ON THE ROAD TO BETTER

MANAGING YOUR DIABETES

Conversation Map® Take-Home Resource
YOU’RE IN THE DRIVER’S SEAT ABOUT THIS PROGRAM
Managing your diabetes starts with you. This take-home resource was designed to
Each week as part of this program you will be asked to set goals and make small, but
help you better manage your diabetes with the support of your diabetes care team.
meaningful changes to help improve your diabetes. You'll learn a lot about managing
As you continue your journey with diabetes, this take-home resource can help you
diabetes throughout these sessions, but more importantly, you'll be asked to put those
keep track of:
learnings into practice. Each week you'll be asked to try something new and when we
regroup at the next session, we will discuss how it went.
ƒ important screenings and visits with your diabetes care team
ƒ your test results
ƒ your daily blood glucose results
Set some short- and long-term goals for managing your
By working with your diabetes care team, checking your blood glucose, and staying SESSION 1 diabetes.
up to date with important tests and screening, you can prevent or delay complications
from diabetes.
SESSION 2 Record at least one blood glucose reading .
This take-home resource includes a general schedule of important tests and
screenings as well as general targets for those screenings. All of these align with
what is recommended by the American Diabetes Association Standards of Medical SESSION 3 Record at least one day of meals.
Care in Diabetes, 2023. However, this schedule is not meant to replace the
recommendations made by your diabetes care team. Your diabetes care team
can help you set individual goals and recommend a schedule for important tests Record one day of meals and one day of blood glucose
and screenings. SESSION 4 readings.

Try one strategy you can use to increase your physical

THIS TAKE-HOME RESOURCE BELONGS TO: SESSION 5 activity.

Write down some questions you have about your current or

SESSION 6 past medications.
MY DIABETES CARE TEAM MEMBERS ARE:
Write down a long-term goal for your diabetes
SESSION 7 management.

SESSION 8 Revisit and reflect on your goals and progress.

2 3
ON THE ROAD TO BETTER MANAGING YOUR DIABETES VIRTUAL CONVERSATION MAP© PROGRAM SESSION
1&2
 ON THE ROAD TO BETTER CONTROLLING YOUR BLOOD GLUCOSE
MANAGING YOUR DIABETES ƒ The current target ranges for blood glucose are:

SESSION 1 AND 2 KEY POINTS - Before meals: 80 to 130 mg/dL

- 2 hours after meals: Less than 180 mg/dL
ƒ Possible causes of high blood glucose (hyperglycemia)
ia)
YOU’RE IN THE DRIVER’S SEAT include:
- Being sick - Increased stress
ƒ When it comes to managing your diabetes, you’re in the driver’s seat. - Less activity than usual
- Eating more carbohydrates
ƒ Diabetes is a disease in which the body does not make
ake enough than usual
insulin and/or does not properly use insulin. The body may also
ƒ Possible causes of low blood glucose (hypoglycemia) include:
keep making glucose (sugar) even though it does not need
it. This causes the blood glucose level to become too high. - Eating a late meal - Drinking alcohol without
eating
ƒ Critically evaluate any new information that you hear - More activity than usual
about diabetes. Discuss any new information with your
our - Taking diabetes medicine
- Skipping meals
healthcare team.
ƒ Help control your blood glucose levels by:
- Think about how reliable the information is.
- Ask yourself if your healthcare team would agree - Eating healthy food: Consider what, how much, and when you eat
with this information. - Keeping active: Helps you regulate blood glucose levels
ƒ Feelings such as anger, frustration, denial, or guilt are common and expected—it’s - Taking medicine: Learn the names of your diabetes medicines and how they work
important to recognize these feelings and how they affect the choices you make in
caring for your diabetes.

MONITORING YOUR BLOOD GLUCOSE

HAVING THE INFORMATION YOU NEED ƒ It is important to monitor your blood glucose regularly because you may not always
feel any symptoms when your blood glucose is out of your target range.
ƒ Blood glucose is the amount of glucose, or sugar,
ar, ƒ Possible signs of high blood glucose (hyperglycemia) include:
in your blood.
- Blurred vision - Thirst
ƒ Insulin is a hormone that moves glucose from
your bloodstream into your cells so your body - Frequent urination
can use the glucose for energy. ƒ Possible signs of low blood glucose (hypoglycemia)
ƒ The pancreas is the organ that produces insulin and include:
other hormones. - Confusion - Shakiness
ƒ The liver has many jobs including making glucose.
se. - Headache
ƒ Excess food and glucose is generally stored as body fat.

