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Spoiled Insulin

High Blood Glucose: What It Means And How To Treat It

High Blood Glucose: What It Means And How To Treat It

What is high blood glucose? People who do not have diabetes typically have fasting plasma blood glucose levels that run under 100 mg/dl. Your physician will define for you what your target blood glucose should be — identifying a blood glucose target that is as close to normal as possible that you can safely achieve given your overall medical health. In general, high blood glucose, also called 'hyperglycemia', is considered "high" when it is 160 mg/dl or above your individual blood glucose target. Be sure to ask your healthcare provider what he or she thinks is a safe target for you for blood glucose before and after meals. If your blood glucose runs high for long periods of time, this can pose significant problems for you long-term — increased risk of complications, such as eye disease, kidney disease, heart attacks and strokes and more. High blood glucose can pose health problems in the short-term as well. Your treatment plan may need adjustment if the blood glucose stays over 180 mg/dl for 3 days in a row. It is important to aim to keep your blood glucose under control, and treat hyperglycemia when it occurs. What are the symptoms of high blood glucose? Increased thirst Increased urination Dry mouth or skin Tiredness or fatigue Blurred vision More frequent infections Slow healing cuts and sores Unexplained weight loss What causes high blood glucose? Too much food Too little exercise or physical activity Skipped or not enough diabetes pills or insulin Insulin that has spoiled after being exposed to extreme heat or freezing cold Stress, illness, infection, injury or surgery A blood glucose meter that is not reading accurately What should you do for high blood glucose? Be sure to drink plenty of water. It is recommended to drink a minimum of 8 glasses each day. If yo Continue reading >>

High Blood Sugar Faqs

High Blood Sugar Faqs

Find possible causes and solutions for high blood sugar here. Some common causes include: In this section, you will find: Why am I having high blood sugars? Possible causes include: Incorrect carbohydrate counting If your mealtime carbohydrate count is wrong, your insulin dose will be incorrect as well. This is particularly true when eating out or when eating foods that don’t have nutrition labels. The solution: Learn more about carbohydrate counting. Weigh and measure your food whenever possible. Eat foods with carbohydrate counts that you already know. Research nutrition information online for food options at restaurants and chain outlets. “Out-eating” the insulin It’s not always easy to anticipate how much you will actually eat during a meal. However, missing the mark has the same effect as if you miscounted carbohydrates. Moreover, there are individual limits on how much mealtime carbohydrate can realistically be covered. The solution: If you decide to eat more than you planned, you will need to take more insulin to cover the additional carbohydrates. In general it’s wise to limit your mealtime consumption of carbohydrate to less than 60-75g or to whatever has been recommended by your nutritionist. If you have a special occasion coming up, be sure to discuss any special “party meal” or “banquet” medication dose adjustment with your medical provider. Insufficient insulin coverage of the carbohydrate (ie Inadequate insulin-to-carbohydrate ratio) It is important to know how many grams of carbohydrate are covered by one unit of insulin – this is your insulin-to-carbohydrate ratio. If you think the ratio is out of balance, ask yourself these questions. Did you count the carbohydrates correctly? Did you take the proper blood sugar correction dose befor Continue reading >>

What Is Diabetes?

What Is Diabetes?

