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Forgot To Take Nighttime Insulin

Giving The Wrong Insulin

Giving The Wrong Insulin

I recently received the following question: What happens if you take your P.M. insulin in the morning? My reply: First of all, everyone (including me) has messed up now and then when giving (or forgetting) their insulin shots, so please don’t blame yourself for what is a very human error. What will happen to your blood sugar level obviously depends on several factors that your question didn’t address. Anyone giving the wrong amount or type of insulin runs a risk of either high or low blood sugars, depending on the duration of effect and the amount of insulin given compared to the usual duration of effect and amount, and also upon meals and exercise. There are a lot of things that can cause your blood sugar reading to be off. Here's how to avoid the most common errors. With that in mind, if you realize you gave the wrong dose, the first thing to do is to realize your blood sugars may be wacky, so plan to check blood sugar levels more frequently during the next day or so, perhaps as often as every hour or two. And tell your family or friend what happened, and be sure they have the phone number to reach your doctor or diabetes nurse educator to discuss how to handle the situation if your blood sugar goes really goofy. Let me go through a few of the possibilities I can think of. If the insulin that you gave was a rapid-acting variety such as Regular, Humalog, Novolog, or Apidra, then the effects of the dose should dissipate over several hours, and the effect should be gone in about 6 hours. If the insulin was a long-acting variety such as Lantus or Levemir, then the effect will probably take a day or somewhat longer to wear off. Several websites have listings of various insulins and their usual duration of activity: See for instance Types of Insulin at my website. If yo Continue reading >>

Forgot To Take My Insulin!

Forgot To Take My Insulin!

Diabetes Forum The Global Diabetes Community Find support, ask questions and share your experiences. Join the community Hi I forgot to take my insulin last night, didn't realise until this morning ....felt sick with worry, as it's Saturday no doctors for advice so went to Boots and spoke to our local guy there, who calmed me down and told me to check sugar levels through out the day. Also to take my insulin a little earlier than normal this evening...going out for a meal tonight...wouldn't you just guess that! Feel happier than I was, drinking more water as well...anything else? What insulin regime are you on? Twice daily, MDI, etc and what insulin do you use? As long as your bg levels remain safe, then there is little to worry about. Thank you for getting back to me....just feel stupid that I forgot to take it! @AnneShirley , which insulin is it you missed, is it a basal insulin such as lantus/levemir? @AnneShirley , which insulin is it you missed, is it a basal insulin such as lantus/levemir? Hi Yes it's Lantus, I take 38 at night.....just took dog for a walk and drinking lots of water!! Hi Yes it's Lantus, I take 38 at night.....just took dog for a walk and drinking lots of water!! There's some flexibility with lantus, provided you leave 24 hours between injections you can move the timing forward or backwards. Shirley, for reference, if I forget to take my basal insulin, I usually take it when I remember and change the dose to match the amount of time i have left until my next shot. I currently use Levemir but did the same thing with Lantus. The example is I normally take two shots 12 hours apart, so if I forget my morning one, I would take however many hours remain, divide it by 12 and then multiply the number by my morning units. E.g. Three hours late leaves nine Continue reading >>

Myth-busting Insulin For Gestational Diabetes

Myth-busting Insulin For Gestational Diabetes

Gestational diabetes is a roller coaster ride from start to finish. There is a lot of information to navigate and often at a session with your diabetes educator you don’t know what questions to ask. So we pulled together an extensive list of questions about insulin for gestational diabetes. We wanted to highlight the positives and to bust the myths. We hope that after reading this you’ll feel more informed and less anxious about insulin treatment. Written by Natasha Leader, Accredited Practising Dietitian & Credentialled Diabetes Educator Do many women with GDM have to take insulin? It tends to depend on your treatment centre and which timing and targets your health practitioners are using. For example you may be advised to check your blood glucose level at 1 hour or 2 hours after the meal. There may also be some variation in the target level of glucose that your doctor/diabetes educator uses i.e may be < 7.4 or 8.0 1hr or <6.7 or 7.0 for 2hr time point. The percentage of women who need insulin is usually between 20 and 60%. Have I failed if I end up having to take insulin? Absolutely not. The need for insulin is related to how much insulin your body is able to make and whether this is enough to process the amount of carbohydrate food you and baby need to stay well. In most cases it is not a reflection of the effort you are making with your diet. Is the insulin going to harm my baby in any way? Insulin will not harm your baby but high glucose levels may. Insulin is used because it only crosses the placenta in very small amounts (compared with oral agents) and therefore is considered the safest way to control your blood glucose levels if diet and exercise alone are not enough. Are there any long-term effects from taking insulin? No. Taking injected insulin is just in Continue reading >>

