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How Long Do You Have To Wait To Take Insulin?

When To Test Your Blood Sugar

When To Test Your Blood Sugar

Checking your blood glucose as recommended can help you see how your meals, medications and activities affect your blood sugar. The American Diabetes Association (ADA) recommends that you routinely test blood sugar levels to aid in managing your diabetes.1 Routine or daily testing For people using an insulin pump or insulin injections throughout the day, the ADA recommends testing multiple times daily.1 If you take another kind of medication, test your blood sugar level as often as your healthcare team recommends. You and your healthcare team will determine when you should check your blood sugar based on your current health, age and level of activity, as well as the time of day and other factors. They may suggest that you test your blood sugar at any of the following times:1,2,3 Before each meal 1 or 2 hours after a meal Before a bedtime snack In the middle of the night Before physical activity, to see if you need a snack During and after physical activity If you think your blood sugar might be too high, too low or falling When you're sick or under stress Structured testing Short-term, structured testing means checking your blood sugar at specific times over a few days. It can help you recognize patterns and problem-solve around how the things you do are connected to your blood sugar. You may want to consider structured testing, in addition to your routine or daily testing, if you: Adjust your insulin or oral medication Begin a new medication unrelated to diabetes Change your activity level, meal plan or schedule There are different ways to perform structured testing, depending on your goals. The Accu-Chek® 360° View tool is a simple paper tool that helps you track your blood sugar over 3 days, so you and your doctor can quickly identify patterns that can guide adjust Continue reading >>

How To Get Approved For Pump Therapy

How To Get Approved For Pump Therapy

A certified diabetes educator provides a step-by-step process for getting fitted with an insulin pump. Integrated Diabetes Services (IDS) provides detailed advice and coaching on diabetes management from certified diabetes educators and dieticians. Insulin Nation hosts a regular Q&A column from IDS that answers questions submitted from the Type 1 diabetes community. Q – I want to use an insulin pump, but I hear insurance might be a problem. Can you tell me how one gets approved for a pump by a doctor and insurance? A – It’s smart to at least consider an insulin pump as a treatment option. The precision in how insulin is delivered with a pump can make a notable difference in blood sugar control. Your first step in procuring an insulin pump is to talk with the doctor who helps you manage your diabetes. Many endocrinologists and certified diabetes educators have demo insulin pumps in their offices or information from different pump companies that they can give you. It’s important to discuss with your doctor what you hope the pump will do for you and the reasons you feel it will be an asset to your blood sugar management. For many people, pump therapy may be easier than multiple daily injections, but it is only effective if the person using it understands the pump and is proactive about blood sugar control. Doctors don’t automatically approve pumps for all their patients with diabetes, and some will refuse to prescribe pump therapy until blood sugar levels are improved to a certain level with traditional insulin therapy. It’s important to advocate for why you believe a pump could help improve your blood sugar management. Bring blood sugar logs and records to your visits, and give concrete reasons why multiple daily injections alone isn’t cutting it. When consi Continue reading >>

Expert Advice: 18 Questions About Taking Insulin

Expert Advice: 18 Questions About Taking Insulin

Stuart Weiss, MD, is a clinical assistant professor of endocrinology, diabetes, and metabolism at New York University's Department of Medicine, NYU Medical Center, in New York City. Q: I have type 2 diabetes. Do I have to take insulin? A: For people with type 2 diabetes, insulin is a very nice tool that's better if used sooner rather than later. (Unlike in type 2 diabetes, in type 1 diabetes insulin is a requirement, not an option.) What happens in type 2 diabetes is that physicians may use insulin as a threat, an “if you” thingif you don't lose some weight, if you don't do some exercise, if you don't follow the diet, then you're going to wind up on insulin. That's really not how people with type 2 diabetes should view insulinas a punishment. Insulin is a very, very safe therapy, and people should not hesitate to use it if needed. The people with type 2 diabetes who must take insulin are those who are unable to control their blood sugar even while on several different oral medications. But if you start using insulin before you reach that point, you can help preserve the function of your insulin-producing pancreatic cells for a longer time. And the longer you continue to make your own natural insulin, the longer you can get by with a less complicated insulin regimen, possibly taking just one shot a day. Q: But I'm afraid of shots! A: You don't need to be, if you're talking about insulin. If you're picturing big syringes that you have to boil and sterilize, think again. Modern insulin needles are very thin and disposableno sterilizing necessary. There are also insulin pens equipped with an insulin cartridge and disposable needles that are so simple even a child can use them. Either type of delivery system makes using insulin very easy and virtually painlessreally. If Continue reading >>

