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Acetaminophen And Insulin

Diabetes And Sick Days: What Meds Are Ok

Diabetes And Sick Days: What Meds Are Ok

In the midst of cold and flu season, you may wonder what medications are safe to take without greatly impacting blood glucose levels when you have diabetes. Overall, it's the sickness that increases blood glucose in people with diabetes, not the medication used to treat it. However, some medications should be used with caution. Stacey O'Donnell, R.N., B.S., C.D.E., nurse manager, at Joslin Diabetes Center, goes over different types of medications and how they could impact your diabetes. Examples: Tylenol, Aspirin Effect on diabetes: No effect. Use cautiously if you have renal disease. Anti-inflammatory Examples: Ibuprofen, such as Advil, Motrin, Nuprin Effect on diabetes: No effect. Also should be used carefully if you have renal disease. Examples: Allegra, Bumex Effect on diabetes: Caution should be used in patients who have diabetes with renal disease, cardiac disease and high blood pressure. General guidelines for taking medications for people with diabetes are to avoid products containing sugar, such as sucrose, dextrose, fructose, lactose and honey, O'Donnell says. Also, choose products with little or no alcohol. A suggested list of sugar-free cough and cold medicines includes: Chlor-Trometon tablets Dimetapp Elixir Scot-Tussin DM Liquid Cerose-DM Liquid Continue reading >>

Safety Information

Safety Information

Dexcom G5 Mobile Safety Information Dexcom G4 PLATINUM (Pediatric) Safety Information Dexcom G4 PLATINUM Safety Information Dexcom Share Secondary Displays Safety Information Dexcom SEVEN PLUS Safety Information Dexcom CLARITY Safety Information Dexcom STUDIO Safety Information Dexcom G5 Mobile Continuous Glucose Monitoring System Indications for Use The Dexcom G5 Mobile Continuous Glucose Monitoring System (Dexcom G5) is a glucose monitoring system indicated for the management of diabetes in persons age 2 years and older. The Dexcom G5 is designed to replace fingerstick blood glucose testing for diabetes treatment decisions. Interpretation of the Dexcom G5 results should be based on the glucose trends and several sequential readings over time. The Dexcom G5 also aids in the detection of episodes of hyperglycemia and hypoglycemia, facilitating both acute and long-term therapy adjustments. The Dexcom G5 is intended for single patient use and requires a prescription. Important User Information Failure to use the Dexcom G5 and its components according to the instructions for use and all indications, contraindications, warnings, precautions, and cautions may result in you missing a severe hypoglycemia (low blood glucose) or hyperglycemia (high blood glucose) occurrence and/or making a treatment decision that may result in injury. If your glucose alerts and readings from your Dexcom G5 do not match your symptoms or expectations, use a fingerstick blood glucose value from your blood glucose meter to make diabetes treatment decisions. Seek medical attention when appropriate. Please review the product instructions before using the Dexcom G5. Indications, contraindications, warnings, precautions, cautions, and other important user information can be found in the product instruct Continue reading >>

Important Safety Information

Important Safety Information

Indications, Contraindications, Warnings and Precautions All Medtronic MiniMed devices and associated components listed below are limited to sale by or on the order of a physician and should only be used under the direction of a healthcare professional familiar with the risks associated with the use of these systems. Patients should always discuss potential risks and benefits with a physician. Please review the product manual prior to use for detailed instructions and disclosure. For a full list of reference documents please visit our Download Library. Insulin Pumps Continuous Glucose Monitor (CGM) Sensors and Serters Meters Injection Port Mobile Accessory Remote Glucose Monitor CareLink Therapy Management Software Medtronic MiniMed® Insulin Infusion Pumps This section applies to insulin infusion function of all MiniMed external pumps, with or without Continuous Glucose Monitoring function, including MiniMed pump model MMT-508 or older, MiniMed Paradigm pumps, MiniMed Paradigm REAL-Time pumps and MiniMed Paradigm REAL-Time Revel pumps. Please refer to Medtronic MiniMed REAL-Time Continuous Glucose Monitoring section for important safety information regarding Continuous Glucose Monitoring function of the MiniMed Paradigm REAL-Time pumps or MiniMed Paradigm REAL-Time Revel™ pumps. Indications for Use The insulin pump is indicated for the continuous delivery of insulin, at set and variable rates, for the management of diabetes mellitus. Age restrictions apply depending on pump model. Contraindications Pump therapy is not recommended for people who are unwilling or unable to perform a minimum of four blood glucose tests per day and to maintain contact with their healthcare professional. Successful insulin pump therapy requires sufficient vision or hearing to allow recogn Continue reading >>