6 7
 CREATING A GOAL CREATING SHORT-TERM GOALS
Write down your responses for steps 1–6 in the spaces provided. During the program, challenge yourself to create short-term goals to try between each
session.
STEP
1 Choose a focus. Think about what is most important to you right now in managing
your diabetes. (Example: I want to have better blood glucose control.)
After session 1, I will… After session 2, I will…

STEP Example: I will make an appointment for my

2 Create a long-term goal. Look at what you chose as a focus in Step 1. Think of a
goal you can reach in 7–12 months. (Example: I want to decrease my hemoglobin A1C (HbA1c/A1C) from 8% important diabetes-related screenings. Example: I will eat more vegetables this week.
to 7%.)

After session 3, I will… After session 4, I will…

STEP
3 Create a short-term goal. Think about what you can do regularly to reach your long-
term goal. (Example: I will pack a healthy lunch to take to work.)
Example: I will increase the number of steps I take
each day. Example: I will drink less soda this week.

STEP
4 Plan for challenges. Consider any challenges that may make it difficult for you to
reach your goals. Think about how you might deal with each challenge.
After session 5, I will… After session 6, I will…
(Example: I think my challenge will be buying healthy food for my lunch. I can deal with this challenge by creating and using a
shopping list of healthy foods when going to the market.)

Example: I will record a blood glucose reading Example: Write down everything I eat and drink for
every day this week. a day.
STEP
5 Stay motivated. To keep yourself motivated, think of how you can celebrate achieving
your goal. (Example: I will send my friend or coworker a message to let him or her know I achieved my goal.)
After session 7, I will… After session 8, I will…

STEP
6 Understand the health benefit(s). Write the health benefit(s) of accomplishing your Example: I will write down all my diabetes-related
long-term goal. (Example: If I decrease my hemoglobin A1C (HbA1c/A1C), I can decrease my risk of diabetes complications.) questions to review with my doctor at our next
Example: Make a medication schedule for the week. appointment.

8 9
MONITORING YOUR BLOOD GLUCOSE VIRTUAL CONVERSATION MAP© PROGRAM
SESSION
3&5
 MANAGING HIGH AND LOW BLOOD GLUCOSE
MONITORING YOUR BLOOD GLUCOSE
ƒ Although you may have some highs and lows, the key is to try
SESSION 3 AND 5 KEY POINTS to minimize those times and know how to deal with them.
ƒ Managing high blood glucose (hyperglycemia):
Causes of high blood glucose include:

BASICS OF BLOOD GLUCOSE - Being sick eased stress

- Increased
- Eating more carbohydrates than usual al
- Less activity than usual
ƒ Blood glucose is the amount of sugar or glucose in your
blood. Glucose is used as fuel and comes from many foods Signs of high blood glucose include:
as well as your liver. - Lack of energy, blurred vision, thirst
ƒ People with type 2 diabetes can have difficulty managing Treatment options for high blood glucose include:
their blood glucose because they don’t have enough insulin
and/or their insulin doesn’t work as it should. - Working with your healthcare team - Drinking water or other non-
to adjust your medicine(s) caloric beverages
ƒ Insulin is a hormone that moves glucose from your
- Physical activity - Adjusting your meal plan
bloodstream into most of your cells so your body can use the
glucose for energy. ƒ Managing low blood glucose (hypoglycemia):
Causes of low blood glucose include:
- Drinking alcohol without eating - Skipping meals
BLOOD GLUCOSE TARGETS AND MONITORING YOUR A1C/eAG - Eating a meal later than usual - Taking too much of certain types
- More activity than usual of diabetes medicines
ƒ The target ranges for blood glucose are:
Signs of low blood glucose include:
- Fasting blood glucose before meals: 80 to 130 mg/dL
- Shakiness, sweats, headache
- Two hours after the start of a meal: Less than 180 mg/dL
Treatment options for low blood glucose include:
ƒ Monitoring your blood glucose gives you information to help you make decisions
about eating, activity, and medicine. Talk to your healthcare team about when you - Drinking ½ cup of orange or apple juice - Taking 3 or 4 glucose tablets
should monitor.
If you have low blood glucose, don’t wait. Take something right away to raise your
ƒ You can monitor your blood glucose throughout the day blood glucose. Use the rule of 15 found on page 15.
A1C (%) eAG (mg/dL)
including before meals, two hours after meals, at bedtime,
and when fasting. 5% 97
6% 126 USING YOUR RESULTS
ƒ Both A1C and estimated average glucose (eAG) measure 7%
your average blood glucose over the past 2 to 3 months. 154 ƒ Monitoring alone will not keep your blood glucose in your target range.
8% 183 You need to actively use your results.
ƒ It is recommended that you get your A1C or eAG measured 9% 212
every 3 to 6 months. Talk to your healthcare team about how 10% 240 ƒ Look for patterns in your blood glucose results and compare them with what you ate
often you should test your A1C/eAG. 11% for each meal. You may need to adjust your meal plan depending on your results.
269
12% 298 ƒ Talk to your healthcare team to learn more about using your results.