Diabetes currently affects 415 million adults worldwide and is expected to affect 642 million by 2040.1 In the UK, there are currently over 3.5 million people with diabetes and it is estimated that up to a million people with type 2 diabetes have the condition and don't know it.2 Even though diabetes affects over 5% of the world’s population,3 many people know very little about the disease. There are three main types of diabetes: Type 1 Diabetes Type 1 diabetes occurs when your immune system destroys the cells in the pancreas that create insulin.4 As a result, the body makes very little or no insulin of its own and people with type 1 diabetes must take insulin daily. Type 1 diabetes is usually diagnosed in children or young adults, although it can occur at any age. The onset of type 1 diabetes is often sudden and can include the following symptoms: Abnormal thirst Frequent urination Extreme tiredness/lack of energy Sudden weight loss Slow-healing wounds Recurrent infections Blurred vision A person with type 1 diabetes supplies their body with insulin in one of the following ways: Insulin pump Insulin pen Injections with a syringe Insulin therapy along with following a healthy diet, regular physical activity and frequent blood glucose monitoring all play an important role in managing type 1 diabetes. Type 2 Diabetes Type 2 diabetes represents more than 90% of all diabetes cases.4 Type 2 diabetes occurs when the pancreas does not make enough insulin, or the body cannot properly use the insulin it does create. Eventually, the pancreas may stop producing insulin altogether. Type 2 diabetes can affect people at any age. Because type 2 diabetes develops slowly and is often hard to detect, many people are not diagnosed until various complications appear. Additional risk fact Continue reading >>

Handling A Diabetes Emergency

Handling A Diabetes Emergency

Emergencies can happen at any time, so it's best to be prepared and know what to do if an emergency occurs. Talking with your veterinarian is a crucial part of being informed and prepared to handle emergencies. Low blood sugar (hypoglycemia) The most common side effect experienced with insulin therapy is hypoglycemia. Hypoglycemia can be caused by: Missing or delaying food. Change in food, diet, or amount fed. Infection or illness. Change in the body's need for insulin. Diseases of the adrenal, pituitary, or thyroid glands, or progression of liver or kidney disease. Interaction with other drugs (such as steroids). Change (increase) in exercise. Signs of hypoglycemia may occur suddenly and can include: Weakness Depression Behavioral changes Muscle twitching Anxiety Seizures Coma Death See below for a list of other side effects. What to do If your pet is conscious, rub a tablespoon of corn syrup on his or her gums. When your pet is able to swallow, feed him or her a usual meal and contact your veterinarian. If your pet is unconscious or having a seizure, this is a medical emergency. CONTACT YOUR VETERINARIAN. In the meantime, you should immediately treat your pet rather than delaying management. Pour a small amount of a sugar solution (eg, corn syrup) onto your finger and then rub the sugar solution onto your pet's gums. The sugar is absorbed very quickly and your pet should respond in 1 to 2 minutes. The sugar solution should never be poured directly into your pet's mouth since there is a risk that the solution will be inhaled into the lungs. Once your pet has responded to the sugar administration and is sitting up, it can be fed a small amount of its regular food. Once the pet has stabilized, it should be transported to your veterinarian for evaluation. Your pet's diet Continue reading >>

Put Some Muscle In Your Insulin

Put Some Muscle In Your Insulin

by gary scheiner, MS, CDE Faster than a speeding bullet. More powerful than a locomotive. Able to overcome high blood sugar with a single bolus. It’s…well, you know the rest. Insulin can do a lot of things, but I would never compare it to a “speeding bullet.” The fact is, even our so-called rapid-acting insulin analogs pale in comparison when it comes to the insulin produced by a functioning pancreas. Endogenous (naturally produced) insulin begins working seconds, not minutes, after it is secreted. Because of the location of the pancreas, endogenous insulin absorbs first into the liver circulation, where it has its greatest immediate impact, then travels through the bloodstream to the muscles and other organs. Its “peak” is in a couple of minutes, and it is cleared from the bloodstream a few minutes later. Now that’s rapid. Compare that to “rapid-acting” insulins (Novolog, Humalog, Apidra), which take several minutes to start working, peak in 45 minutes to two hours, and take anywhere from 3-6 hours to completely finish working. Rapid? Hardly. Sure, it’s more rapid than Regular, but that doesn’t sell all that well from a marketing standpoint. Why is faster better? I can summarize that in one word: MANEUVERABILTY. Injecting (or pumping) “rapid” insulin is like a home thermostat that takes forever to respond to temperature changes. Your home might be freezing cold before the heat kicks in, or swelteringly hot before the air turns on. Naturally-produced insulin is like a very sensitive thermostat that responds almost immediately to the slightest change in temperature, keeping things comfy all the time. When insulin takes too long to react to blood sugar changes, bad things happen. Any increase in physical activity can cause blood sugar to drop too Continue reading >>