Insulins

Insulins

Insulin is a hormone made naturally in the body by the pancreas. This hormone controls the level of sugar (glucose) in the blood. People who have type 1 diabetes need to have regular insulin injections. In type 1 diabetes, the body stops making insulin and the blood sugar level goes very high. Some people who have type 2 diabetes may also need to have insulin injections to help control blood sugar levels. Insulin is usually injected under the skin between 2-4 times a day. There are different types of insulin available which are classified according to how quickly and for how long they work. Your doctor or diabetes nurse will discuss the various preparations and devices available and help you choose a regimen that is right for you. Treatment with insulin is usually lifelong. What is insulin and how does it work? What does insulin do? Play VideoPlayMute0:00/0:00Loaded: 0%Progress: 0%Stream TypeLIVE0:00Playback Rate1xChapters Chapters Descriptions descriptions off, selected Subtitles undefined settings, opens undefined settings dialog captions and subtitles off, selected Audio TrackFullscreen This is a modal window. Beginning of dialog window. Escape will cancel and close the window. TextColorWhiteBlackRedGreenBlueYellowMagentaCyanTransparencyOpaqueSemi-TransparentBackgroundColorBlackWhiteRedGreenBlueYellowMagentaCyanTransparencyOpaqueSemi-TransparentTransparentWindowColorBlackWhiteRedGreenBlueYellowMagentaCyanTransparencyTransparentSemi-TransparentOpaqueFont Size50%75%100%125%150%175%200%300%400%Text Edge StyleNoneRaisedDepressedUniformDropshadowFont FamilyProportional Sans-SerifMonospace Sans-SerifProportional SerifMonospace SerifCasualScriptSmall CapsReset restore all settings to the default valuesDoneClose Modal Dialog End of dialog window. Insulin is a hormone that is Continue reading >>

The Sweet Spot For Intermittent Fasting

The Sweet Spot For Intermittent Fasting

The Sweet Spot for Intermittent Fasting Lower insulin means greater fat loss Intermittent fasting — the practice of going without food for some (undefined) period of time — has many health benefits. It can help prevent heart disease, speed fat loss, and slow or reverse aging. There are a number of physiological mechanisms involved. It reduces inflammation and oxidative stress, leads to increased numbers and quality of mitochondria, and increases autophagy, the cellular self-cleansing process. Many of the beneficial effects are entwined with lower levels of insulin. The function of insulin is to promote energy storage and the growth of the organism. When insulin is increased, fat is stored in fat cells, and other cells take up glucose from the blood. Most importantly, when insulin is increased, lipids can’t leave fat cells. Since fat loss is all about getting lipids out of fat cells to be burned, losing fat requires some attention to how diet, exercise, and fasting cause insulin to rise or fall. Take a look at the following graph, taken from a paper by Volek et al. It shows that even small increases in insulin, within the normal range, virtually abolish lipolysis, or the breakdown of fat. This is where intermittent fasting comes in, as one of its effects is to lower insulin levels and thus increase lipolysis. The question is, how long do you need to fast before insulin comes down? Eating causes insulin to rise, the amount of the rise being dependent on a number of factors, such as type and amount of food eaten and the insulin sensitivity of the person doing the eating. High amounts of carbohydrates and lower insulin sensitivity cause a greater rise in insulin. Insulin increases and stays higher for several hours after eating — that is, during the “fed” state. Continue reading >>

