes after you’ve eaten to be sure the carbohydrate has taken effect. If your blood sugar is still too low, you might need to eat some additional carbohydrate. If your next meal or snack is more than 30 minute4s away, your team member may want to join you for a follow-up snack after you have treated your hypoglycemia.
Your backup team is invaluable when it comes to severe hypoglycemia. Be sure to emphasize that if symptoms of hypoglycemia go unnoticed or ignored and your blood glucose level drops too low for too long, your brain will not get enough glucose and you may lose consciousness. This is a real emergency.
Ideally the best way to deal with severe hypoglycemia is to take precautions so it doesn’t happen in the first place. Help your team to be alert to your symptoms so you can get appropriate treatment right away. Don’t let your team wait to see if it gets worse or put of treatment until a more convenient time. Be sure they know that during a hypoglycemic reaction, you may become so confused and irritable that you refuse help. Those around you need to be persistent to get you the help you need. They can save you from coma and a trip to the hospital by insisting that you take some form of glucose quickly. Your life will be easier and safer those with whom you spend the most time can spot a hypoglycemic reaction and know what to do about it.
If you do lose consciousness some one else must take over. Although you will not be able to eat or drink anything, you still need raise your blood glucose level immediately. To do this, you need a glucagon injection. Glucagon, which is a hormone made by the pancreas, causes the liver to release glucose while simultaneous inhibiting the release of insulin.
It is important that the team members you spend the most time with know how to use your glucagon kit properly. Your diabetes educator can show you and your team members how to put the kit together and give injections with it you may even be able to borrow a sample kit from your educator to practice with.
If you have a severe hypoglycemic reaction and no one can assist you, some one should call immediately for emergency help. Take the time to join your team members and learn where the telephones are located and where emergency numbers are posted, just case they ever need them.
Another safeguard is medical identification, such as an ID bracelet or necklace or a medical identification card that you keep in your wallet. Be sure your team members know where you carry this information so they can give it to emergency medical personnel.
Talking with your team
What you tell each team member and how you go about saying it depends on who he or she is and how often you see each other. Naturally, the people you live with will want and need to know quite a bit about diabetes and how to intervene if you need help. Many diabetes education programs encourage guests to attend education classes. Your family members or roommates may be willing to join you for these classes or to meet with your diabetes educator to gain a better understanding of their role as a member of your diabetes backup team.
What about the people you see every day at work? Telling your co-workers will require some judgment on your part. Think about how much they need to know and how much you want to share with them. You might want to share with them. You might want to maintain your privacy: By not telling, you might lower your risk of being discriminated against. Although there are laws to protect against discrimination, it is not always easy to prove when it occurs.
If your workplace has a health clinic on site, you may want to start by getting to know the staff members there. Other good people to talk to “if you are comfortable” are the person who has the desk or office next to yours, the person who stands beside you on the assembly line, or the manager who hands out assignments. If you feel unsure about what to say or how to get the important information across clearly, ask your diabetes educator or doctor for a brochure that you can share with your team Folks who see you all the time will be honored that you asked them to be on your team. Once your choir director knows that you need to take a break during rehearsal, he may give the entire choir a break at that time. The same holds true for your child’s Scout leader. All the children may benefit from a healthy snack at the same time your child needs to eat.
Of course, some activities involve an ever-changing cast of characters. For instance, if your aerobics class has a rotating staff, you will need to introduce yourself to the different instructors at the beginning of each class. In situations like this, keep the information simple and to the point. Let the instructor know you have diabetes and that if you start to feel sick you may need to step out for a snack, or you may need some assistance. Often, it helps to keep a mental script ready for these occasions. It can be as simple as “I have diabetes”. This means my body doesn’t always provide me with the energy I need. You can help me by letting me know if you notice any of the following symptoms (describe how your body reacts when you have low blood sugar). When I have these symptoms, I need to eat something; I keep some special forms of sugar in my pocket. I’d appreciate it if you’d make sure I take time to eat if I have these symptoms.
If you are the parent of a child with diabetes, it is up to you to enlist members of your child’s backup team. Speak with your child’s school nurse about providing an opportunity to explain diabetes to your child’s classmates. Children are quite accepting of others when the explanation is given in a way that they can understand. The parents of your child’s playmates should also know your child’s signs and symptoms of hypoglycemia. They should know a few sources of fast-acting carbohydrate to give your child and how to contact you in case your child requires treatment.
Caring for your diabetes can be much easier and safer when you have a team to back you up. So gather up your diabetes teammates and make sure everyone understands the game plan. You don’t have to go it alone, and a backup team is really essential to provide the support you need to carry out your diabetes self-care. Family and close friends are obvious choices for membership on your special team. But don’t stop there: Think about where you spend your time and the people who are a part of those activities.
Your backup team is integral to your self-management success. While you are truly the “coach” of the team, your team members can help you achieve your goals. And the more informed and diverse your backup team is, the better they will be able to help you.