Missing A Dose - Type 2 Diabetes - Everydayhealth.com
Sign Up for Our Living with Diabetes Newsletter Thanks for signing up! You might also like these other newsletters: Sign up for more FREE Everyday Health newsletters . My dad has type 2 diabetes. He recently forgot to take his medication for one day, and later that night he felt sick, with vomiting and a slight fever. He was fine after a little rest, but could this have been a reaction to missing his medicine? If it happens again, what should he (we) do? I understand your concern, but this is a difficult question to answer without knowing details specific to your father's case, so I'll give you a general answer. The most likely immediate consequence of missing medicines for diabetes is a high glucose (sugar) level. If the level is very high, it causes frequent and copious urination, thirst, and hunger. Vomiting, dehydration, weakness, and confusion can also be caused by high glucose levels. If the glucose level has been high for a while, the individual might experience weight loss. It is possible that your father's glucose was on the high side for several days before he missed that one day's medicine. Therefore, it is important to make sure that his blood glucose is adequately controlled. When your father feels sick, check his blood glucose level . If it is high, make sure he remains well hydrated and seek the advice of his doctor for instructions on medicines. Continue reading >>
Vitamin Deficiencies In People With Diabetes: The Supplements You Need
As an orthopedic surgeon, I have many patients with diabetes who tell me, “I can’t have surgery because I won’t heal.” That is certainly not the case, however. Diabetes does affect the small blood vessels and the function of immune cells when blood sugar is high, but with proper nutrition and blood sugar management, people with diabetes are very safe to undergo knee replacements, abdominal surgery, and many elective procedures. It is critical, of course, that people with diabetes who undergo elective or traumatic surgery work closely with their doctor to manage their blood sugar, but supplementation is also a vital part of recovery. Diabetes frequently causes nutritional deficiencies, often initiated by changes in diet or medications. As a result, people with diabetes must use supplements. Helping my patients identify their nutritional deficiencies and educating them on the importance of essential vitamins has made an overwhelming difference in their recovery from surgery and their overall daily health. The following essential vitamins are often deficient in people with diabetes. Vitamin B12 Vitamin B12 is bound to protein in food. The activity of hydrochloric acid and gastric protease in the stomach releases vitamin B12 from its protein. Once it is released, vitamin B12 begins to work quickly. It is important for the formation of red blood cells, neurological function, and DNA synthesis. It also supports the digestive system in keeping glucose levels stable. A simple blood test can determine the level of B12 in the body. Adults who have a value below 170 to 250 pg/mL are considered deficient in the vitamin. An elevated blood homocysteine level or elevated methylmalconic acid level may also suggest a B12 deficiency. Symptoms of vitamin B12 deficiency are megalob Continue reading >>
Missing Meals? Avoid Dangerous Blood Sugar If You Have Diabetes
Skipping a meal is typically no big deal. But if you have diabetes , missing meals can throw off the important balancing act between food intake and medication. Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy The result is blood sugars that are too low (hypoglycemia) or too high (hyperglycemia) — and that’s dangerous. “If you take medications for diabetes that can cause low blood sugars, you should try not to skip meals,” says registered dietician Dawn Noe. “If you’re just not up to eating on a regular schedule, talk to your doctor about diabetes medications that won’t cause low blood sugars,” she says. When you’re ill or just don’t feel like eating much, it’s important to monitor your blood sugar levels more closely than ever. How often depends on whether you have type 1 or type 2 diabetes and what medications you take. For type 1 diabetes: Be sure to monitor your blood sugar before meals and before bedtime, typically four times per day, says diabetes specialist Bartolome Burguera, MD . Beyond that, check your blood sugars if you notice symptoms of low blood sugar. Those symptoms include: For type 2 diabetes: If you are taking a sulfonylurea medication, check your blood sugars at least twice a day — in the morning and at bedtime. “It’s important to keep in mind that sulfonylureas may cause blood sugar to drop during the day if you don’t eat anything after taking your medication,” Dr. Burguera says. If your only treatment is metformin, you may not need to check your blood sugar more than once a day. This medication doesn’t typically cause hypoglycemia. It is important to be aware of the symptoms Continue reading >>
Diabetes Testing & Medications
