Diabetes Self-Care Toolkit: Carb Guide, Sugar Log, Hypo Plan, Sick-Day Rules and Foot Checks

Practical diabetes self-care templates: Indian carb-counting guide, blood sugar log, hypoglycaemia plan, sick-day rules, daily foot check and meal planner.

Most diabetes care happens between consultations. These practical templates — a carbohydrate guide for Indian foods, a sugar log, a low-sugar plan, sick-day rules, a daily foot check and a sample meal planner — help you manage day to day and bring better information to your doctor. Use them alongside your personal plan, not instead of it.

Carb-Counting Guide for Indian Foods

Portion sizes and carb content of common Indian foods — chapati, dal, rice, fruits, snacks. Essential for insulin bolus decisions and portion awareness on non-insulin regimens.

Why Carb Counting Matters

• Carbohydrates raise blood glucose more than protein or fat

• Counting carbs helps you match insulin (T1DM/T2DM on insulin) or manage portion sizes (all diabetes)

• Target: know your carb load per meal so you can predict glucose response

QUICK REFERENCE · GRAINS (per serving)

DAL & LEGUMES (per katori/1 cup cooked)

VEGETABLES (mostly free · 5-10 g per serving)

FRUITS (per medium fruit)

DAIRY (per glass/cup)

DRINKS (avoid or limit)

Snacks

Meal Planning Targets

• Typical diabetic meal: 45-60 g carbs

• Light meal / snack: 15-30 g carbs

• Daily total: 130-180 g carbs for T2DM (personalise with dietitian)

Indian Portion Visual Method

• Fill HALF your plate with non-starchy vegetables

• ONE QUARTER with lean protein (dal, paneer, fish, chicken)

• ONE QUARTER with grain/carb (roti, rice, millet)

• Add fibre-rich sabzi, small bowl of curd

Next Step

Call: +91 98991 18504

Blood Glucose Log Template

Daily and weekly glucose tracking — fasting, pre-meal, 2-hr post-meal, bedtime, event-based entries. Space for notes about food, medication, unusual events.

Name: _______________________________

Week of: _____________________________

Medications: _________________________

TARGETS (personalise with your diabetologist)

• Fasting: 80-130 mg/dL (ADA target for most T2DM)

• 2-hr Post-Meal: <180 mg/dL

• Bedtime: 100-160 mg/dL

• CGM Time-in-Range (70-180 mg/dL): >70%

Daily log

Bring the log to every consultation — patterns matter more than single readings.

Hypoglycemia Action Card

Wallet-sized card with signs of low blood sugar, rule-of-15, when to use glucagon, when to call for help. Essential for anyone on insulin or sulfonylureas.

Warning Signs of Low Blood Sugar

Glucose <70 mg/dL. If you feel any of these — CHECK & TREAT:

EARLY (Adrenergic)

• Shaky/trembling

• Sweaty

• Heart racing

• Anxious/irritable

• Hungry

• Tingling around lips

LATE (Neurological — SERIOUS)

• Confusion / difficulty concentrating

• Slurred speech

• Weakness / unable to walk

• Loss of consciousness

• Seizure

Rule of 15 · for Mild-Moderate Hypoglycemia

STEP 1: TAKE 15g FAST CARBS

Choose ONE:

• 3 glucose tablets (chew, don't swallow whole)

• 4 oz (120 ml) fruit juice (apple/orange)

• 4 oz (120 ml) regular soft drink (NOT diet)

• 1 tablespoon sugar or honey

• 3-4 hard sweets (like hard sweets, sugar sweets)

• 1 tablespoon glucose gel

DO NOT USE: chocolate, biscuits, roti, banana — fat/protein slow absorption

Step 2: Wait 15 Minutes

Step 3: Re-Check Glucose

• Still <70 mg/dL? REPEAT with another 15g

• ≥70 mg/dL? Eat a small snack (a fruit + biscuit, or half chapati with dal) if next meal is >1 hour away

If you are Unconscious or Cannot Swallow

• DO NOT put food/liquid in mouth (aspiration risk)

• Use GLUCAGON KIT if available (someone else must give):

• IM injection in thigh or upper arm

• Person should wake in 10-15 min

• CALL 112 (India Emergency) or 102 (Ambulance)

• Turn person on their side (recovery position)

• Someone should stay until help arrives

After a Hypo — Causes to Review

Common causes:

• Too much insulin or sulfonylurea

• Skipped or delayed meal

• Alcohol (especially without food)

• Unusual exercise (esp. late evening)

• Illness/vomiting

• Weight loss → insulin dose needs reducing

• New medication interaction

• More than 2 hypos in a week

• Any severe hypo (needing help from another person)

• Nighttime hypos (waking sweaty, high morning glucose)

• Loss of hypo awareness (no early warning symptoms)

My Emergency Contacts

My name: _____________________________________

My condition: Type ____ Diabetes

Medications: _________________________________

Family contact: ______________________________

Doctor: ______________________________________

Nearest hospital: ____________________________

Emergency:

India Emergency: 112

Ambulance: 102

Sick-Day Rules for Diabetes

What to do when unwell — never skip insulin even if not eating, when to check ketones, when to call doctor, DKA warning signs, when to hold SGLT2i.

