DIABETES SOLUTION KIT | Digital – EBooks Review
Welcome to the Diabetes Solution Kit! If you or someone you know is living with diabetes, you’ve come to the right place. The digital ebooks offer a comprehensive and effective solution for managing diabetes and improving overall health. With the easy-to-follow instructions and valuable insights, you’ll gain a deeper understanding of diabetes and discover practical strategies to control blood sugar levels, maintain a healthy diet, engage in regular physical activity, and successfully manage medications and insulin.
Designed to empower individuals with diabetes, the diabetes solution kit incorporates evidence-based practices and expert advice. By utilizing the digital format, you’ll have access to the information you need anytime and anywhere. Whether you’re newly diagnosed or have been living with diabetes for years, the ebooks provide valuable resources and guidance to support your journey towards better health.
Key Takeaways:
- Gain a comprehensive understanding of diabetes and its various types, causes, symptoms, and risk factors.
- Learn about the importance of regularly monitoring blood sugar levels and explore different methods for doing so.
- Discover the significance of maintaining healthy eating habits and receive practical tips for planning meals and making smart food choices.
- Understand the benefits of regular physical activity and find suitable exercise options for individuals with diabetes.
- Explore different medications and insulin management techniques for effective blood sugar control.
Understanding Diabetes
Diabetes is a chronic medical condition characterized by elevated levels of blood glucose, commonly known as blood sugar. It affects millions of people worldwide and requires careful management to prevent complications. Understanding the different types, causes, symptoms, and risk factors of diabetes is essential for effective management.
Types of Diabetes
There are three main types of diabetes:
- Type 1 diabetes: This occurs when the body’s immune system mistakenly attacks and destroys the insulin-producing cells in the pancreas. It usually develops in childhood or early adulthood and requires insulin therapy for survival.
- Type 2 diabetes: This is the most common type of diabetes, accounting for about 90-95% of cases. It typically develops in adulthood and is often associated with obesity, sedentary lifestyle, and genetic factors. Type 2 diabetes can be managed through lifestyle modifications, medications, and sometimes insulin therapy.
- Gestational diabetes: This type of diabetes occurs during pregnancy and usually resolves after childbirth. However, women who develop gestational diabetes are at increased risk of developing type 2 diabetes later in life.
Causes, Symptoms, and Risk Factors
The causes of diabetes vary depending on the type:
- Type 1 diabetes is believed to result from a combination of genetic and environmental factors, although the exact cause remains unknown.
- Type 2 diabetes is primarily caused by a combination of lifestyle factors, including poor diet, sedentary behavior, and obesity. Genetic predisposition also plays a role.
- Gestational diabetes is thought to be caused by hormonal changes during pregnancy that affect insulin action.
The symptoms of diabetes may include frequent urination, excessive thirst, unexplained weight loss, increased hunger, fatigue, blurred vision, slow wound healing, and recurrent infections.
Several risk factors can contribute to the development of diabetes, such as family history, obesity, physical inactivity, poor diet, ethnicity, and age.
“Understanding diabetes is the first step towards effective management. By educating ourselves about the different types, causes, symptoms, and risk factors, we can take proactive measures to prevent complications and lead healthier lives.” – Dr. Sarah Johnson, Endocrinologist
Comparison of Diabetes Types
| Type of Diabetes | Age of Onset | Cause | Treatment | Prevalence |
|---|---|---|---|---|
| Type 1 diabetes | Usually childhood or early adulthood | Autoimmune destruction of insulin-producing cells | Insulin therapy | 5-10% of all diabetes cases |
| Type 2 diabetes | Usually adulthood | Factors include obesity, sedentary lifestyle, and genetics | Lifestyle modifications, medications, and sometimes insulin therapy | 90-95% of all diabetes cases |
| Gestational diabetes | During pregnancy | Hormonal changes affecting insulin action | Diet and exercise management, sometimes insulin therapy | Affects about 2-10% of pregnancies |
Monitoring Blood Sugar Levels
Regular monitoring of blood sugar levels is crucial for individuals with diabetes to effectively manage their condition and make informed decisions about their health. By keeping track of blood sugar levels, individuals can proactively identify and address fluctuations, helping to prevent complications and maintain optimal health.