Giving Insulin To Your Child With Type 1 Diabetes

Giving Insulin To Your Child With Type 1 Diabetes

Injections and finger sticks are part of life for a child with type 1 diabetes. We've got suggestions to make the process easier. Uncomfortable little jabs are now part of your routine, if yours is one of the 15,000 American children diagnosed each year with type 1 diabetes (T1D). Our experts suggest simple ways to reduce the discomfort, and help your child adapt quickly to needles. How insulin works When a child has T1D, the immune system attacks and destroys cells in the pancreas called beta cells. Pancreatic beta cells produce insulin, the hormone we need to turn food into energy. Without enough insulin, the amount of sugar (or glucose) in the blood rises to dangerous levels. This can cause long-term complications such as kidney failure, heart disease, lower-limb amputations, and blindness in adulthood. That's why kids with T1D have blood glucose levels checked throughout the day and night to help keep the sugar levels within target range. Using a lancet, you'll likely prick your child's fingertip for a drop of blood six or more times a day, and place it on a special test strip in a blood glucose meter. Based on that reading, you'll know how much insulin your child needs to keep blood sugar levels in range. Shots and pumps: the basics You can give your child insulin in a few ways, depending on what works best for both of you. The oldest method is through multiple daily injections with a syringe or insulin pen, which is a disposable needle tip placed at the end of a marker-shaped device that contains a pre-filled insulin cartridge. An alternative to injections is an insulin pump, a beeper-sized computerized device often worn on a belt or in a pocket. It delivers an ongoing low dose of insulin through a small tube inserted into your child's body through a needle. The t Continue reading >>

Indications And Usage For Apidra® (insulin Glulisine [rdna Origin] Injection)

Indications And Usage For Apidra® (insulin Glulisine [rdna Origin] Injection)

Prescription Apidra® is for adults with type 2 diabetes or adults and children (4 years and older) with type 1 diabetes to improve blood sugar control. Apidra® given by subcutaneous injection is usually used with a longer-acting insulin. When used as a mealtime insulin, Apidra® should be given within 15 minutes before or within 20 minutes after starting a meal. Apidra® may be infused subcutaneously by external insulin infusion pumps. Do not use Apidra® during a low blood sugar reaction (hypoglycemia) or if you are allergic to any of the ingredients in Apidra®. Do not share needles, insulin pens or syringes with others. Do NOT reuse needles. You must test your blood sugar levels while using insulin, such as Apidra®. Do not make any changes to your dose or type of insulin without talking to your healthcare provider. Any change of insulin should be made cautiously and only under medical supervision. Apidra® must only be used if the solution is clear and colorless with no particles visible. Apidra®, when given by injection under the skin, should not be mixed with insulins other than NPH. Do not mix Apidra® with any insulin when used in the pump or for intravenous administration. The most common side effect of insulin, including Apidra®, is low blood sugar (hypoglycemia), which may be serious. Some people may experience symptoms such as shaking, sweating, fast heartbeat, and blurred vision. Severe hypoglycemia may be serious and life threatening. It may cause harm to your heart or brain. Other possible side effects may include low blood potassium, injection site reactions, such as changes in fat tissue at the injection site, and allergic reactions, such as itching and rash. Less common, but potentially more serious or life-threatening, is generalized allergy to in Continue reading >>