12 13
STAYING ON TRACK
Continue your diabetes journey with better tracking.
My Medication Schedule
Medication
Tracking Your Blood Glucose3
Tracking your blood glucose can help you and your diabetes care team understand
if you are meeting your treatment goals. Starting on the next page, there is a blood
glucose log. Your diabetes care team can help you decide how often you should
be checking your blood glucose each day.
Dose When How Often
You can use the “Notes” section to keep track of changes to your routine that
might have affected your blood glucose or anything else you might want to discuss
with your diabetes care team.

Rule of 15

Low blood glucose (hypoglycemia) is when your blood glucose is below 70 mg/
dL. You can treat low blood glucose by using the rule of 15, which means that you
should take 15 grams of fast-acting carbs (like juice or glucose tablets) and wait 15
minutes to test again. If your blood glucose is not over 70 mg/dL, then you should
repeat the process again.

NOTES

My Blood Glucose Goals1,3

A typical goal for people with diabetes is before meals: 80 to 130 mg/dL

My goal is: ________________________________

Two hours after the start of a meal: less than 180 mg/dL

My goal is: ________________________________

14 15
MY DAILY BLOOD GLUCOSE TRACKER Date: Breakfast Lunch Dinner Night
Medications: Before After Before After Before After
Your doctor can help you determine how often you should be measuring your blood
glucose. Fasting blood glucose readings are taken before a meal. Post-prandial (after
meal) readings are readings taken 2 hours after a meal. mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL

Time Time Time Time Time Time Time

Notes:

Date: Breakfast Lunch Dinner Night Date: Breakfast Lunch Dinner Night
Medications: Before After Before After Before After Medications: Before After Before After Before After

mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL

Time Time Time Time Time Time Time Time Time Time Time Time Time Time
Notes: Notes:

Date: Breakfast Lunch Dinner Night Date: Breakfast Lunch Dinner Night
Medications: Before After Before After Before After Medications: Before After Before After Before After

mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL

Time Time Time Time Time Time Time Time Time Time Time Time Time Time
Notes: Notes:

Date: Breakfast Lunch Dinner Night Date: Breakfast Lunch Dinner Night
Medications: Before After Before After Before After Medications: Before After Before After Before After

mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL

Time Time Time Time Time Time Time Time Time Time Time Time Time Time
Notes: Notes:

16 17
DIABETES AND HEALTHY EATING VIRTUAL CONVERSATION MAP© PROGRAM
SESSION
4&6
 STRATEGIES FOR HEALTHY EATING AND FOOD CHALLENGES
DIABETES AND HEALTHY EATING
ƒ Find a meal planning strategy that works for you, such
ch as:
SESSION 4 AND 6 KEY POINTS - Reading labels
- Keeping a food diary
- Making a shopping list
UNDERSTANDING DIABETES AND FEELINGS ABOUT FOOD - Counting carbohydrates
ƒ Someone on your healthcare team, such as a dietitian,
an,
ƒ Diabetes is a disease in which the body does not make
can help you develop an individualized meal plan.
enough insulin and/or does not properly use insulin.
ƒ Have a plan for how to handle food challenges, such as family
ƒ For many of us, food is an important part of our lives and
parties, potluck dinners, sick days, and nights spent home alone. If you are prepared
can be influenced by family, culture, and religion.
for situations like these, you will be more likely to stick to your meal plan.
ƒ Understanding your feelings about diabetes and food can
ƒ Keep in mind that no one is perfect. If you get off track for a day, learn from your
help you better manage what, when, and how much you eat.
experience and start over the next day.

