Diabetes Recordkeeping

For many people, record keeping is just part of business or day-to-day life. Librarians have to keep records of what books are in the library and who has borrowed which book. Teachers keep records of your grades. Parents record what checks they write to pay for what on which day. Scorekeepers keep track of who makes which goal in what game.

For some people keeping records can be exciting. For coaches and athletes, it's a way to keep track of what works and what doesn't work. It's a way to win. For researchers and doctors, it's a way to figure out why a disease acts the way it does, and to learn how the human body can fight that disease.

Records are a way to solve mysteries. Imagine if you had spent years looking for the cure for some disease, say diabetes for example, and suddenly by studying the records of your research you found the answer -the cure. There is nothing boring about that!

For someone with diabetes, record keeping definitely needs to be part of day-to-day living, business as usual. But it doesn't have to be boring. There can be an exciting part to it, too. When your records help you and your health care team figure out why your blood glucose (sugar) drops every day at 4:00 and then how to change that pattern, that's exciting. Or why your blood glucose zooms out of sight every Wednesday and Friday after lunch and what to do about it, that's exciting. Maybe it is not as exciting as winning an Olympic medal or taking a dream vacation. But these days, you have to take excitement where you can get it.

Your Own Mysteries

People with diabetes keep records so they can solve mysteries like these.

• Why do I wake up with low blood glucose almost every night at midnight?
  
  
• Why do I go low sometimes when I play soccer or basketball and sometimes I don't?
  
  
• How much insulin will my body need to take care of a hamburger, bowl of ice cream, or a salad?
  
  Why do I wake up with low blood glucose on Saturday and Sunday, but not weekdays?
  
  
• Do unidentified flying objects come to earth to fill up with gas?

Okay, maybe you can't solve that last one, but solutions to those other mysteries start by looking at your records for the last few weeks.

To know what to keep track of, think of the things that affect the control of your diabetes.

• Food (pizza, carrots, ice cream, bananas, steak, cookies, milk, or anything with carbohydrates, calories, fats, proteins, and even skipped snacks and meals.
  
  
• Insulin - How much and when (If you have type 2 diabetes, you get to skip records on this one)
  
  
• Exercise (soccer, basketball games, neighborhood touch football games, extra hard workouts in physical education class, or a canceled PE class.
  
  
• Stress (a tough history test, performing with the community theater, death in your family, and even positive stress like going to the state capitol to receive an award from the governor)

Pencils to Software

Records can be kept in a variety of ways. The important thing is to find a way that fits you and your daily activities. Find something that is easy for you and won't get lost.

Logbooks -- old-fashioned pencil and paper -- work for some people. You can get a logbook from your health care team. Or you can design one yourself with a notebook, stickers, colored paper and pens, glitter, whatever pleases you. Just be sure you have places for the date, time, food, insulin doses, exercise, and results of blood checks. Most glucose meters will store the results of your checks, but if you're using a logbook, it's important for you to write those results in the book.

It might be helpful to go online and find samples of pages to put in your logbook. You can print them out and be ready to go or you can use the ideas to design a page to fit your needs.

If you find sample pages online or design your own page on a computer, you can create computer files to record your information. If you choose to do this, you need to be sure you will be able to get on the computer every day to record your info. If you are away from the computer for a couple of days, you can keep track on paper and then enter it later. But if you can't get on the computer very often, it might be easier to just use a logbook.

It's also a good idea to print out your information twice a week just in case you have a major computer crash. Or in case your sister decides to "clean up" the computer and deletes your files.

Many meters will let you download your blood check records if you have the right cord, the right software, and the right computer. Check with the manufacturer of your glucose meter to see if you can make this work for you. Remember to record the other important pieces of your daily activities with the info downloaded from the meter.

No matter what kind of meter you use, no matter how you choose to record your numbers, remember this: those numbers don't do you any good if they're locked up in the memory of your meter. So check, record, and learn from the information you find.

Well, Sherlock, Now What?

Once you have collected this information, you and your health care team can use it to solve some of your very own mysteries. You can look for patterns and use your information to make adjustments. After your doctor looks things over, she might tell you to change an insulin dose. Or have you try another kind of insulin. If you see that every time you eat pizza for lunch, your blood glucose rises, you might choose to eat something else, make adjustments in your insulin, or exercise. You see, those blood checks you do can help you decide on immediate treatments for high or low blood glucose. But the records of those blood checks can help you see patterns, solve mysteries, and make adjustments to maintain even better control.

When you go to the doctor, be sure to take your records with you. He will want to look them over and talk with you about them. Maybe he'll suggest adjustments. Maybe he'll just tell you how well you're taking care of yourself and your diabetes.

Sharing your records with your health care team gives you the chance to think like a doctor. When you hand someone on the team your records, tell him or her what you think might need to happen. (Like, "I think I may need to increase my insulin at lunch." Or, "My records tell me three burritos at dinner is one too many.") Your health care team, including your parents, will be glad to know you're thinking about how to get control. They'll think about your ideas and let you know if your thoughts are on target. Together, you all can find a solution that works for you.

This is not a test -- no cheating!

One of the worst times for anyone with diabetes is when you have to hand over glucose records at the doctor's office. No one likes to hear "Holey moley, these numbers are sky high!" Or, "Looks like you're eating WAY too much."

Chances are, you're not going to hear this. I mean, think about it. This is what your doctor does for a living - every day! Surely she sees tons of log books that are WAY worse than yours. But, if you do stun your doctor right out of her chair, it's easy to think that you've failed. But that's not true. Remember, this isn't a test.

Diabetes is an unpredictable disease. Even when you're doing everything right, diabetes can make your glucose numbers look crazy. Your body is unpredictable, too. (Like in puberty, your hormones are out of control.) As you grow, the way you deal with diabetes will change. The amount of insulin, carbohydrates, or
calories, and exercise that works perfectly one month may not even come close to what you need the next month.

Your health care team doesn't look at your records to see if you've been "bad" or "good." They want to know if the way you've been treating your diabetes is getting the job done. If it's working -- fine, no changes. But if it's not, it's up to you and the team to figure out a different way of doing things.

The only way your health care team can make the right changes is if you hand them the real numbers. It may be tempting to leave off the numbers that are too high or low and only write down the readings you like. Or to knock a few points off your readings and make them more like the ones you wish you were getting. That may get you a "good job" compliment from your team. But unless they know the truth, your doctor and your team can't help you really do a good job of keeping control.

For The Long Run

So when can you stop keeping records of your life with diabetes? The very minute scientists find the cure.

When you have diabetes, your pancreas doesn't work. So your mind has to work harder. You have to know what works and what doesn't work for you. You have to know how close or far you are from control.

By accurately keeping records, sharing them with your health care team, and working with the team to make the adjustments, your record log can be more than just how to deal with diabetes.

It can be the story of your success.