Acetaminophen Can Falsely Raise Glucose Sensor Readings

Acetaminophen Can Falsely Raise Glucose Sensor Readings

Acetaminophen Falsely Raises Glucose Sensor Readings by Wide Margin Acetaminophen falsely elevates continuous glucose monitor (CGM) readings by a large margin, according to a new report that quantifies and raises cautions about the phenomenon as the devices are used increasingly by patients. The results of an analysis conducted with 40 type 1 diabetes patients were published online August 12, 2015 in Diabetes Care by David M Maahs, MD, associate professor of pediatrics at the Barbara Davis Center for Childhood Diabetes, University of Colorado, Denver, and colleagues. In the current study, CGM readings were as much as two- to nearly fourfold higher than finger-stick readings following ingestion of acetaminophen. User guides for currently licensed CGM devices made by Dexcom and Medtronic Minimed include a warning about acetaminophen interference with the devices. Moreover, since the CGM devices aren't approved by the US Food and Drug Administration for use in making treatment decisions, the product guides also advise patients to instead base insulin dose calculations on finger-stick blood glucose monitor results. The degree to which the instructions are heeded isn't known. Few published studies have documented the magnitude of the acetaminophen effect, particularly on newer sensors. The rapid development of closed-loop technology, which uses CGM readings to automate insulin delivery, also makes this a concern, the authors say. "It's very important that the effect of acetaminophen on CGM and its magnitude be known, especially as CGM technology is being used increasingly by patients. Also, with artificial-pancreas technology rapidly advancing and with the potential for insulin dosing based on CGM instead of only with meter glucose, this is an important topic," Dr Maahs tol Continue reading >>

Are Your Meds Helping Or Hurting?

Are Your Meds Helping Or Hurting?

Its no surprise medications can cause side effects. Commercials have made us numb to them. Still, we rarely hear how dangerous common medications can be, even for those who carefully follow the directions. Ive been blessed to have a patient population I enjoy spending my time with. Doug was no exception. I had cared for him, his wife, and their adult daughter for over a decade. One day, Doug came to see me because his back hurt. I noticed he was also retaining fluid; his face was puffy. The pain didnt seem to feel worse when he bent or movedit just always hurt. I had a small suspicion his kidneys were a culprit, so I did a simple urine test. I had examined Doug and done blood tests just over a year prior, and he had no signs of kidney problems. The urine test showed his kidneys were not filtering protein at all. A few more tests confirmed Doug was in late-stage kidney failure. He spent four months on dialysis in hopes of receiving a kidney transplant. It never came, and he died just before his 51st birthday. The nephrologist who treated Doug attributed his death to ibuprofen use. Doug didnt mention it to me, but hed developed tendonitis and was regularly taking ibuprofen for several months. He never exceeded the recommended dosages. The first sign of there being a problem was his fluid retention. By then, it was too late. Kidneys can lose 80% of their working cells, called glomeruli, before there is any symptom or measurable change in function. In the last decade, the rate of death from prescription medications has gone up 2.8 times. Both prescription and over-the-counter medications have become a leading cause of early mortality, and the trend is only worsening. Below is a quick list of the top offenders. If you see any of these names in your medicine chest, please wo Continue reading >>

How Long Does Tylenol (acetaminopen) Affect Cgm Sensors?