Diabetes Patients Can Eat Immediately After Taking Insulin

Diabetes Patients Can Eat Immediately After Taking Insulin

People with type 2 diabetes no longer have to wait to eat after taking insulin…. People with type 2 diabetes are sometimes told to wait after using insulin for the drug to work its way into the body before they can begin eating, but a new study from Germany indicates that it is not necessary to wait. In a group of about 100 diabetics, researchers found that blood sugar levels remained steady regardless of whether or not participants left a 20 to 30-minute gap between using insulin and eating a meal. The diabetics overwhelmingly preferred being able to eat right away, too. The result of the study can lead to better adherence and satisfaction. Injectable insulin is available for diabetics in a newer fast-acting form, but it’s expensive and many still use human insulin, which takes some time to become active in the body. So doctors often recommend waiting to eat after using human insulin to prevent blood sugar spikes. Not all experts think waiting is necessary, though, according to the researchers led by Nicolle Mueller of Universitätsklinikum Jena. To see what difference it makes, Mueller and her colleagues randomized type 2 diabetics into two groups. For four weeks, one group of 49 people waited 20 minutes to eat after using human insulin. Then they switched to eating immediately after injecting insulin for another four weeks. A second group of 48 diabetics did the same in reverse order, eating immediately after injection for the first four weeks, then observing a waiting period for the next four. Using a blood test that measures average glucose levels over time, the researchers found that all the participants had generally higher than ideal blood sugar levels but the difference in those levels between periods when they waited or didn’t wait to eat after insulin i Continue reading >>

Insulin Pumps: Managing High Blood Glucose

Insulin Pumps: Managing High Blood Glucose

F A C T S H E E T F O R P A T I E N T S A N D F A M I L I E S Step 1: Look for simple solutions Did you forget your insulin bolus, or not take enough insulin with your last meal? If no, check for: • Kinks in the tubing • Leaks in the tubing • Poor connections • Sediment in the insulin • Infection at the insertion site Step 2: Give a correction dose Check your blood glucose. Give a correction dose using your pump. Check your blood glucose in 2 hours. If it has increased, give a correction dose with a syringe or injection pen. Use your usual short‑acting insulin and your normal correction ratio. Then, change your infusion set. If your blood glucose is holding steady, wait another hour and check it again. If still no change, give the correction dose. Do not give a correction dose if your blood glucose is already going down. Doing so may cause dangerously low blood glucose. Step 3: Troubleshoot technical issues If changing the infusion set did not fix the problem, call the 800 number on the back of your pump for help. If you can’t get your pump working again, ask for a replacement pump. Step 4: Take off your pump If your pump is not working or needs to be repaired, take it off and notify your provider. Use the same long‑ and short‑acting insulin that you used before you got the pump. Use the information on the back of this page to figure your insulin. An insulin pump can help you keep your blood glucose stable. But you can still have periods of high blood glucose when using a pump. This sheet will help you know what to do if this happens. Do you know your settings? Write down the current settings from your pump in the spaces below. Keep this sheet in a place where you can easily find it. You may not be able to get th Continue reading >>

7 Techniques To Reduce Post-meal Spikes During Pregnancy

7 Techniques To Reduce Post-meal Spikes During Pregnancy

“Gary, I think I need more insulin at breakfast.” “Why do you say that, Julianne?” “Because I’m always having high readings right afterwards, and my obstetrician said I shouldn’t spike after I eat.” “And what happens after the spike?” “It usually comes down to normal before lunch. So do you think I should take more insulin?” After-meal blood sugar spikes can create quite a quandary for anyone with diabetes, particularly during pregnancy. Research has shown that fetal macrosomia (overgrowth of the baby) becomes more common when post-meal blood sugars exceed 120 mg/dl (6.7 mmol). With post-meal readings above 140 mg/dl (7.8 mmol), the risk more than doubles from baseline. Fetal macrosomia can cause many problems during pregnancy. When the baby grows and develops too rapidly, it can lead to a premature and more complicated birth. It may also cause injuries to occur to the baby during delivery. Why do after-meal blood sugars have such a major influence on the baby’s growth? Nobody knows for certain. Perhaps, when the mother’s blood sugar “spikes” suddenly after meals, the baby is fed more sugar than its pancreas can “cover” with insulin, and high fetal blood sugar results. And because the baby’s kidneys spill almost all excess sugar from the baby’s bloodstream back into the amniotic fluid, the baby then drinks in the extra glucose and winds up growing more than it should. Suffice to say that post-meal blood sugar spikes are something to avoid during pregnancy. But how do we do it? Getting back to Julianne’s question, if she takes more insulin, she’ll probably wind up hypoglycemic before lunch. Luckily, we have some excellent techniques for preventing the after-meal highs without having to take more mealtime insulin. What Causes Sp Continue reading >>

