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Type 2 Diabetes Missed Insulin Dose

Missed Insulin Injection | Diabetic Connect

Missed Insulin Injection | Diabetic Connect

I had to go out for a while today and forgot to carry my insulin with me. I got back home and was here for at least an hour before I remembered that I did not do my lunch time injection. I am torn about if I should go ahead and take it or just wait, check my BS before dinner and take my regular dose then. What would you do. Type 2 has a little more leeway in this kind of situation. Type 1 not so much. As a type 2 I would monitor my levels and see what is going on, maybe eat a little lower carb for dinner and get back on schedule. It also depends on if it's fast acting for that meal only or for a longer duration. I am on long lasting so I take mine every 12 hours, but sometimes it's not quite that accurate. Don't fret over it, I use to miss mine all the time and I finally winged myself off of it completely, just check your b/s level just in case and pick back up on it on your next schedule. Maybe my oops will help someone else down the line who would have the same question. I usually carry my pens with me every where I go, just left in a hurry this morning. Note to self don't forget your insulin.. LOL A BG of 136 an hour or two after eating is within range, so I would wait until your next meal to take another bolus (meal-time) insulin. Also, your low-carb meal certainly helped. You might wish to ask your doctor about a carb to insulin ratio so you can calculate your meal dose based on the number of carbs your are eating rather than just use a 9 unit dose all the time, (unless your meals all have the same carb value.) I would have taken it and noted the reason why.I keep one insulin pen in my purse and the rest at home. That way I have access to it Always Unlike the vials that need to be refrigeratedthe pens need none I am however undedr the loving care of and endocrinol Continue reading >>

Question From Practice: Diabetes - Missing Meals And Doses

Question From Practice: Diabetes - Missing Meals And Doses

A. This patient is a good example of how real life can affect adherence to therapy. Two main issues for the pharmacist to address in this situation are medication options and dietary habits but he or she could also consider supportive advice in terms of this patient’s employment concerns. Medication Metformin has a large evidence base for reducing both morbidity and mortality and it is, rightfully, first-line therapy in the treatment of type 2 diabetes. This is recommended not only by the National Institute for Health and Care Excellence, but also the American Diabetes Association and the European Association for the Study of Diabetes.1,2 Metformin lowers plasma glucose via four mechanisms. It: Reduces hepatic glucose production Increases insulin sensitivity in skeletal muscle Improves peripheral glucose uptake and usage Delays glucose absorption in the gastrointestinal tract Importantly, metformin does not stimulate insulin secretion3 so although there is a small risk of hypoglycaemia if taken without food, this is minimal compared with other antidiabetic drugs. Metformin can, however, increase the risk of hypoglycaemia if used in combination with other antidiabetic medicines. The mechanisms above mean that metformin predominantly increases insulin efficacy and so should be taken with meals when endogenous insulin is produced. Gastrointestinal side effects with metformin — especially diarrhoea and nausea — are widely recognised. To minimise them, patients can be advised to take their tablets after meals rather than before and the dose should be titrated slowly, over a period of weeks. Frequently these side effects are most noticeable in the first few weeks after initiation. If patients are forewarned of side effects and told about the excellent benefits of metfor 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 >>

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 >>

Missing A Dose - Type 2 Diabetes - Everydayhealth.com

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 >>

Health Center: Your Center For Wellness Articles

Health Center: Your Center For Wellness Articles

Diabetes Medications, and the Consequences of Forgetting For many diabetes patients, taking their medications on schedule is a challenge. Some forget regularly, and others miss a dose here or there. Many people with diabetes rely on oral medication or insulin, or both, to control their blood glucose levels. "People with diabetes must take responsibility for their day-to-day care, and keep blood glucose levels from going too low or too high," advises the Centers for Disease Control and Prevention. The vast majority of diabetics control their blood sugar with medication or insulin. Twelve percent of adults with diagnosed diabetes take both insulin and oral medications, 53 percent take oral medications only, 19 percent take insulin only and 15 percent do not take either, according to federal health statistics. What happens if people don't adhere to their medication schedules? The potential for severe consequences is tremendous. In a 2004 study that appeared in Diabetes Care, researchers found that people with type 2 diabetes who missed doses of their medications had a greater risk of being hospitalized. The risk of hospitalization was more than twice as high among type 2 diabetics who did not adhere to their oral diabetes medications the year before. They found that skipping a dose from time to time can be very harmful. "It isn't just the patients who completely stop their medications who are at higher risk," Dr. David Nau, assistant professor in the University of Michigan College of Pharmacy and one of the study's authors, said in a report about the study. Doctors can help patients assess how well they have been treating their diabetes with a hemoglobin A-1-c test, which measures how well the patient's blood sugar has been controlled during the past few months. But diabe 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 >>

