Living with Diabetes

Preferably, regular insulin should be administered 30—60 minutes before a meal.

 Normally, diabetes-associated urinary frequency is caused by a high blood glucose level (over 250mg/dL) over a prolonged period of time (over 2 hours).  Glucose is able to pull water with it into the urine, thereby increasing urinary frequency.  The best way to control frequent urination is to maintain tight glycemic control with diet, exercise, proper medication use, and blood glucose level testing.  Other potential causes for changes in urine frequency should be considered such as impaired bladder function, enlarged prostate and medications. Contact your physician to discuss your symptoms for a proper diagnosis and treatment plan.

 If a woman is diagnosed with diabetes before pregnancy, it is important to have great prenatal care and to find an obstetrician who handles high-risk pregnancies and has cared for other pregnant women with diabetes.  While you are pregnant, your body is constantly changing.  These changes will affect your blood glucose levels.  If you have type 1 diabetes, your body’s need for insulin will increase, especially during the last trimester.  The placenta is making hormones that help the baby grow, but also blocks the action of the mother’s insulin; therefore, the mother’s insulin needs would increase.  Pregnancy may also make it harder to detect hypoglycemia (low blood glucose levels).  Most health care professionals recommend that a pregnant woman test their blood glucose levels at least four times a day to help keep blood glucose levels on target.

Pregnant women who have never had diabetes before but who have high blood sugar (glucose) levels during pregnancy are said to have gestational diabetes. Gestational diabetes develops as a result of insufficient production and use of insulin during pregnancy.  It is usually diagnosed at 28 weeks.  Although it generally disappears after the baby is delivered, gestational diabetes increases the mother’s risk of developing Type 2 diabetes later in life. 

There is no cure for diabetes however, it is very treatable. The treatments available help control blood glucose levels, which can result in fewer complications and slower disease progression.

It is very important to follow your insulin regimen exactly.  Do not miss any doses of insulin.  Your physician should discuss a plan for missed doses with you. If you do miss a dose, follow the plan. Do not take double doses. If you currently do not have a missed dose plan, we recommend that you contact your physician for further assistance.

Would they not provide an accurate reading? There is no grace period for expiration dates.  Expired test strips can cause inaccurate results and should be discarded.

Some patients have high before-breakfast blood glucose levels because of hormones that are released in the early part of sleep (called the Dawn Phenomenon). Typically, the blood glucose level rises between 4 AM and 8 AM. Check your blood glucose level in the middle of the night (around 3 AM). If your blood sugar is high, you may be experiencing the dawn phenomenon. If it is low, it may be a rebound hyperglycemia (high blood glucose) causing your high blood glucose levels in the morning. This occurs if you have low blood glucose levels at night and your body is releasing hormones as a defense mechanism against low blood sugar.

Diabetes is not inherited, but the tendency to develop diabetes is hereditary.  However, the tendency itself is not enough to cause diabetes on its own.  There needs to be another trigger, such as environmental or lifestyle factors.  Specific risk factors include: age over 45, race (African-American, Hispanic Americans, or Native American), family history of diabetes, excess body weight, lack of exercise, high blood pressure, high triglyceride levels, low HDL (good cholesterol) levels, history of diabetes during pregnancy, giving birth to a baby over 9 pounds, poor diet, or impaired glucose tolerance.  You can assess your risk using the Diabetes Risk Calculator at http://www.diabetes.org/risk-test.jsp .

According to the ADA, “nearly all people with diabetes have abnormal cholesterol levels which contribute to their increased risk for heart attack and stroke”.  Therefore, regularly measuring lipid profiles will help maintain levels in the desired range and decrease the risk of a heart attack or stroke.  

According to the manufacturer’s package insert, Glucagon should be stored between 68-77 degrees Fahrenheit.  The manufacturer does not recommend using the product if it is above or below these temperatures.  However, the USP (United States Pharmacopeia) allows for excursions between 59-86 degrees Fahrenheit. 

Glucagon must be reconstituted with sterile water and used immediately.  At temperatures, below freezing, it would be possible for the sterile water to freeze preventing reconstitution.  We recommend that you check with the first aid station at the ski resort to determine if they have glucagon on hand in the case of an emergency. 

Another suggestion would be to advise the student to eat regular meals, snack as often as needed, and to carry “fast sugars” (i.e. glucose tablets, lifesavers, jelly beans, raisins, etc) with him/her on the slopes.

There is no information available stating that it is not safe to take fish oil or omega 3 fatty acids if you have type 2 diabetes.  Please note that "natural" products are not required to undergo the FDA (Food and Drug Administration) approval process to demonstrate their safety and effectiveness.  The FDA only regulates the products package labeling and prohibits a product from making claims that it is intended to diagnose, treat, cure, or prevent a disease.  We suggest contacting your physician to determine if this supplement is appropriate for you.

Regular-release tablets of metformin are usually dosed twice a day with meals.  If you have been prescribed the extended-release tablets of metformin, the dose is usually administered once daily with the evening meal.  

While some medications may cause dysphagia (difficult or painful swallowing), there may be many other causes for the symptoms you are experiencing (i.e. infection, irritation, various diseases).  Since you did not submit a list of your medications, we can not determine if any of them may cause dysphagia. 

You may re-submit your question with a list of your medications to our Ask The Pharmacist service for further research.  We recommend that you speak with your physician regarding your symptoms for a proper diagnosis and treatment plan.

Our Rite Advice Drug Information sheets are available at http://www.riteaid.com/pharmacy/monographs.

Enter the drug name in the “Search by Drug name” field and press "Search".  A list of medications will be displayed.  Click on the appropriate medication and the Rite Advice Drug information sheet will be displayed.  This sheet will include the drug name, uses, side effects, precautions, drug interactions, etc. 

You may also visit the website of a specific manufacturer for information.  For many newer brand name medications, the manufacturers commonly set up a website with the drug name.  For example, for information on Januvia you may visit www.januvia.com.  For older medications or generic medications, you will need to visit the manufacturer’s general website directly. 

If you do not know the manufacturer of your medication, you may contact your local Rite Aid pharmacy for assistance or use our Ask The Pharmacist service.

The only FDA (Food and Drug Administration) approved "non-invasive" glucose meter is no longer on the market. 

The GlucoWatch was a non-invasive monitor that was worn on the wrist like a watch and could be used as an adjunct to a glucose meter. It worked by an extremely low electric current that pulled glucose through the skin.

This device was not designed to replace a regular blood glucose meter. The GlucoWatch was used to detect trends and track patterns in your glucose levels such as hyperglycemia and hypoglycemia; however, a standard glucose meter was still needed to confirm results. 

The GlucoWatch is no longer being manufactured and at this time there are no other FDA approved “non-invasive” glucose meters.