How Long Does Tylenol (acetaminopen) Affect Cgm Sensors?

How long does Tylenol (Acetaminopen) affect CGM sensors? D.D. Family diabetic since 1997, on insulin 2000 Toxic dose seems to be as low as 7500 mg so 4000 per day maybe a bit much. D.D. Family T1 since 1985, MM Pump 2013, CGM 2015 Toxic dose seems to be as low as 7500 mg so 4000 per day maybe a bit much. So I'm reading right off the label of mine: Liver Warning: This product contains acetaminophen. The maximum daily dose of this product is 6 caplets (3000mg) in 24 hours. Severe liver damage may occur if you take * more than 4000mg of acetaminophen in 24 hours * with other drugs containing acetaminophen * 3 or more alcoholic drinks per day while using this product * Do not take more than directed (see Liver warning) * Take 2 caplets every 6 hours while symptoms last * do not take more than 6 caplets in 24 hours unless directed by a doctor * do not use for more than 10 days unless directed by a doctor So, I guess 4000 mg is indeed pushing it, while 1000 mg is well within limits (unless you have liver issues). My (mistaken) belief that it was fine to take Tylenol 4 times a day must be due to confusing Regular Strength (375 mg) with Extra Strength (500 mg). 8 caplets (2 caplets x 4 times a day) of Regular works out to 3000 mg. * Do not take more than directed (see Liver warning) * Take 2 caplets every 6 hours while symptoms last * do not take more than 6 caplets in 24 hours unless directed by a doctor * do not use for more than 10 days unless directed by a doctor So, I guess 4000 mg is indeed pushing it, while 1000 mg is well within limits (unless you have liver issues). My (mistaken) belief that it was fine to take Tylenol 4 times a day must be due to confusing Regular Strength (375 mg) with Extra Strength (500 mg). 8 caplets (2 caplets x 4 times a day) of Regular works o Continue reading >>

How Long Does Tylenol (acetaminopen) Affect Cgm Sensors?

How Long Does Tylenol (acetaminopen) Affect Cgm Sensors?

How long does Tylenol (Acetaminopen) affect CGM sensors? D.D. Family T1 since 1985, MM Pump 2013, CGM 2015 How long does Tylenol (Acetaminopen) affect CGM sensors? So, thanks to DD I know that Tylenol affects CGM readings, but how long does that effect linger after taking Tylenol? I rarely take any OTC pain relief, and due to kidney issues I've been told to avoid most, except Tylenol and Aspirin, I already take low-dose Aspirin nightly for my heart. But today I did have some pain in my leg, and a bit of a headache, and finally gave in and took 2 Tylenol. And also this morning my Sensor ended, and it was time to insert a new one. I've waited, as I don't see the point in attempting to calibrate with the Tylenol in my system. But anyone have any guesses as to when I should expect the "all-clear"? Moderator T2 insulin resistant Using Basal/Bolus Therapy I would call my pharmacy where the majority of my prescriptions are filled. My package says not to exceed 4000mg in 24 hours, these being 500 mg tablets but I do not use a CGM. This stuff sure can get tricky! D.D. Family diabetic since 1997, on insulin 2000 I would call my pharmacy where the majority of my prescriptions are filled. My package says not to exceed 4000mg in 24 hours, these being 500 mg tablets but I do not use a CGM. This stuff sure can get tricky! Wow 4000 mg in 24 hours I would be totaled for days thereafter. D.D. Family T1 since 1985, MM Pump 2013, CGM 2015 Wow 4000 mg in 24 hours I would be totaled for days thereafter. 4000 mg is just 8 extra strength pills. Considering that, if I do take any, I usually take 2 at a time, I can easily see taking that amount in a day. But I'm not worried about taking too much. In fact, after taking the two this morning, I didn't take any more. My concern is/was how long befo Continue reading >>