Why Sick Days are Higher Risk

Fever, flu, diarrhoea, vomiting, infection — all release stress hormones (cortisol, adrenaline) that RAISE blood glucose, even if you eat less. Type 1 diabetics can develop DKA. Type 2 diabetics on SGLT2i can develop euglycemic DKA.

The Four Sick-Day Rules

Rule 1: Never Stop Insulin

Even if you cannot eat, DO NOT stop insulin (basal or bolus).

• Skipping insulin during illness is a common cause of DKA

• If not sure — CALL your diabetologist

Rule 2: Check Glucose More Often

• Every 2-4 hours if T1DM or on insulin

• Every 4-6 hours if T2DM on oral agents

• CGM users: watch trends closely

RULE 3: CHECK KETONES IF GLUCOSE >250 mg/dL

Urine ketone strips (Ketostix) OR blood ketone meter

• Moderate/large ketones = urgent contact with doctor

• If blood ketones ≥1.5 mmol/L + glucose high = go to ER

Rule 4: Stay Hydrated

• Sip fluids every 15-30 minutes

• If glucose >250: sugar-free drinks (water, ORS, dilute nimbu paani no sugar)

• If glucose <200 or hypo: fluids WITH some carbs (juice, chai with sugar)

• Target: 250-500 ml per hour when awake

Medication Adjustments During Illness

HOLD (temporarily stop) if not eating/drinking normally:

• Metformin (rare lactic acidosis risk if dehydrated)

• SGLT2 inhibitors (empagliflozin, dapagliflozin, canagliflozin)

RISK: euglycemic DKA if fasting/dehydrated

• ACE inhibitors / ARBs / diuretics (kidney protection)

• NSAIDs (kidney/GI risks)

CONTINUE (do not stop):

• Insulin (adjust dose, don't stop)

• Statins

• Blood pressure medications (unless BP dropping)

• Thyroid meds

• Immunosuppressants

When to Call for Help

• Vomiting >4 hours (can't keep fluids down)

• Diarrhoea >24 hours

• Fever >101°F for >24 hours

• Glucose consistently >250 despite corrections

• Glucose <70 more than twice

• Ketones present in urine

GO TO EMERGENCY (call 112 or go to ER):

• Deep laboured breathing (Kussmaul) — DKA sign

• Fruity/acetone breath

• Confusion, drowsiness, unresponsive

• Persistent vomiting + high glucose

• Severe abdominal pain

• Chest pain

• Blood glucose >400 or unmeasurable

• Blood ketones ≥3 mmol/L

Foods to Keep at Home for Sick Days

Easy-to-tolerate carbs when nauseous:

• Toast / plain rice / khichdi (small portions)

• Curd / kadhi (probiotic + carbs + fluid)

• Coconut water / ORS

• Bananas

• Apple sauce / stewed apple

If glucose LOW and can't keep food down:

• Sips of regular Coke or sweet lime juice

• Glucose tablets or gel

Before Illness — Prepare

• Keep 1 extra week of medications in stock

• Buy urine ketone strips (Ketostix) — check expiry

• Know your emergency contacts

• Post this sheet on your fridge

24/7 non-emergency:

Daily Foot Self-Check Guide

Daily foot examination protocol for anyone with diabetes >5 years or peripheral neuropathy — check between toes, look for cuts/blisters/callus, when to seek podiatry.

Why Daily Foot Checks Matter

• Neuropathy = reduced feeling = you may not feel small injuries

• Poor circulation + high glucose = wounds heal slowly

MOST amputations are PREVENTABLE with daily self-check + early podiatry.