FOOD BASICS WHAT YOU EAT, HOW MUCH YOU EAT, AND WHEN YOU EAT
ƒ Your body needs a proper balance of the following nutrients to feel good, repair itself,
ƒ Foods that contain carbohydrates will have the biggest impact on your blood
and fight disease:
glucose levels. Some examples of carbohydrate-containing foods include starches,
- Carbohydrates: Another name for sugars and starches. Your body burns this for starchy vegetables, fruits, milk, yogurt, and sweets.
energy and needs more of this nutrient
ƒ Even when people make healthy food choices, they often eat too much. You can use
than any other.
some basic strategies for eating less. A few ideas for eating less include:
- Protein: Helps to build and repair - Share a meal or dessert
- Eat only 1 serving.
muscle, skin, and every cell in the when eating out.
body. - Use a small plate.

- Fat: Has more calories per bite than ƒ Timing of meals can help control your blood glucose.
any other nutrient. It also supplies These include:
energy, helps maintain - Eat at least 3 times throughout the day.
healthy skin, and helps transport some
vitamins. - Eat your meals at about the same time every day.

- Water: Is essential for life. - Avoid skipping meals. Skipping meals may cause
your blood glucose to go low or may make you overeat during your next meal.
- Vitamins and Minerals: Are needed in small amounts. You must get these from
- Your healthcare team can help you learn to balance the times you take your
food because your body can’t make them.
medicine with when you eat.
ƒ The major food groups are grains (starches), fruits, milk, vegetables, meats, and fats
and sweets. Fats and sweets are to be eaten in moderation.

20 21
MORE ABOUT DIABETES AND HEALTHY EATING Fruits
Carbohydrates will have the most impact on your blood glucose but remember that 17 small grapes
ƒ 1 small (4 oz) apple, orange, ƒ
carbohydrates are essential to a healthy balanced diet.
tangerine, pear, or peach
ƒ 1/2 cup whole cherries
One serving of carbohydrates is equal to 15 grams. A dietitian can help you understand ƒ 1/2 cup unsweetened applesauce
ƒ 1/3 grapefruit
how many servings of carbohydrates are appropriate for you.
ƒ 4 fresh medium apricots
ƒ 1 large kiwi
Below is a quick-reference list of carbohydrate serving sizes. ƒ 7 dried apricot halves
ƒ 1 cup berries (strawberries,
ƒ 1/2 small (4 inches) banana blueberries, or raspberries

ƒ 2 tablespoons raisins ƒ 3/4 cup cubed fresh pineapple

Grains
ƒ 1 cup cubed melon (cantaloupe, ƒ 1/2 cup cubed mango
ƒ 1 slice of bread (whole wheat ƒ 3 cups popped popcorn watermelon, or honeydew)
or white)
ƒ 1 six-inch tortilla or pita bread
ƒ 1/2 cup cooked plain oatmeal
ƒ 1/2 English muffin
ƒ 1/3 cup cooked pasta (whole wheat Plate Method Food Labels
ƒ 1/2 hot dog or hamburger bun
or white)
ƒ 1/2 cup dry bran cereal Using your plate as Many of the foods we eat come with food labels.
ƒ 1/3 cup cooked rice (brown or white) a guide can help Food labels can tell you exactly how many grams
ƒ 3/4 cup dry unsweetened cereals to balance your of carbohydrates are in each serving.
meal and keep your
carbohydrates portions
Starchy Vegetables and Beans reasonable without
Check Serving Size Nutrition Facts
using measuring cups 2 Servings Per Container
1/2 cup mashed potatoes or scales. Serving Size 1 cup (140g)
ƒ 1/3 cup cooked beans (kidney, ƒ
Check Calories Amount Per Serving
pinto, etc.) Calories 160
ƒ 1/2 cup hashbrowns
½ plate non-starchy % Daily Value*
ƒ 1/2 cup corn vegetables Limit These Nutrients Total Fat 8g 10%
ƒ 1 cup winter squash
Saturated Fat 3g 15%
ƒ 1/2 cup peas ¼ plate starch Trans Fat 0g
ƒ 1 cup marinara or pasta sauce Check Total Cholestrol 0mg 0%
ƒ 1/2 cup baked potato (sweet, white, ¼ plate protein Carbohydrate Sodium 60mg 3%
(dietary fiber and sugars are Total Carbohydrate 21g 8%
and other varieties) included in the total carb count) Dietary Fiber 3g 11%
Total Sugars 15g
Includes 5g Added Sugars 10%
Quick Guide to % Protein 3g