Insulin And Tylenol Drug Interactions - Drugs.com

Insulin And Tylenol Drug Interactions - Drugs.com

Do not stop taking any medications without consulting your healthcare provider. Disclaimer: Every effort has been made to ensure that the information provided by Multum is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. Multum's information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill, knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2018 Multum Information Services, Inc. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist. Some mixtures of medications can lead to serious and even fatal consequences. Continue reading >>

Diabetes: Medicines

Diabetes: Medicines

Diabetes Pills Some people with Type 2 diabetes can control their blood glucose (sugar) with diet and exercise alone. Others will need to take diabetes pills. Diabetes pills help keep your blood glucose level within a good range. Some people with Type 2 diabetes may need to take insulin shots. Other people may need both pills and shots. It is important to know what medications you are taking, how they work, and possible side effects. You should ask your doctor and pharmacist for more detailed information. Several kinds of pills may help people who have Type 2 diabetes. The groups of drugs listed below work in different ways. Some people with Type 2 diabetes may need 2 or 3 kinds of pills to control blood glucose. Note that the list below gives examples of the most common current medicines used but that there are often new medications made available that may not be listed here. Every medicine has 2 names; a generic (jun-AIR-ik) name and a brand name. The generic name is the basic name of the drug. The brand name is the name that a specific company uses when it makes that drug. For an example, look at a common headache medicine. Many people use acetaminophen (uh-SEET-uh-MINN-uh-fin) for a headache. Acetaminophen is the generic name of the drug. The brand names include Anacin Aspirin Free, Bayer Select Headache, and Tylenol. Sulfonylurea drugs Sulfonylurea (SULL-fon-il-your-EE-uh) drugs help the pancreas produce more insulin (sustained insulin release). The table below lists examples of this type of drug. Brand Name Generic Name Glucotrol Glucotrol XL* Glipizide Amaryl Glimepiride Micronase DiaBeta Glynase Glyburide Follow your doctor’s instructions on how often to take your sulfonylurea drugs. These drugs work best if taken on an empty stomach (30 minutes before a meal) Continue reading >>

Acetaminophen Can Affect Meter And Cgm Readings

Acetaminophen Can Affect Meter And Cgm Readings

The common pain-relief drug does not affect actual glucose concentration in the bloodstream, however. There’s been evidence as far back as 2009 that acetaminophen can cause inaccurate blood sugar readings with meters. Now, a more recent study suggests that the common pain reliever also might interfere with continuous glucose monitor (CGM) readings, as well. In July 2009, The Journal of Diabetes Science and Technology published a paper discussing sources of meter errors in measurement of blood glucose levels, including patient use of acetaminophen. Acetaminophen is a mild painkiller and fever reducer that people use as an alternative to aspirin; although it’s been hard for scientists to pin down exactly how acetaminophen works, the drug is believed to moderate the body’s production of prostaglandins, a hormone-like lipid which, among other things, helps regulate sensitivity to pain. Researchers in the 2009 study documented how acetaminophen use seemed to cause errors in blood glucose readings with meters. The paper has found no chemical or metabolic link between acetaminophen and the body’s production of, or sensitivity to, glucose or insulin. The researchers did say older meters were more prone to these erroneous readings than newer meters, but that such fluctuations can be possible with all meters they researched. Now, a similar inaccuracy has been documented in connection with CGM use. In 2015, clinical investigators published a paper in Diabetes Care describing meter and monitor variations for a group of acetaminophen-using patients who tested both with meters and CGMs. The study, led by Dr. David M. Maahs of the University of Colorado Barbara Davis Center for Childhood Diabetes, was a stress test to predict the reliability of investigational closed-loop arti Continue reading >>