There are several methods available for monitoring blood sugar levels, each offering different benefits and considerations. One common method is through the use of a blood glucose meter, a portable device that measures blood sugar levels from a small drop of blood. This method provides immediate results and allows individuals to quickly respond to high or low blood sugar levels.
Continuous glucose monitoring (CGM) systems are another option for monitoring blood sugar levels. These systems use a small sensor placed under the skin to track glucose levels throughout the day and night. The data is transmitted to a device, such as a smartphone or insulin pump, providing real-time information and trends over time. CGM systems are particularly beneficial for individuals who need frequent monitoring or have difficulty performing regular fingerstick tests.
Regular monitoring of blood sugar levels is crucial for individuals with diabetes to effectively manage their condition and make informed decisions about their health.
Another technique for monitoring blood sugar levels is through the use of urine test strips. These strips detect the presence of glucose in the urine, indicating high blood sugar levels. While urine testing can be a convenient and cost-effective option, it is less accurate and does not provide real-time information like blood glucose meters or CGM systems.
Regardless of the monitoring method chosen, it is essential to establish a routine and monitor blood sugar levels as recommended by healthcare professionals. Consistent monitoring allows individuals to identify patterns, understand the effects of food, physical activity, and medication on blood sugar levels, and make appropriate adjustments to their diabetes management plan.
To help individuals keep track of their blood sugar levels and identify trends, a blood sugar monitoring log can be useful. This log typically includes the date, time, blood sugar readings, and any additional notes, such as meals, exercise, or significant events. By maintaining a monitoring log, individuals can easily visualize their blood sugar patterns and share relevant information with their healthcare team.
Effective monitoring of blood sugar levels empowers individuals with diabetes to take control of their health and make informed decisions about their diabetes management. Whether using a blood glucose meter, CGM system, or urine test strips, regularly tracking blood sugar levels is an essential component of successful diabetes management.
Healthy Eating Habits
Maintaining a healthy diet is crucial for managing diabetes and promoting overall well-being. By making conscious food choices, you can help control blood sugar levels and reduce the risk of complications associated with diabetes.
Meal Planning
One effective strategy for healthy eating habits is meal planning. By taking the time to plan your meals in advance, you can ensure that you have nutritious options readily available and avoid making impulsive food choices.
When planning your meals, aim for a balanced plate that includes a variety of food groups. Fill half of your plate with non-starchy vegetables like spinach, broccoli, and bell peppers. Add a quarter of your plate with high-quality protein sources such as lean meat, fish, tofu, or beans. The remaining quarter can be dedicated to whole grains or starchy vegetables like sweet potatoes or brown rice.
Incorporating healthy fats, like avocados, nuts, and olive oil, is also important. These fats can help improve insulin sensitivity and promote heart health.
Smart Food Choices
Making smart food choices is essential for maintaining healthy eating habits. Opt for whole, unprocessed foods whenever possible. These foods are rich in nutrients and typically have a lower glycemic index, which means they have a smaller impact on blood sugar levels.
Avoid sugary drinks and opt for water, unsweetened tea, or flavored water instead. Limit your intake of processed snacks, sweets, and sugary desserts, as these can cause blood sugar spikes and contribute to weight gain.
When grocery shopping, read food labels carefully. Look for products that are low in added sugars and high in fiber. Choose whole grains over refined grains and opt for lean sources of protein.
Healthy Food Swaps
| Unhealthy Option | Healthy Swap |
|---|---|
| Sugary cereal | Oatmeal with berries |
| White bread | Whole grain bread |
| Fried chicken | Grilled chicken breast |
| Soda | Sparkling water with lemon |
| Ice cream | Greek yogurt with berries |
By implementing these healthy food swaps, you can enjoy delicious meals while keeping your blood sugar levels in check.
Remember that healthy eating habits go beyond individual meals. It’s essential to practice portion control and mindful eating. Pay attention to your body’s hunger and fullness cues, and avoid overeating.
By incorporating healthy eating habits into your daily routine, you can take control of your diabetes management and improve your overall health.
Regular Physical Activity
Engaging in regular physical activity is a vital component of managing diabetes. Not only does exercise help improve insulin sensitivity and lower blood sugar levels, but it also offers a range of other benefits for overall health and well-being.
One of the key advantages of regular physical activity is its ability to help control weight. By burning calories and increasing metabolism, exercise can assist individuals with diabetes in reaching and maintaining a healthy weight, which is crucial for good diabetes management.