Diabetes Medications, And The Consequences Of Forgetting

Diabetes Medications, And The Consequences Of Forgetting

For many diabetes patients, taking their medications on schedule is a challenge. Some forget regularly, and others miss a dose here or there. Many people with diabetes rely on oral medication or insulin, or both, to control their blood glucose levels. "People with diabetes must take responsibility for their day-to-day care, and keep blood glucose levels from going too low or too high," advises the Centers for Disease Control and Prevention. The vast majority of diabetics control their blood sugar with medication or insulin. Twelve percent of adults with diagnosed diabetes take both insulin and oral medications, 53 percent take oral medications only, 19 percent take insulin only and 15 percent do not take either, according to federal health statistics. What happens if people don't adhere to their medication schedules? The potential for severe consequences is tremendous. In a 2004 study that appeared in Diabetes Care, researchers found that people with type 2 diabetes who missed doses of their medications had a greater risk of being hospitalized. The risk of hospitalization was more than twice as high among type 2 diabetics who did not adhere to their oral diabetes medications the year before. They found that skipping a dose from time to time can be very harmful. "It isn't just the patients who completely stop their medications who are at higher risk," Dr. David Nau, assistant professor in the University of Michigan College of Pharmacy and one of the study's authors, said in a report about the study. Doctors can help patients assess how well they have been treating their diabetes with a hemoglobin A-1-c test, which measures how well the patient's blood sugar has been controlled during the past few months. But diabetes medications only provide part of the picture. Because Continue reading >>

Lantus Patient Information Including Side Effects

Lantus Patient Information Including Side Effects

Brand Names: Lantus, Lantus OptiClik Cartridge, Lantus Solostar Pen Generic Name: insulin glargine (Pronunciation: IN su lin AS part, IN su lin AS part PRO ta meen) What is the most important information I should know about insulin glargine (Lantus, Lantus OptiClik Cartridge, Lantus Solostar Pen)? What should I discuss with my healthcare provider before using insulin glargine (Lantus, Lantus OptiClik Cartridge, Lantus Solostar Pen)? What is insulin glargine (Lantus, Lantus OptiClik Cartridge, Lantus Solostar Pen)? Insulin glargine is a man-made form of a hormone that is produced in the body. It works by lowering levels of glucose (sugar) in the blood. Insulin glargine is a long-acting form of insulin that is slightly different from other forms of insulin that are not man-made. Insulin glargine is used to treat type 1 or type 2 diabetes. Insulin glargine may also be used for purposes not listed in this medication guide. What are the possible side effects of insulin glargine (Lantus, Lantus OptiClik Cartridge, Lantus Solostar Pen)? 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. Hypoglycemia, or low blood sugar, is the most common side effect of insulin glargine. Symptoms include headache, hunger, weakness, sweating, tremors, irritability, trouble concentrating, rapid breathing, fast heartbeat, fainting, or seizure (severe hypoglycemia can be fatal). Carry hard candy or glucose tablets with you in case you have low blood sugar. Tell your doctor if you have itching, swelling, redness, or thickening of the skin where you inject insulin glargine. This is not a complete list of side effects and others may occur. Call Continue reading >>