Effect Of Acetaminophen On Cgm Glucose In An Outpatient Setting

Effect Of Acetaminophen On Cgm Glucose In An Outpatient Setting

Effect of Acetaminophen on CGM Glucose in an Outpatient Setting 1Barbara Davis Center for Childhood Diabetes, University of Colorado, Aurora, CO 2Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA Author information Article notes Copyright and License information Disclaimer Received 2015 May 28; Accepted 2015 Jul 2. Copyright 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. This article has been cited by other articles in PMC. Acetaminophen (paracetamol) interferes with continuous glucose monitor (CGM) sensing, resulting in falsely elevated CGM glucose values in both sensors currently approved by the U.S. Food and Drug Administration (FDA). In amperometric glucose biosensors, particularly those measuring hydrogen peroxide, acetaminophens phenolic moiety is oxidized at the sensing electrode, producing an electrochemical signal not related to glucose ( 1 ). Limited published data exist documenting the magnitude of the effect of acetaminophen on CGM glucose ( 2 ), especially in the outpatient setting with contemporary sensor technology. Currently, the FDA recommends that insulin dosing decisions are based on blood glucose (BG) meter values, not CGM glucose values. Given the common use of acetaminophen, its interference with CGM sensing has significant clinical implications for patients who use CGM. To better understand this effect, we performed an acetaminophen challenge as part of an outpatient study designed to investigate the potential challenges to closed-loop systems, which use CGM sensor glucose values to automate insulin delivery. We hypothesized that acetaminophen w Continue reading >>

How To Manage Diabetes While On Oxycodone

How To Manage Diabetes While On Oxycodone

What happens to a person’s blood sugar when they are under stress due to pain, and must take a narcotic pain reliever such as oxycodone? In this article, we will explore what happens to a person with diabetes who is taking long term pain medication. We will look at whether it raises or lowers blood glucose. We will look at how taking oxycodone affects blood glucose levels, activity levels and appetite, and how that could influence the self-management of diabetes. We will look at ways that you can maintain blood glucose in target ranges while taking a narcotic pain reliever such as oxycodone. John’s story As John relayed to me during a phone conversation, he is taking a combination of oxycodone plus acetaminophen for severe pain in his legs related to poor circulation and neuropathy because of his Type 1 diabetes. He has had severe sleep disruption, and was getting no relief on nonsteroidal anti-inflammatory agents. He has been taking oxycodone now for about three months, and has seen a need to increase the basal rate on his insulin pump in order to stay in target range with his blood glucose. He found that once the stress of the pain was gone, his numbers have stayed in range. I suggest reading the following: What is oxycodone? Oxycodone is a narcotic pain reliever that is used to relieve moderate to severe pain. It is in the class of drugs called “opiate analgesics,” and can be found in combination with other nonsteroidal anti-inflammatory medications such as aspirin, acetaminophen, or ibuprofen. Oxycodone can also be found in combination with aspirin and acetaminophen. Each of these components can also have side effects in addition to the oxycodone. Brand names of combination medications include Nortab, Vicodin, and Lortab and Percocet. Precautions for oxycodo Continue reading >>

High-alert Medications - Hydrocodone With Acetaminophen

High-alert Medications - Hydrocodone With Acetaminophen

High-Alert Medications - Hydrocodone with Acetaminophen Download this Safety Information: Hydrocodone with acetaminophen The leaflets are FREELY available for download and can be reproduced for free distribution to consumers. Or, if you are a facility or organization, you can order professional pre-printed leaflets shipped directly to you . Extra care is needed because hydrocodone with acetaminophen is a high-alert medicine. High-alert medicines have been proven to be safe and effective. But these medicines can cause serious injury if a mistake happens while taking them. This means that it is very important for you to know about this medicine and take it exactly as directed. Top 10 List of Safety Tips for Hydrocodone with Acetaminophen Check your medicine. If your doctor prescribes this medicine using one of its brand names, it could be confused with other medicines that have similar names. For example, a handwritten prescription for Lorcet may be mistaken as Fioricet. Lortab might be mistaken as Luride. Vicodin might be mistaken as Hycodan. When you pick up your prescription at the pharmacy, be sure you have the right medicine. Do not take with other acetaminophen medicines. This pain reliever has two active ingredients: hydrocodone and acetaminophen (also known as Tylenol, and often abbreviated as APAP). Too much acetaminophen can damage the liver and cause death. While taking hydrocodone with acetaminophen, do not take nonprescription acetaminophen or medicines that contain acetaminophen, including cold medicines. Adults should not take more than 3,000 to 4,000 mg of acetaminophen each day. Depending on what your doctor prescribed, each tablet or liquid dose of this medicine contains between 300 mg and 750 mg of acetaminophen. Report all medicines. Let your doctor a Continue reading >>