In addition, regular exercise can contribute to improving cardiovascular health. It can help lower blood pressure, reduce the risk of heart disease, and enhance blood circulation. This is especially important for individuals with diabetes who are at a higher risk of developing cardiovascular complications.
“Exercise is the closest thing we have to a wonder drug for diabetes.”
Furthermore, physical activity promotes mental well-being by reducing stress, anxiety, and depression. It can boost mood, increase energy levels, and improve sleep quality, all of which are vital for individuals managing diabetes.
When choosing activities, it is essential to consider the individual’s specific needs and preferences, as well as any existing medical conditions. Low-impact exercises such as walking, cycling, swimming, and yoga are generally well-suited for individuals with diabetes. These activities provide the benefits of regular physical activity while minimizing the risk of injury or excessive strain on joints and muscles.
Regular physical activity can be incorporated into daily routines in various ways. For example, taking the stairs instead of the elevator, walking or biking to work, or participating in group exercise classes can all contribute to increasing overall activity levels.
The Benefits of Regular Physical Activity for Managing Diabetes:
- Improves insulin sensitivity
- Lowers blood sugar levels
- Aids in weight management
- Promotes cardiovascular health
- Enhances mental well-being
| Activity | Duration | Frequency |
|---|---|---|
| Walking | 30 minutes | 5 days a week |
| Cycling | 45 minutes | 3 days a week |
| Swimming | 60 minutes | 2 days a week |
| Yoga | 60 minutes | 2 days a week |
Medications and Insulin Management
For individuals with diabetes, medications and insulin management play crucial roles in controlling blood sugar levels. These treatment options work in tandem to help maintain stable glucose levels and prevent complications associated with diabetes.
Medications
There are several types of medications available to treat diabetes, including oral medications and injectables. Oral medications, such as metformin, work by reducing glucose production in the liver and improving insulin sensitivity in the body’s cells. Other oral medications, like sulfonylureas and meglitinides, stimulate the pancreas to produce more insulin.
Injectable medications, such as GLP-1 receptor agonists, work by increasing insulin production, lowering blood sugar, and reducing appetite. Another injectable medication, called SGLT2 inhibitors, helps the kidneys remove excess glucose from the body through urine.
“Medications are prescribed based on individual needs and may vary depending on the type of diabetes, overall health, and other factors,” says Dr. Joseph Miller, an endocrinologist at XYZ Medical Center. “It’s important to work closely with your healthcare provider to determine the best medication regimen for you.”
Insulin Management
Insulin is a hormone that helps regulate blood sugar levels by allowing glucose to enter the body’s cells. People with type 1 diabetes, and some with type 2 diabetes, need insulin management to maintain optimal blood sugar control.
Insulin is administered through injections or insulin pumps, which deliver a continuous supply of insulin throughout the day. There are different types of insulin, including rapid-acting, short-acting, intermediate-acting, and long-acting insulin. The choice of insulin and the dosing schedule are tailored to each individual’s needs and lifestyle.
“Insulin management is essential for those who require it,” explains Nurse Jane Adams, a diabetes educator at ABC Hospital. “It allows for precise control of blood sugar levels and plays a crucial role in preventing complications.”
It’s worth noting that managing medications and insulin dosages may require regular adjustments based on factors like diet, physical activity, and changes in overall health. Regular communication with healthcare providers and diabetes educators can help with proper medication and insulin management.
Stress Management
Stress can have a significant impact on diabetes management, as it can cause blood sugar fluctuations and make it more challenging to maintain stable levels. It is essential for individuals with diabetes to learn effective stress management strategies to minimize these effects and promote overall well-being.
Here are some practical strategies for managing stress:
- Deep Breathing: Taking deep, slow breaths can help activate the body’s relaxation response, reducing stress levels.
- Exercise: Engaging in regular physical activity not only improves physical health but also releases endorphins that boost mood and reduce stress.
- Journaling: Writing down thoughts and feelings can help individuals process emotions and alleviate stress.
- Meditation or Mindfulness: Practicing meditation or mindfulness techniques can help individuals focus on the present moment and reduce stress levels.
- Seeking Support: Talking to a trusted friend, family member, or healthcare professional can provide valuable support and guidance during stressful times.