Please Help! - Forgot To Take My Basal Insulin

Please Help! - Forgot To Take My Basal Insulin

PLEASE HELP! - Forgot to take my basal insulin PLEASE HELP! - Forgot to take my basal insulin I just noticed when I woke up this morning that I totally forgot to take my basal insulin last night. I have been looking on line and some say to just wait until the next dose tonight and correct with more bolus as needed. But others say to split in half and give myself that immediately. I checked myself this morning and my # was 154, I'm usually between 100-130. So it is higher, but not by much in my opinion. What should I do? I just called endo but no answer, so let message. D.D. Family Getting much harder to control I can not say what to do since I am different, a 154 will not hurt you but you could monitor and see where you are at in an hour or two. Its like no harm no foul territory, just suggest to take the insulin with you in case you keep going higher. This has happened to me before and it was nightmare to try to work out a split dose and then worry about when it will 'deactivated' instead of being more basal insulin on board. How long do you have to wait until your next regular scheduled night time dose of basal? f your numbers are behaving okay just managing on bolus shots, I'd hold off and just manage this way until it's nighttime again. Basal insulin is a 24 hour dose hypothetically. Grisel, according to some of your recent posts, you take both basal and bolus insulin and you only take 9 U at night. Given that your fbg this morning was only 154 (not great, but not too bad) I would just continue wih your bolus injections until you hear back from your doctor. As furball said, you could monitor your bg more often today to make sure you don't get too high, but you will probably be fine. "My fitness trajectory in my senior years does not have to be a continuous downward Continue reading >>

Skipping Insulin - Diabetes Self-management

Skipping Insulin - Diabetes Self-management

Here at Diabetes Flashpoints, we have occasionally covered situations in which a conflict arises between saving money and following the instructions of a health-care provider. Topics in this vein include reusing lancets and syringes , sharing reusable medical devices , and abandoning drugs at the pharmacy because of cost. Weve also mentioned how to talk to your doctor about cost-related concerns. But as the results of a survey on skipping insulin doses show, cost isnt the only factor in whether someone with diabetes disregards certain medical advice or part of a treatment plan. A recent article on the Web site DiabetesInControl.com highlights the results of the survey , published last year in the journal Diabetes Care. The online survey was taken by 502 adults living in the United States who took insulin injections for either Type 1 or Type 2 diabetes. Questions focused on insulin-taking habits as well as background information including age, income, education, and dietary habits. Overall, more than half of respondents reported having intentionally skipped an insulin dose; 20% reported skipping doses regularly. Background factors associated with skipping insulin included younger age, lower income, higher education, having Type 2 diabetes (rather than Type 1), poorer dietary habits, having more injections to take each day, and reporting that injections caused pain or embarrassment or interfered with daily activities. Among people with Type 1 diabetes, skipping insulin was most strongly associated with poorer dietary habits; among those with Type 2 diabetes, the strongest associations were with lower age, higher education, lower income, and greater pain and embarrassment with injections. As a Diabetes Self-Management article notes, the survey also probed injection-relate Continue reading >>

Ask D'mine: Revisiting The Missed Insulin Shot Question

Ask D'mine: Revisiting The Missed Insulin Shot Question

Need help navigating life with diabetes? Ask D'Mine! That would be our weekly advice column, hosted by veteran type 1, diabetes author and clinical diabetes educator Wil Dubois This week, Wil takes another look at a common question often posed by those of us in the Diabetes Community: What do I do if I miss an insulin dose? Happens to us all, at times, and it's always good to refresh our knowledge. {Got your own questions? Email us at [email protected]} Pete, type 2 from Florida, writes:I have been struggling with diabetes for 5 years. I will sometimes fail to do my shot before dinner and wonder if I should take the 40 units when I remember? Or wait and take it before bedtime? I am looking for guidance. I am tying to find a path that works. [email protected] D’Mine answers: One of the universal things we insulin users suffer from — no matter what type of diabetes we have or what type of insulin we take — is the missed shot. Yep, when it comes to life on insulin, the old rodeo adage of it’s not a matter of if you get hurt; it’s only a matter of when you’ll get hurt can be translated directly into diabetes: It’s not a matter of if you will miss a shot; it’s only a matter of when you will miss a shot. We talked about this briefly a while back, but it’s such a universal problem that’s so much more complicated than it looks on the surface, that I think it’s worth revisiting today. So here’s Professor Wil’s quick course on the inevitable missed shot dilemma: Types of Insulin There are two main kinds of insulin: The fast ones and the slow ones. We’ll start slow. Actually, no. I changed my mind. We’ll start fast, because the answer for a missed fast-acting insulin shot is, well, faster. The fast insulins are Apidra, Humalog, and Novolog. One member o Continue reading >>