DAILY 2-MINUTE ROUTINE (do at same time every day)

Step 1: Wash & Dry

• Warm (not hot) water — test with elbow, not foot

• Mild soap

• Dry thoroughly, especially BETWEEN TOES

STEP 2: INSPECT (use a mirror if you can't see soles)

Check for:

• ☐ Any cuts, scratches, blisters

• ☐ Redness, warmth, swelling

• ☐ Cracks in skin (esp. heels)

• ☐ Corns or callus

• ☐ Ingrown toenails

• ☐ Fungal infections (between toes especially)

• ☐ Changes in colour (redness, blue, white)

• ☐ Changes in shape (Charcot foot — arch collapse)

• ☐ Bad odour (may indicate infection)

Step 3: Moisturise

• Apply moisturiser to tops and soles

• AVOID between toes (fungal risk)

• Products: coconut oil, aloe vera, urea cream 10%

Step 4: Nails

• Trim STRAIGHT across (not curved) — prevents ingrown

• File any sharp edges

• Do not cut cuticles

• If nails thick or difficult — see a podiatrist, don't force

Step 5: Footwear Check

Before putting shoes on:

• Shake out shoes (small stones, insects)

• Check inside for rough spots or torn lining

• Wear socks (cotton, seamless, not too tight)

• No barefoot walking — even at home

What Needs Professional Attention

SEE PODIATRIST SOON (within 1-2 weeks):

• Thick calluses or corns

• Deformed nails (thick, yellow)

• Very dry cracked skin

• Bunions or hammertoes progressing

BOOK URGENT CONSULTATION (within days):

• Any new cut or blister not healing in 5-7 days

• Redness spreading around a wound

• Pain or throbbing (in a numb foot, pain is a WARNING)

• New ulcer or open wound

• Foul odour from foot

EMERGENCY (go to ER same day):

• Deep wound with visible tissue underneath

• Foot warm, red, swollen with fever

• Black tissue anywhere on foot

• New severe pain

• Wound with pus draining

Footwear Checklist

GOOD SHOES for diabetic feet:

• Wide toe box (toes don't cramp)

• Cushioned insole

• Firm heel counter

• Adjustable (laces or velcro, not slip-ons)

• Made of breathable material (leather, mesh)

• Diabetic footwear brands: MSMEDIC, Dr Comfort, Orthofeet

Avoid:

• Sandals with thin straps (chafing)

• High heels (pressure points)

• Flip-flops (no support, easy injury)

• Tight or narrow shoes

• Very old worn-out shoes

• New shoes worn for long periods without breaking in

Sock Rules:

• Cotton or wool (moisture-wicking)

• White (so you notice blood/discharge)

• Seamless

• Not too tight at the top

• Change daily

Annual Professional Foot Exam

Your diabetologist / podiatrist should perform annually:

• Visual inspection (skin, nails, deformity)

• 10-gram monofilament test (sensation)

• Vibration test (128-Hz tuning fork)

• Pulse check (dorsalis pedis, posterior tibial)

• Ankle-brachial index (ABI) if pulses reduced

My Foot Care Team

Diabetologist: __________________________________

Podiatrist: _____________________________________

Nearest ER: _____________________________________

Emergency: 112 (India)

Indian Diabetic Meal Prep Planner (7-day)

7-day sample meal plan for Indian vegetarian and non-vegetarian diets. Low-GI staple substitutions, portion visualisation, snack ideas, religious fasting adaptations.

TARGETS FOR MOST T2DM (adjust with dietitian)

• Daily calories: 1500-1800 (women), 1800-2100 (men) — depends on weight goal

• Carbs: 40-45% of calories (~150-180g/day)

• Protein: 20-25% (target 1.0-1.2 g/kg body weight)

• Fats: 25-30% (mostly monounsaturated: nuts, olive oil, ghee small amount)

• Fibre: >30g/day (whole grains, dal, vegetables, fruits)

Meal Structure Pattern

• Breakfast (8am): 300-400 kcal · 40g carbs

• Mid-morning snack (11am): 100 kcal · 15g carbs

• Lunch (1pm): 500-600 kcal · 55g carbs

• Evening snack (5pm): 100 kcal · 15g carbs

• Dinner (7pm): 400-500 kcal · 45g carbs

• Bedtime (10pm): milk 1 cup (12g carbs) if on insulin

Monday

Breakfast: 2 vegetable idli + sambar (1 cup) + coconut chutney (small)

Snack: Apple (medium) + 5 almonds

Lunch: 2 phulka + palak dal (1 cup) + bhindi sabzi + salad + curd 1 cup

Snack: Buttermilk 1 glass + roasted chana (2 tbsp)

Dinner: 1 cup brown rice + rajma curry + cabbage sabzi + salad

Tuesday

Breakfast: 2 besan chilla + mint chutney + curd 1 cup

Snack: Guava (1 medium)