5 Nightmares You Don't Know Until You're Diabetic

5 Nightmares You Don't Know Until You're Diabetic

Hey, remember when everybody was freaking out about Ebola, because of an outbreak that killed more than 10,000 people? Well, diabetes kills 1.5 million people a year worldwide, more than 200,000 of them in the U.S. And you're probably never more than a few dozen feet away from someone who has it -- there are 30 million diabetics in the U.S. alone. In other words, for something most people consider too boring to even think about, the scale of the epidemic is mind-boggling. The U.S. alone spends an astonishing quarter of a trillion dollars a year fighting it. Or to put it another way, diabetes sucks a thousand bucks out of every single man, woman and child in America, every year. We previously debunked the myth that sugar causes diabetes, and when we talked to someone with one variety of the disease, we learned about the parts of the experience you never hear about. He says ... 5 The Disease And The Treatment Can Both Send You To The Emergency Room Comstock/Stockbyte/Getty Images Our diabetic, Zach, once woke up in the middle of the night starving, his legs feeling near-paralyzed. His memory of the incident is hazy, but the next thing he knew, he was on a kitchen chair wearing only his boxers with an empty jar of raspberry jam on the table -- he'd eaten nearly the entire thing with his bare hands like fucking Winnie the Pooh. Oh, bother. When he tested his blood sugar, it was 45 (the normal level is between 80 and 100). Anything below 70 is hypoglycemia, yet even after eating an entire jar of what is essentially pure sugar, his blood sugar level was still near emergency levels. If we're being completely honest, it's remarkable that he ever even woke up to eat that jam. By all rights he should've died in his bed. So this shit can get serious, is what we're saying. "Wait," Continue reading >>

How Long After Eating Does Blood Sugar Peak?

How Long After Eating Does Blood Sugar Peak?

After consuming carbs, your blood sugar levels temporarily go up until insulin steps in to remove the extra sugar. This type of peak is a normal part of digestion. A bigger concern is how high your blood sugar goes after eating. Frequent spikes in blood sugar can lead to long-term medical problems, but you can protect your health through dietary choices. Video of the Day Two types of carbs -- sugars and starches -- are responsible for increasing your blood sugar. After you eat these carbs, digestive enzymes break them down into simple sugars, which are absorbed into your bloodstream. The pancreas responds to the influx of sugar by releasing insulin, which returns sugar levels back to normal. Blood sugar begins to rise about 20 minutes after you eat. It can peak at that time if you consumed quickly digested carbs, such as hard candy or juice. After a balanced meal containing protein, fat and fiber, blood sugar peaks about one to two hours after eating. Your blood sugar should drop back down to its lowest level two to four hours after a meal. Blood Sugar Spikes Portion sizes, the type of foods in your meal and when you eat can all influence how high and how quickly your blood sugar peaks. Carbohydrates that do not contain fiber, such as products made from processed white flour and white rice, cause high blood sugar. High-carb beverages, such as sugar-sweetened drinks, have a significant effect. Bigger portions of carbs also cause a larger spike of sugar. Starches in whole grains and beans are digested slowly, so they have a small impact. You can also keep blood sugar better balanced by eating meals at regular intervals. Glycemic Index Guidelines The glycemic index is a rating system used to show the impact of carb-containing foods on blood sugar. Carbs are assigned a scor Continue reading >>