Beware Summer Extremes With Insulin

Beware Summer Extremes With Insulin

Living with diabetes blog With summer arriving in Minnesota and many other places, I'd like to talk about how to manage insulin storage in extreme temperatures such as this season brings. A number of years ago, I met with a client who used a rapid insulin pen for meal dosing. She shared with me a story of how she attended the county fair on an exceptionally hot day, and had placed her insulin pen in the back pocket of tight jeans and walked around the fairgrounds all day. She used the pen for covering meals eaten at the fair, and her blood sugars were running higher than normal, but she related this to all the junk food. The next day her blood sugars continued to run high and when she took her (rapid) insulin, it didn't seem to affect her blood sugar level at all; in fact, it was like she was taking water instead of insulin. She wondered if the heat had affected her insulin, so she switched to a new insulin (disposable) pen, and soon after her blood sugars started to drop. Has this or something similar happened to you? I looked at insulin manufacturers' websites and found that for the majority of all types and brands of insulin, the maximum temperatures recommended are as follows: Opened room temperature insulin should not exceed 86 F (30 C) with the exception of Lantus, which should not exceed 77 F (25 C). Most manufacturers of insulin recommend discarding insulin if it exceeds 98.6 F (37 C). Other non insulin diabetic injectable medications: Glucagon and Byetta should not exceed 77 F (25 C). Symlin should not exceed 86 F (30 C). Avoiding potential problems Temperatures exceeding manufacturer's recommendations for insulin/medications Store your insulin in the refrigerator, in an insulated case or cooler with a freezable gel pack, or use a cooling wallet. Cooling wallet Continue reading >>

Insulin…an Undeserved Bad Reputation

Insulin…an Undeserved Bad Reputation

I feel sorry for insulin. Insulin has been bullied and beaten up. It has been cast as an evil hormone that should be shunned. However, insulin doesn't deserve the treatment it has received. Insulin: A Primer Insulin is a hormone that regulates the levels of sugar in your blood. When you eat a meal, the carbohydrate in the meal is broken down into glucose (a sugar used as energy by your cells). The glucose enters your blood. Your pancreas senses the rising glucose and releases insulin. Insulin allows the glucose to enter your liver, muscle, and fat cells. Once your blood glucose starts to come back down, insulin levels come back down too. This cycle happens throughout the day. You eat a meal, glucose goes up, insulin goes up, glucose goes down, and insulin goes down. Insulin levels are typically lowest in the early morning since it's usually been at least 8 hours after your last meal. Insulin doesn't just regulate blood sugar. It has other effects as well. For example, it stimulates your muscles to build new protein (a process called protein synthesis). It also inhibits lipolysis (the breakdown of fat) and stimulates lipogenesis (the creation of fat). It is the latter effect by which insulin has gotten its bad reputation. Because carbohydrate stimulates your body to release insulin, it has caused some people to argue that a diet high in carbohydrate will cause you to gain fat. Their reasoning, in a nutshell, goes like this: High Carbohydrate Diet -> High Insulin -> Increased Lipogenesis/Decreased Lipolysis -> Increased Body Fat -> Obesity Using this same logic, they argue that a low carbohydrate diet is best for fat loss, because insulin levels are kept low. Their logic chain goes something like this: Low Carbohydrate Diet -> Low Insulin -> Decreased Lipogenesis/Increase Continue reading >>