By incorporating these stress management techniques into daily routines, individuals with diabetes can better cope with the challenges they face and maintain stable blood sugar levels.
“Stress is a part of life, but it is crucial for individuals with diabetes to develop healthy coping mechanisms. By managing stress effectively, they can improve diabetes management and overall quality of life.” – Dr. Kate Anderson, Endocrinologist
Stress Management Techniques
| Technique | Description |
|---|---|
| Deep Breathing | Taking deep, slow breaths to activate the body’s relaxation response. |
| Exercise | Engaging in regular physical activity to release endorphins and reduce stress. |
| Journaling | Writing down thoughts and feelings to process emotions and alleviate stress. |
| Meditation or Mindfulness | Practicing techniques to focus on the present moment and reduce stress levels. |
| Seeking Support | Talking to trusted individuals or healthcare professionals for guidance and support during stressful times. |
Diabetes Complications
Properly managing diabetes is crucial for preventing potential complications that can arise from uncontrolled blood sugar levels. When diabetes is left untreated or poorly managed, it can lead to a variety of health issues and complications. However, with the right approach and proactive measures, many of these complications can be prevented or minimized.
Cardiovascular Complications
One of the most common complications of diabetes is cardiovascular disease. Individuals with diabetes have an increased risk of developing conditions such as heart disease, stroke, and high blood pressure. The elevated glucose levels in the blood can damage blood vessels and lead to the formation of plaque, increasing the risk of heart-related complications. It is crucial to maintain proper blood sugar control and adopt a heart-healthy lifestyle to minimize the risk of cardiovascular complications.
Neuropathy
Diabetic neuropathy is a condition characterized by nerve damage, predominantly affecting the feet and legs. High blood sugar levels can damage the nerves over time, leading to symptoms such as numbness, tingling, and loss of sensation. If left untreated, neuropathy can progress and result in ulcers, infections, and even amputations. By maintaining tight control of blood sugar levels and practicing proper foot care, individuals can significantly reduce the risk of neuropathy and its associated complications.
Nephropathy
Diabetic nephropathy, also known as diabetic kidney disease, is a common complication that can lead to kidney damage and eventual kidney failure. Persistently high blood sugar levels can damage the blood vessels in the kidneys, impairing their ability to filter waste and excess fluid from the body. Regular monitoring of blood pressure, blood sugar levels, and kidney function, along with lifestyle modifications, such as maintaining a healthy diet and avoiding tobacco and excessive alcohol consumption, can help prevent or slow down the progression of diabetic nephropathy.
Retinopathy
Diabetic retinopathy is a condition that affects the blood vessels in the retina of the eye. It is a leading cause of blindness in adults with diabetes. Elevated blood sugar levels and high blood pressure can damage the tiny blood vessels in the retina, leading to vision problems and, in severe cases, vision loss. Regular eye examinations, strict blood sugar control, and managing blood pressure are crucial in preventing or delaying the onset of retinopathy and preserving optimal vision.
By staying proactive in diabetes management through consistent monitoring of blood sugar levels, adopting a healthy lifestyle, and seeking appropriate medical care, individuals can minimize the risk of diabetes complications. Early detection and prompt intervention are key to preventing the progression of complications and maintaining overall well-being.
Support and Education
When it comes to managing diabetes, seeking support and education is essential for enhancing your self-management skills and improving overall health outcomes. Healthcare professionals, such as doctors and nurses, play a crucial role in providing medical guidance and support. They can help you understand your condition, answer questions, and offer practical advice tailored to your unique needs.
In addition to healthcare professionals, diabetes educators are invaluable resources. These experts specialize in diabetes management and can provide you with comprehensive education on various aspects of the disease. They can teach you how to monitor your blood sugar levels, make healthy eating choices, manage medications and insulin, and identify and prevent complications.
Support groups are another valuable source of support and education for individuals living with diabetes. These groups typically consist of individuals with diabetes who meet to share their experiences, provide emotional support, and exchange tips and strategies for success. Joining a support group can give you a sense of community and help you feel less alone in your journey.
By actively seeking support from healthcare professionals, diabetes educators, and support groups, you can gain valuable knowledge, receive personalized guidance, and develop a strong support network. This support and education will empower you to take control of your diabetes management and make informed decisions about your health.