Starch
Daily Value Vitamin D 5mcg 25%
Milk/Yogurt Calcium 20mg 2%
Vegetables
Iron 1mg 6%
1 cup artificially sweetened yogurt Get Enough of These Potassium 230mg 4%
ƒ 1 cup cow’s milk (skim, 2%, whole, ƒ Protein
Nutrients *The % Daily Values tells you how much a nutrient in a
buttermilk) serving of food contributes to a daily diet. 2000 calories a
ƒ 1 cup fruit sweetened Greek yogurt day is used for general nutrition advice.

ƒ 1 cup plain yogurt Footnotes

22 23
MY WEEKLY FOOD TRACKER Week of: ____________________________________________ MY WEEKLY FOOD TRACKER Week of: ____________________________________________

Total Total
Day Breakfast Lunch Dinner Snacks Water Day Breakfast Lunch Dinner Snacks Water
Calories Calories

Monday Monday
Calories: Calories: Calories: Calories: Calories: Calories: Calories: Calories:
Carbs: Carbs: Carbs: Carbs: Carbs: Carbs: Carbs: Carbs:

Tuesday Tuesday
Calories: Calories: Calories: Calories: Calories: Calories: Calories: Calories:
Carbs: Carbs: Carbs: Carbs: Carbs: Carbs: Carbs: Carbs:

Wednesday Wednesday
Calories: Calories: Calories: Calories: Calories: Calories: Calories: Calories:
Carbs: Carbs: Carbs: Carbs: Carbs: Carbs: Carbs: Carbs:

Thursday Thursday
Calories: Calories: Calories: Calories: Calories: Calories: Calories: Calories:
Carbs: Carbs: Carbs: Carbs: Carbs: Carbs: Carbs: Carbs:

Friday Friday
Calories: Calories: Calories: Calories: Calories: Calories: Calories: Calories:
Carbs: Carbs: Carbs: Carbs: Carbs: Carbs: Carbs: Carbs:

Saturday Saturday
Calories: Calories: Calories: Calories: Calories: Calories: Calories: Calories:
Carbs: Carbs: Carbs: Carbs: Carbs: Carbs: Carbs: Carbs:

Sunday Sunday
Calories: Calories: Calories: Calories: Calories: Calories: Calories: Calories:
Carbs: Carbs: Carbs: Carbs: Carbs: Carbs: Carbs: Carbs:

24 25
CONTINUING YOUR JOURNEY WITH DIABETES VIRTUAL CONVERSATION MAP© PROGRAM
SESSION
7& 8
 CONTINUING YOUR SHORT- AND LONG-TERM COMPLICATIONS OF DIABETES
JOURNEY WITH DIABETES ƒ Short-term complications impact how you feel right now and can happen when your
blood glucose is too high or low.
SESSION 7 AND 8 KEY POINTS
ƒ The signs and symptoms of high and low blood glucose include:
- High blood glucose: fatigue, blurred vision, thirst
THE NATURAL COURSE OF DIABETES - Low blood glucose: shakiness, sweats, headache
ƒ Long-term complications of diabetes affect various systems
ƒ In type 2 diabetes, there is a gradual loss of beta cells that make insulin. Over time, of your body by damaging certain blood vessels and nerves.
there are not enough of these cells to meet the insulin needs of the body and to keep
blood glucose in the target range. ƒ Complications may include:

ƒ Diabetes is a lifelong disease. As your diabetes progresses, it often

ten - Heart disease - Foot complications
becomes harder to keep your blood glucose within your target range.
ange. - Eye complications - Depression
- Kidney disease - Gum disease
ƒ Target ranges for blood glucose for a person with diabetes:
- Fasting blood glucose before meals: 80 to 130 mg/dL ƒ The good news is your chances of preventing or delaying these complications
improves if you keep your blood glucose in your target range and you avoid other
- Two hours after the start of a meal: Less than 180 mg/dL risk factors.
- A1C <7% for many adults with diabetes*
* Talk to your healthcare provider about what goal is right for you.
COMPLICATIONS AND KNOWING YOUR ABCs