Lunch: 2 phulka + toor dal + mixed vegetable sabzi + salad + raita

Snack: Green tea + 10 peanuts

Dinner: 1 cup millet khichdi + kadhi + cucumber salad

Wednesday

Breakfast: 1 cup poha (with vegetables + peanuts) + curd 1 cup

Snack: Pear + walnut (2 halves)

Lunch: 2 phulka + moong dal + baingan bharta + salad + buttermilk

Snack: Sprouts salad (1 katori)

Dinner: 1 cup ragi ball + sambar + carrot bhaji

Thursday

Breakfast: 2 methi paratha (whole wheat) + curd + green chutney

Snack: Orange (medium)

Lunch: 2 phulka + chana dal + gawar phali + salad

Snack: Chaas 1 glass + roasted makhana (1/2 cup)

Dinner: 1 cup jowar bhakri + tomato dal + spinach subzi

Friday

Breakfast: 1 cup vegetable upma (with rava) + curd

Snack: Papaya (1 cup)

Lunch: 2 phulka + rajma + louki sabzi + salad

Snack: Nuts mix (1 tbsp)

Dinner: 1 cup broken wheat + mixed veg curry + salad

Saturday

Breakfast: 2 uttapam (small) + sambar + chutney

Snack: Guava (1 medium)

Lunch: Bisi bele bath (1 cup) + raita + salad

Snack: 1 orange + 3 almonds

Dinner: 1 dosa + palak paneer + salad

Sunday

Breakfast: 3 idli + sambar + coconut chutney

Snack: Watermelon (1 cup)

Lunch: 2 phulka + dal + sabzi + salad + curd + PORTION FRUIT (mango 1/2 cup)

Snack: Green tea + roasted chana

Dinner: Millet khichdi + kadhi + salad

Smart Swaps

Instead of Try

White rice (45g carbs) → Brown/red rice (40g) or millets (35g)

Regular chapati → Multigrain (add ragi/oats to atta)

Fried snacks → Baked / roasted / steamed

Sugar tea/coffee → Stevia / small honey

Fruit juice → Whole fruit

White bread → Multigrain or ragi bread

Regular biscuits → Sugar-free multigrain

Kitchen Prep Checklist (Weekend · 60 Min)

• ☐ Chop vegetables for the week (store in fridge airtight)

• ☐ Soak dals (rotate 3-4 varieties)

• ☐ Boil eggs / cook chicken breast for non-veg

• ☐ Roast peanuts/almonds/makhana for snacks

• ☐ Cook 1 batch of dal that lasts 2-3 days

• ☐ Portion nuts/seeds into daily snack bags

• ☐ Fill water bottle x 2 for daily hydration goal (2-3L)

Religious Fasting Adaptation

• Ekadashi: rock salt allowed; use singhara / kuttu atta chapati; sabudana khichdi (small portion)

• Karwa Chauth: pre-fast meal (sargi) balanced carb + protein; post-fast slow carbs

• Ramadan: consult diabetologist; adjust medication timing (especially insulin/sulfonylureas)

• Navratri: switch to grain fasting (millets, kuttu); reduce fried items

Next Step

This is a general template.

⚠ Diabetes emergencies — know the signs, act fast.🍬

Hypoglycemia · Rule of 15

Signs: Shaky, sweaty, confused, hungry, dizzy, heart racing. Glucose <70 mg/dL.

1. Take 15g fast carbs: 3 glucose tablets, 4oz juice, 1 tbsp sugar

2. Wait 15 min then re-check glucose

3. Still <70? Repeat. Eat a snack once recovered.

4. Unconscious? Use glucagon & call 112🚨

DKA · Diabetic Ketoacidosis

Signs: Very high glucose, deep laboured breathing, fruity breath, nausea/vomiting, confusion, abdominal pain.

1. Test urine or blood ketones if you can

2. Do NOT skip insulin — call your diabetologist urgently

3. emergency room immediately

4. Highest risk: T1DM, illness, SGLT2i + fasting🤒

Sick-Day Rules

When unwell (fever, flu, diarrhoea, vomiting): glucose can swing wildly in both directions.

1. Never stop insulin even if not eating

2. Check glucose every 2-4 hours

3. Stay hydrated — sip fluids constantly

4. Hold SGLT2i if not eating/drinking normally🦶

Foot & Wound Emergency

Warning: Any new cut, blister, or ulcer that doesn't heal in 2 weeks — or shows redness, pus, warmth, or spreading.

1. Do NOT self-treat with heat or sharp implements

2. Keep clean, dry, off-load pressure

3. Book urgent diabetologist + podiatry consult

4. Fever + red foot → emergency room

If in doubt, err on the side of getting help.