Testing Methods Diabetes medication is used to keep blood glucose in a target range suggested by diabetes experts, doctors, or diabetes educators, by replacing missing insulin for those who cannot make enough, or by influencing the body to make more or better use the insulin the body is already producing. The success of these treatments is then monitored through various tests. Blood Glucose Testing (also called Self Monitoring of Blood Glucose) Most people with diabetes have a blood glucose meter at home that they use to monitor and keep track of their blood glucose. Some meters come with software to keep a record of your testing and the times so that the results can be charted and problems corrected. Testing is an important part of learning how your diet and habits affect your blood glucose, and what works for you. For some individuals with diabetes, the target blood glucose range is 70-130 mg/dL of blood before eating and up to 180 mg/dL one to two hours after the start of a meal. Check with your healthcare team to see what goal is right for you! Once you get into a diet and exercise routine, vary the times you take your daily blood glucose tests to help you track how what you do and what you eat affects your blood sugar. If you only test before breakfast and at bedtime, you are missing out on a lot of useful information. Read information from the FDA on using blood glucose monitors, click here. (New!) Read more on what factors can affect your BG readings, click here. Hemoglobin A1C (also called HbA1C) You should ask your doctor for a blood test called the Hemoglobin A1C at least twice a year. The A1C will give you an average of your blood glucose for the past three months. For most adults, the target HG A1C is less than seven percent. Your personal A1C goal might be Continue reading >>
Forgetting To Take Tablets
Forgetting to take tablets is easily done If you have a problem remembering to take your tablets, youre far from alone. Many of us on tablet medication will have had instances when we forget, or keep forgetting, to take our tablets. This guide points you in the direction of what to do if you have missed a dose of tablets as well giving suggestions to help you remember to take tablets on time. I have forgotten to take my tablets, should I take them now or wait until the next dose? This will depend on the type of tablets you have. Some tablets may allow you to take a missed dose as soon as you remember but for other tablets, it may be advised to wait until your next dose. Your medication should come with a patient information leaflet which will usually let you know what to do if a dose is missed. Its useful to keep this leaflet either with your tablets or in a safe and memorable place. If you cannot find the patient information leaflet, call NHS Direct on 0845 4647. Reasons for forgetting tablets may include: Being busy or distracted at the time you usually take them Having a change to your normal daily routine If youve just been put onto tablets and have yet to establish the habit of taking them Knowing the cause of forgetting to take tablets can be helpful in recognising and avoiding the problem in future. How can I remember to take my tablets on time? If you have your tablets just before or at meal times, you may wish to keep your tablets in a place you wont be able to ignore them such as in the middle of your dining table or on top of your dinner plates. Set up an alarm. Many mobile phones these days have a reminder feature and most mobile phones at least have an alarm feature. If you dont have or use a mobile phone, you could use a portable alarm clock or set an ala Continue reading >>
Questions & Answers About Diabetes In The Workplace And The Americans With Disabilities Act (ada)
INTRODUCTION The Americans with Disabilities Act (ADA), which was amended by the ADA Amendments Act of 2008 ("Amendments Act" or "ADAAA"), is a federal law that prohibits discrimination against qualified individuals with disabilities. Individuals with disabilities include those who have impairments that substantially limit a major life activity, have a record (or history) of a substantially limiting impairment, or are regarded as having a disability.1 Title I of the ADA covers employment by private employers with 15 or more employees as well as state and local government employers. Section 501 of the Rehabilitation Act provides similar protections related to federal employment. In addition, most states have their own laws prohibiting employment discrimination on the basis of disability. Some of these state laws may apply to smaller employers and may provide protections in addition to those available under the ADA.2 The U.S. Equal Employment Opportunity Commission (EEOC) enforces the employment provisions of the ADA. This document, which is one of a series of question-and-answer documents addressing particular disabilities in the workplace,3 explains how the ADA applies to job applicants and employees who have or had diabetes. In particular, this document explains: when an employer may ask an applicant or employee questions about her diabetes and how it should treat voluntary disclosures; what types of reasonable accommodations employees with diabetes may need; how an employer should handle safety concerns about applicants and employees with diabetes; and how an employer can ensure that no employee is harassed because of diabetes or any other disability. GENERAL INFORMATION ABOUT DIABETES Diabetes is a group of diseases characterized by high blood glucose or sugar levels Continue reading >>