Selected Important Safety Information

Selected Important Safety Information

Tresiba® is contraindicated during episodes of hypoglycemia and in patients with hypersensitivity to Tresiba® or one of its excipients Never Share a Tresiba® FlexTouch® Pen Between Patients, even if the needle is changed. Sharing poses a risk for transmission of blood-borne pathogens Monitor blood glucose in all patients treated with insulin. Changes in insulin may affect glycemic control. These changes should be made cautiously and under medical supervision. Adjustments in concomitant oral anti-diabetic treatment may be needed Hypoglycemia is the most common adverse reaction of insulin, including Tresiba®, and may be life-threatening Tresiba® (insulin degludec injection) is indicated to improve glycemic control in patients 1 year of age and older with diabetes mellitus. Tresiba® is not recommended for treating diabetic ketoacidosis or for pediatric patients requiring less than 5 units of Tresiba®. Tresiba® is contraindicated during episodes of hypoglycemia and in patients with hypersensitivity to Tresiba® or one of its excipients Never Share a Tresiba® FlexTouch® Pen Between Patients, even if the needle is changed. Sharing poses a risk for transmission of blood-borne pathogens Monitor blood glucose in all patients treated with insulin. Changes in insulin may affect glycemic control. These changes should be made cautiously and under medical supervision. Adjustments in concomitant oral anti-diabetic treatment may be needed Hypoglycemia is the most common adverse reaction of insulin, including Tresiba®, and may be life-threatening. Increase monitoring with changes to: insulin dose, co-administered glucose lowering medications, meal pattern, physical activity; and in patients with hypoglycemia unawareness or renal or hepatic impairment Accidental mix-ups betwe Continue reading >>

Must Read Articles Related To Diabetes Emergencies

Must Read Articles Related To Diabetes Emergencies

A A A Diabetes Emergencies With the changes in regulations in air travel, patients with diabetes are concerned about what they can, and cannot pack in their carry-on luggage. From the TSA website: Notify the Security Officer that you have diabetes and are carrying your supplies with you. The following diabetes-related supplies and equipment are allowed through the checkpoint once they have been screened: Insulin and insulin loaded dispensing products (vials or box of individual vials, jet injectors, biojectors, epipens, infusers, and preloaded syringes; Unlimited number of unused syringes when accompanied by insulin or other injectable medication; lancets, blood glucose meters, blood glucose meter test strips, alcohol swabs, meter-testing solutions; Insulin pump and insulin pump supplies (cleaning agents, batteries, plastic tubing, infusion kit, catheter, and needle); Insulin pumps and supplies must be accompanied by insulin. Glucagon emergency kit; Urine ketone test strips; Unlimited number of used syringes when transported in Sharps disposal container or other similar hard-surface container. Sharps disposal containers or similar hard-surface disposal container for storing used syringes and test strips. Insulin in any form or dispenser must be clearly identified. If you are concerned or uncomfortable about going through the walk-through metal detector with your insulin pump, notify the Security Officer that you are wearing an insulin pump and would like a full-body pat-down and a visual inspection of your pump instead. Advise the Security Officer that the insulin pump cannot be removed because it is inserted with a catheter (needle) under the skin. Advise the Security Officer if you are experiencing low blood sugar and are in need of medical assistance. You have the op Continue reading >>

[adherence Of Type 2 Diabetes Patients On Insulin Analogues Application: Misseddose, Time Imprecision And Dose Reduction. The Results Of Gapp2tm(globalattitudes Of Physicians And Patient) Survey In The Czech Republic].

[adherence Of Type 2 Diabetes Patients On Insulin Analogues Application: Misseddose, Time Imprecision And Dose Reduction. The Results Of Gapp2tm(globalattitudes Of Physicians And Patient) Survey In The Czech Republic].