Timing Your Metformin Dose

Timing Your Metformin Dose

The biggest problem many people have with Metformin is that it causes such misery when it hits their stomachs that they can't keep taking it even though they know it is the safest and most effective of all the oral diabetes drugs. In many cases all that is needed is some patience. After a rocky first few days many people's bodies calm down and metformin becomes quite tolerable. If you are taking the regular form of Metformin with meals and still having serious stomach issues after a week of taking metformin, ask your doctor to prescribe the extended release form--metformin ER or Glucophage XR. The extended release form is much gentler in its action. If that still doesn't solve your problem, there is one last strategy that quite a few of us have found helpful. It is to take your metformin later in the day, after you have eaten a meal or two. My experience with metformin--and this has been confirmed by other people--is that it can irritate an empty stomach, but if you take it when the stomach contains food it will behave. There are some drugs where it matters greatly what time of day you take the drug. Metformin in its extended release form is not one of them. As the name suggests, the ER version of the pill slowly releases the drug into your body over a period that, from my observations, appears to last 8 to 12 hours. Though it is supposed to release over a full 24 hours, this does not appear to be the case, at least not with the generic forms my insurer will pay for. Because there seems to be a span of hours when these extended release forms of metformin release the most drug into your blood stream, when you take your dose may affect how much impact the drug has on your blood sugars after meals or when you wake up. For example, the version I take, made by Teva, releases Continue reading >>

Pet/ct Fdg Scan For Patients With Diabetes

Pet/ct Fdg Scan For Patients With Diabetes

​​​​​​​​​DOWNLOADABLE PDF: English | Chinese | Ru​ssian | ​​Spanish​ This handout gives special instructions for patients with diabetes who are having a PET/CT FDG scan at UW Medical Center, Harborview Medical Center, or Seattle Cancer Care Alliance. Your doctor has ordered an exam for you called a PET/CT FDG scan. Please ask for the handout called “PET/CT FDG Scan” if you do not already have it. PET stands for positron emission tomography. CT stands for computed tomography. FDG stands for 2-Deoxy-2-[18F]fluoro-D-Glucose. This exam uses Fluorine-18 FDG, a radioactive tracer that acts like glucose in the body. The tracer helps us see how much energy your cells are using. We measure this with a FDG PET/CT scan. A PET/CT camera takes 2 types of pictures: The PET scan shows where the radioactive tracer has collected in your body. The CT scan provides pictures of your body structures. Together, the PET and CT images help your doctor see changes in your cells. How to Prepare People with diabetes have trouble processing glucose. This means you need to follow special instructions for your scan. Closely follow all instructions in this handout. This will help keep your blood sugar under control and give us the clearest results from this exam. Call your diabetes care provider 2 weeks before your scan to talk about the best way to prepare for your scan. Review the instructions in this handout with this provider. Do not exercise for 48 hours before your scan appointment. Starting 12 hours before your scan, do not take any dextrose medicines by total parenteral nutrition (TPN) or intravenous (IV) line. Starting 12 hours before your appointment time, you cannot eat or drink. You may only drink plain water during this 12-hour fast. Your scan will be early Continue reading >>

General Pre-op For People With Diabetes

General Pre-op For People With Diabetes

Your Care Instructions Just because you have diabetes doesn't mean you can't have surgery if you need it. Surgery is safer now than ever before. But if you have diabetes, you may need to take extra care. Before your surgery, you may need to check your blood sugar more often. Your doctor may have you do this for at least 24 hours before and for 72 hours after your surgery. If you take insulin or other medicine for diabetes, your doctor will give you exact instructions about how to take them. It may not be the same as how you usually take them. Following is what many doctors advise. But each person is different. If you don't get instructions about your medicines, ask your doctor what to do. And make sure to ask about anything you don't understand. If you take metformin, you may need to stop taking it 48 hours before surgery. And you may need to wait another 48 hours to start taking it again. If you take diabetes medicines other than insulin, you may need to stop taking them on the morning of the surgery. If you take short-acting insulin, you may need to stop taking it on the morning of the surgery. If you take long-acting insulin, you may need to take only half of your usual dose on the morning of the surgery. Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take. What happens before surgery? Preparing for surgery If you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, be sure to talk to your doctor. He or she will tell you if you should stop taking these medicines before your surgery. Make sure that you understand exactly what your d Continue reading >>

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