Insulin Basics

Insulin Basics

How To Store Insulin Store insulin you are not using in a refrigerator. It is a protein dissolved in water, sort of like a soup stock, so keep it cold to prevent it from spoiling. Keep it between 36º and 46º F. If it gets colder it will freeze. If the insulin freezes, when it thaws it will separate and clump and will no longer be usable. If it gets warmer it will be ok for awhile but will eventually spoil. If it starts to spoil, bacteria growing in it breaks down the insulin. It won't hurt you to use this. However, its not as effective so your blood sugar will be higher than you expect even though you took the right amount of insulin at the right time. It is ok to keep a bottle of insulin you are using at room temperature for up to 28 days (room temperature is 59º to 86º F). The preservative in insulin keeps it from spoiling this long. Insulin at room temperature injected into the skin is more comfortable for many people. Also, it may be easier to get rid of air bubbles in the syringe when it is at room temperature. If you live in a hot climate and your room temperature is above 80º, keep your insulin in the refrigerator. Insulin in a pen can only be kept at room temperature for 2 weeks before it begins to spoil. Check with your pharmacist, the package insert or the manufacturer's websites. Insulin used past 28 days at room temperature or past the expiration date on the box may still be good. However, using it may cause control problems and is not recommended. Lantus, Humalog and Novolog seem to spoil faster than Regular and NPH. If you can't afford to buy insulin and insurance does not cover it, you may be able to get it free. Check the website www.helpingpatients.org or call 202-835-3400. The doctor who prescribes your insulin can help you get signed up for free Continue reading >>

Possible Complications Of Type 1 Diabetes

Possible Complications Of Type 1 Diabetes

Video of the Day The acute complications include hypo- and hyperglycemia (low and high blood sugar levels) and diabetic ketoacidosis (DKA). Normal blood sugar levels and desired ranges for people with diabetes are shown in Table 1. Low Blood Sugar (Hypoglycemia, Insulin Reaction) Anyone who has been given insulin can have low blood sugar (hypoglycemia, or a “reaction”). Blood sugars below 70 mg/dL (3.9 mmol/L) are considered low and are usually related to the person having one or more of the signs outlined in Table 2. A “true low” blood sugar is a value less than 60 mg/dL (3.3 mmol/L), which is a level not likely to occur in people who do not have diabetes or another disorder. All families must be trained at the time of initial education to know what hypoglycemia is, what to check for and how to treat it. The causes, symptoms and treatment of hypoglycemia are shown in Table 2. Treatment of Low Blood Sugar (see Table 2) The treatment of hypoglycemia depends on the severity of the episode. Mild lows may be treated with 2 to 8 ounces of sugary fluid (the amount is dependent on age). Moderate reactions in which the person is confused but is conscious are treated with small sips of sugary fluid or Insta-Glucose or cake gel put between the gums and cheeks. Severe lows (loss of consciousness, seizure) are treated with shots of glucagon given with an insulin syringe. Intranasal glucagon is now in development. High Blood Sugar (Hyperglycemia) High levels for blood sugar are shown in Table 1. High levels result in higher HbA1c values which are associated with the chronic complications of diabetes discussed below. Causes of high blood sugar levels can be the result of many factors, including: • Illness • Forgetting to take insulin or other medications • Too low a dos Continue reading >>

What Are The Dangers Of A Sugar Count Over 500?

What Are The Dangers Of A Sugar Count Over 500?

Blood sugar control is a critical aspect of diabetes management. People without diabetes typically have fasting blood sugar readings below 100 milligrams per deciliter. If you are diabetic, your doctor sets an individualized blood sugar goal that you aim for with the help of an individualized treatment regimen. A reading higher than your target indicates your blood sugar is not under control, and having a reading over 500 is a medical emergency. Your body needs glucose to function properly, but it's unhealthy for high levels to circulate in your bloodstream. The hormone insulin regulates blood sugar by allowing glucose to get into your cells. Typically, blood sugar is considered high when it's 160 milligrams per deciliter or above your glucose target, notes the Joslin Diabetes Center. Your doctor may need to adjust your treatment plan if your glucose remains above 180 milligrams per deciliter for three consecutive days. If glucose stays elevated for a long time, it can affect your eyes, kidneys and heart. Ketoacidosis A dangerously high blood sugar level increases your risk for diabetes-related ketoacidosis. When glucose circulates in your bloodstream and can't get into your cells, your cells don't get the energy they need. To compensate, your body begins to burn fat for fuel, producing acids called ketones. These acids build up in your bloodstream and can poison your body when levels get too high. This happens when your body doesn't have enough insulin and is more common with Type 1 diabetes. The American Diabetes Association recommends checking your urine for ketones when your glucose is higher than 240 milligrams per deciliter. Hyperosmolar Syndrome Your kidneys typically excrete extra glucose to help compensate for high blood sugar levels, but when glucose is extrem Continue reading >>