ƒ To help prevent diabetes complications, your healthcare team will

HEALTHY EATING, KEEPING ACTIVE, AND MEDICINES recommend several tests and monitoring, including:
- A1C (every 3 to 6 months) - Comprehensive foot exam
ƒ Making healthy food choices, keeping active, and taking medicine are key - Kidney function (annually) (annually, or more often if you have
strategies to keeping your blood glucose in your target range. foot problems
- Eyes (annually)
Knowing the medicines you are taking for your diabetes and how they
hey - Cholesterol (at least annually)
ƒ - Dental Exam (at least annually)
work will help you understand why they are important for managing
g
your diabetes. ƒ People with diabetes are at a higher risk for heart attack and stroke; managing the
ABCs of diabetes may help you lower the risk of these complications.
ƒ Medicine cannot cure diabetes.
- A is for A1C. The general goal of less than 7% appears reasonable for many adults
ƒ Oral diabetes medicines may work on either the liver, muscles, kidneys,
neys, with diabetes. Talk with your healthcare provider about the goal that is right for you.
intestines, or pancreas to lower blood glucose.
- B is for blood pressure. People with diabetes should determine individual blood
ƒ Other diabetes medicines work to increase insulin production/secretion. pressure targets with a healthcare provider.
ƒ Insulin injections work to lower blood glucose and are classified by type, including: - C is for cholesterol. LDL or ‘bad cholesterol’ can build up and clog your arteries.
- When they work in your body For most people with diabetes, moderate or high intensity cholesterol medicine
- How fast they work
is recommended.
- How long they last

28 29
MY DIABETES CHECKPOINTS At Least Once a Year1,2

Your guide to important diabetes tests and screenings.

Kidney Test (Albumin in the Urine)
At Every Office Visit1,2 My doctor recommends that I have my kidneys checked every _______ months.

Take your blood glucose meter My most recent kidney test was on: _______________________________________
Your doctor will check your blood
and tracker with you to discuss your
pressure and weight. My next kidney test is scheduled for: ______________________________________
readings.

‰I am up to date this year.

Discuss all medications you’re
Your doctor will perform a foot
currently taking including over-the-
check to look for any visible signs
counter medications, vitamins, and
of problems. How Does it Work?
supplements.
When kidneys are damaged, they leak albumin, a type of protein, into the urine.
To assess the health of your kidneys, this test will detect any albumin in your
urine.5
At Least Every 3 to 6 Months1,2

A1C Test
Eye Exam (Retinal Eye Exam)
My doctor recommends that I have my A1C checked every ________ month(s).
My doctor recommends that I have an eye exam every _________ months.
My most recent A1C test was on: ________________________________________
My most recent eye exam was on: ________________________________________
My next A1C test is scheduled for: _______________________________________
My next eye exam is scheduled for: _______________________________________

How Does it Work? ‰I am up to date this year.

An A1C test gives an average of your blood glucose control over the past 2 to 3
months. Your A1C test results can help you and your care team understand how
well your treatment plan is working.4
How Does it Work?
During an eye exam, your eye care professional will check for evidence of
damage to your eyes. Annual dilated eye exams are very important as eye
damage can sometimes have no symptoms.6

30 31
At Least Once a Year1,2
Cholesterol Test
Peripheral Neuropathy Test (VPN Test and Comprehensive Foot Exam) My doctor recommends that I have my cholesterol tested every _______________.

My doctor recommends that I have a neuropathy test (comprehensive foot exam) My most recent cholesterol test was on: ____________________________________
every ______________________.
My next cholesterol test is scheduled for: ___________________________________
My most recent test or exam was on: _______________________________________

My next test or exam is scheduled for: ______________________________________ ‰I am up to date this year.

‰I am up to date this year.

How Does it Work?
Peripheral neuropathy causes tingling, pain, and/or numbness in your hands and
feet. Most often, your doctor will check for peripheral neuropathy by testing your
feet for numbness.7 Your doctor should perform a visual check of your feet at
each office visit. A comprehensive foot exam also includes a visual examination
as well as a neurological and vascular assessment.1
How Does it Work?
A cholesterol test is really just a simple blood test. Cholesterol refers to a group
of fats that play an important role in metabolism. Too much of certain types of
cholesterol in your blood can be harmful.2 You may need your cholesterol tested
less frequently if you are not on certain medications. Your doctor can help you
determine how often you should be having your cholesterol tested.

Visit Notes and Other Important Dates

Dental Exam

My doctor recommends that I have my teeth checked every _______ months.