Questions And Answers - Medication And Insulin

Questions And Answers - Medication And Insulin

Q: I have type 2 diabetes and have been on insulin for a year now. I have lost some weight and my A1C has dropped from 9.5 to 6.5 but I am having a lot of lows ranging from upper 40's to 60's. I am wondering if maybe I might be able to get off insulin. I feel that my oral med is starting to work better now that my beta cells have had a rest. Can that be true? A: Yes, your cells are also in a better position to uptake glucose from the bloodstream now that you have decreased body fat. You should see your physician ASAP to get this adjusted. 40's are a dangerous range to be in. He/she may start weaning you off insulin, watching your levels along the way. Q: How much is blood sugar decreased for every unit of novolog insulin? A: A starting point is to consider that one unit of insulin will lower the glucose 50 points. This can vary from 30-100 points, depending on one's insulin sensitivity, exercise habits, food choices or other variables. Time will tell for you as you test and track your numbers to see if a pattern evolves. Q: What medication is used to replace metformin when liver enzymes are high and the endocrinologist discontinues this medication? A: Much will depend on the advancement of your diabetes and other medications you might be taking. Your physician might choose a meglitinide such as Prandin or an alpha-clucosidase inhibitor such as Precose. Insulin would be another choice. There are other meds and newer ones always in the mill. Some physicians keep their patients on Metformin if the enzyme levels are not too high. If your numbers are not too high and you are otherwise healthy, focus on lifestyle management. Losing body fat, if needed, can help to get things under control. Q: My bottle of insulin will expire next month. Can I still use it or do I need to thro Continue reading >>

Ask D'mine: Missing In Action

Ask D'mine: Missing In Action

Need help navigating life with diabetes? Ask D'Mine! That would be our weekly advice column, hosted by veteran type 1, diabetes author and community educator Wil Dubois. This week he's offering some wisdom on what we people with diabetes (PWD) can do if and when we miss a dose of insulin... Yes, it happens. So, read on! {Got your own questions? Email us at [email protected]} Edwin, type 2 from Maryland, writes: I have been diabetic for approximately 12 years. I take Humalog shots before meals, and one shot of 28 units of Lantus at bedtime. My question is, what do I do if I miss a bedtime Lantus shot, and I realize this the next day? This is exactly what happened this morning. The previous night, I had stayed home watching movies and I had a few vodka martinis. I got sleepy, and just went to sleep. When I woke up, I realized I forgot my shot! [email protected] D'Mine answers: Gotta watch out for those vodka martinis! But these kind of things can happen to all of us, with or without the martinis, so don't feel badly. Actually, I'm amazed you remembered in the morning. Maybe your blood sugar reminded you? ;-) As to what to do about the missed shot, this is a trickier question than you might think. I'll give you my thoughts, but this probably falls into the "ask your doctor" category, which means that I need to remind everyone that my title of Doctor WilD is a purely honorary one, granted to me by an un-accredited mail-order "university" in the northeastern part of Liechtenstein. And on top of that, my honorary doctorate isn't a medical degree, but a PhD, and it isn't even in diabetes, it's in underwater basket weaving. So, the medical disclaimer dispensed with, let us proceed... Some missed meds should be taken as soon as you realize you missed them. With others, you need to Continue reading >>

Missing Insulin Injections

Missing Insulin Injections

Tweet Missed insulin injections are much more of a pain than the injections themselves and can cause a headache as to what effect a late injection will have and what dose should be administered. We look at this common problem and provide some guidance. Always remember that if you are at all unsure what to do, you should contact your health team for advice rather than risk making a mistake. In this article, when it says contact your health team, note that you may need to contact your out of hours service if your health team is not available. Common causes of missed injections Commonly cited reasons for missed injections include: Forgetting to take insulin Oversleeping Not having your injection kit with you Running out of insulin Having a fear of needles Deliberately missing insulin If you have problems with forgetting injections, see our forgetting injections guide dedicated to help prevent problems with forgetting to inject and if you forget whether you have injected or not. What to do if an insulin injection is missed There is not a set rule of what to do if an injection is missed as it can depend on how long ago the injection was meant to be administered and what type of insulin was to be taken. We provide some general tips but if you are in doubt, it is best to consult your health team and follow their advice. If long term/basal insulin was forgotten If you forget to take your long term insulin (basal insulin) and you realise relatively soon, it should usually be fine to inject your usual dose if the dose is given within 2 hours of when it should have been done. In this case, you’ll need to be aware that the injection was taken later and so the insulin will also be active in your body later than it would usually be. In some cases this could increase the chance of h Continue reading >>

