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.
When you have diabetes, we recommend monitoring (checking) your own blood sugar (glucose) with a glucose meter. A glucose meter is a small device (smaller than a cell phone) that quickly reads your blood sugar level and saves the reading for future reference. Meters are easy to use and to carry with you. You can check your blood sugar at home, at work, or anywhere.
Blood sugar levels frequently change. When you have diabetes, many of your daily activities will affect your blood sugar. Hemoglobin A1c is a blood test that measures your average blood sugar during the past 2 to 3 months. This test helps us understand how well we are able to keep your diabetes under control. Even though we like to check the HbA1c levels every 3 months, by checking your own blood sugar levels, you can get more immediate feedback to achieve better control.
By monitoring, you can see how your blood sugar is affected by:
Monitoring tells you your blood sugar level. This will help you know if your level is too high or too low. With this information, you can decide what action to take.
High blood sugar (hyperglycemia). This is a blood sugar reading consistently above 180 mg/dL or above your recommended target range. It can develop because of:
Low blood sugar (hypoglycemia). Blood sugar less than 70 mg/dL is too low for most people who take diabetes pills or insulin. If you take certain diabetes pills (sulfonylureas or alpha-glucosidase inhibitors) or insulin, it's important to know the symptoms of low blood sugar, how to treat low blood sugar, and how to prevent it.
Low blood sugar can develop because of:
When you monitor your own blood sugar, it is important to know your blood sugar targets. Talk with us about your personal targets. For many people, the blood sugar targets are:
|Before a meal||70 to 130|
|2 hours after a meal||Less than 180|
|Bedtime||100 to 140|
Follow the specific directions included with your glucose meter. Here are general steps for checking your blood sugar:
The meter measures your blood sugar in about 5 seconds and displays the reading. The meter automatically saves the reading in its memory, along with the date and time.
When you are diagnosed with diabetes, we will prescribe a glucose meter and necessary supplies like test strips and lancets (small needles used to prick your finger). We will show you how to use your meter and recommend how often to check your blood sugar.
Our Health Education Department has information about classes, videos, or DVDs to help you learn more about using your glucose meter. You can also learn more in the owner's booklet that comes with your meter or on the website of your meter's manufacturer. If your meter is not working properly, we recommend calling the customer service number listed on the back of your meter.
Talk with us about when to check your blood sugar. Our recommendation usually depends on:
We also recommend checking your blood sugar when you are:
Sickness and infection cause blood sugar levels to increase. Steroid medications and cortisone injections also cause blood sugar levels to increase.
Preventing sore fingers. You can prevent sore fingers by pricking the sides of your fingers and staying away from fingertips and pads. Alternate the fingers used for checking so you use a different site each time. Use the lightest setting on your penlet (lancing device) that still allows you to get a small blood droplet. Be sure to change the lancet after each use. With repeated use, lancets can become dull and cause sore fingers.
Getting enough blood. If you have difficulty getting enough blood, shake your hand up and down or run warm water over your hand before you prick your finger.
Safe use of lancets. Do not share your lancets (needles) with others. Check with your city or municipality for the safest way to dispose of used lancets. Do not dispose of lancets in garbage or recycle bins.
We recommend keeping a blood sugar record when you are first diagnosed with diabetes or when starting a new medication, eating plan, or activity. Many people use a notebook or the logbook included with the meter to write down:
Keeping records helps you see patterns or trends in your blood sugar readings. We can use this information to make decisions about your diabetes pills or insulin. You can also use blood sugar records to make decisions about eating, physical activity, or stress management.
You may prefer to keep records by downloading your blood sugar readings from the meter's memory to your personal computer. Your meter's manufacturer usually offers software for downloading blood sugar readings.
To ensure that your meter is working properly, you will want to calibrate your meter carefully following the manufacturer's instructions. Also, you will want to ensure that the battery is in good working order to get the most accurate results.
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. They have someone on call at all times, and you should call them for advice: 1-800-439-8376.
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.