Benefits of Support and Education in Diabetes Management
“Without support and education, managing diabetes can feel overwhelming. But with the right guidance and a supportive community, it becomes much more manageable.”
Support and education play a crucial role in diabetes management by providing several key benefits:
- Knowledge and Understanding: Support and education help you better understand your diabetes and its management, enabling you to make informed decisions about your health.
- Improved Self-Management: By learning about monitoring blood sugar, healthy eating, medication and insulin management, and stress reduction, you can effectively manage your diabetes and prevent complications.
- Emotional Support: Connecting with others who understand your experiences can provide emotional support, reduce stress, and boost motivation to stay on track with your diabetes management plan.
- Networking Opportunities: Support groups allow you to network with individuals facing similar challenges, giving you the opportunity to share tips, strategies, and success stories.
- Access to Latest Information: Healthcare professionals and diabetes educators stay up-to-date with the latest research and advancements in diabetes management, ensuring you receive accurate and evidence-based information.
Testimonial: The Power of Support
“Joining a support group was a game-changer for me. Meeting others who were dealing with the same challenges and sharing strategies and advice made me feel less alone on my diabetes journey. The support and education I received were invaluable in helping me manage my diabetes and improve my overall well-being.” – Sarah, a member of a diabetes support group
Diabetes Support and Education Resources
There are various resources available that can provide support and education to individuals with diabetes:
| Resource | Description |
|---|---|
| American Diabetes Association | A national organization focused on diabetes advocacy, research, education, and support. Offers valuable resources such as online tools, educational materials, and community networks. |
| Joslin Diabetes Center | One of the world’s foremost institutions for diabetes treatment, research, and education. Provides comprehensive resources, including educational programs, support groups, and online resources. |
| Local Hospitals and Clinics | Contact your local healthcare facilities to inquire about diabetes education programs, support groups, and resources available in your community. |
| Online Forums and Communities | Participate in online forums and communities dedicated to diabetes. These platforms allow you to connect with individuals globally, share experiences, and gain support. |
Remember, the key to successfully managing diabetes lies in seeking support and education. Take advantage of the resources available to you and build a strong support network. By investing in your knowledge and surrounding yourself with individuals who understand and support you, you can effectively manage your diabetes and lead a healthy and fulfilling life.
Lifestyle Changes for Long-Term Success
Managing diabetes requires a comprehensive approach that includes not only medications and insulin management but also lifestyle changes. By making sustainable changes to your daily routine, you can effectively manage your diabetes and promote long-term health.
One of the key lifestyle changes for long-term success is adopting healthy eating habits. A balanced diet rich in whole grains, lean proteins, fruits, and vegetables can help stabilize blood sugar levels and improve overall health. Incorporating portion control and monitoring carbohydrate intake can also play a crucial role in managing diabetes.
Regular physical activity is another essential component of diabetes management. Engaging in moderate aerobic exercise, such as brisk walking or cycling, for at least 150 minutes per week can help lower blood sugar levels and improve insulin sensitivity. Additionally, strength training exercises can help build muscle mass and enhance overall metabolic health.
It’s important to consult your healthcare provider and a certified diabetes educator to determine the most suitable exercise plan for your condition.
Reducing stress levels is also vital for long-term success in managing diabetes. High levels of stress can cause blood sugar levels to rise, making it difficult to control diabetes. Incorporating stress management techniques such as meditation, deep breathing exercises, or engaging in activities that bring joy and relaxation can be beneficial.
Implementing these lifestyle changes may seem daunting at first, but with proper support, education, and motivation, you can achieve long-term success in managing your diabetes. Joining diabetes support groups, attending educational workshops, and working closely with healthcare professionals can help you stay informed and motivated on your journey.
Remember, diabetes management is a lifelong commitment, and by embracing these lifestyle changes, you can lead a fulfilling life while effectively managing your diabetes for long-term success.
Resources and Additional Information
For those seeking more information and resources on managing diabetes, the following list provides a range of helpful references and support:
- American Diabetes Association: A leading organization dedicated to improving the lives of people affected by diabetes through education, advocacy, and research. Visit their website for a wealth of resources, tips, and support for managing diabetes. www.diabetes.org
- Diabetes Solution Kit: This comprehensive digital resource offers valuable insights, tips, and strategies for effectively managing diabetes. The Diabetes Solution Kit provides in-depth information on diet, exercise, medication, and lifestyle changes to help individuals take control of their health. Learn more about this digital resource at www.diabetessolutionkit.com.