Lantus

Lantus

NOTICE: This Consumer Medicine Information (CMI) is intended for persons living in Australia. (lant-us) What is in this leaflet It does not contain all the available information. It does not take the place of talking to your doctor, pharmacist or diabetes educator. All medicines have risks and benefits. Your doctor has weighed the risks of you using Lantus against the benefits they expect it will have for you. If you have any concerns about using this medicine, ask your doctor or pharmacist. What Lantus is used for Lantus is used to reduce high blood sugar (glucose) levels in people with diabetes mellitus. Lantus is a modified insulin that is very similar to human insulin. It is a substitute for the insulin produced by the pancreas. Lantus is a long-acting insulin. Your doctor may tell you to use a rapid-acting human insulin or oral diabetes medication in combination with Lantus. Ask your doctor if you have any questions about why Lantus has been prescribed for you. Before you use Lantus When you must not use Lantus Some of the symptoms of an allergic reaction may include: If you have a lot of hypos discuss appropriate treatment with your doctor. After the expiry date printed on the pack or if the packaging is torn or shows signs of tampering. If you use Lantus after the expiry date has passed, it may not work as well. If it has expired or is damaged, return it to your pharmacist for disposal. If the product appears cloudy, discoloured or contains particles, or if the injection pen/cartridge/vial appears damaged. If you are not sure whether you should start using this medicine, talk to your doctor. There is no experience with the use of Lantus in children less than 6 years. Before you start to use Lantus Tell your doctor if you have allergies to any other medicines, foo Continue reading >>

Forgot To Take Insulin? Here Are 3 Tips To Help You Remember Your Insulin Shot

Forgot To Take Insulin? Here Are 3 Tips To Help You Remember Your Insulin Shot

5 0 It’s probably a safe bet to say that modern technology has made all of us a little more distracted. Whether we’re texting friends, checking our email, watching television, or playing video games, being able to focus completely on a task has become a bit of a chore. Unfortunately, that distraction can come at a cost – especially when you have diabetes and need to be able to remember when (or if) you took your last shot. So what do you do if you forgot to take insulin? Accidents happen and sometimes insulin shots get overlooked, and when that happens, we’ve covered the basics for accounting for that oversight in our blog post here about “What to Do if You Forget Your Insulin Shot”. But what if you just want to create an environment that helps you stay on track with your insulin schedule? Well, there’s some easy tips that can help you remember to take your shot and decrease the number of times you forget. And if you really want to ensure that you don’t miss a dose, grab a time-enabled replacement cap for your insulin pen from Timesulin. Now, on to the tips! 1. Don’t get distracted during injections You might be in the middle of a conversation or finishing work, but when it’s time to inject, politely excuse yourself and take care of it right away. Putting off any kind of task – even for one minute – can increase the likelihood of forgetting it altogether. 2. Lump daily habits together If your injection falls around the same time as other daily habits, get into the routine of doing them altogether. For example, an injection at night before you go to bed can be done along with brushing your teeth and washing your face. 3. Keep insulin injection supplies in an obvious location Having your insulin supplies in the location where you will need to injec Continue reading >>

What Happens If You Forget To Take Insulin?

What Happens If You Forget To Take Insulin?

Why not ask your diabetes team for a customised set of instructions for what to do if you forget your insulin? Then if it occurs you will already have the information you need. Make sure you ask for information that includes the following: 1. The amount of time after a missed injection e.g. Give x units if <2 hours after; Give x units if > 4 hours etc. 2. What your blood glucose levels are like at the time e.g. if high you don't need to drop the dose as much as if your levels are low and giving the injection later 3. What activity levels you will be doing - if doing more activity in the afternoon and levels already low, then the insulin dose will be lower than usual when giving it later. 4. The action times of your insulin/s - you need to consider the length of time the insulin will be working fior These 4 issues all influence the amount of insulin you would need to give yourself when you have missed the usual injection time. Why not book a session with your diabetes educator to go through the various components to feel more able to manage this situation. Everyone forgets their insulin sometimes but knowing what to do can make you feel better when it happens - because it is very likely to happen! Continue reading >>

What Is Levemir (insulin Detemir)?