What To Do When You Forget Your Pill
If you've missed your oral medication, there are guidelines you can follow to get back on track. Sign Up for Our Living with Diabetes Newsletter Thanks for signing up! You might also like these other newsletters: Sign up for more FREE Everyday Health newsletters . If you forget to take your oral diabetes medication , the rules are simple. Here's what you need to know: If you are within three hours of the time you usually take your medication, and you normally take your pills twice a day, go ahead and take your medication. If more than three hours have passed, wait for your next scheduled dose. If you are on a long-acting medication that you take once a day, take your medication if you are within 12 hours of the missed dose. Otherwise, wait until the next scheduled time to resume taking your medication. This plan is appropriate for medications in the classes of sulfonylureas (such as Glucotrol), thiazolidinedione (such as pioglitazone) and biguanides (such as Glucophage). For medications such as acarbose (Precose) or repaglinide (Prandin), wait until your next meal to take them. Continue reading >>
The Effects Of Skipping Meals With Diabetes
Missing a meal here or there isn't uncommon, but it's not wise -- especially if you have diabetes. Keeping your blood sugar level at a normal level is vital for managing the disease. What you eat -- and don't eat -- has a substantial effect on your blood glucose. Skipping meals puts you at risk for developing low blood sugar, which can have drastic repercussions. If you're trying to lose weight, work with your physician to develop an eating plan that takes your diabetes into consideration. Video of the Day Balancing your food consumption with your medications is vital if you're diabetic, whether you're talking an oral drug or using insulin injections. Both of these treatment methods require sticking to a consistent eating schedule. You may not be consuming enough carbohydrates -- which are broken down into glucose -- if you're skipping meals. Missing meals, especially if you take insulin or an oral medication, can raise your risk of developing low blood sugar, according to Oklahoma State University's Janice R. Hermann, a registered dietitian. Low blood sugar, or hypoglycemia, can be a potentially dangerous health event for diabetics. You may develop headaches, dizziness, sweating and fatigue due to the low level of glucose in your blood. Your cognitive function and memory may also be impaired. Some of the more drastic effects of hypoglycemia include seizures, an irregular heartbeat and difficulty with speech. Consuming a sugar-rich food or beverage, such as orange juice, can increase your blood sugar quickly in minor cases, but you may need medical attention in more severe situations. Taking the correct amount of your medication and eating on schedule can help prevent these episodes. Missing meals may also increase your risk for developing gallstones. Most gallstones ar Continue reading >>
Distress And Depression With Type 2 Diabetes Tied To Skipping Meds
Distress and depression with type 2 diabetes tied to skipping meds (Reuters Health) - People with type 2 diabetes who also have symptoms of distress or depression are more likely than others to miss or skip their diabetes medications, according to a recent study. Although it would seem intuitive to expect that depression would make the already difficult job of diabetes self-management that much harder, the available data have not been very clear, lead author Jeffrey S. Gonzalez of Yeshiva University in New York said by email. It is clear, however, that treating depression may be necessary though it is unlikely to be sufficient to improve treatment adherence and diabetes self-management, Gonzalez told Reuters Health. Diabetes-related distress reflects the emotional and psychological reactions to the burden and stress associated with diabetes and its management, Gonzalez and his coauthors write in the journal Diabetes Care. Physical symptoms of depression like poor sleep or appetite as well as low energy can overlap with symptoms of diabetes and with side effects some patients blame on their diabetes medications, the researchers write. To identify the effects of distress and depression on whether patients adhere to their medications, researchers recruited 104 men and women with type 2 diabetes. The participants answered questions about their diabetes-related emotional distress and depression symptoms, and researchers interviewed them for further detail about their depression experience. Participants also provided blood samples for researchers to assess how well controlled their diabetes was. Just over 46 percent of participants had clinically significant diabetes distress, and 21 percent had some depression symptoms, although only five individuals met the criteria for ma Continue reading >>
Proper Use