- Diabetes Online Community: Join an online community of individuals living with diabetes to connect, share experiences, and gain support. Online forums and social media groups can provide a valuable source of information and encouragement throughout your diabetes journey.
- Diabetes Educators: Consulting with a certified diabetes educator can provide personalized guidance and support tailored to your unique needs. These healthcare professionals specialize in diabetes management and can help you navigate the challenges of living with diabetes. Speak to your healthcare provider for recommendations or search for a diabetes educator in your area.
- Healthcare Provider: Your primary care physician or endocrinologist can offer additional information and personalized advice on managing your diabetes. They can assist you in creating a comprehensive diabetes management plan and address any questions or concerns you may have.
Remember, it’s important to consult with healthcare professionals and trusted sources when seeking information and support for diabetes management. The resources mentioned above can provide valuable guidance in addition to the Diabetes Solution Kit, helping you on your journey towards better health.
Conclusion
In conclusion, effectively managing diabetes requires a proactive approach that encompasses various aspects of lifestyle and healthcare. Through this article, we have explored the key components of diabetes management, including understanding the condition, monitoring blood sugar levels, adopting healthy eating habits, engaging in regular physical activity, and properly managing medications and insulin. We have also discussed the importance of stress management, the potential complications of diabetes, and the value of seeking support and education.
However, to maximize your diabetes management efforts, consider utilizing the Diabetes Solution Kit. This comprehensive digital resource provides valuable information, tools, and resources to empower individuals with diabetes to take control of their health and enhance their overall wellbeing. With the Diabetes Solution Kit, you can access expert advice, learn effective strategies, and gain the knowledge you need to manage your diabetes effectively.
Remember, proactive and informed diabetes management is key to achieving improved health outcomes and maintaining a high quality of life. By implementing the strategies outlined in this article and utilizing the Diabetes Solution Kit, you can make positive changes, prevent complications, and enjoy a fulfilling and healthy life, even with diabetes.
FAQ
What is the Diabetes Solution Kit?
The Diabetes Solution Kit is a collection of digital ebooks that provides effective strategies for managing diabetes.
What is diabetes?
Diabetes is a chronic medical condition characterized by high blood sugar levels. There are different types of diabetes, including type 1, type 2, and gestational diabetes.
How can I monitor my blood sugar levels?
You can monitor your blood sugar levels using a glucose meter, continuous glucose monitor, or by measuring A1C levels through a blood test.
Why is maintaining a healthy diet important for managing diabetes?
Maintaining a healthy diet is crucial for managing diabetes as it helps control blood sugar levels and reduces the risk of complications. It is essential to plan meals and make smart food choices.
What are the benefits of regular physical activity for individuals with diabetes?
Regular physical activity can help control blood sugar levels, improve insulin sensitivity, manage weight, reduce the risk of cardiovascular disease, and enhance overall well-being.
What medications and insulin management techniques are available for diabetes management?
There are various medications, including oral medications and insulin injections, that can effectively control blood sugar levels in individuals with diabetes. Your healthcare provider will determine the most suitable treatment plan based on your specific needs.
How can I manage stress to prevent blood sugar fluctuations?
Effective stress management techniques, such as relaxation exercises, meditation, and engaging in hobbies, can help prevent blood sugar fluctuations and promote better diabetes management.
What are the potential complications of poorly managed diabetes?
Poorly managed diabetes can lead to complications such as heart disease, stroke, kidney damage, nerve damage, vision loss, and foot problems. It is important to manage diabetes effectively to prevent or minimize these complications.
Where can I find support and education for managing diabetes?
You can seek support and education from healthcare professionals, diabetes educators, and support groups. They can provide valuable guidance and resources to enhance your diabetes self-management skills.
How can I make sustainable lifestyle changes for long-term success in managing diabetes?
Making sustainable lifestyle changes involves adopting healthy eating habits, engaging in regular physical activity, managing stress, taking medications as prescribed, and regularly monitoring blood sugar levels. It is essential to make gradual changes and seek support when needed.
Are there any resources available for further information on diabetes management?
Yes, there are many resources available for further reading and learning about diabetes management. Some helpful resources include books, websites, and educational materials provided by reputable organizations specializing in diabetes care.