Storage Of Unopened Insulin:

Storage Of Unopened Insulin:

Insulin is very sensitive to sunlight, indoor lights, and to extremely hot or cold temperature. Insulin is not OK to use if exposed to very hot or cold weather. The three drug manufacturers of insulin in the United States say UNOPENED insulin is best stored inside the fridge [2° to 8°Celcius (36° to 46°Fahrenheit)]. UNOPENED insulin stored in the refrigerator is good until the expiration date printed on the insulin box. The expiration date will usually be 1 year from the date of purchase but you have to check the box to find out. Storage of OPENED insulin: Once open there are different storage needs for insulin. What does OPEN mean? This does NOT mean removed from the box. OPEN means the insulin cap is removed and the rubber stopper was punctured. Vials and pens have different needs for storage. These differences can lead to confusion. Therefore, it is very important for you to become familiar with the recommendations for the insulin product that you use. What is an OPEN vial? Vial: Once the vial is punctured, it is OPEN. Once you stick a needle in the vial, it is OPEN. OPEN vials can be stored in the fridge or at CONTROLLED room temperature. Regardless of where it is stored, OPEN insulin will only last 28 days before it must be thrown in the trash. Insulin kept in the fridge should be removed and allowed to reach room temperature before injection. PEN: Once used for the first time, insulin pens should not be stored in the fridge. Instead, they should be stored at CONTROLLED room temperature. The number of days you can use the pen will depend on which pen you use. Talk to your doctor or pharmacist. Pens last 7-28 days if stored at CONTROLLED room temperature. The number of days depends on which pen you use. PUMP: Once 6 IMPORTANT Storage tips for all insulin: Do not Continue reading >>

Bad Insulin: When To Toss The Vial

Bad Insulin: When To Toss The Vial

Recently, the question was asked: "Does anyone have any tricks for knowing when it’s time to toss a vial of insulin?" The writer was concerned about whether a vial contains bad insulin - that is, insulin that has a diminished ability to decrease blood sugar levels compared to what was expected. There are lots of discussions on the Internet about how to identify bad insulin, so I’ll focus on what to do with the insulin and the vial when bad insulin is suspected. I’d like to point out that there are two different categories of what to do with bad insulin: First, contacting the manufacturer or your pharmacy about returning suspected bad insulin, and second, deciding to discard a vial of partially-used insulin. _Contacting the manufacturer or pharmacy: _ For many insulin products, the liquid that contains insulin should be clear and colorless. Therefore, if you open a box of this kind of insulin, and find that the liquid in the vial is discolored, or that the liquid has particles floating in it, there’s something wrong. In such a case, the insulin should not be used, and the manufacturer should be notified. They will want to take back the vial and test it, and they will arrange for you to get a replacement vial. For example, one label states "Only use XXX that is clear and colorless. If your XXX is cloudy or slightly colored, return it to your pharmacy for a replacement." If you are using a type of insulin that is naturally cloudy (such as NPH), you might find small white clumps that sank to the bottom of the bottle, or a white coating or “frosting” on the inside wall of the glass vial. Again, the insulin should not be used, and arrangements made to return the vial for replacement. There’s another circumstance about bad insulin that might occur, and doesn’t Continue reading >>