Drug information provided by: Micromedex This medicine usually comes with a patient information insert. Read the information carefully and make sure you understand it before taking this medicine. If you have any questions, ask your doctor. Carefully follow the special meal plan your doctor gave you. This is a very important part of controlling your condition, and is necessary if the medicine is to work properly. Also, exercise regularly and test for sugar in your blood or urine as directed. Metformin should be taken with meals to help reduce stomach or bowel side effects that may occur during the first few weeks of treatment. Swallow the extended-release tablet whole with a full glass of water. Do not crush, break, or chew it. While taking the extended-release tablet, part of the tablet may pass into your stool after your body has absorbed the medicine. This is normal and nothing to worry about. Measure the oral liquid with a marked measuring spoon, oral syringe, or medicine cup. The average household teaspoon may not hold the right amount of liquid. Use only the brand of this medicine that your doctor prescribed. Different brands may not work the same way. You may notice improvement in your blood glucose control in 1 to 2 weeks, but the full effect of blood glucose control may take up to 2 to 3 months. Ask your doctor if you have any questions about this. Dosing The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so. The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the Continue reading >>
The Impact Of Treatment Noncompliance On Mortality In People With Type 2 Diabetes
The Impact of Treatment Noncompliance on Mortality in People With Type 2 Diabetes We are experimenting with display styles that make it easier to read articles in PMC. The ePub format uses eBook readers, which have several "ease of reading" features already built in. The ePub format is best viewed in the iBooks reader. You may notice problems with the display of certain parts of an article in other eReaders. Generating an ePub file may take a long time, please be patient. The Impact of Treatment Noncompliance on Mortality in People With Type 2 Diabetes Craig J. Currie, PHD, Mark Peyrot, PHD, [...], and Marc Evans, MD To assess the association of compliance with treatment (medication and clinic appointments) and all-cause mortality in people with insulin-treated type 2 diabetes. Data were extracted from U.K. general practice records and included patients (N = 15,984) who had diagnostic codes indicative of type 2 diabetes or who had received a prescription for an oral antidiabetic agent and were treated with insulin. Records in the 30 months before the index date were inspected for clinical codes (recorded at consultation) indicating medication noncompliance or medical appointment nonattendance. Noncompliance was defined as missing more than one scheduled visit or having at least one provider code for not taking medications as prescribed. Relative survival postindex date was compared by determining progression to all-cause mortality using Cox proportional hazards models. Those identified as clinic nonattenders were more likely to be smokers, younger, have higher HbA1c, and have more prior primary care contacts and greater morbidity (P < 0.001). Those identified as medication noncompliers were more likely to be women (P = 0.001), smokers (P = 0.014), and have higher HbA1c Continue reading >>
Are We Missing Hypoglycaemia? Elderly Patients With Insulin-treated Diabetes Present To Primary Care Frequently With Non-specific Symptoms Associated With Hypoglycaemia - Sciencedirect
Volume 12, Issue 2 , April 2018, Pages 139-146 Are we missing hypoglycaemia? Elderly patients with insulin-treated diabetes present to primary care frequently with non-specific symptoms associated with hypoglycaemia Author links open overlay panel Suzy V.Hopea Non-specific symptoms make hypoglycaemia recognition difficult in older patients Patients aged >65 commonly present to primary care with non-specific symptoms Those with documented hypos present more on other occasions with non-specific symptoms, which could represent unrecognised hypoglycaemia Nausea, falls & unsteadiness were more common in these patients. We assessed if patients with known hypoglycaemia present on other occasions with non-specific symptoms associated with (but not diagnosed as) hypoglycaemia, potentially representing missed hypoglycaemia. 335 primary care records (5/2/12-4/2/13) from patients aged >65 (79 on insulin, 85 on sulphonylureas, 121 on metformin only, 50 without diabetes) were assessed for hypoglycaemia episodes and consultations with non-specific symptoms, hypo clues. 27/79(34%) insulin-treated patients had >1 documented hypoglycaemia episode, compared to 4/85(5%) sulphonylurea-treated patients, 2/121(2%) metformin-only treated patients, and none without diabetes, p<0.001. Hypo clue consultations were common: 1.37 consultations/patient/year in insulin-treated patients, 0.98/patient/year in sulphonylurea-treated, 0.97/patient/year in metformin only-treated, and 0.78/patient/year in non-diabetic patients, p=0.34. In insulin-treated patients with documented hypoglycaemia, 20/27(74%) attended on another occasion with a hypo clue symptom, compared to 21/52(40%) of those without hypoglycaemia, p=0.008. No significant difference in the other treatment groups. Nausea, falls and unsteadiness Continue reading >>
Investigations After Boy Missing Without Diabetes Medication Dies