What Is Levemir (insulin Detemir)?

Levemir is the brand name for the prescription drug insulin detemir. It's used to treat type 1 and type 2 diabetes. Levemir is a long-acting insulin that lowers blood sugar by encouraging tissues to take excess glucose, discouraging the body from making more glucose, preventing the breakdown of fat and protein, and helping the body regulate levels of blood sugar. The Food and Drug Administration (FDA) approved Levemir in 2006. Novo Nordisk manufactures the drug. Levemir FlexTouch Levemir FlexTouch is an insulin pen syringe prefilled with Levemir. It's designed to make the drug easier to use. You should keep unopened Levemir FlexTouch in the refrigerator until you’re ready to use it. After opening, store it at room temperature no warmer than 86 degrees Fahrenheit. You should dispose of FlexTouch 42 days after opening, regardless of whether or not there is any left in the device. Levemir versus Lantus Levemir is similar to another man-made form of insulin, insuline glargine, which is sold under the brand name Lantus. Both drugs have similar side effects and have been to be effective at managing blood sugar levels in people with type 1 and type 2 diabetes. Talk to your doctor about which drug is better for you. Levemir Warnings You should not take Levemir if: You’re allergic to Levemir or any other ingredient in the drug Your blood sugar is low Talk to your doctor before taking Levemir if: You’re sick, stressed, or have an infection You have kidney or liver problems The potassium level in your blood is low Your doctor may lower your dose of Levemir if you are taking certain drugs, such as exenatide (Bydureon), liraglutide (Victoza), or albiglutide (Tanzeum). Levemir Storage You can store unopened vials of Levemir at room temperature or in the refrigerator, but toss a Continue reading >>

Getting The Right Dosage

Getting The Right Dosage

Even for those on Lantus® for a while, it may take a little time to get to the right dose of insulin. Your doctor may change your Lantus® dose several times in the first few weeks. This is to be expected. For best results, keep taking your Lantus® as prescribed, and keep talking to your doctor. What if You Miss a Dose? Your doctor will guide you on when to take Lantus®. Ask him or her what to do if you forget to take your insulin, so you can be prepared in advance in case it ever happens. Here are a few ways to remember to take your Lantus® once-a-day: 3 Helpful Tips Make yourself a reminder If you take your Lantus® at night, it might also be a good idea to leave yourself a note on your nightstand as a way to remember. If you take it in the morning, put your supplies where you can't miss them—next to your toothbrush, for example. Keep out of reach of children. Add it to your other daily "to dos" Many people take Lantus® right after brushing their teeth in the evening or while making breakfast in the morning. Set an Alarm Some people set alarms on their wristwatches or mobile devices to remind them when to take their Lantus®. “We changed doses a couple of times when I started on Lantus®, until we found the right amount for me.” Continue reading >>

Levemir Patient Information Including Side Effects

Levemir Patient Information Including Side Effects

Brand Names: Levemir, Levemir FlexPen Generic Name: insulin detemir (Pronunciation: IN su lin DE te mir) What is the most important information I should know about insulin detemir (Levemir, Levemir FlexPen)? What is insulin detemir (Levemir, Levemir FlexPen)? Insulin detemir is a man-made form of insulin, a hormone that is produced in the body. It works by lowering levels of glucose (sugar) in the blood. Insulin detemir is a long-acting form of insulin that is slightly different from other forms of insulin that are not man-made. Insulin detemir is used to treat type 2 diabetes in adults. Insulin detemir is also used to treat type 1 diabetes in adults and children who are at least 2 years old. Insulin detemir may also be used for purposes not listed in this medication guide. What are the possible side effects of insulin detemir (Levemir, Levemir FlexPen)? Get emergency medical help if you have any of these signs of insulin allergy: itching skin rash over the entire body, wheezing, trouble breathing, fast heart rate, sweating, or feeling like you might pass out. Call your doctor at once if you have a serious side effect such as: itching, swelling, or redness where you inject insulin detemir; swelling in your hands or feet; or low potassium (confusion, uneven heart rate, extreme thirst, increased urination, leg discomfort, muscle weakness or limp feeling). Less serious side effects may include: thickening of the skin where you inject insulin detemir; weight gain; mild headache, back pain; stomach pain; or flu symptoms, or cold symptoms such as stuffy nose, sneezing, sore throat. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. What is the most impo Continue reading >>

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