My most recent dental exam was on: _______________________________________

My next dental exam is scheduled for: ______________________________________

‰I am up to date this year.

How Does it Work?

People with diabetes are at higher risk for gum disease. During a dental exam,
your dentist can evaluate the health of your gums and teeth.8

32 33
IMPORTANT VACCINATIONS1

Flu Vaccine Shingles (Zoster) Vaccination (for patients 50+)

Every Year A two-dose seriese administered once in your life

My most recent flu vaccination was on: _____________________________________

‰ I had this vaccination on: _____________________________________
‰I am up to date this year.
Tetanus, Diphtheria, and Pertussis (Tdap) Vaccination
Pneumonia Vaccine Adults should get a booster every 10 years

Once in your life

‰ I had this vaccination on: _____________________________________
‰ I had this vaccination on: _____________________________________

Hepatitis B Vaccine Vaccination Notes and Other Important Dates

A three-dose series administered once in your life

‰ I had this vaccination on: _____________________________________

COVID-19 Vaccine

Check with your doctor and CDC guidelines for your recommended dose frequency

‰ I had this vaccination on: _____________________________________

34 35
NAVIGATING THE ABC’s OF DIABETES CARE1,2
Know your goals and track your results.
Cholesterol2
A1C For most people with type 2 diabetes, a cholesterol medicine is
A typical goal for people with diabetes is: Less than 7% recommended. Each time you get your cholesterol and blood fat
levels tested, you will get results for three different measurements:
A My A1C goal is: ___________________
ƒ LDL (“bad”) cholesterol: LDL can lead to a build up of
cholesterol in the arteries over time. In general, the lower this
number, the better.
Tracking My Results ƒ HDL (“good”) cholesterol: HDL helps to remove cholesterol
Date A1C Level from your body. In general, the higher this number, the better.

%
C ƒ Triglycerides: Triglycerides are another kind of blood fat that
can increase your chances of a heart attack or stroke if they are
too high.
%

% Your diabetes care team will help set individual cholesterol goals
for you.

Blood Pressure
My Cholesterol Goals Tracking My Results
The target goal for people with diabetes is less than
130/80 mmHg. However, your doctor can help you determine Date Cholesterol and Blood Fat Levels
your individualized goal. LDL (“bad”)
cholesterol LDL ____________________ mg/dL
mg/dL HDL ____________________ mg/dL
B My blood pressure goal is: ___________________________
HDL (“good”)
Triglycerides _____________ mg/dL

LDL ____________________ mg/dL

cholesterol
HDL ____________________ mg/dL
Tracking My Results mg/dL
Triglycerides _____________ mg/dL
Date Blood Pressure
LDL ____________________ mg/dL
Triglycerides
mmHg HDL ____________________ mg/dL
mg/dL Triglycerides _____________ mg/dL
mmHg

mmHg

36 37
 NOTES REFERENCES
1. American Diabetes Association. Standards of Medical Care in Diabetes - 2023. Diabetes Care 2023;
46: S1-S4 https://doi.org/10.2337/dc23-Sint
2. American Diabetes Association. Health Checks for People with Diabetes. Retrieved June 21, 2022 from
https://www.diabetes.org/diabetes/newly-diagnosed/health-checks-people-with-diabetes.
3. American Diabetes Association. The Big Picture: Checking Your Blood Glucose. Retrieved June 21, 2022
from https://www.diabetes.org/healthy-living/medication-treatments/blood-glucose-testing-and-control/
checking-your-blood-sugar.
4. American Diabetes Association. A1c and eAG. Retrieved June 21, 2022 from
https://www.diabetes.org/diabetes/a1c/a1c-and-eag.
5. American Diabetes Association. Kidney Disease (Nephropathy). Retrieved June 21, 2022 from
https://www.diabetes.org/diabetes/chronic-kidney-disease.
6. American Diabetes Association. Eye Complications. Retrieved June 21, 2022 from
https://www.diabetes.org/diabetes/complications/eye-complications.
7. American Diabetes Association. Peripheral Neuropathy. Retrieved June 21, 2022 from
https://www.diabetes.org/diabetes/neuropathy/peripheral-neuropathy.
8. American Diabetes Association. Diabetes and Oral Health. Retrieved June 21, 2022 from
https://www.diabetes.org/diabetes/keeping-your-mouth-healthy.

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