Are you having back pain with any of the following?
We understand that you are experiencing one or more of the health issues that might be impacting your back pain.
We recommend that you discuss these health issues with your doctor before proceeding with this program.
Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.
Diabetes is a condition that makes it difficult for your body to regulate blood sugar levels. Managing diabetes means adopting healthy behaviors and taking medication as directed to stay healthy and prevent complications.
Low blood sugar (hypoglycemia) means you have a low level of sugar (glucose) in your blood. Blood sugar below 70 mg/dL is too low for most people who take insulin or certain diabetes pills.
Without enough blood sugar, your muscles and organs, including your brain, do not have enough energy to function well. You may experience symptoms such as suddenly feeling shaky and sweaty. This is your body's way of getting your attention so you can then take action to increase your blood sugar. You may also feel confused since your brain is not getting enough glucose to think as clearly as usual.
Low blood sugars are serious, but you can almost always treat low blood sugars on your own. You can effectively correct low blood sugar by planning ahead and treating it right away. Without treatment, your blood sugar can continue to decrease to a very low level. If your blood sugar drops too low, you may eventually pass out.
When blood sugar drops too low or drops very quickly, your body usually sends you signals or symptoms. Symptoms of low blood sugar develop suddenly and often include feeling sweaty, shaky, or dizzy.
You may also feel some of these symptoms:
You need immediate medical care if your symptoms are more severe. Symptoms of dangerously low blood sugar include:
If you have any of these symptoms, get immediate medical help. If someone is with you, ask them to call our advice line immediately. The advice nurse will tell you what to do next. If you are alone, dial 911 or call for an ambulance. It is not safe for you to drive.
If you take certain diabetes medications, you are at risk for having low blood sugar. These medications include:
You may also increase your risk of low blood sugars if you don't eat regularly.
If you have had diabetes for a long time or have nerve damage (neuropathy), you may not feel symptoms of low blood sugar. This condition is called hypoglycemia unawareness. With hypoglycemia unawareness, it is possible for blood sugar to drop very low and even cause you to pass out. If you experience hypoglycemia unawareness, we recommend these ways to stay safe:
Monitoring your own blood sugar on a regular schedule is an important part of preventing low blood sugar. You can also reduce your chance of having low blood sugar by:
When you take insulin or diabetes pills that may increase your risk of developing low blood sugar, it is important to plan ahead and treat low blood sugar right away if it occurs. Other important tips include:
Always carry a sugar source. You can buy glucose tablets or gel in a supermarket or pharmacy without a prescription. You may also wish to carry your glucose meter.
Wear a MedicAlert bracelet or identification that identifies you as a person with diabetes in an emergency.
Tell others you live or work with that you have diabetes. Teach them how to help if you become too confused to treat your own low blood sugar or if you pass out.
Test your blood sugar before driving a motor vehicle. Low blood sugar while driving can be dangerous to you and others.
If you feel symptoms of low blood sugar, we recommend checking your blood sugar and treating it if your blood sugar reading is below 70 mg/dL. If your meter is not with you, we recommend treating without waiting to check your blood sugar. Here are the treatment steps:
Step 1. Eat or drink a fast-acting sugar source containing 15 grams of carbohydrate. Examples are:
If you take Miglitol, the only effective way to treat low blood sugar is with glucose tablets or gel. Other sugar sources will not work for you.
Step 2. Wait 15 minutes and check your blood sugar again. If your blood sugar is still below 70 mg/dL, repeat step 1.
Step 3. If your next meal is more than 1 hour away, eat a snack with 15 grams of carbohydrate to keep your blood sugar up. Examples are half a small sandwich or 6 crackers with cheese or peanut butter.
Step 4. Think about what caused your blood sugar to drop too low. Plan how you can prevent low blood sugar in the future.
Tell us if you have frequent low blood sugar readings or symptoms. We will discuss changes in medication or treatment.
Call us right away if you:
Have a friend or coworker call if you lose consciousness and make sure friends and coworkers know that you have diabetes and what to do if you lose consciousness.
We urge you to call if your blood sugar gets:
And especially if you have symptoms such as:
If you are pregnant and your blood sugars get very low (hypoglycemia), call 911.
As part of your routine care, I will order lab tests to screen for diabetes at the appropriate time, based on your risk factors. If you have prediabetes, you can enroll in the prediabetes class without a referral for more information and support.
If we determine that you have diabetes, I will work with you to help manage it. We have a comprehensive program to help you live well with diabetes and maintain your health. I will refer you to a Diabetes Education class. You will be prescribed a glucose monitor, and you or your family will be trained to use it. We have online tools and classes to help you with physical activity, healthy nutrition, smoking cessation, and weight management.
I will likely prescribe medication. As we continue to monitor your blood sugar levels, blood pressure, and cholesterol levels, we will send you for follow-up tests and make adjustments as needed.
If you have difficulty getting your blood sugar under control, I may recommend that you work closely with a Diabetes Care Manager to help you achieve ideal blood sugar, blood pressure, and cholesterol levels. If you have diabetes and you are working with a Care Manager, you may call him or her directly. If you are interested in a referral to this program, please contact me.
If we know about your diabetes when you become pregnant, I may help you enroll in the Kaiser Regional Perinatal Nursing Services Program. You should call them for advice: 1-800-439-8376 (they have someone on call at all times).
You can connect with me in a variety of ways, depending on the situation and what is most convenient for you at the time. I am available online, by telephone, or in person.
Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology and health education, makes getting your care easier for you.
Another major benefit is our comprehensive electronic medical record system which allows all of the doctors and clinicians involved in your care to stay current on your health status and to collaborate with each other as appropriate.
When every member of the health care team is aware of all aspects of your condition, care is safer and more effective.
We will work together to monitor and assess how your medications are working and make adjustments as needed. Prescriptions can be filled at any Kaiser Permanente pharmacy. Just let me know which pharmacy works best for you and I will send the prescription electronically in advance of your arrival at the pharmacy.
If refills are needed in the future, you can:
For lab tests, I will use our electronic medical record system to send the requisition to the Kaiser Permanente laboratory of your choice. For imaging procedures we will schedule an appointment with the radiology department. When the results are ready I will contact you with your results by letter, secure e-mail message, or phone. In addition, you can view most of your laboratory results online, along with any comments that I have attached to explain them.
My specialty colleagues are readily available to assist me if I need additional advice about your condition. In some cases, I may contact them during your visit, so we can discuss your care together. If we decide you need a specialty appointment after that discussion, we can often schedule it the same day or soon thereafter.
As part of our commitment to prevention, additional members of our health care team may contact you to come in for a visit or test. We will contact you if you are overdue for cancer screenings or conditions which may require monitoring.
My goal is to provide high quality care and to offer you choices that make your health care convenient. I recommend that you become familiar with the many resources we offer so that you can choose the services that work best for you.
My Doctor Online is available 24/7 so that you can access and manage your care where and when it is most convenient. From my home page you can:
If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.
This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.