Acetaminophen Can Falsely Elevate Cgm Readings

Acetaminophen Can Falsely Elevate Cgm Readings

With commentary by David Maahs, MD, associate professor of pediatrics at the Barbara Davis Center for Childhood Diabetes at the University of Colorado Acetaminophen can affect the accuracy of continuous glucose monitors (CGMs), a fact that is well known in the diabetes education and treatment field, but not necessarily recognized by all patients who use them. What’s also not known is how much acetaminophen changes CGM readings. Though manufacturing companies have reported the problem, there has been little data on the impact of this effect on patients who self monitor their glucose levels. David Maahs, MD, associate professor of pediatrics, the Barbara Davis Center for Childhood Diabetes at the University of Colorado, studies complications with CGMs and wanted to investigate the effect of the pain reliever on CGM readings. In his study, which was published online in Diabetes Care, he tested the effects of acetaminophen on CGM in 40 patients with diabetes. He compared the CGM glucose values to blood glucose meter values. The subjects used a Dexcom G4 CGM system, and were given 1,000 mg of acetaminophen, the equivalent of two extra strength Tylenol, in the morning with breakfast. Glucose meter readings were taken before they took the pills, a half hour later, and several more times throughout the day. The researchers found significant differences in values, even as long as eight hours after taking the pain reliever. The greatest difference (61 mg/dL) occurred two hours after taking acetaminophen. Dexcom, a leading manufacturer of CGMs, warns users that “Taking medications with acetaminophen (such as Tylenol) while wearing the sensor may falsely raise your sensor glucose readings. The level of inaccuracy depends on the amount of acetaminophen active in your body and ma Continue reading >>

High-alert Medications - Oxycodone With Acetaminophen

High-alert Medications - Oxycodone With Acetaminophen

High-Alert Medications - Oxycodone with acetaminophen Download this Safety Information: Oxycodone with acetaminophen The leaflets are FREELY available for download and can be reproduced for free distribution to consumers. Or, if you are a facility or organization, you can order professional pre-printed leaflets shipped directly to you . Extra care is needed because oxycodone with acetaminophen is a high-alert medicine. High-alert medicines have been proven to be safe and effective. But these medicines can cause serious injury if a mistake happens while taking them. This means that it is very important for you to know about this medicine and take it exactly as directed. Top 10 List of Safety Tips for Oxycodone with Acetaminophen Check your medicine. If your doctor prescribes this medicine using one of its brand names, it could be confused with other medicines that have similar names. For example, a handwritten prescription for Endocet might be mistaken as Indocin. Percocet might be mistaken as Percodan. Roxicet may be mistaken as Roxanol. Tylox might be mistaken as Trimox. When you pick up your prescription at the pharmacy, be sure you have the right medicine. Do not take with other acetaminophen medicines. This pain reliever has two active ingredients: oxycodone and acetaminophen (also known as Tylenol, and often abbreviated as APAP). Too much acetaminophen can damage the liver and cause death. While taking oxycodone with acetaminophen, do not take nonprescription acetaminophen or other medicines that contain acetaminophen, including many cold medicines. Adults should not take more than 3,000 to 4,000 mg of acetaminophen each day. Depending on what your doctor prescribed, each tablet or liquid dose of this medicine contains between 300 mg and 650 mg of acetaminophen. R Continue reading >>

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