[Adherence of type 2 diabetes patients on insulin analogues application: misseddose, time imprecision and dose reduction. The results of GAPP2TM(GlobalAttitudes of Physicians and Patient) survey in the Czech Republic]. OBJECTIVE: Irregular insulin dose is one of the main problems associated withinsulin therapy in patients with type 2 diabetes; its extent is not knownprecisely. The aim of survey conducted in the Czech Republic in the internationalproject GAPP2 - Global Attitudes of Patients and Physicians was to determine the incidence and the impact of irregular use of basal insulin analogues in patients with type 2 diabetes, to point out the reasons for these irregularities and tofocus on how physicians discuss irregular application of insulin with patients.METHODS: The project GAPP2 is an international cross-sectional study performedon-line via the Internet using a questionnaire filled by diabetic patientstreated with insulin analogues and physicians who treat these patients. Thesurvey was conducted in two steps in 17 countries; the first step included 6countries and was completed in the beginning of 2012, the second step involved 11other countries including the Czech Republic with termination in 2014. The surveywas designed to obtain the views of patients and physicians on certain aspects ofinsulin treatment and persistent issues in this field in the real daily practice.Special focus was on the incidence and management of hypoglycaemia as well as on irregularities of insulin application. In the part dedicated to adherence tobasal insulin application were observed three types of irregular insulin therapy:missed dose, time imprecision of dose ( 2 hours vs. the prescribed time) anddose reduction in all cases in the past 30 days before completing thequestionnaire. In ad Continue reading >>

Diabetes Latest: Missing Mealtime Insulin Dose Increases Risk Of Serious Complications

Diabetes Latest: Missing Mealtime Insulin Dose Increases Risk Of Serious Complications

A survey of 200 people living with type 1 or type 2 diabetes, who need mealtime insulin to control their blood glucose levels. This can lead to unpleasant mental and physical symptoms and puts them at risk of serious long-term complications, such as amputation and blindness, kidney failure and on rare occasions, a condition called Charcot foot. According to guidance by health watchdog NICE, people with type 1 diabetes and type 2 diabetes requiring a mealtime insulin should take it before a meal to effectively control a post-meal spike in their blood sugar levels. Over 4 million people are living with diabetes in the UK. In 2015, the burden of NHS expenditure on diabetes was about £10 billion - roughly ten per cent of total NHS resource expenditure. This rate of expenditure works out at around £192 million a week6. Ponnusamy Saravanan, clinical professor, said: “We need to get people thinking seriously about the impact of high blood sugar after meals. “In addition to immediate and sometimes dangerous symptoms such as blurred vision and extreme tiredness, regular high blood sugar levels could lead to serious long-term complications, including heart disease, blindness, nerve damage Fri, August 19, 2016 Diabetes is a common life-long health condition. There are 3.5 million people diagnosed with diabetes in the UK and an estimated 500,000 who are living undiagnosed with the condition. “The survey results show a lack of education and awareness of the consequences of poorly controlled blood sugar levels around mealtimes, leaving people at real risk of developing irreversible complications. “If we don’t get this message out now then we will continue to spend billions each year on treating these complications on the NHS, in addition to significant social costs to the Continue reading >>

Missing Meals? Avoid Dangerous Blood Sugar If You Have Diabetes

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 >>

How Much Do Forgotten Insulin Injections Matter To Hemoglobin A1c In People With Diabetes? A Simulation Study

How Much Do Forgotten Insulin Injections Matter To Hemoglobin A1c In People With Diabetes? A Simulation Study

Go to: Forgotten or omitted insulin injections are an important contributing factor to poor glycemic control in people with type 1 diabetes. This study uses mathematical modeling and examines the impact on hemoglobin A1c (HbA1c) levels if insulin injections are forgotten. The simulation concerns people with type 1 diabetes on intensive insulin therapy. Five sets of blood glucose profiles with and without a forgotten injection were obtained. The difference to HbA1c was calculated using an HbA1c estimator on the profiles and was multiplied by the frequency of forgotten events. A frequency of 2.1 forgotten injections per week was found in the literature. Calculations showed that forgetting 2.1 meal-related injections per week would lead to an increase in HbA1c of at least 0.3–0.4% points, and similarly 0.2–0.3% points related to forgotten injections of the long-acting insulin. In case of even more pronounced nonadherence (e.g., if 39% of all injections are forgotten) there is a possible increase of HbA1c of 1.8% points. The magnitude of the possible improvement in HbA1c agrees well with other studies in the relation between adherence and HbA1c levels. The estimated numbers suggest that missing injections are an important reason for suboptimal treatment. Keywords: adherence, compliance, HbA1c, self-treatment Continue reading >>

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