Dka – What You Need To Know By A Certified Diabetes Educator

Dka – What You Need To Know By A Certified Diabetes Educator

Q – My doctor told me I needed to do ketone testing. What is it, how is it done and why is it important? A – When you live with diabetes, there’s a lot to juggle. It can be understandable if your eyes glaze over when your physician or diabetes educator mentions ketone testing (another test!), but here’s why you should take this part of your treatment plan seriously: Ketones are acid molecules generated when we burn fat for energy. This isn’t a problem as long as it doesn’t happen in excess. When you flood your body with too many acids, it starts to become toxic. Combined with dehydration and high blood glucose levels, it can lead to a life-threatening condition called diabetic ketoacidosis (DKA). Often, DKA can occur when you’re not able to get enough glucose into your cells to burn as energy, and the body relies almost exclusively on fat for fuel. This can occur for a number of reasons: • Illness and infection (which can cause intense insulin resistance and elevated blood sugar) • A lack of insulin in the body (due to missed injections, spoiled insulin, or poor absorption) • Insulin pump malfunctions (clogs, leaks, air pockets, cannula displacement, prolonged disconnection, failure to prime the tubing, or accidentally erasing the basal settings) This is very different than nutritional ketosis, which is caused by starvation, prolonged fasting, or a severe lack of carbohydrates in one’s diet. READ THE ENTIRE ARTICLE AT: insulinnation.com Continue reading >>

Tracking Insulin's Health In The Summer Heat

Tracking Insulin's Health In The Summer Heat

Sunscreen: check. Water bottle: check. Beach ball: check. Insulin cooler....? Yep. For those of us who use insulin, summer heat creates an extra level of complexity and worry. The real question we all ask ourselves in the heat of the summer is whether our fun-in-the-sun will cook our insulin and leave us having-not-so-much-fun in an air conditioned ICU unit? There's a whole industry of solutions dedicated to helping us keep our insulin cool, ranging from cooling packs such as the ReliOn and others, to portable fridges, to high tech cooling crystals. Hell, we're even running a Giveaway contest this week in which our readers can win some of these products! With much of the U.S. suffering under a stifling drought-baked summer, the question of just how hot insulin can get is on all our minds. But you have to wonder if these products are serving an important need or just preying on our fears. To find out, we asked the manufacturers themselves, some leading insulin experts, and the American Diabetes Association — and guess what? The answer isn't as clear as you might like. Not Your Grandma's Insulin First, a bit of history: Didn't grandma keep her insulin in the fridge all the time? Well, only if she read the label. The original pork and beef insulin formulations were supposed to be kept cold all the time. As cold insulin stings like hell to inject, the move to being able to keep the newer human insulin and later analogs at room temperature was a great victory (!) for those of us who are human pin cushions. But wait a minute... whose room temperature are we talking about? My father used to get annoyed with me when I'd shovel ice cubes into my glass of red wine. "Wine is supposed to be consumed at room temperature," he'd huff. "Yeah, in the frickin' French Alps,where room te Continue reading >>

Hyperglycemia

Hyperglycemia

Hyperglycemia, or high blood glucose, occurs when blood glucose rises above your recommended range. Your healthcare professional will determine the proper healthy blood glucose range for you. High blood glucose can be caused by many things, including: Eating too much food Little or no physical activity Not taking medications Stress, infection or illness Bad or spoiled insulin High blood glucose can cause serious problems and a major cause of long-term diabetes complications. Warning signs of high blood glucose include: Tiredness or fatigue Increased thirst Frequent urination Blurred vision Dry mouth or skin Slow-healing cuts and sores Unexplained weight loss It is important to keep your blood glucose level within your target range. Checking your blood glucose often may help you avoid hyperglycemia. During illness your blood glucose levels can increase because of the hormones in the body that are helping you to get better. If you have type 1 diabetes you may need more insulin when you are sick, talk to your healthcare provider. Continue reading >>

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