Investigations after boy missing without diabetes medication dies These are external links and will open in a new window Image caption Blake Ross, who was thought to be one of triplets, died in hospital after becoming unwell on a bus in Edinburgh Two investigations have been launched after a 13-year-old boy who went missing in Edinburgh without his diabetes medication fell ill and died. Blake Ross, who was in care, was reported missing from Howdenhall at 15:15 on Saturday. He was found unwell two days later on a city bus, and subsequently died at the Sick Kids Hospital. Edinburgh Council is to conduct a Significant Case Review and police watchdogs are also investigating. The Crown Office and Procurator Fiscal has instructed the Police Investigations and Review Commissioner (PIRC) to conduct an independent investigation into the actions the police took in relation to the case. The youngster's death, which is understood to have been related to his diabetes, is currently being treated as unexplained and police inquiries are continuing. One relative claimed he had suffered a cardiac arrest. A crowdfunding charity page has been set up to raise money for a "send off" for Blake, describing him as a "much loved son, brother, triplet grandson, nephew and friend to many". City of Edinburgh Council confirmed it would conduct a multi-agency significant case review into Blake's death. A spokesman for the council said it was standard practice for an inquiry to be carried out when a child in care died. He said: "The Care Inspectorate have been informed and there will be a multi-agency significant case review, commissioned by the chair of the Edinburgh Child Protection Committee, in accordance with our procedures. "We are deeply shocked at Blake's sudden death and our thoughts are wit Continue reading >>
Metformin Side Effects
Generic Name: metformin (met FOR min) Brand Names: Fortamet, Glucophage, Glucophage XR, Glumetza, Riomet What is metformin? Metformin is an oral diabetes medicine that helps control blood sugar levels. Metformin is used together with diet and exercise to improve blood sugar control in adults with type 2 diabetes mellitus. Metformin is sometimes used together with insulin or other medications, but it is not for treating type 1 diabetes. Important information You should not use metformin if you have severe kidney disease or diabetic ketoacidosis (call your doctor for treatment). If you need to have any type of x-ray or CT scan using a dye that is injected into your veins, you will need to temporarily stop taking metformin. This medicine may cause a serious condition called lactic acidosis. Get emergency medical help if you have even mild symptoms such as: muscle pain or weakness, numb or cold feeling in your arms and legs, trouble breathing, stomach pain, nausea with vomiting, slow or uneven heart rate, dizziness, or feeling very weak or tired. Get emergency medical help if you have signs of an allergic reaction to metformin: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Some people develop lactic acidosis while taking this medicine. Early symptoms may get worse over time and this condition can be fatal. Get emergency medical help if you have even mild symptoms such as: muscle pain or weakness; numb or cold feeling in your arms and legs; trouble breathing; feeling dizzy, light-headed, tired, or very weak; stomach pain, nausea with vomiting; or slow or uneven heart rate. Common metformin side effects may include: low blood sugar; nausea, upset stomach; or diarrhea. This is not a complete list of side effects and others may occur. Call your doc Continue reading >>
Type 1 Insulin Therapy
When you have type 1 diabetes, you will need to take insulin. When you understand how insulin therapy works in your body, you can more easily control your blood sugar. When you have type 1 diabetes, it will be necessary to take insulin. This is known as insulin therapy, which your medical provider will prescribe for you. When you understand how insulin therapy works in your body, you can more easily control your blood sugar. Things you’ll need to know are: What type of insulin are you using? When is that insulin active in your body? What is your insulin regimen: How much insulin do you take and when ? Is the insulin doing what it is supposed to do? This section explains how to use insulin therapy to treat diabetes It focuses on: Types of Insulin: Action and characteristics of the different, commercially available types of insulin. Calculating insulin dose: Formulas to calculate general total daily requirements, and basal and bolus insulin replacement. Other topics that may be of interest to you: Self-assessment Quiz Self assessment quizzes are available for topics covered in this website. To find out how much you have learned about Treatment of Type 1 Diabetes, take our self assessment quiz when you have completed this section. The quiz is multiple choice. Please choose the single best answer to each question. At the end of the quiz, your score will display. If your score is over 70% correct, you are doing very well. If your score is less than 70%, you can return to this section and review the information. Continue reading >>
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