Living with Diabetes

Most companies offer financial assistance for patients. Contact the manufacturer of your insulin pump to inquire about available programs. Additional prescription assistance information is available at http://www.diabetes.org/living-with-diabetes/treatment-and-care/health-insurance-options/prescription-assistance.html

Flushing has been reported as a possible side effect of metformin. If the flushing is bothersome, notify your doctor. A change in therapy may be possible.

Loss of blood glucose control can be caused by a number of factors including a change in your diet or activity level, illness, stress, and/or other medications (side effect of a medication or drug interaction with your current medications). Another cause could be a change in your body’s insulin production or usage due to the fact that over time the pancreas doesn't produce insulin as well which can create a need for other medications and/or the addition of insulin. It is not uncommon for your medication needs to change over time. If you haven’t done so already, contact your doctor to report the change in your glucose levels. 

Although epsom salt (magnesium sulfate) soaks can be soothing and relaxing, they should be used cautiously in people with diabetes. While soaking in epsom salt, the body can absorb magnesium through the skin. Magnesium can increase the release and function of insulin and cause unexpected changes in blood sugar. The temperature of the water may also pose a problem. Always use warm, not hot, water especially if you have neuropathy to avoid burns. Check with your doctor to determine if epsom salt soaks are safe for you.

Smoking is harmful to your health, especially if you have diabetes, because smoking and diabetes cause many of the same problems. Many people with diabetes have artery disease; nicotine also causes artery disease by hardening and narrowing the blood vessels. This can reduce blood flow to different parts of the body. In addition, complications that can occur with both diabetes and smoking include: damage to the heart, increase in blood pressure, increase in cholesterol levels, eye disease, kidney disease, nerve damage and foot problems. For help with smoking cessation, visit https://www.riteaid.com/pharmacy/health-information/quit-smoking.

Some research suggests that the caffeine contained in green coffee could alter how people with diabetes process sugar. Caffeine has been shown to cause both increases and decreases in blood sugar levels. By increasing blood sugar, green coffee might decrease the effectiveness of diabetes medications. We would not recommend the use of this product until further studies have been completed. If you choose to use green coffee extract, please do so with caution and monitor your blood sugar carefully.

Adults with diabetes should aim for at least 30 minutes of exercise a day.  Although your family member is limited by her broken toes, she can still exercise while sitting in a chair or on the floor. Stretching exercises can stimulate blood flow to the muscles and keep joints loose. Resistance bands or small weights can be used while sitting to strengthen the muscles of the upper body. For a list of chair exercises, visit http://www.sitandbefit.org/chair_exercises_for_seniors. Please note: she should not begin any exercise program without the consent of her physician.

There is no particular time frame to wait between injections of Novolog and Lantus. Lantus is a long-acting insulin that provides a slow, steady release of insulin to control your blood sugar between meals and overnight. It should be injected at the same time each day. Novolog is a fast-acting mealtime insulin. It works quickly to control the rise in blood glucose that occurs after meals. Novolog should be injected within 5 to 10 minutes before the start of a meal. Do not inject Novolog if you do not plan to eat right after your injection. Be sure to rotate injection sites and monitor your blood glucose as directed by your physician.

Januvia can be taken at any time of the day, with or without food. Choose a time of day that is best for you, and take the medication at that same time every day. 

The Coalition for Safe Community Needle Disposal is a collaboration of businesses, community groups, non-profit organizations and government that promotes public awareness and solutions for the safe disposal of needles, syringes and other sharps in the community. Visit www.safeneedledisposal.org or call 1-800-643-1643 for information on safe needle disposal options in your area.

Novolog and Levemir flex pens contain 100 units of insulin per milliliter, not per pen. Each pen contains a total of 3 milliliters, or 300 units. The scale you see on the pen (12 to 250) is a measurement of the units of insulin. Again, each pen contains 300 units, but the highest marking in view on the product is 250.  

In type 2 diabetes, the body does not produce enough insulin or it does not properly use the insulin available. Medication is often prescribed to lower blood glucose levels. Lifestyle modifications such as diet, exercise, weight loss and stress reduction are also effective for reducing blood glucose levels, and can sometimes decrease or possibly eliminate the need for medication in some people. It is best for you to discuss your particular situation with your physician to determine if medication will always be needed to control your blood glucose levels.

There are several over-the-counter cough preparations available. For a productive cough, choose a product containing guaifenesin. Guaifenesin is an expectorant that helps to loosen congestion in your chest and bring up (expectorate) bronchial secretions. For a dry, hacking cough, choose a product that contains dextromethorphan. Dextromethorphan is a cough suppressant and should not be given for a productive cough, unless the cough is disrupting sleep at night. Guaifenesin and dextromethorphan are available as single ingredient products or as combination products. 

Although dextromethorphan and guaifenesin do not affect blood glucose levels, it is important to check the inactive ingredients of the cough preparation. Many formulations contain some form of sugar which can increase blood glucose levels. Additionally, many contain alcohol which can cause increases or decreases in blood glucose levels. It is best to look for a sugar-free and an alcohol-free preparation to minimize the impact on the blood glucose level.               

Penicillin is an antibiotic used to treat a number of bacterial infections. Penicillin is not expected to affect blood glucose levels. Infection causes stress on the body and a release of hormones that can increase blood glucose levels and affect the action of insulin. Therefore, during an illness, you may have a more difficult time keeping your blood glucose levels within target range. It is important to monitor your blood glucose levels and urine ketones more frequently. Contact your doctor if your levels remain consistently high and/or you test positive for ketones in your urine or blood.

Lantus® and Byetta® work in different ways to lower blood glucose levels and are often used together to manage type 2 diabetes.